Hypoglycemia and Relapse

The Role of Blood Sugar Regulation in

Addiction and Recovery

Christina Veselak, LMFT, CN

Sugar and Carb Consumption Astronomical

??? Lbs sugar consumed annuallyRefined carbohydrates are

themselves addictiveContribute to obesity, cancer and

diabetes

What About Addicts?Sugar is often suggested to offset a craving!

Many people gain significant weight in early recovery!

Most treatment programs do not teach healthy eating, cooking or shopping.

Many residential programs allow their clients to have unlimited amounts of soda, candy, and refined carbohydrates

Why Is This a Problem?The human body is not designed to

metabolize such large amounts of refined sugar or carbohydrates, and reacts in very

predictable ways.

What is Reactive Hypoglycemia?.

Disturbed Glucose Metabolism

low blood sugar levels or a

precipitous drop in blood sugar levels

high carb meal or challenge

Reactive HypoglycemiaPrimary Relapse Trigger

For ALL ADDICTIONS

It can be genetic, and runs throughout alcoholic families.It afflicts at least 80% of all alcoholicsIt was probably present prior to the onset of alcoholism,

but is clearly present following abstinenceRate is unknown for other addictsDry Drunk or PAW symptoms closely resemble

Hypoglycemic Sx5 Hr Glucose Tolerance Test recommended, not required

Typical Process Causing Reactive Hypoglycemia

Eating a high carbohydrate meal with lots of simple sugars

Dramatic rise in blood sugar levels.

Over-production of insulin

Dramatic drop in blood sugar levels

Release of adrenaline to release stored sugar

Symptoms and Cravings

Patterns of Glucose Metabolism

Symptoms of Hypoglycemia

HYPOGLYCEMIA DRY-DRUNK/PAWIrritabilityDepressionAggressivenessInsomniaFatigueRestlessnessConfusionDesire to Drink or UseNervousness

IrritabilityDepressionAggressivenessInsomniaFatigueRestlessnessConfusionDesire to Drink or UseNervousness

Glucose Tolerance Test Interpretation

Type 1 (Neuroglycopenic)This type results in a rapid rise in blood glucose within the first hour followed by a pronounced or precipitous drop in blood glucose in the second hour. Symptoms of this type of response are rapid mood swings, volatile personality, erratic behavior before and after eating. Possible cause of this response is gastric dumping, too large an insulin response (pancreatic problems) and glucose tolerance factor problems (liver problems).

Type 2 (Adrenergic Type)After ingestion of glucose the blood sugar rises for the first three hours followed by a hypoglycemic rebound at 4 to 6 hours. Symptoms associated with this type of response are tiredness 2 hours after eating, allergic responses or food intolerances, and shakiness before meals. When blood sugar falls rapidly, the early symptoms are those brought on by a compensating secretion of adrenalin; these include sweating, weakness, hunger, racing pulse and an "inner trembling". This response can be due to adrenal cortical insufficiency or thyroid deficiency

Type 3 (The Flat Curve Response) In this case the blood glucose does not deviate more than +/- 15% from fasting level through the whole test. Symptoms that may appear are fatigue, apathy or hypotonia (poor muscle tone). These symptoms are due to poor digestion and absorption of nutrients.

How Does Hunger Cause Relapse?Conditioned Response:

DOC used to restore equilibrium

A hungry brain goes off-lineLess self-controlLess impulse controlLess access to sobriety skills

Alcohol Lowers Blood Sugar!Alcohol is not metabolized as a carbohydrateIt is O on the glycemic indexIt stimulates insulin release and causes

insulin resistanceIt is metabolized before other sources of

energy because it is a toxinIt blocks gluconeogenesis in the liver2 oz is enough to dangerously lower blood

sugar levels

To Control HypoglycemiaHypoglycemia Diet:

Eat protein and complex carbs every 3-4 hours

Include fiber and healthy fats: To slow down the absorption of sugar into the blood stream

Premenstrual women have more reactive blood sugar & need to eat more frequently. Most women relapse premenstrually

Avoid allergenic foods: Allergens frequently provoke blood sugar dysregulation

To Control Reactive HypoglycemiaSupplements:

Use a full spectrum multi like True Balance by NOW, or Gluco-balance by Biotics

Chromium:Biotin:

Support Adrenals: Saliva test, Adaptogens, Vit C, B5

To Control Reactive Hypoglycemia

Avoid Smoking and Caffeine : Smoking causes a rapid rise in blood sugar with just as

rapid a drop shortly after the cigarette is put out. Nicotine is the culprit. A smoker must totally stop in order to return their blood levels to normal and eliminate their symptoms

Test for Heavy Metals Heavy metals such as mercury, cadmium, lead and

thallium poison the glucose metabolizing catalysts. Note that the symptoms of heavy metal poisoning are similar to symptoms associated with hypoglycemia: hyperactivity, mood swings, manic depressive behavior, poor concentration and impulsive and unpredictable behavior.