anxiety and low blood sugar
Anxiety can be directly caused by fluctuations in blood sugar levels. This is an extremely common underlying cause of anxiety, and most people aren’t aware. Why does this happen?
Because your brain’s #1 job is survival.
And when levels of its two most important resources (oxygen and glucose) dip lower than your brain is comfortable with, your brain will do anything in its power to correct it. If your blood sugar drops, the healthy response is for your brain to send you a hunger signal, so that you eat food to increase glucose.
If that signal doesn’t go through, or you don’t hear it, your brain will use another strategy to increase blood sugar: stress hormones.
Your brain starts a cascade of events, mobilizing glucose from storage in the muscles and liver by increasing stress hormones—levels of cortisol and adrenaline (epinephrine). These stress hormones not only raise glucose, but facilitate the entire fight-or-flight response in reaction to a perceived threat. This physiological state can cause sensations of racing heart, sweating, panic, fear, tremors, shaking, stomach pain and nausea, loose stools, distractedness, lightheadedness, and other symptoms.
Here’s a flow of what happens:
Blood sugar drops —> hunger signal fails —> stress hormones rise —> anxiety surges
To put it simply, if your body responds to low blood sugar with a stress response, you’re likely to feel anxious.
Another slightly more sneaky way that low blood sugar causes anxiety relates to a neurotransmitter called GABA.
GABA is referred to as a “downer” neurotransmitter and is considered your brain’s calming hormone. GABA requires steady supplies of glucose to be produced, because it is made from a byproduct of sugar metabolism. When blood sugar levels drop, the available fuel is used to keep your glucose up, and less fuel is funneled into making GABA in the cells. Low GABA levels are directly related to symptoms of anxiety.
Everyone’s physiology is unique. Not everyone gets anxiety when they forget to eat.
We all respond differently to fluctuations in blood sugar. Some people can go long periods without eating and maintain steady mood and energy. This doesn’t necessarily mean it’s healthy for those people to skip meals; it’s possible that person is unaware of the more subtle body cues that might inform them of their need to eat. But other individuals very clearly show symptoms of low blood sugar when they’re undernourished. These people often need food every few hours and, if they go too long without eating a full meal, begin to feel symptoms creeping in. This latter scenario is an opportunity to learn how to listen to your body and meet its needs through nutrition.
A few possible causes of hypoglycemia
A few possible causes and triggers of hypoglycemia include mineral deficiency, adrenal insufficiency, history of trauma, chronic stress, biotoxin illness malnutrition, maldigestion, and diabetes.
What can we do about the link between blood sugar and anxiety?
Below are some of the steps I instruct my patients to take when Here are a few foundations to keep in mind that can help you support balanced blood sugar and the health of your mind and body.
Eat early
Going more than an hour without food in the mornings (even on days you don’t feel hungry for breakfast!) can put stress on your system that sets you up for a rocky day. Building in a breakfast routine can help your body ready itself for food simply out of ritual. Adding things like warm lemon water, apple cider vinegar, bitter tinctures, and diaphragmatic breathing can all help stimulate our parasympathetic nervous system and help increase hunger cues.
Eat often
This is related to the “eat early” part. If you tend toward hypoglycemia, waiting too long between meals can disrupt blood sugar and trigger symptoms. Bring awareness to your mood and energy in relation to the timing of your meals. Start to notice how long after a meal you start to feel symptomatic – 30 minutes? Four hours? It will depend on what you eat. If half a plain bagel, your blood sugar will spike and drop fairly quickly. If a full meal with fats and proteins in addition to carbohydrates, it will be much longer. Your metabolism is unique. Learn your own patterns through mindful awareness of how you feel.
Eat enough
It’s common to eat a really small breakfast, or sort of skip lunch, especially when we’re in a low-level stress response with minimal hunger cues. But meals with insufficient calories and fuel will only sustain your body for a short time, and once that fuel is used up, it will need to mobilize more glucose for energy, with those stress hormones, causing that fight-or-flight response. This is similar to the “eat often” part in that it requires an exploration of your body’s unique needs.
Eat balanced
The types of foods we eat have a large impact on our mood. You know how it feels to have a meal of mostly simple carbs—the good-feeling high energy comes before the crash, fatigue, and possible fight-or-flight response of reactive hypoglycemia. Also notice how you feel with other, potentially more balanced meals. The internal states might feel more subtle than that high and crash, and maybe less obvious.
A stable blood sugar is supported by more protein, fat, complex carbohydrates, and fiber, with less sugar and processed grains. This doesn’t mean sugar is bad—food is neutral and carries no moral value. We’re addressing how food makes you feel so that you feel better equipped to make choices that support your mental health.
Listen to how your body responds to different foods, and amounts of foods. Maybe you find that a whole bagel with cream cheese sends you into an anxious mess in three hours, but half a bagel with two eggs feels more stable. You get to experiment and decide. In general, more refined carbohydrates than your body requires, and less protein/fat/fiber than your body requires, will contribute to patterns of hypoglycemia.
In summary, fluctuations in blood sugar may be contributing to your anxiety symptoms.
This is a cause of anxiety that can be resolved and requires you to get to know your own response to foods.
Resist the urge you might feel to completely control your food intake surrounding this issue—that kind of stress could actually contribute to the underlying cause.
Allow this information to gently inform your food choices and remind you to build awareness around your body’s unique needs, and know that your wise body will guide you.
Sometimes as we’re making changes in support of our mental health goals, some of the changes require us to show up with our “mamma bear” energy to play the role of parent, creating a bit more routine and firmer boundaries out of love.
This might feel the opposite of intuitive at times (i.e. choosing to plan meals, anticipating needs before they arise, etc.) but could also awaken a new expression of self-love that eventually feels aligned with who you want to be. Shifting your physiology toward a more stable blood sugar will take time, commitment, and building new rituals around food. It might include some trial and error, but it is 100% possible.