Hypoglycemia is a common condition where the blood sugar levels are low. Reactive hypoglycemia is due to the excessive secretion of insulin, usually after someone eats a meal. On the other hand, spontaneous or functional hypoglycemia usually occurs in between meals, and both types of hypoglycemia can develop due to insulin resistance, hypothyroidism, weak adrenals, as well as other conditions. On blood tests, someone is typically diagnosed with hypoglycemia when their levels are below 70 mg/dl, although sometimes the blood tests will fall within the normal reference range even when someone has the symptoms of hypoglycemia. Hypoglycemia can occur in diabetics when they take too much insulin or skip meals. And of course people with thyroid and autoimmune thyroid conditions commonly have blood sugar imbalances, which could lead to hypoglycemia.
As for some of the symptoms of hypoglycemia, these include rapid heartbeat, headaches, sometimes double vision, shaking or convulsions, a constant feeling of hunger, and there are numerous other symptoms. These symptoms usually improve upon eating. Of course some of these symptoms I just mentioned are common with people who have hyperthyroidism, and so if someone with hyperthyroidism or Graves’ Disease has the excessive secretion of thyroid hormone under control though the use of antithyroid medication, or an herb such as Bugleweed, but if they have low blood sugar levels, then they still might experience symptoms such as an elevated pulse, palpitations, and or shaking, along with an increased appetite. This is one reason why it is also a good idea to look at the blood sugar levels of people with thyroid and autoimmune thyroid conditions, and sometimes it might be necessary to do a glucose tolerance test to help determine the presence of hypoglycemia .
But once again, while looking at the blood tests can be valuable, some people have the symptoms of reactive hypoglcyemia even though they have normal blood tests. And many times people with hypoglycemic symptoms who have normal blood tests will respond well to the same dietary changes and nutritional supplements as those who have positive blood tests for hypoglycemia.
Poor Diet and Nutritional Deficiencies Can Cause Hypoglycemia
Not surprisingly, one’s diet plays a big role in hypoglycemia, as if someone frequently eats refined foods and sugars, then this obviously will affect the blood sugar levels. When someone eats a refined food, this causes a surge in the hormone insulin, which causes the blood sugar levels to spike up. Cortisol then comes into play, as it’s secreted by the adrenal glands, and causes the blood sugar levels to come crashing down. If someone constantly eats this way then this will put a lot of strain on both the adrenal glands and pancreas, and can eventually lead to a hypoglycemic state. As mentioned before, skipping meals will also affect the blood sugar levels. So for example, if someone is accustomed to skipping breakfast, then this too can lead to hypoglycemia.
A deficiency in the mineral chromium can also lead to hypoglycemia. Chromium helps the body to utilize insulin properly. This mineral is also important in breaking down carbohydrates, fats, and protein. Many people are deficient in this mineral, which will affect the way insulin is utilized, and also will impact the breakdown of carbs, fats, and proteins. So if someone has hypoglycemia due to a chromium deficiency, then obviously this deficiency needs to be corrected. Eating chromium-rich foods can help, but if someone has a moderate to severe deficiency then supplementation is usually necessary.
Hypoglycemia Is More Common In Hypothyroid Conditions
Poor diet and nutritional deficiencies not only can cause hypoglycemia, but these also can be a factor in the development of many thyroid and autoimmune thyroid conditions. This is one reason why I’m constantly talking about how one needs to eat mostly whole foods and minimize the refined foods and sugars from their diet. Although people with hyperthyroidism and Graves’ Disease can develop hypoglycemia, it does seem to be more common in people with hypothyroidism and Hashimoto’s Thyroiditis. The reason for this is because thyroid hormone helps to stimulate gluconeogenesis, and so when there is a deficiency of thyroid hormone then this will be affected.
The adrenals play a big role in balancing the blood sugar levels due to the hormones cortisol and epinephrine, and so when someone has weak adrenal glands, this not only can lead to hypoglycemia, but can also slow down the thyroid gland. Of course many people with hyperthyroid conditions also have weak adrenal glands too. Another potential reason why hypoglycemia is more common in people with hypothyroidism and Hashimoto’s Thyroiditis is because thyroid hormone impacts the liver, and a compromised liver can lead to the development of hypoglycemia. Excess glucose is stored in the liver, and so if the liver isn’t functioning properly then the storage of glucose might be affected. In addition, the excess consumption of alcohol can prevent the liver from releasing the stored glucose, and this also can lead to hypoglycemia.
How To Correct Hypoglycemia
In order to correct a condition such as hypoglycemia, one of course needs to find out what is causing this problem. Sometimes this can be challenging, but it usually comes down to making dietary changes. So if someone has hypoglycemia and eats a lot of refined foods and sugars, then they need to minimize their consumption of such foods, and eat mostly whole foods. If they have a chromium deficiency, then besides eating chromium-rich foods it might be necessary to supplement with chromium. If the person with hypoglycemia consumes a lot of alcohol, then this also needs to be avoided. This doesn’t mean they will need to avoid alcoholic beverages on a permanent basis, but until the hypoglycemic condition is corrected it’s probably best to completely avoid the consumption of alcohol.
While making dietary changes frequently will correct a hypoglycemic state, sometimes other factors need to be addressed. For example, if someone has weak adrenal glands, then this needs to be corrected. Sometimes just making dietary and lifestyle changes will help to restore the health of the adrenals, but other times additional adrenal support will be necessary. For example, if someone has depressed cortisol levels and/or a low DHEA, then it might be necessary to take some herbs such as licorice and rehmannia . And even though I try to avoid giving bioidentical hormones if at all possible, every now and then taking a low dose of bioidentical DHEA will be helpful.
If the person has a compromised liver that is causing problems with the storage of glucose, and/or the release of glucose, then this needs to be addressed. Sometimes doing a liver detoxification will help greatly. If someone has a condition such as hepatitis then some additional support might be required.
The good news is that when someone has both hypoglycemia and a thyroid or autoimmune thyroid condition, there is a great deal of overlap in restoring one’s health back to normal. Frequently changing one’s diet, managing the stress, and correcting nutritional deficiencies will balance the blood sugar levels and restore someone’s thyroid health. Sometimes it can be more challenging to accomplish this, but either way, with both hypoglycemia and hypothyroid/hyperthyroid conditions, the key to correcting these disorders is to detect and then correct the underlying cause of the problem.
Hi Dr Eric – I am a patient so no need for a reply. Article very informative. Keep the info coming. We all appreciate all the natural help we can get!
Hi, I have Hashimoto’s Thyroiditis and am trying to prevent these other scary conditions from developing. Your article is excellent. It calmed me right down.
Thank you for your info. I have both these issues. Good to read that they are linked.
Dr I have adrenal insufficiency for 5 years now. 10 months ago while stress disinfect prednisone Out of nowhere I developed Reactive Hypoglycemia. Not even extra steroids could help it. I have a support group I joined that has been helcantbut I am still struggling. It seems the steroids aggrevates the RH alot. I found chromium to be helpful but not always. During this time I was also DX with hypothyroidism. Even on thyroid meds and steroids and chromium I still can’t get my sugars to stay up. I have changed my diet so much. I eat protein complex carbs healthy fat & protein with each meal. I also cut out caffeine it seems to really make it drop. I tested negative on gcc and insulin test. I don’t know what else to do it has made my life a living hell more so then my adrenal disease. Please tell me is there anything else I can do to keep my sugars from dropping. Or test my doctor can do. My symptoms are red face shaky confusion blurry vision fatigue loss of appetite bad headache stomach pain. My sugar fasting is 74 but
I feel awful at that number. My sugar drops even after I take supplements or Tylenol. Could this be a liver issue? I skipped my steroids yesterday for testing and my sugars were alot more steady just dont want to continue with this I can’t take much more Any advice would be so helpful. God Bless
Hi Pamm, are you still struggling with these issues? I had the exact same situation for two years and absolutely nothing helped, it seemed everything, even herbs and adaptogens made it worse. Most days I struggled to just get showered and dressed. My doctor put me on the Renew eating plan, which basically cuts out all grains, potato’s , dairy and starches and focuses on lean meats, healthy fats and lots of veggies. I was very sceptical when I started on the diet, but within three days my blood sugar issues stabilized. Just a suggestion of something that might help. I used to think that complex carbs were helping me but it just made things worse. I think that as I heal further I will be able to add in a few healthy carbs again like buckwheat and sweet potato. But for now, this eating plan has given me my life back. Maybe you can ask your doctor about it?
Thank you for a very thorough overview. I have hypoglycemia, but only when I’m severely stressed. The connection to adrenal glands and cortisol makes sense. I’ll take my vitamins and eat more protein and leafy greens!
Hi. I’m hypothyroid but have not been put on medication yet due to my TSH is in the normal range but I’m having multiple symptoms of hypothyroid. Since Thursday I’ve been having extreme thirst. I’ve been to the doctor my blood glucose is always in normal range. My liver and kidney test normal but I don’t know what’s causing my extreme thirst. I stopped drinking and eating a y thing with sugar. I only drink water and I drink about 6 bottled waters a day. I’m worried I know something isn’t right but Dr’s can’t find out. They did find I have a UTI but they didn’t link that to my extreme thirst. Could it be my thyroid?
Hi Beatrice,
Although it’s possible that the extreme thirst could be due to your thyroid, it very well might be due to an imbalance of your adrenal glands. And most medical doctors don’t do anything to evaluate the adrenals, other than looking at the serum cortisol, which has some value, although I would recommend getting an saliva panel to evaluate the cortisol levels throughout the day, and also would look at DHEA and 17-OH progesterone.
I have had papillary thyroid cancer and no longer have a thyroid as it was removed. I am taking synthroid as a thyroid replacement and my endocrinologist keeps me hyperthyroid to suppress any growth. I notice times when I haven’t eaten protein in my breakfast, getting very shaky, brain foggy and weak( how I experience low blood sugar) I had gestational diabetes with 2 different pregnancies and my sugars, when I felt that way, went as low as the 20’s when I tested.(so it was confirmed in other words)
I am no longer diabetic so does this low blood sugar have to do with being hyperthyroid? Thanks for any information you might have.
Hi Rachel,
Although your low blood sugar levels can possibly be related with the hyperthyroid condition, there can be numerous other factors which can cause this. In most cases it’s due to eating too many refined foods and sugars and/or not eating regularly. Adrenal problems and food sensitivities can also be factors.
Dr. Eric,
I started having excessive fatigue, bilateral arm & leg weakness, numbness/tingling, migraines and lost 20lbs in a month. Drs. couldn’t figure it out. After endo/colonoscopy discovered h.pylori infection which was erradicated with antibiotic protocol. Same symptoms persisted in addition to thigh muscle burning so went back to neurologist to ask if I had b12 deficiency. He started me on B12 injections as level was 240. Still symptomatic went to Endo. He said everything was fine. After tracking my bloodwork I noticed my TSH was like a rollercoaster so tried another Endo. He trialed Levothyroxine. Numbers went up so he increased dosage and kept me there. Got somewhat better temporarily. Still with all the issues and tilt table suggested possible orthostatic hypotension but was inconclusive. Now they want another tilt table study and other electrophysiologist says just start Fludrocortisone. I used to get the mild tremor type shaking episodes and they stopped. Now they are back and happen anywhere from reaching up high, movements, sleeping…not sure what these are and since I have been to every dr. under the moon who continue to dx migraines (different variants) there is definitely something causing this shakiness. Read up on reactive hypoglycemia and thought maybe this was cause for shakiness. Do you have any advice on what or where to go. Have had mri’s, ct’s, xrays, tons of bloodwork, tilt table study, etc. I asked about diabetes and they say no the A1C is normal. Wondering if I should ask about 4 hours glucose testing or if it is pointless due to A1C being normal. Also did the Cortisol injection testing a few years ago when this started. I typically get shaky, weak, muscle/joint pains, fatigued, migraines, etc. This shakiness is quite scary to me. Thank you for any light you could shed on this matter.
Hello Dr, I have had hashimotos thyroiditis for about 8 years. About 2 years ago I started having what I now know to be hypoglycemic episodes. Diabetes has been ruled out for me with blood tests, but during one of my episodes todayI had a friend test my blood sugar, it was at 68. (she is a mom of a type 1 diabetic) We got it back up in the 80s within 15 minutes. When she tested it that was the first time I actually saw the level I had during an episode. I am scared that I’ll have another episode. I am doing the diet research but should I have glucagon on hand? Can there be long term neurological effects from these recurrent episodes? I’ve felt just off for a long time as if I am forgetting things easier sand losing some focus.
Hi Amy,
You would only want to take glucagon if absolutely necessary, and so I’m not sure if it would be a good idea to have this on hand, as it’s not something you want to rely on. You definitely want to make sure that you continue to eat well, trying to avoid refined foods and sugars, and you also want to eat on a regular basis. In addition, food allergens can potentially be a culprit and is therefore something to consider.
Hi,
I have had hypoglycemia since I was a freshman in high school, now I am 25. I have had many hypoglycemic episodes where I pass out and go into convolutions. I self-regulate it and am not on any medication to treat it. I have spent the last 2 years dealing with sever depression but I feel that I am taking pills to treat the symptoms and not getting to the root of the cause. I have sever fatigue, weight gain, heavy irregular periods, intolerance to cold, cold extremities to the touch, stiff sore muscles, weakness, mental fogginess, brittle nails… the list goes on. I was tested a few months back and my thyroid levels were considered normal and my psychiatrist left it at that. What should I do now?
Hi Ashley,
You obviously have a lot going on, and so without question I would find a local natural healthcare professional to work with. I’m assuming you have already made some dietary changes, but if you haven’t then you of course will want to cut out the refined foods and sugars, minimize your carbohydrate intake, eat every 2 to 3 hours, consider avoiding gluten and dairy, etc. But I would also get your adrenals checked, and other issues to rule out would be estrogen dominance, SIBO, a leaky gut, etc. Once again, you really do need to find someone to work with, as your psychiatrist isn’t going to help you address the cause.
Hi,
I have some questions regarding hypoglycemia and hyperthyroidism. I’ve been hypoglycemic for years, but as long as I eat right I can control it. (Not sure what type of hypoglycemia you would call that.) Anyway, I am currently 15 weeks pregnant and my TSH levels are down to 0.146. The endocrinologist that I saw earlier this week refuses to do anything until she has a third test that shows it’s still low three weeks from now. (I had one a month earlier that was 0.385.) I am VERY concerned that waiting this long is doing irreparable damage to my developing baby. This is my second pregnancy and I had nothing like this with my first pregnancy but then again every pregnancy is different (obviously). Is there any reason I should be concerned? What could this be doing to my baby? Should I seek a second opinion elsewhere like I’m thinking about doing? Please let me know what your thoughts are. I GREATLY appreciate it.
Hi Amanda,
I apologize for the delay in response, as I notice you have a time-sensitive question. I’m not sure if the depressed TSH alone is doing harm to your baby, but if the thyroid hormone levels are elevated then this definitely isn’t a good thing. And if you happen to have elevated TSH receptor antibodies then this also can be problematic to the developing fetus. And so I do think it would be a good idea to seek a second opinion, which you might already have at this point.
Dr. Eric,
Thank you so much for being so involved with these conditions, this explains a lot of things that have been going on with me. I was diagnosed with Hashimoto’s Thyroiditis 1 yr ago, but I have been having symptoms of Hypoglycemia too unbeknownst to me for about 5 yrs. In the past year as the side effects have become much more noticeable, I have been leaning on my nurse practitioner to run tests and get more involved with my symptoms. She does run some tests, but quickly downplays my concern; I think she thinks I’m a hypochondriac. I have Medi-Cal insurance, so at times I feel I am at a great disadvantage. I will be moving to greatly change my poor diet of missed meals, sugary and refined foods, and lack of exercise (which I love). I hope this will help greatly. Also I recently lost my mother, who I was her live-in caregiver for 7 yrs. This too probably has brought on more frequency in hypoglycemic symptoms due to even more poor eating, poor sleep and stress. The good news is that I am due to see my nurse practitioner and have an ultrasound on my thyroid to see if the synthroid is helping.
Hi Jodi,
It does sound like you have been dealing with a lot of stress, which of course can have a huge impact on your health. Cutting out the refined foods and beginning a regular exercise routine will greatly help balance the blood sugar levels, improve insulin sensitivity, etc. Sometimes additional herbs and nutrients can be beneficial such as gymnema, chromium, and alpha lipoic acid.
Hi Eric,
I am taking thyronorm medicine from last 5 years , suddently my TSH down to 0.01 and feel very tired and doctor asked me to reduce the dosage from 125 to 100 mcg.
After the dosage change also some times i feel dullness , eyes getting strain , mild headaches etc. Recently i feel am facing low blood sugar , so i am taking some snakes between meals , which give little better, still i feel that i am not like before. I shared the same with doctor , he simply continue the thyronorm medicine and ask to wait for 3 more months. I am suffering almost last 3 months.
What is your advice , do you think i need to be done any particular tests to identify what is the exact cause.? Thanks for your help
Hi George,
While taking thyroid hormone medication might be necessary, it doesn’t address the cause of the problem. If you haven’t had your adrenals tested I would look into this, as I usually recommend adrenal testing through the saliva. Having a few blood tests might also be a good idea, such as a metabolic profile with fasting glucose, fasting insulin, and hemoglobin A1C. There can be other factors, but these are what I would start with.
Hello all! Have any of you been successful in “correcting” this hellish nightmare?? I was recently diagnosed with Reactive Hypoglycemia after suffering for a few years with what was said to be anxiety. I was diagnosed by way of 4 hour GTT test. My sugar level at hour 4 was 46. Scary stuff. I suffer from chronic fatigue, brain fogg, rapid heart rate, sweating, feeling clammy, feeling flushed, feeling “zoned” out, shaking, Anxious, irritable, etc.
After DX, my doc said just Googl it & eat healthy. That’s it. He said no other tests needed.
Now, fast forward to over a month later, I eat AMAZINGLY! absolutely no white sugar, (other than an emergency peppermint if needed) no white bread, no potatoes, no white rice, cut out dressing completely & replaced with fresh lemon for salad, check labels on everything! I’ve added avocados, boiled eggs, lentils, beans, whole grain, apples, beef jerky, moderate red meat, brown rice, nuts, etc. I’m still tanking within two hours!
This tells me there is more to my story, although my doc says no. Any ideas??? Please help. I’m an emotional wreck!
Well diet will help you manage it better usually, but you really have to get to what is causing the problem, or the root, to get better. Like the article above states, it can be a number of things…a severely congested liver (which affects your pancreas), weakened adrenals, thyroid condition, or possibly a little bit of each. I’m on this journey myself! Hypoglycemia started with me during second pregnancy and I’ve been making changes and progress ever since (4 1/2 years now). Its under control for the most part, but I’m still getting to the bottom of it! I just found out about Hashimotos and hypothyroidism and now I’m getting a thyroid panel just to rule that out. I hope things get better for you. Healing is a journey.
I’m not sure if I’m doing this correctly; but I feel as though I need help. My medical history is very long and strange so I apologize in advance.
I was diagnosed with Hashimoto’s at 14 years old. My Endo told me that it was unnecessary to treat me even though I had the anti-bodies because all my levels as far as T3, T4, and I believe my TSH were normal. I suffered up until recently, at age 22 and it was confirmed that my anti-bodies were at 1000iu. I’ve been put on Armor Thyroid and Nystatin powder to help with a leaky gut issue, as well as completely changed my dieting habits. I lost about 20lbs in three weeks, but I feel as though that was mostly organ swelling.
Now, my weight is stagnant even though I’m hardly eating and my body fluctuates between starvation and nausea constantly (I even get to a point where the thought of drinking water makes me sick to my stomach). I try to only eat veggies, fruit, and meats or proteins because I’m allergic to wheat. But, I am so exhausted all the time and even though I
tried to cut out soda and sugars, sometimes I feel so terrible and run down that it seems like a can of coke is the only thing that will bring me up. I usually don’t do that though and end up sleeping it off instead because I’m at a loss of what to do.
I get worse after I eat as well; I feel groggy when I don’t eat, of course – but when I do eat I feel like I’ve got the Thanksgiving sleepies. It hits me hard and then I fall into a funk of not wanting to do anything and start to slump around because I can’t function.
I was diagnosed with IBS about two years ago, and again my GI doctor told me there was no reason to do anything and that I just had to deal with it, even though I’ve had terrible bleeding problems. I also have a polyp in my stomach that he refused to remove after taking a biopsy and telling me it was normal.
I get frequent headaches/migraines and muscle cramps or spasms and I constantly feel shaky. I get hot really easily and other times I’ll be so cold I’ll shake and start to get nauseous. I have terrible cognitive fog issues as well as focus and attention span issues. I can’t seem to remember things as well as I used to or speak as fluidly as I used to. I’ve also noticed I frequently bruise for no reason. I’ll just wake up to apple sized bruises that are yellowish-purple on my arms or legs and even my tummy. At one point, my nails were flaking and my hair was falling out; that seemed to be one of the few things that the Armor Thyroid helped with.
Recently, I’ve been on the medication for about two months now and I don’t feel much better. I feel as though some of the mental cob-webs have been lifted, but I’m so tired I take a nap every day and often times I will go to bed as soon as I get home from work and then don’t wake up until I have to start the next day (ie 6:30pm to about 8:00am) and I still have to drag myself out of bed. When I wake up I feel dizzy and disoriented, never rested. It takes me a full hour or two before I even feel like my brain is functioning enough to call myself ‘normal’ even though I know it’s not running at the levels it should be. I feel like I’m better than this and I’m stuck inside a dusty box in the attic. I just want my life back! I’m 22 and I feel like I’m only half living because I just can’t seem to find the energy to even be myself anymore.
I’ve done so much research on my own because I got tired of going through an endless loop of specialists and being told I may have everything from Leukemia to Lupus and then being told they don’t know what’s wrong with me. Needless to say, I was beside myself at one point and wanted to give up. I even tried psychiatric help, and again seemed to find no resolution. This time, they just wanted to drug me into a sense of false happiness rather than trying to find the true problem (and after being told I was Schizophrenic, Bi-Polar, Manic Depressed, and even had Dissociative Identity Disorder, by about 17 different Psychiatrists or Psychologists can you blame me for being skeptical? Not to sound cliché, but I know I’m not ‘crazy’). I even had several problems with my skin and rashes breaking out; one doctor thought it was Ringworm, another said it was an anxiety rash, and another said Lupus (it wasn’t on my face, I know of the butterfly rash).
After several years of anti-biotics on my system (being auto-immune, I seem to catch everything from having Shingles at 15 to Strep, etc.) I even wondered about a possible yeast infection in my blood. I was put on Diflucan for a while, double with the Nystatin and haven’t really noticed any changes other than in the swelling of my gut and no longer having the common yeast infection.
My research has led me back to Adrenal Function, Hypoglycemia, possible Blasto-overgrowth, Hashimoto’s Encephalopathy, Anemia, etc. I’m at a loss of what kind of questions I need to be asking. No one seems to be listening to me fully and only seem to take in about half of what I’m telling them is wrong with me and then grip to one item and run with it.
Please, please help me. I realize I’m listing a lot and I’m sorry; but it’s been a lot to go through.
Thank you for anything you can tell me!
Idk if your still following this but it seems you have reactive Hypoglycemia something many Drs do not know alot about.
I found for me going whole food plant based with some seafood here & there, low grain coconut fats turned my low blood sugar issues around. Paleo, keto, was my worst enemy.