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Diet and Dysautonomia: Blood Sugar Regulation

We receive a lot of questions from our dysautonomia warriors about what diet and foods are important to avoid and eat when you have a dysautonomia. In this blog post, we will be talking about blood sugar regulation and its role with your brain health and how that relates to diet and dysautonomia. This is why we study the importance of blood sugar regulation.

Food = Fuel

Everything we put into our bodies is made for one thing: Fuel. Food is crucial for our bodies to survive because it is how we receive our macronutrients such as carbs, fat and proteins. It is also how we receive our micronutrients, such as vitamins and minerals.

When a person has dysautonomia, it usually leads to their system being in a fight or flight state, this results in blood not circulating adequately throughout their body. Glucose is transported through our bloodstream to reach cells all over the body and provide nutrients. This means that when someone has a dysautonomia, oxygen and glucose are not being adequately transported throughout their system. This can lead to deficiencies of iron, B12, proteins and other vitamins and nutrients.

This makes it very important for our dysautonomia warriors to maintain their blood sugar constantly through the day and avoid any blood sugar dysregulation or reactive hypoglycemic bursts. This will help maintain fuel delivery of glucose around your body.

It is important to note that, when discussing blood sugar dysregulation, this is not referencing the topic of diabetes or individuals who are diagnosed with hypoglycemia. This is referring to the functional shifts of blood sugar throughout someone’s day.

Some of the symptoms that identify if you are having a blood sugar dysregulation are:

  • Waking up with nausea

  • Loss of appetite in the morning and throughout the day

  • Energy bursts and/or crashes after eating

  • Sleep difficulties like waking up in the middle of the night

  • Unexplained anxiety throughout the day

  • Fatigue throughout the day

Reactive Hypoglycemia: What is it? How can it affect my dysautonomia symptoms?

Symptoms that are consistent with reactive hypoglycemia include:

  • Increased energy after meals

  • Craving for sweets between meals

  • Nausea in the mornings

  • Irritability if meals are missed

  • Eating relieves fatigue

  • Feeling shaky, jittery if meals are missed

  • Poor memory

  • Blurred vision

The only symptom that should be felt after meals is a reduction in hunger. Energy levels should not be increased or decreased after eating. There should be no change in mental stamina around foods, such as attention, brain fog etc.

Reactive hypoglycemia is when blood sugar drops between meals. This is usually due to insufficient cortisol release. Between meals, our blood sugar lowers the brain signals to our adrenal glands to release cortisol. Cortisol then signals to the liver to break down and release glycogen and turn it into glucose to circulate around our system. This keeps our blood sugar constant throughout the day.

Typically what we see with our dysautonomia warriors is that their cortisol levels are either too low or too high. For individuals with too low cortisol levels, this will result in blood sugar dropping too low and there is not enough cortisol to bring it back up. The body then releases adrenaline in its place. This can cause jitters, anxiety, heart palpitations, high blood pressure, brain fog, and difficulty focusing between meals. At night, this can cause panic attacks that wake you up out of your sleep or can cause you to wake up in the middle of the night with energy, and/or having more energy before bedtime than in the morning. Do any of these symptoms sound like you? We recommend discussing with your provider about your blood sugar and cortisol levels.

Cortisol and Dysautonomia: Does what I eat affect my cortisol levels?

When we examine dysautonomia patients at CFNC, we often find that they have a dysfunction in their hypothalamus pituitary adrenal axis. Meaning that they will be over-producing, under-producing or have fluctuations in their cortisol levels throughout the day.

Why does this matter? Cortisol is a vital hormone that our adrenal glands produce. The initiation of the release of this hormone begins in your brain, specifically in your hypothalamus. The hypothalamus also helps to regulate the autonomic nervous system.

Cortisol is a stress hormone and it can cause your system to go into more of a fight or flight state when released. During the day when we are eating regularly, we are fueled by glucose. At night, when we stop eating and begin to fast, cortisol is released. Once cortisol is released, it causes our muscles and liver to liberate glucose into our bloodstream to fuel our bodies.

When we experience blood sugar dysregulation during the day, cortisol is released. This will cause your nervous system to go into fight or flight mode, which can result in an increase in heart rate and blood pressure.

For our dysautonomia warriors who have blood sugar dysregulation, you may also be experiencing too much cortisol release. Over time, cortisol is no longer sufficient to meet the demands and the body will release adrenaline in its place. This causes an adrenaline surge which can cause anxiety attacks, tachycardia, shakiness and more. This can also cause you to have unexplained anxiety at night or waking up in the middle of the night in a panic or with a high heart rate.

Hypoglycemia versus Insulin Resistance: The Difference

Most people are familiar with the terms hypoglycemia and insulin resistance. We affiliate hypoglycemia with low blood sugar and insulin resistance with diabetes. These are not incorrect affiliations. Prolonged insulin resistance can result in diabetes and hypoglycemia means that an individual’s blood sugar is dropping too low.

But why are you experiencing insulin resistance, hypoglycemia or even reactive hypoglycemia? To summarize it, you may not have low fasting blood sugar or low hemoglobin A1C but you are experiencing shakiness, jitters and lightheadedness between meals.

As for insulin resistance – you do not need to be diabetic to have insulin resistance! Yes, you read that correctly. Diabetes does not manifest overnight. It is due to many years of insulin resistance! How do you know you battle with insulin resistance? Some symptoms are:

  • Chronic acne

  • Crashing in the afternoons and/or after meals

  • General fatigue

  • Craving for sweets after meals

Over time this can lead to either disruptions in your blood sugar or a diagnosis of diabetes. Insulin is a hormone, and if you are chronically and constantly spiking insulin through the day then your body will gain resistance to it and you will not take glucose from your foods into your cells well.

On the other side, hypoglycemia is when we are spiking blood sugar so frequently, insulin is released and then blood sugar drops suddenly and cortisol is released in its place to fuel our bodies.

Do you experience any of the symptoms listed above? Good news is that you can make changes to your diet and the timing of your meals to help with both of these issues. It is important to figure out if you are dealing with hypoglycemia and/or insulin resistance.

Hypoglycemia and Insulin Resistance: You Can Have Both

Spiking blood sugar, spiking insulin and dropping blood sugar over time forms both a reactive hypoglycemia and insulin resistance situation. Yes, you can be both experiencing hypoglycemia and insulin resistance. It is important to work with a provider to understand if you are dealing with one of these situations or both.

Do you experience any of the following symptoms:

  • Chronic fatigue

  • Changes in energy or mental stamina around meals

  • Crashing after meals

  • Craving sweets throughout the day or after meals

  • Unexplained anxiety

  • Waking up in the middle of the night in a panic

  • Light headed or jittery between meals or if they are missed

  • Nausea in the morning

  • Brain fog throughout the day or after meals

  • Loss of appetite in the morning

If you answered yes to any of these questions, we suggest you reach out to your provider or functional doctor to evaluate if you are dealing with reactive hypoglycemia and/or insulin resistance.

Sugar Causes Inflammation

Sugar is in almost everything that is packaged and processed. Standard American diets are filled with processed foods and sugary diets that cause chronic insulin spikes. These diets tend to be filled with simple carbohydrates at every meal and snack. Over time this creates blood sugar dysregulation, and this in time will cause systemic inflammation.

What does this mean for our dysautonomia warriors?

The autonomic nervous system, overall brain function and the immune system work very close together. If your diet consists of a lot of packaged foods that are high in sugar (both natural and artificial) and carbohydrates then you may not get enough fiber, protein and fat. This leaves you more susceptible to increasing inflammation, which can affect your dysautonomia and make you feel more symptomatic. This is because your immune system is constantly trying to reduce the inflammation that affects the autonomic nervous system.

Some suggestions our doctors at CFNC make to help improve this is, includes choosing to eat as many whole foods as possible, decrease your consumption of packaged foods, and make sure you have fiber (veggies), protein (lean meat, tofu, eggs) and fat (olive, coconut, avocado, nuts) during your snacks and meals.

Food is our fuel! What you put into your body is very important to support your body’s function, energy and overall output.

Why Fasting May Not Be Good

Dysautonomia warriors usually have difficulty with blood flow and circulation around their body. This means that oxygen and glucose are not being adequately transported.

Fasting has its benefits, it can be used to help with blood sugar dysregulation and improve insulin sensitivity. Fasting is beneficial but not always beneficial for individuals who suffer from dysautonomia because it is important for dysautonomia warriors to maintain fuel delivery throughout their body.

Also, if you experience jitters, lightheadedness and shaking between meals, which are common symptoms of hypoglycemia, then fasting will further these symptoms and can further hypoglycemic reactions.

We do not recommend fasting for our dysautonomia patients. It is important to work with your providers closely if you are considering any type of fasting regimen, especially if you experience any type of blood sugar dysregulation symptoms.

Some symptoms that indicate blood sugar dysregulation are:

  • Increased energy after meals

  • Craving for sweets between meals

  • Nausea in the mornings

  • Irritability if meals are missed

  • Eating relieves fatigue

  • Feeling shaky, jittery if meals are missed

  • Poor memory

  • Blurred vision

  • Chronic fatigue

  • Changes in energy or mental stamina around meals

  • Crashing after meals

  • Light headed or jittery between meals or if they are missed

  • Brain fog throughout the day or after meals

If you have any questions for our doctors about these symptoms, blood sugar dysregulation, fasting or more, please contact us to schedule a consultation.


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