Breathlessness, palpitations, lightheadedness, dizziness or unsteadiness, hot flashes, sweating, tingling or numbness in the extremities, tremor, nausea, intense fear, feelings of unreality, mental confusion, nervousness, lack of coordination … These are the classic symptoms of a panic attack.

When reactive hypoglycemia masquerades panic attack

Breathlessness, palpitations, lightheadedness, dizziness or unsteadiness, hot flashes, sweating, tingling or numbness in the extremities, tremor, nausea, intense fear, feelings of unreality, mental confusion, nervousness, lack of coordination … These are the classic symptoms of a panic attack. However, they are also the same symptoms experienced by people suffering (in most cases unknowingly) of reactive hypoglycemia.

Panic attacks are considered an irrational fear related to emotional psychological trauma or unknown factors. All efforts made to help people who suffer are based on psychological therapies and / or tranquilizers to relieve anxiety that undoubtedly accompanies drugs.

The patient is repeated over and over again, you have to learn to master your thoughts to produce no symptoms. However, thoughts are generated in the brain and this is a physical organ that responds to chemical messages. Like any other organ of the body, the brain can be properly fed, malnourished or damaged, and react accordingly.

Before going into details and analyze why panic attacks may be confused with reactive hypoglycemia, it is important to understand what this imbalance is.

Reactive hypoglycemia

Hypoglycemia, by itself, the medical profession is accepted only when the diabetic diabetic conditions undergoes a decrease in glucose. If, on the contrary, it occurs in a non-diabetic then it is called reactive hypoglycemia. However, allopathic medicine only recognizes this imbalance and therefore, when the patient turns to the doctor with these symptoms, most commonly diagnose anxiety, recommend anti-anxiety drugs and send them home, psychologist or, in the most serious cases, the psychiatrist.

Biochemically speaking, reactive hypoglycemia is a concentration of glucose in the blood lower than normal standards of the person who suffers. The blood glucose level of a hypoglycemic person up after meals and has a significantly lower decline than normal after 2 to 5 hours.

Hypoglycemia and panic attacks

Glucose is the main food of the brain and nervous system. No one can synthesize it or save it. Thus, if the concentration of low blood glucose to a critical level, both the nervous system and the brain will be affected causing a host of symptoms. However, the blood glucose level fluctuates more or less small margin during the day, depending on meals and the time between them, without such fluctuation time cause brain dysfunction. To this, it is NOT called reactive hypoglycemia. In addition, at times some people may experience a temporary drop in blood sugar, which is quickly rectified by the mechanisms of regulation of glucose available to the body.

It is important to note that the average glucose level is between 70 and 115 mg / dl. However, this figure is just an approximation. Some people have a level below and, instead, they feel perfectly; while others maintain levels within these parameters, even when they suffer a letdown, and yet feel great discomfort.

Symptoms of reactive hypoglycemia are divided into two groups. The neuroglycopenic, symptoms caused when the brain does not receive enough glucose; and neurogenic symptoms, which manifest when the adrenal glands produce adrenaline and noradrenaline, in order to re-raise levels of blood glucose.

Neuroglycopenic symptoms:

Weakness, tearfulness, anxiety, blurred vision, confusion, fatigue, irritability, panic, nervousness, poor concentration, incoordination, depression

Neurogenic symptoms:

Sweating, flushing, tachycardia, dizziness, nausea, tremors, dizziness, feeling of panic and fear, anxiety, headaches, intestinal spasms, shortness of breath, tingling

These symptoms are usually episodic and relate to the elapsed time and the content of the previous meal. Usually, they improve when eating. They have their rationale: under normal circumstances, the blood glucose remains within the fairly narrow range of variation controlled by different hormones, which respond quickly to the slightest change. With the intake and metabolism of carbohydrates (vegetables, salads, cereals …), glucose levels in the blood increase steadily, enabling the production of a moderate amount of insulin. This gradually lowers glucose levels escorting the one hand, cells, and on the other, sending the liver and muscles to be stored.

However, when sugars (table sugar, honey, fructose, etc.) or refined carbohydrates (refined flours such as white bread, pasta, pastries etc.), glucose levels increase disproportionately consumed. This causes the pancreas to secrete strong the amount of insulin, which causes a sudden withdrawal of glucose too: in other words, appears reactive hypoglycemia with corresponding neuroglycopenic symptoms.

The hypothalamus when you feel low blood sugar glucose, activates the autonomic nervous system, through which catecholamines (adrenaline and noradrenaline, mainly) are secreted. These hormones stimulate glycogen-stored output, which causes an increase in glucose levels. This production of catecholamines is causing neurogenic symptoms.

Over the years, and if the habit of eating sugars and refined carbohydrates continue, the body is conditioned to produce more and more insulin, and in turn, more and more catecholamines. This produces a depletion of both the pancreas and adrenal, reaching also affect how the body faces any other stress. It is no wonder that the patient suffering from reactive hypoglycemia feel stressed and anxious, and many times the victim of a misdiagnosis based solely on your emotional state.

Not only sugar and refined carbohydrates are responsible for the development of reactive hypoglycemia, also, cigarettes and coffee can cause or worsen this imbalance. These substances directly activate the adrenal glands to produce catecholamines, which, as I mentioned above, activate glycogen output and, therefore, increasing glucose. To counter, the pancreas releases insulin and as a result, the “dip” in blood glucose appears. In fact, in a research study on snuff and reactive hypoglycemia conducted by Dr. Don C. Hemingway, published in the Journal of Orthomolecular Medicine in 1989, found that if they were made with hypoglycemia smokers smoking a cigarette and they were subjected to Test glucose Tolerance, their glucose levels increased, showed an immediate improvement and decreased physical symptoms of hypoglycemia. So he realized that the body learns very quickly to crave a cigarette when glucose levels decrease. It seems that the same happens with caffeine. On the other hand, alcohol inhibits the mobilization of the reserves of glucose from the liver causing severe hypoglycemia.

It is important to note reactive hypoglycemia when treating patients with panic attacks, especially in those who find no emotional reason, trauma or shock that may be causing them lived. Personally, I think there are several reasons to think that behind many panic attacks glucose imbalance lies, specifically reactive hypoglycemia.

These reasons are…

Western Diet

First, the dietary habits adopted by our society over the past 100 years have contributed to the increase in a variety of health problems, including reactive hypoglycemia, which is mainly caused by a diet high in refined carbohydrates and stimulants. There had been problems such magnitude anxiety, panic, and even phobic imbalances, as hitherto never before.

These processes are virtually unknown among the few surviving populations eating naturally, with a feed unrefined.

More women than men

In most studies, articles and books about panic attacks are talked that there is a greater number of women than men suffering from this imbalance. Let us not forget that the endocrine system of women is much more complex: only menstruation, pregnancy, and menopause produce a variety of hormonal changes, thus, women are more given to suffering hormonal imbalances in the system.

According to a study conducted on the differences between the sexes in reactive hypoglycemia, conducted by Dr. Amiel and published in Diabetologia in 1993, women suffer lower glucose levels than men and also have more symptoms neurogenic and neuroglycopenic. Other doctors, like Dr. Toft, believe that reactive hypoglycemia is more common among female patients 20 to 40 years.

On the other hand, a high percentage of PMS symptoms are caused by an excessive amount of estrogen and, by the conversely, low levels of progesterone. Both hormones control glucose levels; therefore, any imbalance between them can easily produce reactive hypoglycemia. For example, as we saw earlier, a decrease of glucose stimulates the production of adrenaline, which promotes segregation of glycogen, and, therefore, increased glucose levels. Epinephrine is formed by progesterone, thus, a deficiency relentizar this can easily raise causing glucose reactive hypoglycemia.

The pill also seems to affect glucose levels. Dr. Wayne Huey-Heng they conducted a research study published in Clinical Endocrinology in 1994; it shows that the contraceptive pill taken for at least 3 months produces glucose intolerance.

On the other hand, more women than men tend to follow strict diets to lose weight. These diets can have a major effect on the development of reactive hypoglycemia: on the one hand, not eating regularly, or, conversely, do not consume enough protein can cause this imbalance; on the other, a poor diet can promote the lack of essential nutrients for glucose control, such as zinc, chromium, magnesium and B vitamins, to name a few.

Panic attacks at night

Anyone who has suffered panic attacks knows that the worst times are during the night and early morning. This is not surprising, since glucose reached its lowest peak precisely at those times, usually when the person takes without eating about 8 or 10 hours from the last meal. These people usually need a coffee or a cigarette (or both) newly awakened to face the day.


The test usually carried out to verify a possible reactive hypoglycemia is the test Glucose Tolerance (which is usually done in a period of 2 to 6 hours). However, few doctors recommend it.

I personally believe that if you decide to perform this test lab should be only to confirm the diagnosis, and NEVER to discard it.

It is important to respect the biochemical individuality of each patient: there are people who may show symptoms and discomfort during the test with just a reduction of 2 mg of glucose within the parameters accepted and yet, the test will not indicate any imbalance.

On the other hand, has been shown in several studies, such as Dr. Taylor published in the Journal of Behavioral Medicine, in 1988, the symptoms that appear during the test are more intense not at the lowest point level glucose, but half an hour later. This can mislead when making a diagnosis.

On the other hand, the lowest point glucose level may last only a short time, and if not blood samples are taken regularly, reactive hypoglycemia may go unnoticed.

If carried out the test, it is important to also take into account the patient’s diet; meal times; family history of migraines, allergies, diabetes, epilepsy, depression …; imbalances suffered in the past as hepatitis, gallbladder problems, nausea during pregnancy …; and possible nutritional deficiencies.



The diet is essential to prevent, control and combat reactive hypoglycemia (or assumptions panic attacks). First, it is important to remove:

  • Sugars (white or brown sugar, honey, fructose, saccharin, syrups, soft drinks);
  • Refined carbohydrates (white bread, refined flour, pasta and white rice, sweetened breakfast cereals);
  • Overly sweet fruit (especially bananas, grapes, figs, watermelon, and cantaloupe)
  • Dried fruits like raisins, prunes, and dried figs;
  • Fruit juices, potatoes, beets, peas, corn, turnips, sweet potatoes and cooked carrots;
  • Alcohol
  • Stimulants such as coffee, tea, and caffeinated sodas

It is essential to eat some protein at every meal (either plant or animal protein). This includes meat, fish, eggs, seaweed, nuts and seeds, soy products, cereals mixed with beans. Protein results in the production of the hormone glucagon, which counteracts the release of insulin, and prevents sudden decreases glucose.

It is also important to eat regularly during the day. There are patients who do three meals daily rigor, but the breakfast food can pass between 6 and 7 hours. Therefore, it is important to ask mealtimes. They should not spend more than 3 hours without eating any food. It is, therefore, important to respect the 3 main meals, plus a “snack” at mid-morning and mid-afternoon.


The most important nutrients for glucose control are:

  • Zinc: It is responsible for the production, storage, and offloading insulin. Its deficiency can cause decreases in glucose… Dose: 15-60 mg daily.
  • Chrome: Part, along with vitamin B3, and the amino acids glycine, glutamine, and cysteine, called “Factor Glucose Tolerance”. This factor works with insulin to regulate glucose levels. Literally, chromium increases the body’s tolerance to glucose. Dose: 200-600 mcg
  • Magnesium: It fulfills an important task in downloading and insulin action. It also converts glucose into energy. Coincidentally, its deficiency is associated with the onset of panic attacks. Dose: 400 mg daily.
  • Potassium: Hypoglycemia causes a substantial loss of this mineral in the urine, mainly due to adrenal wear. Ingestion of potassium chloride quickly corrected this deficiency, and it is much safer and effective than glucose tablets normally doctors recommend. Dose: 200 mg daily, and 1 g in acute reactions. (Beware if there are kidney problems.)
  • Glutamine: It helps increase glucose levels and reduces cravings for sweet foods and alcohol. Dosage: 500-1500 mg daily.
  • Glycine: Glucagon stimulates downloading. . Dose: 500-1000 mg daily
  • Vitamin B: Especially the B3, B5, and B6 are vital for the metabolism of carbohydrates, in addition to balancing the adrenal glands, pancreas and liver. Vitamin B6 for example also helps metabolize magnesium and zinc had better absorb. B3 Dosage: 500-1000 mg (no blushing effect) daily. B5 dose: 500 -1000 mg daily. B6 dose. 200 mg daily
  • Vitamin E: It promotes the entry of glucose into the muscles, improving symptoms of hypoglycemia. Dosage: 400-1000 mg daily. (Beware if you suffer hypertension.)
  • Vitamin C is essential for normalizing insulin production. It is found in large quantity in the adrenal glands and is essential for the production of adrenaline and cortisol. Dose: 1000-4000 gr. daily.


Exercise is essential to our health. However, excessive exercise can lower blood glucose levels. Thus, it is recommended to follow a gentle exercise routine. It is known that this hormone helps maintain optimal levels, in addition to helping glucose enter cells better in increasing energy, without requiring insulin. Good exercise options include walking, swimming, cycling, yoga, tai-chi, trampoline … It is important to practice regularly at least 3 times a week, with half-hour sessions each.

In conclusion, it is important to note that not all cases of anxiety and panic attacks are due to emotional imbalances. In some cases, the problem may lie in a glucose imbalance. Many cases of panic attacks have been successfully resolved very simply: balancing the levels of blood glucose with a good diet, nutrients, and exercise.