Sweet Poison: Life with Hypoglycemia

Note: I am not a doctor nor any other kind of medical professional. This post is not intended to be medical advice, but a description of one person’s personal experience. Please consult with a real medical professional if you need advice about any medical problems. Thank you.

Hypoglycemia is a medical condition in which the sufferer has too little sugar (glucose) in their bloodstream, like an inverse diabetes. Diabetics suffer an inability to produce/absorb insulin, without which their cells cannot properly absorb glucose from the blood. Hypoglycemics over-produce/absorb insulin, driving too much sugar into the body and leaving too little in the blood.

There are actually two kinds of hypoglycemia–general low blood sugar, which can be caused by not having eaten recently, and reactive hypoglycemia, caused by the body producing too much insulin in response to a sugar spike.

What does hypoglycemia feel like?

It’s difficult to describe, and I make no claim that this is how other hypoglycemics feel, but for me it’s a combination of feeling like my heart is beating too hard and weakness in my limbs. I start feeling light-headed, shaky, and in extreme cases, can collapse and pass out.

It’s not fun.

So how do I know it’s not just psychosomatic?

The simple answer is that sometimes I start feeling nasty after eating something I was told “has no sugar,” check the label, and sure enough, there’s sugar.

By the way, “evaporated cane juice” IS SUGAR.

It took several years to piece all of the symptoms together and figure out that my light-headed fainting spells were a result of eating specific foods, and that I could effectively prevent them by changing my diet and making sure I eat regularly.

I don’t fancy doing experiments on myself by purposefully trying to trigger hypoglycemia, so my list of foods I avoid can’t be exact, but extrapolated based on what I’ve experienced:

More than a couple bites of any high-sugar item like ice cream, candy, cookies, chocolate, or flavored yogurt.

Yes, yogurt. Lots of people like to tout flavored yogurts as “health food.” Bollocks. They strip out the good, tasty fats and then try make it palatable again by loading it up with sugar, creating an abomination that makes me feel as nasty as a bowl of ice cream. “Health food” my butt.

I also avoid all sugary drinks, like soda and fruit juice.

Yes, fruit juice. Fruit juice is mostly fructose, a kind of sugar, and your body processes it into glucose just like other sugars. A cup or two of juice and I start feeling the effects, just like any other sugary thing.

(Note: the exact mechanism of sugar metabolism varies according to the chemical structure of the individual sugar, but all sugars get broken down into glucose. Fruit sugar is fructose, the same stuff as is in High Fructose Corn Syrup.)

I generally don’t have a problem eating fruit.

I don’t eat/drink products with fake sugars, like Diet Soda or sugar-free ice cream, on the grounds that I don’t really know how the body will ultimately react to these artificial chemicals and because I don’t want to develop a taste for sweet things. There’s a lot of habit involved in eating, and if I start craving sweets that I can’t have, I’m going to be a lot more miserable than if I drink a glass of water now and forgo a Diet Soda.

A quick digression about artificial foods: once upon a time, people were very concerned about saturated fats in their diets, so they started eating foods with laboratory-produced “trans fats” instead. The differences between regular fats and trans fats are chemical; the regular fat it’s based on is typically a liquid, (that is, an oil,) and essentially moving one of the molecules in the fat from one side to the other creates a room-temperature solid. The great thing about trans fats is that they’re shelf-stable–that is, they won’t go rancid quickly at room temperature–and can be made from plant oils instead of animals fats. (Plants are much cheaper to grow than animals.) The downside to trans fats is that our bodies aren’t quite sure how to digest them and incorporate them into cell membranes and they appear to ultimately give you cancer.

So… You were probably better off just frying things in lard like the Amish do than switching to margarine.

The moral of the story is that I am skeptical of lab-derived foods. They might be just fine, but I have plenty to eat and drink already so I don’t see any reason to take a chance.

Finally, I eat bananas, pasta, and cereals in moderation, and certainly not in the morning. These are all items with complex sugars, so they aren’t as bad as the pure sugar items, but I am cautious about them.

Yes, timing matters–your body absorbs sugars more quickly after fasting than when you’ve already eaten, which is why your mother always told you to eat your dinner first and desert second. My hypoglycemia is therefore worst in the morning, when I haven’t eaten yet. Back in the day I had about 20 to 30 minutes after waking up to get breakfast or else I would start getting shaky and weak and have to lie down and try to convince someone else to get me some breakfast. Likewise, if I ate the wrong things for breakfast, like sugary cereals or bananas, I also had to lie down afterwards.

I’ve since discovered that if I have a cup of coffee first thing in the morning, my blood sugar doesn’t crash and I have a much longer window in which to eat breakfast, so I have time to get the kids ready for school and then eat. I don’t know what exactly it is about the coffee that helps–is it just having a cup of liquid? Is it the milk I put in there? The coffee itself? All three together? I just know that it works.

As with all things food and diet related, it’s probably more useful to know what I can eat than what I don’t: Meat, milk, cheese, sandwiches, lasagna, nuts, peanut butter, potatoes with butter + cheese, beets, soup, soy, coconuts, pizza, most fruit, coffee, tea, etc.

It’s really not bad.

In the beginning, I was occasionally sad because I’d get dragged to the ice cream shop and watch everyone else eat ice cream while I couldn’t have any (technically I can have a couple of bites but they don’t sell it in that quantity.) But when eating something makes you feel really bad, you tend to stop wanting to eat it.

So long as I have my morning coffee, avoid sweets, and eat at regular intervals, I feel 100% fine. (And coffee excepted, this is what nutritionists say you’re supposed to do, anyway.) I don’t feel sick, I don’t feel weak or dizzy, I don’t shake, etc.

The only problem, such as it is, is that I live in a society that assumes I can eat sugar and assumes that I am concerned about diabetes and gaining weight. Every pregnancy, for example, doctors try to test me for gestational diabetes. The gestational diabetes test involves fasting, drinking a bottle of pure glucose, and then seeing what my insulin levels do. I have yet to talk to any ob-gyn (or midwife practice) with policies in place for handling hypoglycemic patients. Every single one has a blanket policy of making all of their patients drink bottles of glucose. No, I am not drinking your goddamn glucose.

Obviously I have to bring a sack lunch to group events where the “catered meal” turns out to be donuts and cookies. (“Oh but there is a tray with celery on it! You can eat that, right?” No. No I can’t. I can’t keep my blood sugar levels from dropping by eating celery.) And of course I look like a snob at parties (No, sorry, I don’t want the punch. No, no pie for me. No, no cookies. Ah, no, I don’t eat cake. Look, do you have any potatoes?) But these are minor quibbles, and easily dealt with. Certainly compared with Type I Diabetics who must constantly monitor their blood sugar levels and inject insulin, I have nothing to complain about. To be honest, I don’t even think of myself as having a problem, I just think of society as weird.

F. daltoniana, Himalayan strawberry

Step back a moment and look at matters in historical perspective. For about 190,000 years, all humans ate hunter-gatherer diets. About 10,000 years ago, more or less, our ancestors started practicing agriculture and began eating lots of grain. (Hunter-gatherers also ate grain, but not in the same quantities.) Only in the past couple of centuries has refined sugar become widespread, and only in the past few decades have sugars like HFCS become routinely added to regular foods.

Consider fruit juice, which seems natural. It actually takes a fair amount of energy (often mechanized) to squeeze the juice out of an apple. Most of the juice our ancestors drank was fermented, ie, hard cider or wine, which was necessary to keep it from going bad in the days before pasteurization and modern bottling techniques. Fermentation, of course, whether in pickles, yogurt, wine, or bread, transforms natural sugars into acids, alcohols, or gasses (the bubbles in bread.)

In other words, your ancestors probably didn’t drink too many glasses of fresh, unfermented juice. Even modern fruit is probably much sweeter than the fruits our ancestors ate–compare the sugar levels of modern hybrid corns developed in laboratories to their ancestors from the eighteen hundreds, for example. (Yes, I know corn is a “grain” and not a “fruit.” Also, a banana is technically a “berry” but a raspberry is not. It’s a “clusterfruit.” These distinctions are irrelevant to the question of how much fructose is in the plant.)

Or as Anastapoulo writes on the history of apples:

The apple was first brought to the United States by European settlers seeking freedom in a new world. At first, however, these European cultivars failed to thrive in the American climate, having adapted to environmental conditions an ocean away. They did, however, release seeds, leading to the fertilization and eventual germination of countless new apple breeds. Suddenly, the number of domesticated apples in North America skyrocketed, and the species displayed an amount of genetic diversity that far surpassed that of Europe or other areas of the world (Juniper).

…Traditionally, apple production had been a domestic affair, with most crops being grown on private properties and family orchards. However, a rise in commercial agriculture at the beginning of the twentieth century, the institution of industrial farming practices, and the introduction of electric refrigeration in transportation all impacted the process of growing apples, and these innovations caused the industry to grow. This expansion of commercial apple growing eventually caused apple biodiversity to decline because growers decided to narrow apple production to only a handful of select cultivars based primarily on two key selling factors: sweetness and appearance. In so doing, the thousands of other existing apple varieties, each specialized for a different use, started to become obsolete in the face of more universally accepted varieties, including the infamous Red Delicious, a sugary sweet and visually appealing apple that has become the poster child of the industry (Pollan). …

Rather than rely on natural crossbreeding and pure chance to hopefully create a successful apple variety, growers instead turned to science, and they began implementing breeding practices to develop superior apples that embodied their desired characteristics. … As a result, heirloom and other traditional varieties became all but irrelevant; banished from commercial orchards, they were left to grow in front yards, small local orchards, or in the wild. … Indeed, according to one study, of the 15,000 varieties of apples that were once grown in North America, about eighty percent have vanished (O’Driscoll). It should be noted that a number of these faded because they were originally grown for hard cider, a beverage that fell out of popularity during Prohibition. … Such practices now mean that forty percent of apples sold in grocery markets are a single variety: the Red Delicious (O’Driscoll).

There’s certainly nothing evolutionarily normal about eating ice cream for dinner–your ancestors didn’t even have refrigerators.

So to me, the odd thing isn’t that I can’t eat these strange new foods in large quantities, but that so many other people go ahead and eat them.

Yes, I know they taste good. But like most people, I have normative biases that make me assume that everyone else thinks the same way I do, so I find it weird that “food that makes people feel bad” is so common.

And you might say, “Well, it doesn’t actually make other people feel bad; everyone else can eat these things without trouble,” but last time I checked, society was “suffering an obesity epidemic,” the majority of people were overweight, “metabolic syndrome,” pre-diabetes and Type II Diabetes were rampant, etc., so I really don’t think everyone else can eat these things without trouble. Maybe it’s a different, less immediately noticeable kind of trouble, but it’s trouble nonetheless.

Ultimately, maybe hypoglycemia is a blessing in disguise.