hypoglycemia

Blood Sugar and Recovery — A Critical Issue

The farther I got into the mind, body and spirit thing that is recovery, the more I realized how completely the three aspects dovetail. It is possible to be spiritually and mentally healthy while in poor physical condition, but generally the aches, pains and discomfort associated with such things — even with poor nutrition or lack of exercise — will interfere with our overall recovery. As someone so succinctly put it (it may even have been me), “When you feel like hell, it's hard to rise above it.”

In recovery we say, “Don't get Hungry, Angry, Lonely or Tired” (H.A.L.T.). It's amazing how often those seem to go together. We feel low on energy, may have a dull headache, and become irritable, stubborn, and prone to seemingly irrational fits of anger or even rage. I've often wondered how many cases of “Road Rage” could have been avoided if the perpetrator had eaten a decent snack before beginning the drive home after work.

What we're talking about here is levels of blood sugar. Regulation of blood glucose is one of the many bodily functions that are messed up by alcoholism and addiction.  Roughly 25% of the calories we eat go to keeping our brains operating at their most efficient level. When our blood sugar begins to drop, our brains begin to malfunction for lack of fuel, and that can cause big problems.

Until recently it was thought that each person's reaction to a given level of blood sugar was pretty much the same, but it has been found that many people are affected emotionally by glucose levels that were once believed to be within the normal range.

To find out if you suffer from mood swings caused by low blood sugar, use this easy way to self-diagnose. Get a small candy bar and a package of snack crackers (not cookies). About three hours after your last meal or snack, eat the candy bar. Begin keeping track of the way you feel. The symptoms of sub-clinical hypoglycemia may include any or all of the following symptoms:

* Irritability, ranging from mild to raging
* Low energy
* Depression
* Rigid facial muscles (can't smile)
* Muscle tension
* No sense of humor
* Dull headache
* Minor visual disturbances
* A jumpy, edgy feeling
* Difficulty concentrating
* Light-headedness.

These symptoms will normally begin to occur within an hour, often in much less time, and tend to worsen rapidly. Once you have satisfied yourself about the symptoms, go ahead and eat the crackers; they'll help stabilize your glucose and bring you back to normal.

The cure is simple: don't get that hungry. Our bodies are designed to work best when we eat several small meals a day, rather than three larger ones. We have artificially imposed a schedule on them that they don't accept well. We should eat a good breakfast, not too heavy on sweets, because we have been fasting for a third of a day.  A low-sweet snack at mid-morning will hold us until lunch, at which time we again avoid heavy sweets. A mid-afternoon snack will take us through the rush hour commute to dinner time, with a reasonable dessert, in a far better mood. A high protein snack before bedtime will help us sleep better.

The big trick is to avoid things that will cause our blood sugar to rise quickly, like our candy bar on the empty stomach did during the test. When our glucose level rises too rapidly, our bodies overreact and bring it down too far and too fast. That's what causes the hypoglycemic episodes — the blast of sugar. If it was accompanied by caffeine, the result is likely to be exaggerated even more. A low-sugar snack will bring the glucose up slowly and avoid the overcompensation. Obviously another candy bar would bring it up, too, but that will result in chasing our blood sugar curve all over the place, and many of us are doing that already.

A common complaint is “I can't eat all those snacks — I'll gain weight!” You will probably find, if you choose your snacks carefully, that you'll actually eat less over the course of a day because you won't be as hungry at meal times. Also, remember that we're cutting down the sweets. Sweets are OK, but not by themselves. We need to have them after a decent meal, or small amounts with our snacks, to avoid that blood sugar “spike.”

Give up the donuts and coffee for breakfast and the high-sugar snacks between meals. If you can make yourself reduce your caffeine intake, that's good too — especially if you're in the habit of drinking sweetened coffee or energy drinks on an empty stomach. Try it for a week, and keep a log of how you feel. You may be amazed at the difference it will make in the quality of your life. I was.

This is also the recommended diet to reduce the chance of developing diabetes, especially when combined with exercise and sufficient rest.

Remember, the Universe will cheerfully refund your misery at any time; all you have to do is ask.

Hungry, Angry, Lonely, Tired — A Major Cause Of Relapse

Folks who abuse alcohol and drugs often have problems controlling their blood sugar when they stop using. That can be due to poor eating habits, but it can also be due to craving the stimulation that we receive from eating sweets. (It can even be related to diabetes. Alcohol is particularly hard on the pancreas, the organ that produces insulin.) Whatever the cause, fluctuating blood sugar (glucose) can cause a variety of problems, from grumpiness to inability to think clearly — even relapse.

How can low blood sugar (hypoglycemia) be related to relapse? Simple. When we were using, our sugar fluctuated frequently because of our poor eating habits, and most of us drank or used drugs when hungry instead of getting a good square meal under our belts. That often relieved our symptoms, and over time we came to think of feeling hungry as needing to use. OK? Combine that feeling with anger and an inability to think clearly. Does that sound like a recipe for relapse to you?

Breakfast of Champions (Not)

Here's how it usually goes: I start feeling hungry, so I have a snack — usually a “high-energy” snack, like a donut or candy bar. Maybe I wash it down with a cup of coffee, or one of those monster energy drinks that us recovering people — still seeking relief from chemicals — seem to love so much. I just gave myself a nice jolt of sugar from the snack, and maybe the drink had sugar added, too. In addition to that, the caffeine causes my liver to release a chemical called glycogen, which is rapidly converted by the body to even more sugar.

The result is that I get a huge blast of sugar all at once, and my blood glucose shoots up. This causes my pancreas to produce a lot of insulin (the chemical that allows glucose to enter the cells from the blood). This provides a quick jolt of fuel to the cells, and combined with the adrenaline prompted by the caffeine, it gives me a real lift. Wheee!

The lift is short-lived, however. As soon as the blast of insulin brings my blood glucose back down, I'm hungry again and back in the dumps. I may even be worse off than when I started, because sometimes the blood sugar will fall even lower than it was before. Candy and caffeine work in the short term, but not for very long. Smoking makes it even worse. It's easy to see what happens next: we have another Twinkie and some more coffee or Red Bull (or maybe just the caffeinated, sugary drink). Zing! There we go again.

We can chase our blood sugar curve all over the map that way, and all we'll get out of it in the long run is  jitters, insomnia, and perhaps worse.

Hello? The smart thing to do when we're hungry is eat. It's best to:

  • have a good breakfast (coffee and donuts is not the breakfast of champions).
  • have a low sugar snack mid-morning
  • eat a reasonable lunch
  • snack again in the afternoon
  • and have dinner.

Another snack before bedtime will help us sleep. If we do it right, breaking our meals up into three meals and three snacks, we can actually end up eating less than usual, because we won't be devastatingly hungry at any point.

Better nutrition, calmer, better mood, clearer thinking, better interpersonal and work relationships, better sleep, less chance of relapse, and a possible start at some weight loss. What's not to like? Give it a shot. Next time you're starving, avoid sugar and caffeine, eat a package of peanut butter crackers, and see what happens.  Let us know how it goes.