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Reactive hypoglycemia

Reactive hypoglycemia is a medical term describing recurrent episodes of symptomatic hypoglycemia occurring 2-4 hours after a high carbohydrate meal (or oral glucose load). more...

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It is thought to represent a consequence of excessive insulin release triggered by the carbohydrate meal but continuing past the digestion and disposal of the glucose derived from the meal.

The prevalence of this condition is difficult to ascertain and controversial, because a number of stricter or looser definitions have been used, and because many healthy, asymptomatic people can have glucose tolerance test patterns said to be characteristic of reactive hypoglycemia. It has been proposed that the term reactive hypoglycemia be reserved for the pattern of postprandial hypoglycemia which meets the Whipple criteria (symptoms correspond to measurably low glucose and are relieved by raising the glucose), and that the term idiopathic postprandial syndrome be used for similar patterns of symptoms where abnormally low glucose levels at the time of symptoms cannot be documented.

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Hypoglycemia responds to natural treatment - chromium and dimethyl glycine; includes related information
From Better Nutrition (1989-90), 10/1/89 by Deborah Semour Taylor

Hypoglycemia Responds to Natural Treatment

Characterized by faulty regulation of blood sugar, hypoglycemia can be effectively treated with chromium and dimethyl glycine.

When the body's highly sensitive sugar regulation thermostat stops working, nearly every aspect of health can be affected. "When you remember that sugar is what your body uses to fuel every one of its organs and muscles and that without it, all of your body's cells could `run out of juice,' you begin to appreciate just how serious low blood sugar can be," said Stuart Berger, M.D. "Hypoglycemia is, in short, the biological equivalent of a race car running on empty.

Hypoglycemia, an abnormal decrease of sugar in the blood, affects both the nervous and muscular systems, causing a headache, fatigue, lethargy, depression, nausea, blurred vision, insomnia, an inability to concentrate, anxiety and mood swings.

Physicians divide the disorder into two major types. The first, called fasting hypoglycemia, is quite rare, and is due to a genetic abnormality, alcoholism, liver disease, certain specific cellular disorders or a cancerous growth in the cells responsible for maintaining blood sugar levels.

The second type is called reactive hypoglycemia. "This is a simple imbalance in your body's sugar circuitry," said Dr. Berger. "The name reactive means that it occurs in reaction to an event, in this case, eating. By definition, its symptoms occur two to five hours after a meal. Either the body cannot properly absorb and assimilate nutrients, or your diet is too high in refined carbohydrates, or you have an overactive response of the nervous system controlling the body's reaction to food."

Normally, the blood glucose level is maintained within a narrow range by various hormones which respond immediately to even slight changes. Insulin is released from the pancreas when glucose enters the bloodstream after food is digested. The insulin in turn causes rapid uptake, storage or use of glucose by almost all tissues of the body. One of the most important effects of insulin is to cause glucose to be stored in the liver as glycogen. Between meals, when blood sugar drops, liver glycogen is converted back to glucose to nourish the cells.

Hypoglycemia causes excess insulin to be secreted and sugar levels to drop too quickly. As the level of sugar in the blood begins to climb following a meal, the pancreas alerts the insulin-producing cells to release large amounts of the hormone into the blood. Sugar is quickly taken from the blood and stored in the liver. Blood sugar levels plummet and the symptoms of hypoglycemia begin.

The most commonly used test for hypoglycemia is the Glucose Tolerance Test, in which a high-glucose solution follows an overnight fast. Blood samples are drawn during the following five hours and checked for glucose content. In a true case of hypoglycemia, such a large dose of glucose may cause the body to overproduce insulin, which in turn drives blood sugar levels dangerously low. If the dose is tolerated, hypoglycemia is not the problem.

Many physicians claim that true hypoglycemia is rare and that the diagnosis of low blood sugar is only given because it is more acceptable than attributing symptoms to emotions. Other physicians believe the condition is not so rare, but that diagnosis is difficult. "First, under laboratory conditions, a large proportion of those tested will show up in the too-low blood sugar range, yet exhibit no symptoms of low blood sugar," wrote Arthur Winter, M.D., and Ruth Winter. "Other patients who exhibit classic symptoms pass the glucose test with flying colors."

According to a study published in the New England Journal of Medicine, 25 percent of a group of healthy, symptom-free people registered as hypoglycemic after taking the Glucose Tolerance Test. The results of another study conducted by the Mayo Clinic with 129 patients who suffered from hypoglycemic symptoms were equally confusing. Two-thirds of the patients passed the Glucose Tolerance Test.

Another reason the Glucose Tolerance Test may not identify hypoglycemics is that insulin is not the only blood sugar regulator. In fact, a new hormone called gastric inhibitory polypeptide (GIP) recently discovered by investigators from the National Institute of Aging in collaboration with scientists from the University of British Columbia, appears to be critical for maintaining normal blood sugar levels. In the normal individual, the pancreas releases sufficient insulin to clear the blood of excess glucose within two hours. But if the blood sugar is too high for the pancreas to clear, GIP is released. If you eat a high-sugar meal, you may activate both insulin and GIP, which may clear the blood more rapidly than glucose alone.

A number of supplements have been found effective for treating hypoglycemia. Dimethyl glycine (DMG), the active ingredient in "vitamin B15," has long been used by athletes to improve performance and endurance, to enhance oxygen utilization and improve recovery after strenuous exercise. Russian scientists have demonstrated that the reason for DMG's impressive results with athletes may be due to its role in regulating sugar metabolism. Nutritionally-minded physicians use DMG to enhance blood sugar metabolism in diabetics and to strengthen the cardiovascular system.

Chromium, found in brewer's yeast, is another nutrient used to treat hypoglycemia. As a cofactor to insulin, chromium is central to the body's utilization of blood sugar.

"Insulin works hand in hand with a vitamin-like substance called the Glucose Tolerance Factor (GTF), so named because it was discovered in connection with the Glucose Tolerance Test," wrote Gary Null.

"Chromium is vital to GTF; in fact, it resides in the center of GTF. GTF, in turn, is vital to insulin, because without its co-worker, insulin cannot transport it." Fatigue, irritability, depression and other symptoms of impaired sugar tolerance result when chromium is not supplied.

Chromium has been shown to eliminate or reduce the insulin requirements of diabetics. "In studies with diabetic children, chromium supplements have helped lower the dosage of insulin and chromium therapy has helped some older patients end their dependence on insulin altogether," Null wrote. "In some experiments with chromium therapy, it has taken only a few months for formerly diabetic adults to get their metabolism to function properly again."

Food sources of chromium include whole-wheat flour, nuts, seafood, legumes and mushrooms. One of the best sources is brewer's yeast. Although the FDA has made no formal recommendation for a daily allowance of chromium, 50 to 200 micrograms are suggested in government studies.

Anyone suffering from chronic fatigue or other symptoms of hypoglycemia should consult his doctor to rule out serious illness.

Deborah Seymour Taylor is a freelance science and health writer based in Virginia Beach, Va. A nutrition consultant, Ms. Taylor is a newspaper columnist and former editor of Physique magazine.

COPYRIGHT 1989 PRIMEDIA Intertec, a PRIMEDIA Company. All Rights Reserved.
COPYRIGHT 2004 Gale Group

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