By the time Roberta Ruggiero was diagnosed with hypoglycemia in the 1970s, she’d had a horrifying array of diagnoses and treatments, from Valium to electric shock therapy. No one could determine the cause of her severe depression, fatigue and headaches.
Finally, someone asked her, “What do you eat?”
“I stopped and thought, ‘Well, I really don’t,” she says. “I was a young mom.” Her description of her poor diet habits led her doctor to administer a glucose tolerance test and finally give her a diagnosis of severe reactive hypoglycemia.
There are several kinds of hypoglycemia, or low blood sugar, says Dr. Betul Hatipoglu, an endocrinologist at the Cleveland Clinic. The condition is often associated with diabetes, or a side effect of certain medications, but it does sometimes occur independently.
“The more common type in that case is reactive hypoglycemia, which occurs a few hours after a person eats,” says Dr. Hatipoglu.
Symptoms can range from a feeling of weakness or shakiness, sweating and increased heart rate to psychological effects like anxiety, depression and mental confusion.
But Ruggiero, who founded the Hypoglycemia Support Foundation in 1980, says she frequently hears from people whose doctors dismiss their concerns that they may suffer from this form of low blood sugar.
“I am a big believer in reactive hypoglycemia, but there is some debate in medicine about whether it exists,” Dr. Hatipoglu says. “It is not meanness on the part of doctors, but a problem with the data and the information we have. You can’t include the entire world in your research, and some individuals are not going to fit. But some of us do believe in it.”
The good news is that reactive hypoglycemia is not typically treated with medication, so if you suspect you have it, you can make lifestyle changes that should ease your symptoms.
“It’s not really a disease; it’s a condition,” says Connie Bennett, who was diagnosed with the disease in 1998. “You don’t heal it, you manage it.” Her experience, particularly her struggle to eliminate sugar from her diet to control her hypoglycemia, inspired her to write the book Sugar Shock!: How Sweets and Simple Carbs Can Derail Your Life — And How You Can Get Back on Track.
The best way to stabilize blood sugar and keep hypoglycemia in check is to eat smaller meals more frequently, such as every few hours, with an emphasis on healthy, low glycemic foods with higher protein and a bit of fat. Hypoglycemics should avoid refined carbs as much as possible, taking care to learn the many places where sugar can “hide” in foods.
“I challenge people who say, ‘I don’t eat that much sugar,’” says Bennett, pointing out that it can be found in things like wheat bread, mayonnaise and yogurt. “The average American has about 22 teaspoons a day.”
But while reactive hypoglycemia is usually controllable without a doctor’s care, primarily by maintaining a healthy lifestyle, it’s worthwhile to keep pushing for a formal diagnosis. There is some evidence linking hypoglycemia to diabetes — specifically that it manifests in people who are prone to diabetes or have a family history of the disease, and in some cases is the first symptom.
Additionally, if your hypoglycemia symptoms occur after fasting — i.e. in the morning before breakfast rather than a few hours after a meal — you may have a rare form of the condition that can be indicative of tumor or liver disease. In that case, it is crucial to be in a doctor’s care and not try to self-treat.
“I tell people who write to me that I am not a doctor, but I know what you’re up against trying to get a diagnosis,” says Ruggiero, who hopes to raise the condition’s profile with a fundraising gala in October. “I suggest they keep a diet symptom diary. If you go in to the doctor with that information and he sits down and looks at it, you have somewhere to start from. And if he’s not sympathetic, there are other doctors out there who will be.”