Also indexed as: Low Blood Sugar, Reactive Hypoglycemia
When blood-sugar levels fall fast, symptoms such as fatigue and
anxiety may arise. Simple changes can control many cases of hypoglycemia. According to
research or other evidence, the following self-care steps may be helpful:
- Choose foods with fiber
- Stabilize your blood sugar by eating fiber from whole grains,
beans and other legumes, vegetables, and fruit
- Eat light, eat often
- Spread out your meals during the day to sustain a consistent
supply of absorbable sugar
- Give chromium a go
- Take 200 mcg a day of this essential mineral to help stabilize
blood sugar swings
- Cut back on refined carbs
- Avoid carbohydrates that are quickly absorbed, such as sugar and
white flour, which may trigger hypoglycemic reactions
- Say no to alcohol and caffeine
- To improve blood-sugar control, reduce or eliminate alcoholic and
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full hypoglycemia article for
more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
“Hypoglycemia” is the medical term for low blood sugar (glucose).
Occasionally, hypoglycemia can be dangerous (for example, from injecting too much insulin). It may also indicate a serious underlying
medical condition, such as a tumor of the pancreas or liver disease. More often, however, when
people say they have hypoglycemia, they are describing a group of symptoms that occur when the
body overreacts to the rise in blood sugar that occurs after eating, resulting in a rapid or
excessive fall in the blood sugar level. This is sometimes called “reactive
Many people who believe they have reactive hypoglycemia do not, in fact, have low blood
sugar levels,1 and many people who do have low blood sugar levels do not have any
symptoms of reactive hypoglycemia.2 Some evidence suggests that reactive
hypoglycemia may be partly a psychological condition.3 Consequently, some doctors
believe that reactive hypoglycemia does not exist.4 Most doctors, on the other
hand, have found reactive hypoglycemia to be a common cause of the symptoms listed below.
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What are the symptoms?
Common symptoms of hypoglycemia are fatigue,
anxiety, headaches, difficulty concentrating, sweaty palms, shakiness, excessive hunger,
drowsiness, abdominal pain, and
A diet of frequent, small, high-protein, low-carbohydrate meals is often recommended. If
illness prevents eating, hospitalization for intravenous glucose injections is typically
required. In cases of pituitary or adrenal insufficiency, hormone replacement may be
prescribed. For hypoglycemia due to an insulin-producing tumor, surgical removal of the tumor
is usually recommended.
Dietary changes that may be helpful
Doctors find that people with hypoglycemia usually improve when they eliminate refined sugars and alcohol from their diet, eat foods
high in fiber (such as whole grains, fruits,
vegetables, legumes, and nuts), and eat small, frequent meals. Few studies have
investigated the effects of these changes, but the research that is available generally
supports the observations of doctors.5 6 7 8 Some
symptoms of low blood sugar may be related to, or made worse by, food allergies.9
Even modest amounts of caffeine may
increase symptoms of hypoglycemia.10 For this reason, caffeinated beverages (such
as coffee, tea, and some soda pop) should be avoided.
Some people report an improvement in hypoglycemia episodes when eating a high-protein,
low-carbohydrate diet. That observation appears to conflict with research showing that
increasing protein intake can impair the body’s ability to process sugar,11
possibly because protein increases insulin levels12 (insulin reduces blood sugar
levels). However, some doctors have seen good results with high-protein, low-carbohydrate
diets, particularly among people who do not improve with a high-fiber,
Vitamins that may be helpful
Research has shown that supplementing with
chromium (200 mcg per day)13 or
magnesium (340 mg per day)14 can prevent blood sugar levels from falling
excessively in people with hypoglycemia.
Niacinamide (vitamin B3) has also been found to be helpful for hypoglycemic
people.15 Other nutrients, including
vitamin C, vitamin E, zinc,
copper, manganese, and vitamin B6, may help control blood sugar levels in diabetics.16 Since there are
similarities in the way the body regulates high and low blood sugar levels, these nutrients
might be helpful for hypoglycemia as well, although the amounts needed for that purpose are
Glucomannan is a water-soluble dietary
fiber that is derived from konjac root (Amorphophallus konjac). In a preliminary
trial,17 addition of either 2.6 or 5.2 grams of glucomannan to a meal prevented
hypoglycemia in adults with previous stomach surgery. A trial of glucomannan in children with
hypoglycemia due to a condition known as “dumping syndrome” produced inconsistent
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
1. Palardy J, Havrankova J, Lepage R, et al. Blood glucose measurements
during symptomatic episodes in patients with suspected postprandial hypoglycemia. N Engl J
2. Kwentus, JA, Achilles JT, Goyer PF. Hypoglycemia etiologic and
psychosomatic aspects of diagnosis. Postgrad Med 1982;71(6):99–104.
3. Johnson DD, Dorr KE, Swenson WM, Service J. Reactive hypoglycemia.
4. Yager J, Young RT. A non-editorial on non-hypoglycemia. N Engl J
5. Sanders LR, Hofeldt FD, Kirk MC, Levin J. Refined carbohydrate as a
contributing factor in reactive hypoglycemia. South Med J 1982;75:1072–5.
6. Permutt MA. Postprandial hypoglycemia. Diabetes
7. O’Keefe SJD, Marks V. Lunchtime gin and tonic as a cause of
reactive hypoglycemia. Lancet 1977;1:1286–8.
8. Hofeldt FD. Reactive hypoglycemia. Metabolism
9. Rippere V. “A little something between meals”: masked
addiction not low blood blood-sugar. Lancet 1979;1:1349 [letter].
10. Watson JM, Jenkins EJ, Hamilton P, et al. Influence of caffeine on
the frequency and perception of hypoglycemia in free-living patients with type 1 diabetes.
Diabetes Care 2000;23:455–9.
11. Anderson JW, Herman RH. Effects of carbohydrate restriction on
glucose tolerance of normal men and reactive hypoglycemic patients. Am J Clin Nutr
12. Ullrich IH, Peters PJ, Albrink JA. Effect of low-carbohydrate diets
high in either fat or protein on thyroid function, plasma insulin, glucose, and triglycerides
in healthy young adults. J Am Coll Nutr 1985;4:451–9.
13. Anderson RA et al. Chromium supplementation of humans with
hypoglycemia. Fed Proc 1984;43:471.
14. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium
15. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug
Cosm Ind 1981;129(4):68–69,104–5.
16. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J
Advancement Med 1991;4:57–71.
17. Hopman WP, Houben PG, Speth PA, Lamers CB. Glucomannan prevents
postprandial hypoglycaemia in patients with previous gastric surgery. Gut
18. Kneepkens CM, Fernandes J, Vonk RJ. Dumping syndrome in children.
Diagnosis and effect of glucomannan on glucose tolerance and absorption. Acta Paediatr