Are you hypoglycemic?

Discussion in 'Fibromyalgia Main Forum' started by Smiffy, Feb 13, 2006.

  1. Smiffy

    Smiffy Member

    from the Fibromyalgia Treatment Center website:


    Hypoglycemia:

    Hypoglycemia, low blood sugar, is a name often used to denote a disease though it is only one symptom of an illness with many complaints. It represents a syndrome better defined as "carbohydrate intolerance." It is expressed by the inability to use certain carbohydrate loads effectively without adverse consequences.

    Sugar and complex carbohydrates evoke a rise in blood sugar that triggers insulin release from the pancreas. This hormone facilitates storage or utilization of these carbohydrates in various parts of the body. It can also signal the liver to convert the excess to fatty acids transported to fat cells where insulin induces storage as triglycerides, our fuel reserve. In hypoglycemics the insulin control mechanism is faulty. This creates a system-wide disturbance that results in one of the endocrine "fatigue" syndromes we call "hypoglycemia."
    The standard for diagnosis has been the five-hour glucose tolerance test. A certain sugar solution is given; blood samples are drawn and tested at various intervals. Such tests were done in 1994 by Genter and Ipp on a group of young, healthy people who had no symptoms of hypoglycemia*. Samples were taken every ten minutes to measure the timing and amount of various hormones that normally prevent an excessive drop in blood sugar by counteracting insulin. One-half of the test subjects developed acute symptoms of hypoglycemia near the peak epinephrine (adrenaline) release, which coincided with their lowest blood sugars. Each reacted at different glucose levels considered normal. Obviously each person has a personal alarm system, an individual blood sugar level at which the brain perceives danger, and releases adrenaline (epinephrine).

    The symptoms of "hypoglycemia" (the term we will continue to use) are many. They consist of fatigue, irritability, nervousness, depression, insomnia, flushing, impaired memory and concentration. Anxieties are common as are frontal or bitemporal headaches, dizziness, faintness or actual syncope. There is often blurring of vision, nasal congestion, ringing in the ears, numbness and tingling of the hands, feet or face. Excessive gas, abdominal cramps, loose stools or diarrhea are frequent. Many complain of leg or foot cramps. These are the chronic symptoms of the condition and are experienced even in the presence of a normal blood sugar.
    The acute symptoms are frightening and occur at very variable sugar levels usually three or four hours after eating. They include hand or inner shaking, especially with hunger, accompanied by sweating. Heart irregularities or pounding and severe anxiety complete the picture. When attacks occur during the night, they are often preceded by nightmares and result in severe sleep disturbance that results in daytime somnolence. Bouts of higher intensity are labeled "panic attacks." Acute events last twenty to thirty minutes and are induced by the sudden release of large amounts of adrenaline, more than sufficient for the abrupt correction of the falling blood or brain sugar. In the past, we did many glucose tolerance tests during which patients listed their symptoms. Sampling frequently missed the lowest sugar levels that had triggered the acute attack so rapid was the adrenaline correction. We rarely do the test now since the acute symptoms suffice for diagnosis.

    Only a perfect diet will control hypoglycemia. It is not the food one adds but what one removes that determines recovery. Patients must eat no table sugar, corn syrup, honey, sucrose, glucose, dextrose or maltose. All heavy starches must be avoided including potatoes, rice, pasta etc. Excessive fructose is provided by the several pieces of fruit needed to make one glass of juice. Caffeine intensifies the action of insulin and is also forbidden. Certain carbohydrates such as sugar-free bread are allowed but intake is limited to one slice three times per day. Only one piece of fruit should be eaten in a four-hour period.

    Improvement begins in about seven to 10 days. Considerable relief is afforded within one month. Symptoms totally clear within two months but only if the diet has been followed perfectly! During the first 10 days of treatment headaches are common from caffeine withdrawal and fatigue induced by changing the body's basic source of fuel, and in some patients can be quite severe Consider the entire dietary process as if one were building a checking account.First, deposits must be made to obtain sufficient funds. Only at this point should one begin writing checks knowing that balances are lowered with each one written.Similarly, the hypoglycemia diet builds energy reserves to the highest amount attainable for a given individual. Only then can experimentation with forbidden carbohydrates begin. Each such "cheat" draws on the account and one cannot overspend without developing symptoms anew. Thus, over time, this hunt and peck system will define the ultimate, necessary, dietary restrictions.

    In the searching phase one will slip occasionally by overindulging in carbohydrates. Close observation should detect the first symptom that develops after such excesses. Often this may be merely fatigue, but in other cases it will be frontal, pressure headaches. Gradually, most hypoglycemics learn exactly what they can allow themselves. They must often resume a perfect diet when emotional or physical stresses occur since these place greater demands on their energy bank. The premenstrual period is the most fragileAt such times it becomes more difficult to maintain an adequate account. No physician or dietician can adequately predict the final dietary restrictions. The patient must make this judgement with judicious cheating that is individually variable.

    Some hypoglycemics suffer simultaneously from another condition, fibromyalgia, an illness that causes chronic symptoms similar to hypoglycemia but not the acute ones listed above. This is the subject of another paper we have written. Simply put, the fibromyalgic has a deranged metabolism inducing contracted muscles, ligaments and tendons, which constantly burn fuel. Energy deprivation occurs system- wide. For those with a predisposition, yielding to carbohydrate craving provides the final push to induce hypoglycemia. These are ill patients who suffer overlapping symptoms of combined diseases. No compromise is allowed with the carbohydrate intolerance syndrome. One eats correctly or the illness continues. The reward is great, however, since well-being is exhilarating when contrasted with the disabling symptoms of hypoglycemia. It is yours to control.


    Diets For Hypoglycemia
    by R. Paul St. Amand, M.D.

    Both these diets work to correct hypoglycemic symptoms. Choose the "Strict" diet to lose weight or the "Liberal" diet to maintain weight. Each hypoglycemic's tolerance for listed foods will vary. Judge your tolerance level by how you feel and adjust your intake of foods accordingly.

    The Strict Diet:
    Choose any foods from the following list

    MEAT and FISH
    All meats except cold cuts that contain sugars or dextrose; All fowl and game; All fish and shellfish.
    DAIRY PRODUCTS
    Eggs; Any natural cheese (bleu, roquefort, cheddar, cream, gouda, swiss, etc;) Cream (heavy and sour;) Cottage and Ricotta (1/2 cup limit per day;) Butter; Margarine.
    FRUITS
    Fresh coconut; Avocado (limit 1/2 per day;) Cantaloupe (limit 1/4 per day;) Strawberries (limit 6-8 per day;) Lime or Lemon juice for flavoring (limit 2 tsp. per day.)
    VEGETABLES
    Asparagus; Bean Sprouts; Broccoli; Brussels sprouts; Cabbage (limit 1 cup per day); Cauliflower; Celery Root (celeriac;) Celery; Chard; Chicory; Chinese cabbage (limit 2 cups per day;) Chives; Cucumber; Daikon (long, white radish;) Eggplant; Endive; Escarole; Fennel Bulb; Greens (Mustard, Beet, Collard etc;) Jicama; Kale; Leeks; Lettuce (any type;) Mushrooms; Okra; Olives; Parsley; Peppers (green, red, yellow, etc;) Pickles (dill, sour, limit one per day;) Pimiento; Radicchio; Radish; Rhubarb; Sauerkraut; Scallions (green onions;) Spinach; Squash (yellow or summer only;) String beans (green or yellow;) Snow peas; Tomatoes (not sauce or paste); Water Chestnuts; Watercress; Zucchini.
    NUTS (limit 12 per day)
    Almond; Brazil; Butternut; Filbert; Hazel; Hickory; Macadamia; Pecan; Pistachio; Sunflower seeds (small handful); Walnut.
    DESSERTS
    Sugar-free Jell-O with NutraSweet; Custard (made with cream and artificial sweetener.)
    DRINKS
    Club soda; Decaffeinated coffee; Decaffeinated tea; Caffeine-free diet sodas.
    CONDIMENTS and SPICES
    All herbs and spices including seeds (fresh or dried); All imitation flavorings; Horseradish; Sugar-free sauces such as Hollandaise, Mayonnaise, Mustard, Ketchup; Sugar-free salad dressings; Oil and Vinegar (all types;) Worcestershire sauce.
    MISCELLANEOUS
    All fats; Caviar; Tofu.
    FOODS TO STRICTLY AVOID
    Alcohol (most hypoglycemics can tolerate one drink after two months on the diet - use discretion as individual tolerance levels vary;) Baked beans; Refried beans; Black-eyed peas (cow peas); Bananas; Lima beans; Potatoes; Corn; Dried fruits & Fruit juices; Barley; Rice; Pasta (all types;) Flour and Corn Tortillas; Tamales; Sweets of any kind; Products which contain Dextrose, Glucose, Hexitol, Lactose, Maltose, Sucrose, Honey, Fructose, Corn Syrup, Food Starch, Caffeine.


    The Liberal Diet:
    You may add the following foods to the strict diet:

    FRUIT
    (limit: one piece of fruit every four hours. No fruit juices.)
    Apples; Apricots; Blackberries (1/2 cup limit;) Blueberries (1/2 cup limit;) Boysenberries; Casaba melon (1 wedge limit;) Grapefruit; Honeydew melon (1 wedge limit;) Lemons; Limes; Nectarines; Oranges; Papaya; Peaches; Pears; Plums; Raspberries; Strawberries; Tangerines; Tomato juice; Tomato sauce or paste; V8 Juice.
    VEGETABLES
    Artichokes; Beets; Carrots; Onions; Peas; Pumpkin; Winter squash; Hubbard squash; Turnips; Rutabagas, Spaghetti squash.
    NUTS
    Cashews; Peanuts; Soy Nuts.
    DAIRY PRODUCTS
    Whole, Non-fat, Low-fat milk and buttermilk, unsweetened yogurt.
    DESSERTS
    Sugarless diet puddings (1/2 cup a day limit)
    BREADS
    Three slices a day of sugar-free white, whole wheat, sourdough or light rye. No more than two slices at one time.
    MISCELLANEOUS
    Corn tortillas (2 only per day;) Carob powder; Flour (gluten or soy only;) Gravy made with gluten or soy flour only;) Popped popcorn (one cup only;) Sugar-free cereals (puffed rice, shredded wheat, oatmeal etc;) Wheat germ.

    Each hypoglycemic's tolerance for listed foods will vary. Judge your tolerance level by how you feel and adjust your intake of foods accordingly.

    If cholesterol is a problem, avoid cold cuts (except turkey,) cheese, cream, solid margarine, hollandaise sauce, and macadamia nuts. Use egg whites or Egg Beaters instead of whole eggs. Use liquid margarine only. Nuts should be dry roasted only. Trim all visible fat from meats and remove skin from poultry. Use canola or olive oil.

    This information comes from R. Paul St. Amand, M.D. It is not meant to be a medical diagnosis or advice. Please consult your physician before making any changes to your diet or treatment. Prior to commencing any diet R. Paul St. Amand M.D. recommends a basic work-up that includes a thyroid test, and blood count to rule out anemia or infections that mimic fibromyalgia.




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  2. Rene

    Rene New Member

    Yes I am. I have CFS. Thanks for the articles. I got some good ideas to figure out what to eat. I needed a refesher on that.

    When I got diagnoesed I got happy that maybe i'd be cured of CFS or at least be able to go out ot eat more then once every three YEARS but no it didn't help me.
    Thanks!