by Jennifer Crystal
Hypoglycemia and Lyme Disease
The first symptom of tick-borne illness that I experienced was one I’d never heard of: hypoglycemia. I was working as a summer camp counselor in the woods of Maine and had just finished a morning teaching water sports in the hot sun. As I walked into the dining hall for lunch, I suddenly felt the room was spinning. The chatting campers morphed into a blur of color. I sensed the blood draining from my face and grabbed onto a bench before my legs gave out. Friends held my arms and got me to an adjacent counselors’ room, where I lay down on a couch. “You must be dehydrated,” one said.
I shook my head and said, “I’ve been drinking water all morning.” Despite lying down, I still felt like I might faint. My palms were sweaty and my heart raced. One counselor put her hand on my foot as a gesture of reassurance. I panicked. “I can’t feel your hand,” I cried as my whole body started to shake. “My feet are numb!”
What I could feel, however, was a plastic spoon that had suddenly been placed in my mouth. I tasted the sweet syrup of blueberry pie. “Eat this,” I heard the camp nurse say. Dutifully, I swallowed spoonful after spoonful. Within minutes, my body calmed down. Sensation returned to my extremities. I stopped sweating, and my heart stopped racing. My cheeks flushed, and the blurry faces came back into view. The nurse held my hand and said soothingly, “You had a low blood sugar reaction. You need to get checked for diabetes.”
Tests showed that I was not diabetic, but I was hypoglycemic, a condition I’d never heard of before. I learned that after a meal is consumed, food breaks down into glucose, releasing insulin from the pancreas to give a person energy. For most people, when their supply of energy is low, glucagon compensates and sends stored sugar from the liver to the bloodstream. For people with hypoglycemia, this exchange does not always happen, causing blood sugar levels to drop. A dangerously low dip can produce all of the symptoms I have just described, as well as extreme hunger, nausea, headache, weakness, fatigue, lack of coordination, irritability, and loss of consciousness.
My doctor at the time didn’t seem concerned with why I had suddenly developed this condition. He just told me to keep snacks on hand. It wasn’t until eight years later, when a Lyme literate physician put together all the symptoms I’d experienced since that first episode—including frequent blood sugar crashes, flu-like aches and fatigue, fevers, migraines, hallucinogenic nightmares, insomnia, and burning extremities—that I learned hypoglycemia can be caused by the tick-borne illness babesia, which my body had been harboring all that time.
Many Lyme and babesia patients experience hypoglycemia and also find themselves treated by doctors who aren’t familiar with the connections. As a result, hypoglycemics, like myself, also struggle with weight management, and with the frustration and embarrassment of having to interrupt social interactions or work meetings to eat, often at inopportune times.
Over the years, I’ve learned a few tricks for minimizing blood sugar crashes:
- Avoid sugar—This may seem counter–intuitive to the remedy given by my camp nurse—and to the fact that you are trying to raise blood sugar—but what I described was an acute reaction. If your blood sugar crashes like that, then, yes, sugar will help you boost it. The problem, though, is that it may boost it too high, and then you’ll just crash again later. To avoid these peaks and valleys, it’s best to eliminate sugary foods altogether. I eat natural sugars like honey, fruit, and agave nectar, but even those I consume in small quantities. I never eat sugary foods on their own.
- Familiarize yourself with the glycemic index—The International GI Database explains: “The glycemic index is a ranking of carbohydrates on a scale of 0 to 100 to the extent to which they raise blood sugar levels after eating. Foods with a high GI are those which are rapidly digested and absorbed and result in marked fluctuations in blood sugar levels.” Obviously, straight up sugar has a high GI; glucose comes in at 96. But you’d be surprised what other seemingly healthy foods rank high on the GI list: bananas are a 70, while certain apples are only a 28. Bananas still have health benefits, but an apple will keep your blood sugar stable for longer.
- Avoid processed foods—The more a food is processed, the greater chance it has added sugar. Bread, crackers, and cookies, even if they’re gluten and sugar-free, contain lots of simple carbohydrates that will quickly turn into sugar in your body. Even eating all-natural applesauce will raise your blood sugar more than a whole apple. Keep it simple!
- Eat a good mix of protein and carbs—Protein gives you sustained energy, while carbohydrates give you a quicker rise; I find my body needs both to function well. If I don’t eat protein, my blood sugar will crash shortly after a meal, but if I don’t eat carbs, I feel nauseous. Having a mix of both at every meal and snack helps me stay stable throughout the day.
- Focus on complex carbohydrates—Whole grains such as quinoa and rice will keep your blood sugar steadier—and keep you fuller longer—than simple carbohydrates. I do eat sandwiches on gluten-free bread, but not every day. Instead I try to make lunches of salad with turkey or chicken, and corn chips; or quinoa with stir-fried vegetables and tofu; or brown rice with chicken.
- Eat every few hours—Have a well-balanced breakfast, lunch, and dinner, but have a morning and an afternoon snack, too. If you’re worried about calories, these meals and snacks don’t need to be big—just enough to keep your energy, and your blood sugar, steady. Your body needs good, healthy calories to get better!
- Carry snacks—The advice the doctor gave me long ago was sound. I always carry a protein bar and/or some nuts or fruit in my purse. Always. You never know when your blood sugar is going to drop, and you don’t want to have to make a scene in line at the post office—where there is no food.
- Eat before you’re hungry—If you wait until you’re starving, your blood sugar is already low, and you’re going to need to eat more to bring it up. Then you’ll probably raise it too high, putting you at risk for a crash.
- Look for sugar everywhere—Sugar shows up in the strangest places, like salad dressing, marinade, spaghetti sauce and soup. Always check labels!
- Eat something with protein before bed—It’s not good to go to sleep on a full stomach, but a snack such as a piece of cheese or a small protein shake will keep your blood sugar steadier during the night, decreasing those 3:00 a.m. stumbles to the kitchen for orange juice.
Perhaps most importantly, keep the big picture in mind. You’re going to have some sugar. I eat a piece of dark chocolate every day. That’s made some people say, “See, you do eat sugar.” But in the grand scheme of things, I eat a very small amount; that one treat contains four grams of sugar. I choose it as my cheat, but I avoid sugar in other products, so that my overall daily intake is low. Will I have brownies sweetened with agave nectar at the holidays? You bet. I’ll probably have two. But the next week, I’ll be back to apples and nuts, salad and rice. It’s okay to indulge to a degree during this sweets-filled period between Halloween and New Year’s. But if you keep these general tips in mind, you should be in good shape.
Opinions expressed by contributors are their own.
Jennifer Crystal is a writer and educator in Boston. She is working on a memoir about her journey with chronic tick borne illness. Contact her at email@example.com.