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Hypoglycemia or calorie deprivation: a focus on food

March 18, 2014

Weight LossFat HealthExerciseEating DisordersMy Boring-Ass LifeDickweedDiet Talk

Trigger warning: Talk of eating disorders, restrictive eating and eating enough calories for minimum function.

I’ve struggled with hypoglycemia-like symptoms for years — more years than I can remember. My doctor finally diagnosed me with hypoglycemia and recommended eating every two to three hours, or eating when symptomatic. The odd part is that I don’t experience my symptoms except for when I’m active.

Even light housework can make me sick to my stomach, dizzy, weak, and shaky. So, I dutifully did as my doctor asked and monitored my symptoms based on when, how much, and what I ate. The final score? It doesn’t seem to matter. What I eat or when I eat hasn’t had an effect on my symptoms one way or the other.

So I got to think about Shaunta’s recent journey to eat enough for her body and wondered whether my problem is not hypoglycemia, but calorie deprivation? After all, these symptoms are very close to what many eating disorder (ED) patients, including myself, experienced when not eating enough. When I was eating 300 calories a day, I was often dizzy, sick, weak, and shaky.

The thing is, I’ve been in recovery for three years. So why are my symptoms not improving? Well, having thyroid disease means that I am often too tired and sleep through meals. It also means I’m rarely hungry, so I often skip meals; one to two meals a day is pretty normal for me and I only average 1,400-1,700 calories on a day when I’m eating a solid three times. So if I’m eating fewer calories than that from less than three meals a day, then it’s not unreasonable to think something might be connected here. Especially lately, as my diet has only gotten more restrictive. Not only am I vegan which, let’s face it, is naturally pretty low calorie, but I’m also gluten free and have recently been put on an extremely restrictive autoimmune elimination diet. So even when I’m not skipping meals because I’m asleep or not hungry, I’m skipping meals because I just don’t know what the heck to eat!

I’m cautious about bringing this up to my doctor though because he’s, well, a fatphobe and obsessed with me losing weight. When he put me on the autoimmune elimination diet he was convinced the “pounds will just melt away,” even though I have not lost a single pound and I’m pretty sure I’ve gained a few. Maybe because of the hypothyroidism, maybe because my body is perpetually stuck in starvation mode because I’m not feeding it enough, maybe because genetics have stubbornly put my set point squarely at a size 22 and 280lbs. I’m not sure.

What I do know is that I love being active. And that doesn’t always mean going to the gym, although I do love that too. But I also love gardening and walking with my son and redecorating and fixing things up and cleaning (yes, when I’m in a good mood, I love to clean), but these are all things I cannot do when I feel this sick every time I try to accomplish anything. Doing the dishes shouldn’t make me feel like I’m going to hit the floor or make my stomach churn. It’s gotten unbearable.

So, I’ve committed to eating five times a day. I don’t want to count calories, not even to make sure I’m eating enough, because it’s triggering and, well, let’s face it: a pain in the ass.  If eating five times a day doesn’t work, then I’ll count whatever I need to, but first things first. Eat solidly throughout the day.

I want to give a special shout out to Shaunta for going on her wonderful food journey to eat enough to nourish her body because if she hadn’t, I may seriously have never thought to do the same. Eating very little has been my way of life since I was 15 years old (I’m almost 29 now so, wow, 14 years). It’s almost unthinkable for me to eat up to 2,000 calories or more a day!

I was on a diet once where I had to fluctuate between eating 2,500 calories a day and eating 1,000 calories a day. Let me tell you, for me personally, eating 2,500 was tough, even though I was only a vegetarian at the time and not vegan. I felt like I was constantly eating and constantly full.

I may not need that much to function or make my symptoms disappear, but whatever I’m eating now just doesn’t seem to be enough. But here’s where I need your advice: should I keep this experiment secret from my fat-hating doctor? Or should I tell him flat out that I think I’m eating too little and watch his head explode when I say I want to eat more?

15 Comments leave one →
  1. March 18, 2014 9:41 am

    I can’t wait to read about how much better you feel! You got this. You do. Eating consistently, the same number of calories everyday, has had big benefits for me as far as keeping my blood sugar from falling.

  2. March 18, 2014 9:56 am

    I too have struggled with low blood sugar for a long time, but thankfully I can control it by eating every 3-4 hours, even if it’s just a snack and making sure I nail breakfast.

    As for what you should or shouldn’t tell your doctor, that’s up to you. Personally, I would keep my experiment to myself for a little while and see if it worked. If it has positive results, share with him later. If not, no harm, no foul. Good luck!

  3. Twistie permalink
    March 18, 2014 9:58 am

    I’m not sure what you would be better off doing in re: telling your doctor, but I do think you’re taking a good step, here.

    Here’s a thought! Maybe you should do your experiment for a while, and when you’ve got a significant period of time without dizziness, etc. then tell him how you accomplished it.

    Best of luck with the experiment!

  4. Nof permalink
    March 18, 2014 10:19 am

    I hope you feel better!

    I’ve never used it, but there’s an app called Recovery Record that’s a food-logging application specifically geared toward ED recovery. It seems to be very highly rated. If you need to start food logging, that might be a less triggering way to do it?

  5. March 18, 2014 10:22 am

    I’m so glad you’re making moves to look after and care for yourself. I think that Shaunta has inspired us all.

    And, as an added bonus, we can have even more fun watching the trolls suck off their own faces with rage. Win win.

  6. March 18, 2014 12:54 pm

    “should I keep this experiment secret from my fat-hating doctor?” I say absolutely yes. When you see a podiatrist you don’t tell him/her about your gynocological symptoms, do you. Of course if you wanted to she/he probably wouldn’t listen anyway. But the thing is this — he isn’t just a fat-hater. He is uneducated, ignorant, about food and nutrition and all the stuff that you and I and the rest of us have learned so painfully. He hasn’t learned any of that. They are impressed with themselves having graduated from medical school and think they know everything. They don’t. And what they don’t learn in medical school they make up, i.e., they adopt as their scripture all the b.s. diet talk that comes out of ignorance and prejudice. My g.i. dr. is pretty good about most things g.i. related but one day I asked him if he believed in the doctrine of calories in/calories out and he assured me that he does. I told him that was stupid; it was a belief like the one that insists the world is flat and the sun circles the earth and our planet is only 4000 years old. Nonsense. I simply won’t talk with him again about any issues related to us. Why bother telling him? He won’t have anything sensible to say. Do your experiment and tell us what you learn.

  7. Carrie permalink
    March 18, 2014 1:06 pm

    For SOME people (I am one of them) it isn’t how much you eat but what you eat that keeps your blood sugar low. Have you had your fasting insulin tested? My blood sugar has been low since they started testing it (in my 20’s) but no one ever knew why. Fast forward to my late 30’s and I read about hyperinsulinemia; a body that makes too much insulin. Insulin drops blood sugar and it packs on fat. Certain high glycemic index foods cause a sharp rise in insulin to deal with the fast rise in blood sugar these foods create. That sudden drop in blood sugar makes a person hungry, light headed, dizzy shaky and crabby.

    So far; no one is sure why some people have hyperinsulinemia (high insulin) but it could be caused by early ( during childhood) caloric deprivation (I was put on a diet at 2 months old because the doctors back then said I was a “fat baby”).

    My fasting insulin was 29.5, it should be 10 or under. So I researched what foods cause high spikes in blood sugar and found ,most processed foods, most white foods, most starchy foods, and most refined foods cause it. So I stopped eating them. I did lose some weight but i am still at 284 lbs and fat but I FEEL BETTER and no longer get dizzy. I eat a lot of food but I don’t have low blood sugar crashes or headaches or dizziness or shakes like I used to.

    I did this not to lose weight but to feel better and I DO feel better. I have tons of energy now. I found my body cannot have grains of any kind, legumes, or potatoes of any kind without these spiking my blood sugar and then my insulin and then that drops my blood sugar and I get headaches and all the rest. Not everyone has the problems with all those foods; I had to do an elimination diet to figure that out but now I eat a lot and feel a lot better and though I am still technically fat (by American weight standards) I am very healthy (by the blood pressure, cholesterol, fasting blood sugar and fasting insulin and healthy heart standards).

    I just thought I would pass that on. It isn’t about weight loss; it is about feeding your body what your body needs and no one size way of eating fits everyone. Good luck with finding what your body needs and feeling better!

    • April 21, 2014 1:45 pm

      You may already know this, but thought I should mention this. High insulin levels are very common with PCOS, Polycystic Ovarian Syndrome. Many women with PCOS find that they are extremely sensitive to grains (esp gluten) and do best when they increase the protein levels and fat levels in their intake, while decreasing carbs or certain types of carbs.

      PCOS may be associated with problems with insulin signaling; some women with PCOS find a lot of help with myo-inositol or d-chiro-inositol, which helps improve insulin signaling so your body doesn’t need to produce as much insulin.

      No one can say from your description whether this is an issue for you but you might want to check into it.

  8. March 18, 2014 1:07 pm

    I was just thinking about the period when the hot diagnosis was hypoglycemia. There’s always a hot diagnosis. It’s not that those problems don’t exist; they do. They are real. It’s just that there’s always one that is the disease du jour. These days it’s gluten intolerance. Which I have. I’m a genuine celiac disease person with ulcerative colitis and many many allergies. So I talked it over with my husband trying to remember which decade the disease du jour was hypoglycemia. He thinks it was the 1970s, I just can’t remember when it was. But when it was the one everyone was talking about and being tested for the diet everyone who was diagnosed as hypoglycemic was just the one you are proposing for yourself. That is, frequent small meals. I think there was a resurgence of interest in the that way of eating maybe a decade or so later. Then it was called “grazing.” Is that familiar to you? I am happiest or perhaps I should say feel best when I eat that way.

  9. March 18, 2014 2:33 pm

    I’m so glad you posted this! I just had my doctor test my blood sugar because I was feeling so hypoglycemic–my blood sugar always tends to run low. It wasn’t low, was normal. Then I realized I am hardly eating. I have no appetite. Food is hard to eat with my dry sore mouth/throat. But I know I feel better when I eat regularly throughout the day. Still, the little voice in my head keeps telling me not to eat. Even though I, too, am fascinated with Shaunta’s journey!

  10. March 18, 2014 2:42 pm

    Reblogged this on The Cheese Whines and commented:
    I hope you’re able to start feeling better. My situation is different, as I never have low blood sugar. The whole “this will just melt away pounds” thing drives me crazy. As a diabetic, I have to count carbs, but I don’t count calories because it’s too triggering. What I do know is that I’m eating a lot less calories than I did when I had an actual appetite, and I’m certainly eating a lot less simple carbohydrates. I’m fairly physically active. I can’t do extremely strenuous physical activities due to asthma, mitral valve prolapse, and joint and spine problems, but I do a minimum of an hour a day of moderate physical activity a minimum of four days a week. Have the pounds “just melted away?” I guess if losing the ten pounds of retained fluid when my kidneys started functioning properly again counts, then yes. Beyond that, the scale still reads 300 pounds.
    What I care about is the fact that my blood sugar, blood pressure, and kidney function are now normal. I can’t allow myself to care about the number on the scale, or I’ll begin sabotaging myself.

  11. purple peonies permalink
    March 19, 2014 1:28 pm

    i can relate to this so much! i’m vegan and glutenfree, with some food allergies, and i was sick for a very VERY long time before i got to this point with my eating. i’ve also been hypoglycemic for a very long time as well, much longer than i’ve been eating in a way that makes me feel my best.

    when i’ve talked to doctors since the hypoglycemia dx, many of them were awful: they say that’s a precursor to diabetes. (vague future health threat! fuck the current health threat!) they say it *is* diabetes, i just haven’t tested positive for it yet. (wut?) and they say that i couldn’t possibly have low blood sugar because i’m eating too much, or else i wouldn’t be so fat.

    stupidly, at one point, when i realized i literally was not eating enough, and that was contributing to the problem, i tried to talk to a doctor about this. they were awful. just awful. they did NOT believe me that i wasn’t eating enough. it was impossible for me to be starving myself (or else i wouldn’t be so fat). i’m just not eating “right,” and i need to lose weight. it devolved into me defending my health nut food choices and the doctor thinking i’m a liar in denial about my fatness. (i tried to talk to more doctors about this, and got the same response.)

    that’s not to say that there arent doctors who believe us when we talk about food. and that there arent doctors who believe you can have restrictive eating and still be fat. but i haven’t found any.

    the short answer: i wouldn’t tell your doctor. they’re uneducated about nutrition and proper eating anyway, let alone intuitive eating. if you make changes that improve your health greatly, it might be worth mentioning to the doctor after the fact and make sure it’s noted in your chart when you talk about it, so it’s documented in your permanent record. but the best thing i ever did for my food-related health was to STOP talking to doctors about it unless there was a very specific issue. (like telling my allergist that i have a gluten reaction from eating oats. or telling a GP that eating steak to keep my iron levels up is not a suitable recommendation for me, citing my now-non-negotiable veganism and a past history of increased cholesterol when eating animal products.)

    i wish you the very best of luck and health. i hope you can find a system that works!! when i first went glutenfree and started discovering new allergens, i was having blood sugar drops ALL THE TIME. i was terrified of eating, so i didn’t, but even when i did, like you said– what i CAN eat is naturally low in fuel. i found if i bumped up my fat intake, it helped a LOT. protein made a big difference too (that was my trick early on with hypoglycemia: eat lots of protein with the carbs so they stick around longer), but what i really needed was fat. and that was a big ol’ mindfuck, after years of eating a nearly-no-fat diet (i had gall bladder pains that magically went away after going glutenfree, but prior to that i would just avoid eating fat that triggered the pains, and also fat is bad for fat people, amirite?? just another great excuse to trigger someone’s disordered eating. thanks docs!)… it turns out i really needed dietary fat. ymmv, and all that, but mostly i was just saying: OMG I RELATE SO MUCH.

    thanks for this post.

  12. hlkolaya permalink
    March 19, 2014 2:27 pm

    wow! thanks SO much for all the comments everyone! I’m glad y’all enjoyed this particularly little rant/complaint of mine and i’ll take your advice and NOT tell my doc what I’m doing. I have to say that eating more has been a lot harder than I thought it would be with having almost no appetite, but I think I’ll manage if I just keep at it 😉

  13. Jennifer Hansen permalink
    March 20, 2014 1:23 am

    Are you using the autoimmune gut repair diet plan outlined here:

    http://thyroidbook.com/blog/autoimmune-gut-repair-diet/

    Three things jump out at me:

    First, is raw food a prior decision on your part or a feature of your autoimmune diet? If it is a prior decision on your part, do the benefits of continuing a raw food diet concurrently with the autoimmune diet outweigh the potential expansion of your food options if you decided to eat cooked food? Several of the vegetables on the recommended list are, IME, more digestible when eaten cooked, especially sweet potatoes, and being able to prepare a rapidly assimilable dinner in the slow cooker in the morning or in the microwave at the last minute might help you increase your intake. But you know whether eating raw food produces benefits for you that outweigh any potential benefits from eating cooked foods.

    Second, fat, fat, fat fat fat: All kinds of unsweetened coconut products are allowed in the diet behind the link. Is this a feature of your autoimmune diet? I also see avocados (as I posted under your previous post) and olive oil. Working as much of these as feels satisfying into your diet seems to me to be a priority, because fat = strength. Could you snack on a “gorp” made from unsweetened coconut and dried low-glycemic fruit, or a handful of olives? Salads with oil and vinegar dressing, the avocado recipes I talked about earlier…hey, is coconut milk drinkable as-is? Can you make low glycemic fruit smoothies out of it? With the cream as well?

    Third, as wrenching as the decision would be, do you foresee a time when your self-preservation might require you to eat the full list of foods, including animal foods? The autoimmune diet I found recommends against grains, nuts (although I see that your doctor isn’t calling for you to drop these), seeds (ditto), legumes, and mushrooms. This cuts off many non-animal sources of iron and the B12 vitamins. On the other hand, the version I am looking at gives a pass to an extremely limited list of animal foods, which could fill in the nutrient gaps. I am not saying that you can’t maintain health on a combination vegan and autoimmune eating plan, but if you do experience symptoms of deficiency, and supplements don’t seem to be helping, it may be time for a damned hard decision. I really hope you don’t have to take this option, because I know that veganism is most often a deeply important personal choice.

    I hope that some of the above is helpful in some way.

  14. March 20, 2014 5:55 am

    *cheers you on*

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