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Hypoglycemia (Low Blood Sugar)

Posted by: Cleo Libonati, RN, BSN in A LISTING OF ALL HEALTH CONDITIONS, Blood Plasma Disorders, Carbohydrate, Malabsorption Disorders, Symptoms, Classic, System - Blood 0 3,328 Views

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hypoglycemia symptom of celiac disease and glutenWhat Is Hypoglycemia?

Hypoglycemia means the level of glucose within cells is too low to meet metabolic needs of the body for this essential sugar.

Q: What are the metabolic needs for glucose?

A: Glucose is the most important simple sugar in human metabolism mainly because it is the primary source of energy for most cells of the body.

Energy contained in the glucose molecule is obtained by the body from its reaction with oxygen (oxidation). This oxidation reaction occurs in power producing mitochondria structures that are located within cells.1

Hypoglycemia is characterized by alterations in neurologic, metabolic and muscular functions:

  1. Neurologic function because brain tissue is particularly dependent on glucose for energy,
  2. Metabolic function of glucose-dependent tissues which include red blood cells, white blood cells, bone marrow, eye, inner heart of the kidney, and peripheral nerves because these tissues cannot metabolize fatty acids as an alternate source of energy, and
  3. Muscle function because muscle cells continually require glucose for energy production.

Glucose is made available to cells through the regulating action of insulin, a hormone produced by specialized cells located on the surface of the pancreas.

What Is Hypoglycemia In Celiac Disease and/or Gluten Sensitivity?

  • Hypoglycemia is a classic sign of celiac disease that results from impaired glucose digestion, absorption and use in the body.
  • During digestion, dietary glucose is not adequately released from food or absorbed from the small intestinal lining by active transport into the bloodstream.  Active transport of glucose with low chemical reactions in patients with celiac disease suggests that in these patients not only the number of functioning carrier molecules in the small intestinal lining is reduced but also the affinity (attraction) of the existing carrier for sugar molecule is reduced.2
  • In the body, glucose is not adequately produced by the metabolism of carbohydrates, fats and proteins due to insufficient levels of various nutrients required for metabolism, including chromium, vitamin B1, vitamin B2, vitamin B3, vitamin B6, zinc, magnesium and vitamin D. These nutrients are commonly deficient in untreated celiac disease, thus contributing to glucose deficiency.

How Prevalent Is Hypoglycemia In Celiac Disease and/or Gluten Sensitivity?

Hypoglycemia is a common serology result in people with untreated celiac disease.3

What Are The Symptoms Of Hypoglycemia In Celiac Disease and/or Gluten Sensitivity?

Hypoglycemia is marked by symptoms that can involve the sympathetic nervous system (body) and/or the central nervous system (brain):

  • Sympathetic nervous system stimulation includes these symptoms:
  • Faintness.
  • Weakness.
  • Tremulousness.
  • Palpitation.
  • Sweating.
  • Hunger.
  • Nervousness.
  • Central nervous system dysfunction includes these symptoms:
  • Headache.
  • Confusion.
  • Visual disturbances.
  • Weakness.
  • Palsy.
  • Ataxia.
  • Personality changes such as marked irritability.

How Does Hypoglycemia In Celiac Disease and/or Gluten Sensitivity Develop?

  • Hypoglycemia develops from these mechanisms:
  1. Poor absorption of glucose from the small intestine due to limited mucosal absorbing surface;
  2. Maldigestion of glucose from carbohydrates due to enzyme deficiency caused by injury to villi. Inadequate sugar splitting enzymes (lactase, maltase, sucrase) located in the surface brush border of intestinal villi limits release of glucose from complex sugars and starches;
  3. Impaired active transport of glucose from the gut into the bloodstream;2 and
  4. Impaired metabolic production of glucose in part due to required, but insufficient, levels of chromium, vitamin B1, vitamin B2, vitamin B3, vitamin B6, zinc, magnesium and vitamin D caused by malabsorption.

Does Hypoglycemia Respond To Gluten-Free Diet?

Yes. Celiac disease-related hypoglycemia normalizes on gluten free diet.

6 Steps To Improve Hypoglycemia In Celiac Disease and/or Gluten Sensitivity:

Treatment. This condition responds to the complete elimination of gluten, which is the required treatment that improves both hypoglycemia and gut health.

  • Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.
  • A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.
  • Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.

Correct Your Individual Nutritional Needs.

Recovery. You should begin to feel better within a week and notice more energy as inflammation subsides and the  absorbing cells that make up the surface lining of your small intestine are better able to function.

  • Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.
  • Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.4
  • The intestinal lining may take up to a year to heal.
  • 2 Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).

Here Are Major Inflammatory Food Types That Reduce Healing:

  • Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.5
  • Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
  • Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.6
  • Fats. Limit deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.6.
  • Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.6
  • Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
  • Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.6
  • Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.6
  • Cocoa and Black Tea increase blood sugar.
  • Rosemary. Increases blood sugar levels and should not be used by persons with insulin resistance or diabetes.

Here Are Important Anti-Inflammatory Food Types to Promote Health:

  • Fruits. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.
  • Non-Starchy Vegetables. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes green leafy vegetables such as lettuce and kale, also onion, broccoli, garlic, and others.
  • High Quality Complex Carbohydrates. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
  • Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.
  • Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.
  • Probiotics. Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.
  • Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
  • Protective Herbs and Spices.  See below #6 below for examples.
  • 3 Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

  • 4 Manage Your Medications Safely:

Certain medications deplete nutrients that cause hypoglycemia which includes chromium, vitamin B1, vitamin B2, vitamin B3, vitamin B6, zinc, magnesium and vitamin D. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

 This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS

ANTI-DEPRESSANTS

  • Adapin®, Aventyl®, Elavil®, Pamelor®, Paxil®, Zoloft®, and others deplete Riboflavin (vitamin B2).

ANTIBIOTICS disrupt intestinal permeability which complicates celiac disease.

ANTI-INFLAMMATORIES disrupt intestinal permeability which complicates celiac disease.

ANTICONVULSANTS

  • Phenobarbital and Barbituates; and Dilantin®, Tegretol®, Mysoline®, Depakane/Depacon® deplete Vitamin D, Vitamin B1,  Zinc.

ANTIVIRAL AGENTS

  • Zidovudine (Retrovir®, AZT and other related drugs) deplete Zinc.
  • Foscanet depletes Magnesium. 

BRONCHODILATORS

  • Inhaled corticosteroid inhalers (Flovent, Pulmicort and others) that are breathed in on a daily basis as a long term therapy to reduce inflammation in airways deplete Vitamin D, and B vitamins.
  • Albuterol inhalers that are breathed in on a daily basis as a long term therapy and also for quick relief as rescue inhalers to open airways depletes Magnesium.

CARDIOVASCULAR DRUGS

  • Antihypertensives (Catapres®, Aldomet) deplete Vitamin B6, Vitamin B1 Zinc.
  • ACE Inhibitors (Capoten®, Vasotec®, Monopril® and others) deplete Zinc.

CHOLESTEROL DRUGS

  • Colestid® and Questran® deplete Vitamin D.

DIURETICS

  • Thiazide Diuretics (Hydrochlorothiazide, Enduron®, Diuril®, Lozol®, Zaroxolyn®, Hygroton® and others) deplete Magnesium, Zinc.
  • Loop Diuretics (Lasix®, Bumex®, Edecrin®) deplete Magnesium, Vitamin B1, Vitamin B6, Zinc.
  • Potassium Sparing Diuretics (Midamor®, Aldactone®, Dyrenium® and others) deplete Zinc.

FEMALE HORMONES disrupt intestinal permeability which complicate celiac disease.

LAXATIVES

  • Metamucil, FiberCon, Citrucel, Colace, Glycolax, Milk of magnesia, Dulcolax deplete: Vitamin D.

MAJOR TRANQUILIZERS  

  • Thorazine®, Mellaril®, Prolixin®, Serentil® and others deplete Vitamin B2.

WEIGHT LOSS DRUGS THAT BIND FAT also interfere with absorption of some nutrients.

  • 5Nutritional Supplements To Help Correct Deficiencies:

The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.

  • Multivitamin/mineral combination that provides 100% once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.
  • Calcium citrate is the best absorbed of calcium supplements. Calcium carbonate is a poor choice.
  • Vitamin D3 as prescribed following blood test for status.
  • Chelated magnesium  as prescribed but do not take at same time as calcium because they compete for absorption.

Storage Note: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet – not in the bathroom or on the kitchen table.

  • 6Manage Natural Remedies: 

Hydration:

  • Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
  • If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
  • Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
  • What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.

Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

  • Raspberry.
  • Carrot is also a cleansing digestive tonic.
  • Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
  • Redbeets also stimulate and improve digestion and are easily digested.
  • Cabbage also stimulates and improves digestion and is also a liver decongestant.
  • Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
  • Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

  • Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
  • Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
  • Parsley also relieves indigestion.
  • Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion. However, because it increases blood sugar levels, it should not be used by persons with insulin resistance or diabetes.
  • Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

  • Cloves are also antispasmodic.
  • Nutmeg is also useful for indigestion.
  • Ginger.

Exercise Helps:

Exercise improves circulation and rids the body of toxins.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal.

What Do Medical Research Studies Tell About Hypoglycemia In Celiac Disease and/or Gluten Sensitivity?

“Sugar absorption by small bowel biopsy samples from patients with primary lactase deficiency and with adult celiac disease.” This study investigating glucose absorption showed that the absorption of glucose by the biopsies from patients with celiac sprue did not follow Michaelis-Menten kinetics and was compatible with that of passive diffusion or low saturation conditions. Active transport with low saturation kinetics (chemical reactions) in patients with celiac disease suggests that in these patients not only the number of functioning carrier molecules is diminished but also the affinity of the existing carrier for sugar molecule is reduced.2

  1. http://hyperphysics.phy-astr.gsu.edu/hbase/organic/sugar.html accessed 11 14 12 [↩]
  2. Beck IT, Da Costa LR, Beck M. Sugar absorption by small bowel biopsy samples from patients with primary lactase deficiency and with adult celiac disease. Am J Dig Dis. 1976 Nov;21(11):946-52. [↩] [↩] [↩]
  3. Murray JA, the widening spectrum of celiac disease. American Journal of Clinical Nutrition. Mar 1999;69(3):354-365. [↩]
  4. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
  5. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩]
  6. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩]
  7. https://umm.edu/health/medical/altmed/depletion/antibiotic-medications-penicillin-derivatives. [↩]
  8. http://umm.edu/health/medical/altmed/depletion/antibiotic-medications-macrolides [↩]

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