Do you reach for a snack when you feel your energy levels drop mid-afternoon? Or maybe you’re just the opposite: lunch makes you so sleepy, you feel like curling up under your desk for a nap?

I’m going to let you in on a little secret…

The only thing eating should make you feel is not hungry.

If meals either give or drain your energy, that’s a sure sign you’re dealing with blood sugar dysregulation such as hyperglycemia, hypoglycemia, and insulin resistance.

Unstable blood sugar causes everything from cravings to mood disorders. It can hold you hostage from your ideal weight, cause inflammation, and even impact fertility. Not to mention, it can be the start of blood-sugar related diseases like Type 2 diabetes and Alzheimer’s (which is sometimes called Type 3 diabetes!). 

On the other hand, stable blood sugar is the secret to reducing inflammation, having stable energy, better sleep, a better mood, and balanced hormones. I’ve even seen stable blood sugar have a positive impact on relationships (that’s why I always carry snacks for my toddler… and my husband!)

The bad news is that blood sugar issues are one of the most common problems I see in practice… but the great news is that there is an entire suite of things we can do to bring blood sugar back into balance. 

 

What Are Normal Blood Sugar Levels? 

Blood sugar is exactly what it sounds like: the amount of sugar in our blood. When we eat carbohydrates, they are broken down by the body into a simple sugar called glucose. Glucose crosses from the small intestine into the bloodstream where it can be taken up by the mitochondria – the “powerhouses”of our cells – and converted into energy, called adenosine triphosphate (ATP). 

This process is helped along by key hormones like insulin and glucagon. Insulin is released by the pancreas and helps lower blood sugar levels by allowing sugar to enter the mitochondria, as well as be stored in the liver and muscles as glycogen, or stored in fat. Glucagon works in the opposite direction: it helps free stored glucose to raise blood sugar levels when they drop too low.This give and take is extremely important, as the body thrives when blood sugar remains stable – not rising too high or dropping too low. 

When blood sugar levels are chronically low, it is called hypoglycemia. People with hypoglycemia often feel tired, anxious, or unfocused when they are hungry – and a meal helps energize them and allows them to focus. On the other hand, those with hyperglycemia (also called insulin resistance) have blood sugar levels that are too high. They feel tired after eating. Many people have symptoms of both hypo- and hyperglycemia at different times. 

According to the American Diabetes Association (ADA), normal fasting blood sugar is below 100 mg/dL. Levels between 100-125 indicate pre-diabetes, and anything over 126 when fasting is considered diabetic. After eating (postprandial), the ADA considers 70-140 mg/dL to be normal.

But, what’s “normal” isn’t necessarily optimal. Fasting glucose can be “normal,” but you may still experience glucose spikes over 140 mg/dL throughout the day. Instead, I prefer to look for these signs of optimal blood glucose levels:

• Fasting: 70-90 mg/dL
• Postprandial: Below 120 with a return to pre-meal glucose levels within 2 hours (ideally below 100)

(For how to find your blood sugar levels, see “Testing Your Blood Glucose and the Benefits of Continuous Glucose Monitoring” below.)

 

What Is Hypoglycemia and What Causes Hypoglycemia?

Hypoglycemia is low levels of blood sugar, generally less than 70 mg/dL when fasting. 

A Lactate dehydrogenase (LDH) level below 140 is also a sign of hypoglycemia.

Clinically, a person with hypoglycemia is often on the thinner side, and a “healthy” eater. However, they may skip meals (or just never feel hungry – only realizing they need to eat when they are shaky, foggy, or depressed), then have a mid-day crash, anxiety, and irritability. They often have strong sugar cravings in the afternoon or after dinner. When they do finally eat, they have improved energy and mental function-  but it doesn’t last long! They also often struggle to stay asleep, as they don’t have the necessary glycogen stores. 

The main complaints I see with hypoglycemia are:

• Fatigue, especially an afternoon or mid-day crash, or between or after meals
• Insomnia, trouble staying asleep or falling asleep
• Mood swings
• Anxiety
• Depression
• Hair thinning
• Infertility and hormone imbalances
• Impaired metabolism or weight gain

What causes hypoglycemia? The main culprits I see are a habit of missed meals, high-sugar snack, using caffeine or nicotine to suppress appetite, eating sweets or snacks instead of meals, and overtraining without properly replenishing glucose. 

Low blood sugar can also be the first step toward developing insulin resistance and hyperglycemia. Low blood sugar causes a stress response, where cortisol rises and catecholamine spikes, to “save” low blood sugar, which can cause nervousness, shakiness, and anxiety. Catchelomanes also suppress appetite, masking hunger and leading to more hypoglycemia.

 

What Is Hyperglycemia and What Causes Hyperglycemia?

Hyperglycemia is elevated blood sugar levels, with a morning fasting glucose above 99 mg/dL (though I prefer to see it below 92!), and levels after meals rising above 140 mg/dL. It is also signaled by an HBA1c above 5.6, though this marker isn’t always accurate. Fasting insulin levels above 5 indicate mild hyperglycemia, while levels above 10 indicate pre-diabetic levels of hyperglycemia. 

If not addressed, hyperglycemia can intensify into diabetes, where fasting glucose is above 126,  HBA1c is above 7, and fasting insulin is above 20.

Clinically, people with hyperglycemia often complain that after they eat, they feel fatigued, have impaired mental function, and often crave sugar. Chronic inflammation is another hallmark of hyperglycemia, and may present as anything from chronic joint pain to acne to autoimmune disease. Frequent urination is another key sign of hyperglycemia I look for. Finally, those with hyperglycemia often have a very hard time exercising, but once they do, have notable improvements in energy levels. 

Hyperglycemia and insulin resistance are often used interchangeably. Hyperglycemia is simply the state of having high blood sugar – it could be a one-time thing due to a particularly high-carb or sugary meal. Insulin resistance, on the other hand, is a result of ongoing, sustained high blood sugar, which tells the pancreas to constantly make more insulin to help lower blood sugar levels back down. Over time, the body becomes less sensitive to elevated levels of insulin, and essentially “stops listening” – keeping blood sugar levels high.

 

What Are the Root Causes of Insulin Resistance?

Chronic stress, eating too many highly processed carbs, and lack of exercise all play a role in the development of hyperglycemia and insulin resistance. However, there are other factors at play that aren’t as simple to control as skipping the bun on your burger.

For instance, people with polycystic ovarian syndrome (PCOS) are genetically prone to be less insulin sensitive, even with a “perfect” diet.

In addition, the normal phases of the menstrual cycle can have a major impact on blood sugar levels. As progesterone rises in the week before your period starts, insulin resistance also increases, leading to elevated blood sugar levels. In addition, progesterone can also increase cravings for carbs and sugary foods, intensifying the problem. (It can also tank workout performance and hinder proper recovery!) On the other hand, estrogen, which rises during the follicular phase, actually increases insulin sensitivity. 

For these reasons, I recommend people workout harder and eat more whole-food carbs during the follicular phase, then reduce carbs and do lighter training in the luteal phase. Use the last week of your cycle as a recovery period, and prepare to bounce back hard right after your period ends.

 

Testing Your Blood Glucose and the Benefits of Continuous Glucose Monitoring

You might have some symptoms of hyper or hypoglycemia, but the only way to know for certain is with blood glucose monitoring. I recommend continuous glucose monitoring with a monitor like NutriSense. This little device is convenient, painless, doesn’t require any finger sticks, and gives you 24-hour-a-day data on your glucose levels. Plus, you can wear it during workouts, sleeping, and everything in between.

Continuous glucose monitoring allows you to see the impacts of everything you do on your blood sugar levels – these are just some of the things I like to pay attention to:

• The types of carbs you eat whole food vs. processed)
• Eating carbs with or without other foods
• The time of day you eat carbs
• Workouts
• Sleep
• Menstrual cycle
• Stress
• Meditation and stress management techniques

You can use this information to optimize your lifestyle for wellbeing and glucose control. You may have never guessed that eating an apple alone at 10 AM would give you a crazy blood sugar spike – but now that you know it does, you can make a point to pair it with almond butter. 

One other test I use with those with hyper or hypoglycemia concerns is the ION panel. This gives us a look at nutrient levels, so that we can make personalized supplement recommendations – like adding key blood-sugar control nutrients like magnesium, folate, and other B vitamins. 

Elevated levels of Pyruvate, L-Lactate, and/or B-Hydroxybutyrate on an organic acids panel (like the ION/Organix or the OMx) are also potential signs of impaired insulin metabolism. But, because other things – like a strict ketogenic diet or deficiencies of specific nutrients such as CoQ10, B1, or pantothenic acid – can cause elevations in these markers, I only consider them in the context of other symptoms or lab markers. 

 

Food, Fiber and Supplements to Help Stabilize Blood Sugar Levels

Fortunately, if your blood glucose levels aren’t stable, there is a lot you can do about it! 

First up, let’s talk about what you can do at meals. Start with a glass of water with 2 teaspoons of apple cider vinegar mixed in. Next, take a look at your plate. Start by eating the greens on your plate – and if there aren’t greens (ideally you’re having greens with every meal) – instead grab a serving of fiber like PureLean Fiber, or Glucomannan Caps if you are on the go (I prefer powder in water as it works better!).

Once you’ve had your greens/fiber, move on to eating your protein and fat. Make sure you’re prioritizing eating enough protein – especially early in the morning. Finally, go ahead and eat your carbs as the last component of your meal. Bonus points if you eat meals containing carbs earlier in the day, as most people are more insulin sensitive in the morning and early afternoon. (And avoid refined carbs and added sugars, in general). If you find that you’re sleepy after meals, it’s simply a sign you ate too many carbs at one time. 

When you’re done eating, go for a walk. And if you don’t have time to walk, even just doing a few squats can really help. And when you’re done with dinner, be done, and skip those bedtime snacks. A 12-hour fast (from dinner to breakfast) is an easy goal to aim for. But just be aware: fasting longer than your body likes can actually backfire and drive cortisol levels up, so stick to 12-13 hours to start. If you’re not sure about the ideal fast length for your body, a continuous glucose monitor can help clue you in. 

Away from the table, actively minimizing stress is key. Stress causes increases in cortisol, and cortisol spikes also spike glucose. If you don’t believe me, just look at your continuous glucose monitor. My glucose has gone up during a couple’s therapy appointment! Sleep is also essential: getting less than 6 hours of sleep per night increases insulin resistance. 

I also encourage all my clients to fix any underlying gut health issues, especially an imbalanced microbiome. A lack of butyrate-producing bacteria decreases insulin sensitivity, which many of the proteolytic bacteria are gram-negative and contain pro-inflammatory LPS, which causes or  increases insulin resistance. 

Hormones play an important role, as well. In women, getting support for hormone balance early on in the peri-menopausal window (after around age 35 for most of us) is essential. Keeping levels of progesterone and estrogen adequate maintains insulin sensitivity. The decline in estrogen that eventually occurs can push up to 40% of women into pre-diabetes or diabetes at menopause. Alternately, having too much testosterone as a woman can make you more insulin resistant (like in many cases of PCOS). Progestin-containing birth control pills have the same effect, as they convert into androgen-like substances in the body. In men the opposite is true: too little testosterone can cause insulin resistance.

And finally, grab some weights: research has shown that building muscle is one of the best tools we have for improving insulin sensitivity. 

For my clients, I also like to create custom supplement plans utilizing these nutrients:

• Alpha LIpoic Acid – one of the only substances actually known to recondition insulin receptors to make them more sensitive over time!
  
• Vitamin B1 (Thiamine) – shown to improve glucose tolerance.
• Chromium  – regulates and enhances the effects of insulin.
• Myo-inositol and D-Chiro-Inositol- reduces glucose variability and improves fasting blood glucose.
• Berberine – lowers blood sugar comparably to the drug Metformin, increasing insulin sensitivity and production.
• Magnesium – low consumption of this mineral is associated with poorer blood sugar regulation and a higher risk of type 2 diabetes. 

Other herbs I use include fenugreek, cinnamon, bitter melon, pycnogenol, and gymnema, among others.  

 

Get Personalized Help with Your Blood Glucose Levels

 Whether you’re dealing with hyperglycemia or hypoglycemia, insulin resistance, or even a diagnosis like diabetes, you have the power to take back control and help your body (and blood sugar) get back into balance.

For a customized plan, step-by-step support, and expert guidance, the first step is to book a free, no-obligation discovery call with my health team.

Learn about how we work with clients to achieve their unique health goals and help them step back into radiant health, so they can stop worrying about how they feel and start living a purposeful life. 

>>> Book your free discovery call here