iThei mdcdaelcinfd o c elllllrllll ThofthThseHashimoto’s Carbohydrate Metabolism Abnormalities
Some people with Hashimoto’s may be unable to tolerate any fruit or starchy
vegetables, especially at first. Up to 50 percent of people with Hashimoto’s
were found to have abnormalities in carbohydrate metabolism.
After carbohydrate consumption, blood sugar levels increase, which trig-
gers insulin release to normalize blood sugar levels. Reactive hypoglyce-
mia is an excessive release of insulin within four hours of eating carbohy-
drates, which leads to low blood sugar levels.
Symptoms of low blood sugar may include mental fog, blurry vision,
sleeping difficulties, palpitations, fatigue, dizziness, sweating, headaches,
depression, irritability, anxiety, sweet cravings, stuffy nose, panic attacks,
numb/cold extremities, confusion, nausea, and hunger.
Low blood sugar levels are defined as <50 mg/dL, but some people may
experience symptoms of low blood sugar at even higher levels. (Normal
fasting ranges of blood sugar vary between 70 and 100 mg/dL.)
Adrenergic Postprandial Syndrome
When our blood sugar gets too low, a counter-regulatory response from
our autonomic adrenergic system occurs. Epinephrine and glucagon are
released to counteract the low blood sugar when blood sugar drops below
50 mg/dL. In people with adrenergic postprandial syndrome, epinephrine
and glucagon may be released at higher blood sugar levels. These individu-
als experience the same unpleasant symptoms of hypoglycemia due to the
epinephrine, but their actual blood sugar levels may come out normal.
Nighttime Symptoms
A hypoglycemic state can occur in the middle of the night. People may
experience night sweats, nightmares, and anxiety, or the person may have
no symptoms at all. This hypoglycemia causes the adrenals to create more
cortisol to raise the blood sugar back to normal, and cortisol winds up
depleted by morning, leading to difficulty waking up. Drinking tea with
coconut oil at bedtime may be helpful.
Treatment
The treatment for reactive hypoglycemia and postprandial syndrome
consists of a low-carbohydrate diet with frequent smaller meals. Small
meals should be added in mid-morning and afternoon, when blood sugar
starts to decline.