If hypoglycemic, get further tests

Dear Dr. Gott: I’m interested in information on low blood sugar. I think I have this condition, but I can’t afford professional analysis. Thus, I have to cope with minor bouts of anxiety, lightheadedness, rapid heartbeat and occasional vertigo. Will diet alone cure my problems?

Dear Reader: When the blood-sugar level drops too low (usually less than 40 milligrams per deciliter; normal is 75-100), some people experience palpitations, anxiety, sweating, fatigue, hunger and lightheadedness.

I say “some people” because the phenomenon is far from universal; healthy young athletes, for example, may experience no symptoms from low blood sugar (hypoglycemia).

Conversely, otherwise healthy individuals can experience the symptoms I mentioned even though their blood-sugar levels may exceed 50 mg/dL. Therefore, the diagnosis of hypoglycemia depends on two criteria: documentation of a sugar level below 40 mg/dL with the simultaneous appearance of symptoms.

In most cases of bona fide hypoglycemia, the cause is unknown. For some reason, after a carbohydrate-rich meal, the level of insulin in the bloodstream overshoots, driving the sugar down too far. In a few cases, however, this insulin overabundance may be the result of a tumor in the pancreas, the digestive gland that produces insulin.

Thus, any person with hypoglycemia (as shown by blood testing) should also be checked for a pancreatic tumor, using ultrasound, CT scanning and sophisticated blood tests, including serum insulin levels.

I’ve subjected you to this rather technical treatise for two reasons.

One, hypoglycemia has been a “designer disease” in the past. Naturally nervous and anxious persons have inappropriately latched onto this disorder as a facile way of explaining what is apparently a purely emotional condition.

Two, if you really have hypoglycemia, you should undergo further medical tests to rule out a tumor.

Having said this, I will add that trying a diet for a while won’t hurt you and, in the absence of the unlikely tumor, may actually help.

• Avoid alcohol and concentrated sweetsand foods containing corn syrup, a commercial sweetener.

• Eat several small meals a day, in preference to two or three large ones.

• Consume a high-protein diet, using complex carbohydrates (grain and flour products) in moderation.

• Snack on fruit, if snacks are necessary.

Again, I advise you to see a doctor if this diet doesn’t effectively relieve your symptoms within two weeks.

To give you related information, I am sending you a copy of my Health Report “Hypoglycemia.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.