Hypoglycemia

Background

Hypoglycemia, defined as abnormally low blood glucose levels—typically below 70 mg/dL—can significantly affect energy, mood, cognition, and physical performance. While it is frequently associated with diabetes and insulin use, hypoglycemia can occur in non-diabetic individuals due to a variety of underlying metabolic, hormonal, and nutritional imbalances.

At Intercoastal Health, we take a root-cause functional medicine approach to hypoglycemia, focusing on restoring metabolic balance, stabilizing glucose regulation, and identifying contributing nutritional and lifestyle factors.

What Is Hypoglycemia?

Glucose is the body’s primary energy source, particularly for the brain. The regulation of blood glucose depends on a complex interaction of hormones—including insulin, glucagon, cortisol, epinephrine, and growth hormone—and involves the liver, pancreas, adrenal glands, and digestive system.

Hypoglycemia occurs when blood glucose falls below the threshold necessary to maintain normal neurological and cellular function. In most individuals, this is defined as a blood glucose level under 70 mg/dL, though some people may experience symptoms at slightly higher or lower levels depending on their physiology and metabolic history.

Recognizing Symptoms of Hypoglycemia

Symptoms often develop quickly and reflect the body’s physiological response to a perceived state of energy deprivation. They can be neurogenic (triggered by the nervous system) or neuroglycopenic (due to lack of glucose in the brain).

Common Symptoms Include:

• Shakiness, jitteriness, or tremors
  
• Palpitations or rapid heartbeat
  
• Sweating, chills, or clamminess
  
• Irritability, nervousness, or anxiety
  
• Nausea or hunger
  
• Headache
  
• Weakness or fatigue
  
• Confusion, drowsiness, or poor concentration

   

Severe Hypoglycemia May Present With:

• Slurred speech
  
• Loss of coordination
  
• Seizures
  
• Loss of consciousness
  
• Coma

Diagnostic Evaluation in Functional Medicine

1. Documented Blood Glucose Measurement

Confirming hypoglycemia during symptomatic episodes is key using fingerstick testing or continuous glucose monitoring (CGM).

2. Symptom and Meal Timing Correlation

• Fasting hypoglycemia: Occurs after prolonged periods without food
  
• Reactive hypoglycemia: Occurs within 2–4 hours after meals

   

3. Functional Labs and Biomarkers

• Fasting insulin and C-peptide
  
• Cortisol – Total/AM
  
• Liver function markers like ALT and BUN
  
• TSH and thyroid hormones

   

Root Causes of Hypoglycemia

• Diabetes Medications: Insulin or sulfonylureas
  
• Poor Dietary Habits: Skipping meals or high-glycemic food choices
  
• Alcohol Use: Impairs liver glucose production
  
• Hormonal Deficiencies: Including adrenal insufficiency and hypothyroidism
  
• Liver Disease: Impaired gluconeogenesis
  
• Insulinoma: Insulin-secreting pancreatic tumors

   

Conditions Linked to Hypoglycemia

• Diabetes mellitus
  
• Adrenal insufficiency
  
• Insulinoma (pancreatic tumors)
  
• Liver dysfunction
  
• Reactive hypoglycemia

   

Functional Medicine Strategy at Intercoastal Health

We view hypoglycemia as a sign of deeper metabolic imbalance and approach it comprehensively:

1. Nutritional Support

• Emphasize low-glycemic meals
  
• Adequate intake of protein, fiber, and healthy fats
  
• Address nutrient deficiencies (Magnesium, chromium, B vitamins)

   

2. Blood Sugar Monitoring

• Continuous glucose monitoring (CGM)
  
• Periodic fasting insulin and C-peptide measurements

   

3. Stress Management and Sleep

• Stress reduction to balance adrenal function
  
• Prioritizing restorative sleep

   

4. Hormonal and Organ Support

• Comprehensive evaluation of thyroid, adrenal, hepatic, and pancreatic health

   

5. Botanical and Supplement Support

• Adaptogens for adrenal support
  
• Berberine, inositol, alpha-lipoic acid for glucose control

   

6. Patient Education

• Early recognition of hypoglycemia symptoms
  
• Safe, rapid correction strategies

   

When to Refer or Escalate Care

Urgent referral if:

• Persistent, unexplained hypoglycemia
  
• Severe neurological symptoms (seizures, coma)
  
• Suspected insulinoma
  
• Adrenal crisis symptoms

Conclusion