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How To Treat Low Blood Sugar On Keto Diet

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Understand Cortisol And Its Impact On Blood Glucose

Low Blood Sugar On Keto (Hypoglycemia On Ketogenic Diet)

We all live stressful lives, but some of us have a harder time reducing or releasing our stress. That fact may play out in restlessness, poor sleep, insomnia, or feelings of anxiety or constant tension. Cortisol is the stress hormone that mediates the fight or flight physiologic response. And it has a direct bearing on our glucose levels.

Prolonged cortisol stimulation will raise blood glucose levels, notes Dr. Jason Fung, who wrote an entire chapter on the stress hormone in his 2016 bestseller The Obesity Code.8 In it he describes how cortisol, released from the adrenal glands, sends a message to the body to release glucose to prepare for a perceived threat, spurring gluconeogenesis in the liver. In prehistoric times, that surge of glucose energy was usually used up fighting or fleeing from the threat. But in current days, often that stress goes unreleased, the energy not used, which can lead to prolonged higher glucose levels

I, too, discovered the same stress impact, especially with sleep. Since this spring, I am doing yoga in the early evening, focusing on other stress reduction activities and wearing earplugs and an eye shade to help ensure a better night sleep. Doing so drops my FBG back into the normal range the next morning.

Drinking a glass or two of wine at night can lower readings, too, because the liver metabolizes the alcohol first before turning to gluconeogenesis, but I dont want to drink daily.

Glucose Meters Can Give False Readings

While physiologic reasons cause higher glucose readings, technical reasons can cause them, too. The US Federal Drug Administration allows home glucose monitors to have a variance of 15% in results. That means a reading of 100 mg/dl might actually be as low as 85 mg/dl or as high as 115, a huge variation!9

Dave Feldman, the software engineer who has cracked the Cholesterol Code, has blogged about his glucose meter variance, charting and taking pictures of his two glucose meters, measuring the same drop of blood. While he was expecting his blood glucose set point to be higher because of his long-term low-carb keto eating, he was surprised by the sometimes huge variation in results. He notes that whenever he gets an unexpected result, he takes three readings, all within a few minutes of each other, and then averages the result.

Other researchers have noted that false readings can be caused by pricking a finger for blood with hands that have minute traces of sugar or food Dehydration raises results, too. You should always wash your hands before testing, but some soaps have additives like honey or a fragrance that can linger on fingers and distort readings. As well, strips that are too hot or too cold, or other environmental conditions like high altitudes, can produce higher or lower readings. Even different lots of strips can produce different results on the same meter.

Get The Right Nutrients

Its important for everyone to have the right nutrients in their diets, regardless if youre hypoglycemic or trying the keto diet or intermittent fasting.

Be sure to get enough of these nutrients in particular:

  • B vitamins: can be found in eggs, meat, dairy, fish, seeds, and most vegetables
  • Potassium: can be found in leafy greens, fish, and avocados
  • Magnesium: can be found in fatty fish, nuts, and seeds

Specific to hypoglycemics, some supplements are needed to give extra help to stabilize your insulin levels and your blood sugar.

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One Last Thing About Ketones

Just to clarify, dietary ketosis is different from diabetic ketoacidosis, a dangerous condition that can cause a coma or death. Diabetic ketoacidosis happens when blood sugar is extremely high, and insulin is very low. This causes ketones to accumulate too much. Diabetic ketoacidosis typically only happens to people with Type 1 diabetes, because their bodies cant produce insulin. But it can happen to people with Type 2 diabetes too.

Although ketoacidosis is rare in people with type 2 diabetes, its still something youll want to be aware of if you ever decide to take ketone supplements or try the keto diet for that matter. Youll want to keep a close eye on your blood sugar and ketone levels, especially as your body adjusts.

How Does The Keto Diet Work

diabates remedies: how to treat low blood sugar on keto diet

In case you don’t know, the ketogenic diet has many other names, such as the low-carbohydrate, high-fat diet. As the name suggests, adopting this diet means you are going to reduce your carb intake to below 60 grams per day. On the other hand, you may have to up your consumption of fat and protein, says a review published in the European Journal of Clinical Nutrition.

keeping that point in mind, if you are on a non-keto diet, you may easily end up consuming a lot more carbs on a daily basis. For example, if you consume a turkey, vegetable sandwich, and cheese along with a whole-grain bread and one oz of potato chips, you may end up having more than 51 grams of carbohydrates.

What happens when you avoid all these things for a long-term? Avoiding low-carb foods for a long-term may cause a reduction in your insulin levels, which may put your body in a state ofketosis. In this state, your body burns fat instead of carbohydrates in order to produce energy.

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How To Cut Carbs When You Suffer From Hypoglycemia

So youre trying to lean out, and youre cutting down on carbs. But every time you swap out the rice for more greens and you hit the gym, you end up shaky, nauseous, cold, and clammy, and youre stuck with a killer migraine for the rest of the day.

Sound familiar? You could be dealing with low blood sugar, also known as reactive hypoglycemia. As a nutritionist, I have many clients who struggle with this issuebut theyre often unsure how to manage it.

When your blood sugar levels take a nosedive, dieting becomes difficult, if not impossible. Every time you try to eat less or exercise more, you crash hard and crave fast carbs to get your blood sugar up. If youre struggling with reactive hypoglycemia but still want to lose weight, heres how to make it work.

Reactive hypoglycemia occurs when blood sugar levels drop too low about 3-4 hours after eating carbohydrates. This can be a result of your body consistently releasing too much insulin for the amount of carbohydrates you eat. When thats the case, every time your body signals for insulin release, it removes more carbohydrates from your bloodstream than you need. When blood sugar drops too low, symptoms like dizziness, nausea, and headaches can occur. These symptoms are alleviated by eating carbohydrates.

The only problem: If youre cutting, eating more carbohydrates probably isnt part of your fat-loss strategy.

With reactive hypoglycemia working against you, how do you make fat loss happen?

May Damage Bone Health

The keto diet is also associated with impaired bone health.

Several studies in animals link the keto diet to decreased bone strength, likely due to losses in bone mineral density, which may occur as your body adapts to ketosis .

In fact, a 6-month study in 29 children with epilepsy on the keto diet discovered that 68% had a lower bone mineral density score after going on the diet .

Another study in 30 elite walkers determined that those who followed keto for 3.5 weeks had significantly higher levels of blood markers for bone breakdown, compared with those who ate a diet higher in carbs .

All the same, more extensive research is warranted.


The keto diet may reduce your bone mineral density and trigger bone breakdown over time, though further studies are needed.

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Who Shouldnt Try The Keto Diet

Its not that ketogenic diets are inherently dangerous, they just may not be effective for certain conditions. For example, those with type I or II diabetes will need to work with a knowledgeable healthcare professional while implementing a keto diet. Before jumping headfirst into a keto diet, try to uncover the cause of your adrenal fatigue.

If your main stressors are coming by way of sleep issues or lifestyle stress the ketogenic diet will not cure your adrenal fatigue.

In all likelihood, trying to implement a ketogenic diet when youre dealing with sleep disturbances and/or high levels of stress at work will backfire. The extreme dietary changes involved with the keto diet will only add to your stress. This will often make your fatigue levels worse.

Even if you are dealing with inflammation and/or blood sugar issues, the proper implementation of the ketogenic diet is in itself stressful. Do your best to get a friend or your family on board. Having a support system is essential to your long-term success. Or, check out my digital course its a stress-free way to balance your blood sugar and overcome adrenal fatigue!

And, perhaps most importantly, take your time. If youre eating a Standard American Diet, dont try to go keto next week. Start with a fatigue reset diet. Start adding whole foods to your diet. Once you have a solid foundation, then look at implementing a keto diet.

Third Step: Test Out Your Protein Threshold

Low Blood Sugar Issues on Keto Diet | Dr.Berg

The threshold for protein is typically high, though anything in excess will lead towards energy storage. To find out if you are consuming too much protein at one meal, test your ketones and glucose in a fasted state and make note of it. Eat a meal and make note of how much protein is in that meal. If the protein amount is too high, we typically see a very gradual rise in glucose data through the CGM. This rise can occur anywhere from 2Â4 hours after a meal .

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The Difference Between Keto And Atkins

Since both the keto diet and the Atkins diet focus on consuming fewer carbs, many people get confused between the two. However, theyre quite different at the core. Both diets have the potential to help manage type 2 diabetes, but the Atkins diet focuses on low-carb, high-protein intake while the keto diet focuses on low-carb, high-fat intake. The Atkins diet does not discuss increasing fat intake and there are fewer studies regarding its benefit in controlling type 2 diabetes.

What Happens When We Eat Carbohydrates Protein And Fat

âYour blood insulin responds very differently to different macronutrients. Fat does not impact blood insulin levels. Carbs have a high impact, and protein impacts them moderately, but fat has no impact.

Carbs and fats can both provide energy for the bodyâbut not at the same time. When carbs are abundant in the diet, carbs function as the preferred fuel source. But when carbs are limited in the diet, fat becomes the preferred fuel source.

When you reduce your intake of one macronutrient, you have to increase your intake of at least one other macronutrient to avoid feeling hungry and not have enough energy.

In a low carb, high-fat diet, fat provides you with the energy your body needs, and it also reduces hunger and cravings.

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Youre Eating Too Much Fat

The ketogenic diet is a big fan of healthy fats, but could too much fat could be hurting our blood glucose levels. Dr. Nikola Djordjevic, MD from explains that the general assumption of the ketogenic diet lowering blood glucose levels is only partially correct. Some individuals do experience high levels of glucose in their blood while on a ketogenic diet. The reason for this is that substituting fat for sugar isnt exactly sustainable over time, she explains. Whats important to understand is that the glucose in your blood is dependent on both carbohydrate and fat intake. According to Dr. Djordjevic, when you consume too much dietary fat, you can actually increase your insulin resistance. This results in high glucose levels in your blood and can lead to conditions such as high cholesterol. It can also increase your risk of developing chronic diseases.

While its true that cutting down on carbs will definitely help reduce glucose levels in the short term, says Dr. Djordjevic, I wouldnt recommend loading up on dietary fat in order to achieve ketosis, since, in the long-term, it can affect your insulin resistance and lead to more serious health conditions.

Is Keto Good For Low Blood Sugar

Lowering Blood Sugar: treat low blood sugar at home

Keto may offer a solution to people in need of lowering their blood sugar levels.

Being low in carbs, the diet can actually help people dealing with type 2 diabetes avoid or reduce their need for medication.

Ketosis low blood sugar benefits are largely the reason many diabetics give this diet a try. Carbs generally translate into high blood sugar levels.

Therefore, following a keto diet, which strictly reduces the intake of carbs, can cause a significant decline in blood sugar levels.

However, if low blood sugar would cause problems such as hypoglycemia , then this diet might not be a good idea.

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What Is The Keto Diet

Itâs a low-carb, high-fat eating plan. Most of what you eat is fat, whether thatâs unsaturated fats like nuts, seeds, and avocados, or saturated fats like butter and coconut oil. About 20%-30% of your diet is protein, either lean or fatty . Youâre supposed to strictly limit carbs, even those that are typically considered healthy, such as beans, whole grains, milk, and many types of fruits and vegetables. On the keto diet, you eat less than 50 grams of carbs a day. To put that in perspective, one medium apple has 25 grams of carbs.

How does it work? Normally, your body fuels itself from sugar, or glucose, that it gets from carbs. After a few days of the keto diet, your body runs out of glucose. So it starts burning body fat instead. This is called nutritional ketosis. It creates fatty acid substances called ketones, which your body can use for energy.

Identify Your Trigger Foods Using A Cgm

Everyone has a unique response to carbs. If we were to perform a test with two different people eating a banana, we could see drastically different glucose responses. The reason is that nutrition is very individualistic. This is why understanding your bioÂ-individuality and your responses to different carbohydrates is so important. Identifying how you tolerate specific carbs and identifying the foods that drastically increase your glucose will help optimize your keto diet. With a CGM, you don’t have to guess if a certain food is kicking you out of ketosis. The CGM will provide you with the data you need to optimize your diet and give you some peace of mind. You may find that you tolerate more carb foods than you think!

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Managing Your Blood Glucose

Here are some proven strategies for keeping blood sugar within a healthy range:

  • Exercise: Physical activity increases insulin sensitivity, the opposite of insulin resistance. Both endurance exercise and weight training have been shown to have positive effects.
  • Fasting: Nothing lowers blood glucose and insulin levels like not eating. Start with 16-hour intermittent fasts, and work your way up as comfort and schedule permit.
  • The keto diet: The ketogenic diet severely limits carbs, helping minimize the blood sugar response. .
  • Measure your blood glucose: Knowing how blood sugar fluctuates with different foods helps you make smarter choices.
  • Spice and supplement: Spice your food with turmeric and cinnamon or consider supplementing berberine to limit your blood sugar response.
  • Sleep well: Sleep is crucial for insulin function. Prioritize it.

Sugar And The Keto Diet

Keto and Low Blood Sugar (Hypoglycemia) | A SUPER EASY FIX!

There are two things that you have to avoid the most while on a keto diet: carbohydrates and sugar. If youve been interested in the keto diet for a while, then youve probably heard plenty about why carbs arent great for you and how cutting them out is essential to a keto diet, but youve likely heard much less about sugar.

You know its bad and you know to leave it out of your diet, but why?

The keto diet is all about lowering your blood glucose levels so that your body begins to run on fat instead of glucose. Blood glucose is more commonly known as blood sugar so, basically, sugar can jeopardize your bodys state of ketosis and knock you back into carb-burning mode.

A high sugar intake in general is bad for you too, so its not just a keto diet thing. Consuming concentrated sugar causes your blood glucose levels to rise in a sudden spike, which triggers your pancreas to release large amounts of insulin.

This can slowly result in problems with insulin sensitivity and insulin resistance, and it can also make you more susceptible to diabetes as your pancreas becomes overworked and starts being unable to properly use insulin.

Being on a keto diet can stop this destructive cycle in its tracks. But there is another problem: having enough willpower not to eat sugar!

The long-term solution to stopping sugar cravings permanently is by switching to a low-carb diet.

To understand how this works, lets talk a bit about how sugar cravings happen and why.

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May Stress Your Kidneys

High fat animal foods, such as eggs, meat, and cheese, are staples of the keto diet because they dont contain carbs. If you eat a lot of these foods, you may have a higher risk of kidney stones.

Thats because a high intake of animal foods can cause your blood and urine to become more acidic, leading to increased excretion of calcium in your urine .

Some studies also suggest that the keto diet reduces the amount of citrate thats released in your urine. Given that citrate can bind to calcium and prevent the formation of kidney stones, reduced levels of it may also raise your risk of developing them .

Additionally, people with chronic kidney disease should avoid keto, as weakened kidneys may be unable to remove the acid buildup in your blood that results from these animal foods. This can lead to a state of acidosis, which can worsen the progression of CKD.

Whats more, lower protein diets are often recommended for individuals with CKD, while the keto diet is moderate to high in protein .


Eating a lot of animal foods on the keto diet can lead to more acidic urine and a higher risk of kidney stones. This acidic state can also worsen the progression of chronic kidney disease.

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