Hypoglycemia and Fibromyalgia

[Guest guest]

GREETINGS --

The following article came from the Fibromyalgia Treatment Center

website.

wambo1941

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. (see below). 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 fragile. At 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.

Dietary Restrictions the Hypoglycemic Must Follow

(Hypoglycemia Diet)

HAVE NONE OF THESE:

Alcohol (Most hypoglycemics can tolerate one drink after 2 months on

the diet - please use discretion as individual tolerance levels vary)

Sugar in any form, including soft drinks

Fruit juices and dried fruits

Baked beans

Black-eyed peas (cowpeas)

Garbanzo beans (chickpeas)

Refried beans

Lima beans

Potatoes

Corn

Bananas

Barley

Rice

Pasta of any kind

Burritos (flour tortilla)

Tamales

Caffeine

Dextrose

Maltose

Sucrose

Glucose

Honey

Corn syrup

Starch

Lentils