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Low Sugar Causes: What Are They and How Do You Deal with Them?

Blood sugar fuels your body, so keeping your level in the normal range helps you feel energetic and allows cells to operate as they should. Throughout the day your blood sugar levels naturally fluctuate. A number of variables play a part in this changing level. If your sugar levels stay within the normal range, you won’t even notice the changes. In this article will discuss some low sugar causes as well and what you can do if your blood sugar gets low.

If your blood sugar falls below normal far enough, you may begin feeling some of the symptoms of hypoglycemia, or low blood sugar. If your levels stay below the normal range long enough, some significant physical changes can occur.

What is Low Blood Sugar?

An image of a person massaging his templesTypically, if your blood sugar falls below 70 milligrams per deciliter (mg/dl), your blood sugar is low. As a result, your body doesn’t get the fuel it needs to function properly.

Insulin, released by the pancreas, helps your body’s cells take in sugar from your bloodstream. And too much of it can cause a person with diabetes to fall into low blood sugar.

But you don’t have to be diabetic to suffer from low blood sugar.

Symptoms of Low Blood Sugar

If your blood sugar gets low, you may feel any or all of the following symptoms.

  • Difficulty concentrating
  • Shaky
  • Dizzy
  • Moody
  • Hungry
  • Have difficulty focusing your eyes
  • Confused
  • You may pass out
  • Headache
  • Nervousness or anxiety
  • Irritability or impatience
  • Nausea
  • Fast heartbeat
  • Feeling sleepy
  • Feeling weak

Hypoglycemia Unawareness

If you experience low blood sugar frequently, you may not experience symptoms. When this occurs, it is called hypoglycemia unawareness. People with this condition don’t know when their blood sugar levels get low. As a result, they become more at risk for severe low blood sugar reactions that may necessitate help from others.

With this condition, you may not awaken at night when your blood sugar drops too low. Therefore, this makes it very important for you to check your blood sugar level often.

Two Types of Non-Diabetic Hypoglycemia

When considering low sugar causes, there are two types of non-diabetic hypoglycemia to know. Reactive hypoglycemia usually occurs within a few hours after eating. Fasting hypoglycemia may relate to a more serious condition. The two types of hypoglycemia result from different low sugar causes.

Reactive Hypoglycemia

We don’t know all of the reasons a person might suffer from reactive hypoglycemia. Aside from having had stomach surgery and rare digestive enzyme deficiencies, however, it usually involves too much insulin in your blood at the wrong time.

If you suffer from Adrenal Fatigue Syndrome (AFS), you may experience reactive hypoglycemia when you consume a meal with too many carbohydrates. The excess of carbohydrates leads to your pancreas releasing a large amount of insulin that continues to work after digestion takes place. As a result, your blood sugar level falls. Consequently, you may be at risk of developing diabetes if you experience reactive hypoglycemia.

Fasting Hypoglycemia

Non-reactive, or fasting, hypoglycemia does not associate with meals. But it may indicate an underlying health condition. Some of the low sugar causes in this category can include:

  • Drinking too much alcohol, which inhibits your liver from producing glucose.
  • Some medications such as salicylates, sulfa drugs, pentamidine, or quinine.
  • Disorders affecting the liver, heart, or kidneys.
  • Adrenal and pituitary disorders, which control key hormones like cortisol.
  • Tumors in the pancreas or a type of tumor that produces proteins called IGF-II that has a structure similar to insulin.

Low Sugar Causes

Adrenal Fatigue and Low Cortisol Levels

An image of a woman using a glucometer on the couchLet's take a closer look at how some of these factors lead to low blood sugar levels.As noted above, AFS can affect your blood sugar levels. AFS results from your adrenals becoming fatigued due to an overwhelming demand for cortisol to fight the effects of stress. And when your adrenals can no longer supply sufficient cortisol, reactive hypoglycemia becomes more likely. As a result of lower cortisol, blood sugar also decreases after an initial surge at the beginning of stress. This leads to hypoglycemia because of the increased insulin released to counter the initial surge of glucose.

A related mechanism, the NeuroEndoMetabolic (NEM) stress response helps maintain homeostasis of your body in the face of chronic stress.

One of its six inter-related circuits, the bioenergetics circuit, plays a major role in the regulation of blood sugar. If this circuit becomes dysregulated, your body begins going into a catabolic state to conserve energy. As a result, reactive hypoglycemia occurs. Likewise, when the bioenergetics circuit becomes dysregulated, insulin levels become unbalanced, leading to problems with blood sugar levels. As stress continues, your body requires more glucose to fuel the cells.

Any imbalance in insulin leads to low blood sugar and less energy available for your body. Therefore, stress can cause multiple continuing problems due to low energy. In addition, added to low thyroid levels that typically result from this dysregulation, low blood sugar leads to a slowed metabolism and increased feelings of fatigue.

Kidney Problems

Another of the low sugar causes, kidney disorders lead to a slowing down of the processing of medications and body waste. Consequently, medications can build up in your bloodstream, causing low blood sugar.

Pancreatic Tumor

Although rare, a pancreatic tumor can cause hypoglycemia. In this condition, your pancreas produces too much insulin, which then leads to lower blood sugar levels.


Newer insulin types do not cause the drops in blood sugar, especially overnight, that regular insulin might. Using insulin pumps may lower the risk of low blood sugar as well. Using the wrong type of insulin, too much insulin, or injecting it directly into muscle instead of just under the skin can all cause low blood sugar.

Food and Low Sugar Causes

The types of foods you eat can bring on low blood sugar. One of the low sugar causes related to insulin is eating too few carbohydrates without decreasing the amount of insulin injected if you suffer from diabetes.

In addition, the timing of insulin injection should change, depending on whether your carbs come in liquid or solid form. Liquid carbs absorb into your body much faster than solid carbs, so the timing of your injection can become tricky.

Likewise, the composition of your meals can affect blood sugar. Amounts of fats, proteins, and fiber affect the absorption of carbohydrates. If you eat a high carbohydrate meal, insulin is produced in higher amounts, trying to bring the glucose into your cells quicker, therefore making your blood sugar drop even quicker in 1-2 hours after the meal, causing reactive hypoglycemia to worsen right after eating and having the need to eat again soon after.

Physical Activity and Low Sugar Causes

For people with Type 1 diabetes, exercise can lower blood sugar levels in the near term and longer. Research indicates about half of the children with Type 1 diabetes who exercise for an hour in the daytime experience low blood sugar that night. Timing, duration, and intensity of exercise all affect the risk of low blood sugar.

What To Do If Your Blood Sugar Is Low: The 15-15 Rule

An image of a glucometer, sugar cubes, apples, and a stethoscope scattered on a pink surfaceIf you experience low blood sugar, typically below 70 mg/dl, remember the 15-15 rule. Consume 15 grams of carbohydrates to raise your blood sugar level, wait 15 minutes, and check it again. And if it still reads low, repeat the 15 grams of carbs. Keep repeating the process until your blood sugar reaches at least 70 mg/dl. Then eat a meal or snack to keep it at a normal level.

The carbohydrates can include:

  • Glucose tablets (come with instructions)
  • 4 ounces (1/2 cup) of juice or regular soda (not diet)
  • 1 tablespoon of honey, or sugar
  • A gel tube (comes with instructions)
  • Gumdrops, hard candy, or jellybeans (look at the food label to tell how many)

This should only be used for those with actual low blood sugar. If you feel like you have low blood sugar but upon checking your sugars are not lower than 70 mg/dl, don't eat more sugar because it could worsen the sugar spikes and drops that you feel. The reactive hypoglycemia that comes with adrenal fatigue should be combatted by eating fewer carbohydrates and always having protein or fat when you're eating any form of carbohydrates.

Conclusions Regarding Low Sugar Causes

Low sugar causes do not always mean diabetes. People without diabetes can also experience low blood sugar due to a number of reasons. Normally, blood sugar fluctuates during the day. But if your blood sugar falls below 70 mg/dl, you need to address the issue. If you experience the symptoms of low blood sugar, remember the 15-15 Rule. People with AFS may be more prone to experiencing hypoglycemia symptoms when their sugar reading is normal. They should have food containing fats and proteins to ensure a slow release of carbohydrates into the body.

What Can You Do?

If you are suffering from low blood sugar or experience any of the low sugar causes, here are a few things you can do to alleviate the situation.

  1. Become aware of the symptoms of low blood sugar.
  2. Check your blood sugar level frequently if you are diabetic or experience low blood sugar often.
  3. If you suffer from AFS, lowering stress and supporting adrenal health are important for decreasing the risk of reactive hypoglycemia.
  4. Remember the 15-15 Rule.
  5. Watch your diet to be sure you consume adequate levels of carbs, protein, fats, and fiber.

Whatever course of action you decide to take, however, please do so with the guidance of your healthcare professional who can help you decide the best option for you.

If you would like to know more about or need assistance with low sugar causes or low blood sugar, the team at Dr. Lam Coaching can help. We offer a free** no-obligation phone consultation at +1-626-571-1234 where we will privately discuss your symptoms and various options. You can also send us a question through our Ask The Doctor system by clicking here.

© Copyright 2021 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

Low sugar causes include experiencing reactive hypoglycemia, eating the wrong foods or wrong combination of foods, exercising too much, using the wrong or too much insulin, suffering from adrenal problems, drinking too much alcohol, or reacting to some medications or taking another person’s medications.

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