Low Blood Sugar

[Rpoole8537]

I have an issue with low blood sugar. I'm scheduled to have more blood tests tomorrow, and a scan of my pancreas. My doctor feels that diet is my greatest challenge. I'm thinking of getting a dietician, but I want to get my fasting blood work back first. I have been drinking Atkins chocolate drinks at night, and my morning levels have increased. But, despite my riding and exercising, I feel like I'm gaining waistline!!! Doctor's advice has been very general, "eat more protein". This is a group of tremendous collective knowledge. Any ideas and suggestions will be appreciated.
Thanks in advance.

[joosttx]

I have an issue with low blood sugar. I'm scheduled to have more blood tests tomorrow, and a scan of my pancreas. My doctor feels that diet is my greatest challenge. I'm thinking of getting a dietician, but I want to get my fasting blood work back first. I have been drinking Atkins chocolate drinks at night, and my morning levels have increased. But, despite my riding and exercising, I feel like I'm gaining waistline!!! Doctor's advice has been very general, "eat more protein". This is a group of tremendous collective knowledge. Any ideas and suggestions will be appreciated.
Thanks in advance.

Listen to your Doctor. BTW what is your height and weight and age?

[velofinds]

Reduce carbohydrates, in particular simple or refined carbohydrates. Bread, pasta, anything sugary or starchy, that sort of thing. Track everything you consume through a fitness app (MyFitnessPal, etc.) if you are not already doing so. Try intermittent fasting, e.g., eat only during an 8 hour window, abstain (including calories consumed through drinks) during the remaining 16 hours.

[dddd]

Caffeine increases the secretion of insulin and adrenaline in a poorly-regulated way, so that one's insulin response to any given carbohydrate "load" may exceed the necessary duration needed to control one's blood sugar.

An obvious result is that one's blood sugar "dips" too low (after first peaking) an hour or two after a meal, particularly when the meal has a relatively-high glycemic load.

Adding fat and/or soluble fiber to a meal will slow the entry of sugars into the bloodstream, which will do two things:

1) It will reduce the insulin response to the meal.
2) It will extend the time that the meal supplies sugars into the bloodstream.

Both of these effects will reduce the "dip" in one's blood sugar in the hour or hours following a meal.

Having coffee with sugar, especially first thing in the morning would thus be particularly bad, as the stomach and upper G.I. system is empty upon waking, so entry of the caffeine and sugars is particularly rapid.
Adding starchy foods to this with breakfast really compounds the problem, so one should be aware of where quantities of sugars are "hiding" in all of the foods one likes to eat. There can be a LOT of sugars and quickly-converted starches in a small bowl of cereal with milk for example.

If one is heading out on a strenuous bike ride immediately following breakfast, the resulting combined slowing of digestion and metabolic uptake of sugars may reduce blood sugar swings noticeably, and with the insulin response actually having the positive effect of driving carbohydrate into the muscles and liver as stored energy. But these are quantitative effects that must be adjusted to suit conditions. If you're having to drive your car some distance to the ride start after breakfast for instance, then that's probably plenty of time for your blood sugar to "spike" in a not-so-good way.

The recommendation to increase protein intake with each meal can improve the balance between insulin and another hormone called glucagon. Glucagon tends to mobilize fat while insulin favors carbohydrate being stored ultimately as fat unless used it is soon used by the muscles. Protein itself can cause an insulin spike of it's own however, so here is where quantities of all foods must be moderated, especially in the absence of strenuous physical activity.

Obviously then, big meals are bad unless it's mostly vegetables and water as the main ingredients (something like soup or stew can be eaten in larger quantities).

Lastly, one's liver, muscle and fat cells are key players in the regulation of blood sugar and blood lipid levels, so maintaining a lower bodyfat level and greater muscle mass will allow blood sugar to be better regulated with the pancreas not having to secrete as much insulin. Liver enzyme tests are commonly taken these days as part of one's annual exam, and any mention of "elevated liver enzymes" or less than "very good" blood pressure should be cause for immediate "evasive" action in terms of one's diet-vs.-exercise ratio.

[John H.]

"Feel like I am gaining waistline"? It is pretty easy to quantify that- Use a scale.

It might be extra calories that you don't need.

On the surface the Atkins drink is fairly low calorie, high protein and low carb- But it is highly processed food (like there highly processed foods)- It should be a goal to reduce that-
Atkins also has a lot of crap ingredients like sunflower oil, dipotassium phosphate, sodium hexametaphosphate, acesulphame potassium, and sucralose.

Find out why your blood sugar is low and treat accordingly.

As others have mentioned, usually you need less processed carbs, more fiber, and possibly more and better fats.


Seek to educate yourself on current diet science. Many/most doctors do not know much about this. And they don't spend enough time reviewing your history or interviewing you to even know your specific needs.

[Rpoole8537]

Listen to your Doctor. BTW what is your height and weight and age?

I’m 6’2”, 180 lbs and 63 yo. Been riding 29 years.

[DfCas]

Lots of wrong info on here. i suggest you see an Endocrinologist that works with a dietician. You need to determine why your regulatory mechanisms are letting your BS levels go too low.

Normally low BS people are instructed to eat small, balanced meals frequently, but you may have a medical condition that needs addressed.

[pincopallinobis]

This is a group of tremendous collective knowledge.
Some people, about certain subjects, but definitely none about you, your body, your history, your situation, your etc., etc., etc., etc.

Why ask on a cycling forum about purely personal health issues and questions, especially risky ones, with no real facts in hand? It doesn't make any sense. Do people ask on medical forums how to adjust their derailleurs?

DfCas reply is the only rational one so far.

And ask your doctor why he or she seems somewhat unconcerned. "Eat more protein" is really not a very specific, acceptable answer, is it?

[Spaghetti Legs]

Low blood sugar causing symptoms, if you are not taking medicine for diabetes (or bonking on a long bike ride), is very unusual and not typically something you manage with tweaking your diet. Keep working with your doc on it.

[pdxharth]

I was diagnosed as hypoglycemic in 8th grade. Now, at 52, I am finally balancing my blood sugar in an effective manner. Others have offered good advice, so I’ll just tell you what has worked for me. I’m a vegetarian, so I will just use the word protein and you can fill in the blank with whatever you choose. BUT, I totally agree that diet is only one component and you need to get the cause figured out first and foremost.

Coffee intake - I used to drink it all day long, but once I learned about caffeine’s effect on blood sugar, I limited it to the morning only. No more coffee after those first couple cups. This has really helped in the afternoons.

Large, high protein breakfasts - Today, for example, I ate two eggs over half a veggie burger w/cheddar, which was on top black beans, salsa, and quinoa. Lots of protein, minimal carbs, and very filling and tasty. That alone balances me out for much of the day. Breakfast is now my biggest meal of the day.

Note: because I have a long commute, I eat breakfast at work. That gives me over an hour’s ride before eating, which has been great.

Light lunches with protein and complex carbs - stir fries over brown rice, roasted veggies w/protein with a small bit of pasta, brown rice, or quinoa. Burrito with no rice, just beans, cheese, avo and protein, and stuff like that.

Light dinners, but I don’t worry about a lot of protein for dinner, though there is always some.

Snacks - this may be my most important tool - toasted nuts or peanuts. I always carry them with me. No dried fruit or anything else, just nuts. I also keep a dark chocolate bar in my desk just in case a sweet tooth calls, but I eat it with my nuts and only a little each day.

With all that, my biggest downfall is my beer in the evening - bad for blood sugar, for sure. But I have pretty much stopped eating sweets for dessert, so I enjoy my beer without worrying about it. If I want a late snack, it’s fruit and nuts or a piece of cheddar.

I rarely feel a blood sugar crash these days. It’s kind of freeing, in a way, and I’m very thankful for it.

Good luck.

Harth

[makoti]

Some people, about certain subjects, but definitely none about you, your body, your history, your situation, your etc., etc., etc., etc.

Why ask on a cycling forum about purely personal health issues and questions, especially risky ones, with no real facts in hand? It doesn't make any sense. Do people ask on medical forums how to adjust their derailleurs?

While you are correct about no one here knowing the particulars of the OP's situation, we tend to ask such things, not looking for hard rules to follow but for others experience with a similar issue. You'll find questions about all sort of non-cycling related issues.
And, BTW, WebMD says take you bike to a decent mechanic, so it's done right the first time.

[Bentley]

I have an issue with low blood sugar. I'm scheduled to have more blood tests tomorrow, and a scan of my pancreas. My doctor feels that diet is my greatest challenge. I'm thinking of getting a dietician, but I want to get my fasting blood work back first. I have been drinking Atkins chocolate drinks at night, and my morning levels have increased. But, despite my riding and exercising, I feel like I'm gaining waistline!!! Doctor's advice has been very general, "eat more protein". This is a group of tremendous collective knowledge. Any ideas and suggestions will be appreciated.
Thanks in advance.

i go to a "wellness" doctor, my only "chronic" issue is a slow thyroid, but my Doc has me on a low glycemic index diet. Basically it is a math excercise, add protein, Fat and Fiber, if that is greater than total carbs you are good to go.

You will find most prepared foods are "carb laden", even healthy things like "yogurt". i find it makes me a more conscious eater.

One other point is to be careful about "dieting", not eating regularly and working out can fool your body into thinking its in starvation mode and stifle weight loss.

Im over 60, losing weight is not easy

Ray

[Rpoole8537]

I was diagnosed as hypoglycemic in 8th grade. Now, at 52, I am finally balancing my blood sugar in an effective manner. Others have offered good advice, so I’ll just tell you what has worked for me. I’m a vegetarian, so I will just use the word protein and you can fill in the blank with whatever you choose. BUT, I totally agree that diet is only one component and you need to get the cause figured out first and foremost.

Coffee intake - I used to drink it all day long, but once I learned about caffeine’s effect on blood sugar, I limited it to the morning only. No more coffee after those first couple cups. This has really helped in the afternoons.

Large, high protein breakfasts - Today, for example, I ate two eggs over half a veggie burger w/cheddar, which was on top black beans, salsa, and quinoa. Lots of protein, minimal carbs, and very filling and tasty. That alone balances me out for much of the day. Breakfast is now my biggest meal of the day.

Note: because I have a long commute, I eat breakfast at work. That gives me over an hour’s ride before eating, which has been great.

Light lunches with protein and complex carbs - stir fries over brown rice, roasted veggies w/protein with a small bit of pasta, brown rice, or quinoa. Burrito with no rice, just beans, cheese, avo and protein, and stuff like that.

Light dinners, but I don’t worry about a lot of protein for dinner, though there is always some.

Snacks - this may be my most important tool - toasted nuts or peanuts. I always carry them with me. No dried fruit or anything else, just nuts. I also keep a dark chocolate bar in my desk just in case a sweet tooth calls, but I eat it with my nuts and only a little each day.

With all that, my biggest downfall is my beer in the evening - bad for blood sugar, for sure. But I have pretty much stopped eating sweets for dessert, so I enjoy my beer without worrying about it. If I want a late snack, it’s fruit and nuts or a piece of cheddar.

I rarely feel a blood sugar crash these days. It’s kind of freeing, in a way, and I’m very thankful for it.

Good luck.

Harth

I really like your breakfast menu! Morning is the worst time of day because I wake up famished. I don't dare drink coffee before I eat and even then I have only one cup. Someone mentioned riding as soon after breakfast can assist with balance. I'm retired now so that is possible on most days. I know that always seems to help my mood and my energy. I have reached out to a couple of dietitians and a wellness coach though my insurance company. Responses to this post has assisted me in knowing what questions and information are important.I'll know more when I get more blood test results.

[dustyrider]

Reduce carbohydrates, in particular simple or refined carbohydrates. Bread, pasta, anything sugary or starchy, that sort of thing. Track everything you consume through a fitness app (MyFitnessPal, etc.) if you are not already doing so. Try intermittent fasting, e.g., eat only during a 16 hour window, abstain (including calories consumed through drinks) during the remaining 8 hours.

I think you reversed those numbers. Eat only during an 8 hour window and fast for 16. Not that this is a solution to the OPs particular medical issue, but it really feels like it changes the way the body works after a while.

[velofinds]

Good catch. Correct, I meant the other way around. (A 16hr eating window would be great though!)

[oldpotatoe]

Caffeine increases the secretion of insulin and adrenaline in a poorly-regulated way, so that one's insulin response to any given carbohydrate "load" may exceed the necessary duration needed to control one's blood sugar.

An obvious result is that one's blood sugar "dips" too low (after first peaking) an hour or two after a meal, particularly when the meal has a relatively-high glycemic load.

Adding fat and/or soluble fiber to a meal will slow the entry of sugars into the bloodstream, which will do two things:

1) It will reduce the insulin response to the meal.
2) It will extend the time that the meal supplies sugars into the bloodstream.

Both of these effects will reduce the "dip" in one's blood sugar in the hour or hours following a meal.

Having coffee with sugar, especially first thing in the morning would thus be particularly bad, as the stomach and upper G.I. system is empty upon waking, so entry of the caffeine and sugars is particularly rapid.
Adding starchy foods to this with breakfast really compounds the problem, so one should be aware of where quantities of sugars are "hiding" in all of the foods one likes to eat. There can be a LOT of sugars and quickly-converted starches in a small bowl of cereal with milk for example.

If one is heading out on a strenuous bike ride immediately following breakfast, the resulting combined slowing of digestion and metabolic uptake of sugars may reduce blood sugar swings noticeably, and with the insulin response actually having the positive effect of driving carbohydrate into the muscles and liver as stored energy. But these are quantitative effects that must be adjusted to suit conditions. If you're having to drive your car some distance to the ride start after breakfast for instance, then that's probably plenty of time for your blood sugar to "spike" in a not-so-good way.

The recommendation to increase protein intake with each meal can improve the balance between insulin and another hormone called glucagon. Glucagon tends to mobilize fat while insulin favors carbohydrate being stored ultimately as fat unless used it is soon used by the muscles. Protein itself can cause an insulin spike of it's own however, so here is where quantities of all foods must be moderated, especially in the absence of strenuous physical activity.

Obviously then, big meals are bad unless it's mostly vegetables and water as the main ingredients (something like soup or stew can be eaten in larger quantities).

Lastly, one's liver, muscle and fat cells are key players in the regulation of blood sugar and blood lipid levels, so maintaining a lower bodyfat level and greater muscle mass will allow blood sugar to be better regulated with the pancreas not having to secrete as much insulin. Liver enzyme tests are commonly taken these days as part of one's annual exam, and any mention of "elevated liver enzymes" or less than "very good" blood pressure should be cause for immediate "evasive" action in terms of one's diet-vs.-exercise ratio.

Ya know, sometimes your very wordy and IMHO, oftimes too complicated explanations of bike stuff gets an eye roll from me but the above detailed explanation is very impressive. Methinks your 'talents' might be wasted on bike subjects..:)

Retired scientist/medical professional who has found a more simple lifestyle wrenching on bikes?

[DfCas]

Glucagon causes the liver to release glycogen, to elevate glucose levels. It is used by diabetics for rescue from low blood sugar. I have some in the cabinet.

Adrenalin/epinephrine and nor epinephrin are counteregulatory hormones, meaning they elevate glucose.

The original poster needs to see an endocrinologist to make sure a bad disease is not present. To simply seek diatery tweaks without knowing the problem is madness.

[dddd]

Ya know, sometimes your very wordy and IMHO, oftimes too complicated explanations of bike stuff gets an eye roll from me but the above detailed explanation is very impressive. Methinks your 'talents' might be wasted on bike subjects..:)

Retired scientist/medical professional who has found a more simple lifestyle wrenching on bikes?

Early in my career I worked in a hospital, in a blood analysis lab, all quantitative stuff. Much of this was toward getting prototype semi-automated equipment certified.

I ended up doing mechanical and process engineering, but not in the last decade or so.

These days, I spend more time doing things that feel healthier, more riding of course but also construction work and always trying to make old bikes work better than they ever could (with the subtle application of newer consumable parts and of careful assembly and mostly-invisible modifications).
There's also things like rural-scale yard work that are a healthy way to spend time, and I am fortunate to have finally overcome the symptoms from a rheumatic/autoimmune illness that struck about six years ago. I made a firm decision to keep riding daily through the worst years of that, so I suffered none of the weight gain usually associated with the prolonged use of corticosteroids.

[oldpotatoe]

Early in my career I worked in a hospital, in a blood analysis lab, all quantitative stuff. Much of this was toward getting prototype semi-automated equipment certified.

I ended up doing mechanical and process engineering, but not in the last decade or so.

These days, I spend more time doing things that feel healthier, more riding of course but also construction work and always trying to make old bikes work better than they ever could (with the subtle application of newer consumable parts and of careful assembly and mostly-invisible modifications).
There's also things like rural-scale yard work that are a healthy way to spend time, and I am fortunate to have finally overcome the symptoms from a rheumatic/autoimmune illness that struck about six years ago. I made a firm decision to keep riding daily through the worst years of that, so I suffered none of the weight gain usually associated with the prolonged use of corticosteroids.

Good for you....best wishes to you...

[dddd]

Thanks, oldpotatoe, and thanks for helping me get a belated, abbreviated introduction out.

[hotspur.serotta]

Lots of wrong info on here. i suggest you see an Endocrinologist that works with a dietician. You need to determine why your regulatory mechanisms are letting your BS levels go too low.

Normally low BS people are instructed to eat small, balanced meals frequently, but you may have a medical condition that needs addressed.

Best advice here. Since this could have serious ramifications, find a doctor or specialist who takes your condition seriously.