Is high blood sugar worse than low?
Most answers online treat this as a contest. Dr. Martin does not. To him a high and a low are two ends of the same swing.
A listener once asked him what to do when blood sugar bottoms out. He reminded her that your body works hard to keep sugar in a tight range, not high and not low. Then he said this:
Dr. Martin, The Doctor Is In, Episode 848Hypoglycemia and hyperglycemia is a problem of insulin. Okay? Now whether it goes low or whether it goes high, it's not normal. You need to fix insulin.
So if you are asking which one to worry about, his answer is both, and for the same reason.
Why is high blood sugar so damaging?
Dr. Martin is blunt about what sugar does inside the blood. He says the whole body holds only about five liters of blood, and even after a plate of donuts there would be barely a teaspoon of sugar in it a little later, because insulin hurries it out.
Dr. Martin, The Doctor Is In, Episode 755Because sugar is so destructive to your blood vessels, they start damaging blood vessels in nanoseconds.
That is why he points to the eyes, the kidneys, the liver and the heart when he talks about long-term high sugar. But he does not stop at the sugar reading. In his view the number on the meter is the end result, not the cause.
"So diabetes is not a problem of sugar in your bloodstream, it's not that, that is a symptom."
Dr. Martin, The Doctor Is In, Episode 755If you want to know where your own numbers should sit, see what a normal blood sugar is for a woman over 60.
What causes low blood sugar?
Most people picture low blood sugar as the opposite of diabetes. Dr. Martin says the low usually comes from a high.
Dr. Martin, The Doctor Is In, Episode 1035Hypoglycemia really comes from hyperglycemia. And when you get low blood sugars, it's cuz your blood sugars are fluctuating all the time.
A listener named Ron pushed him on it. If insulin pulls sugar out of the blood, how does anyone end up low? He answered with a phrase he uses again and again.
Dr. Martin, The Doctor Is In, Episode 1238Okay, what goes up must come down. And for some people it comes down too low.
He told Ron he wrote an article about hypoglycemia back in the seventies, and that in his experience low blood sugar is always a precursor to high blood sugar. The culprit, again, is insulin.
Dr. Martin, The Doctor Is In, Episode 1238It's always a problem of insulin. Sometimes insulin works so much that it can bring your blood sugar too low, okay? And you get hypoglycemia.
That is the link to insulin resistance, which he covers in the signs of insulin resistance in women over 60.
Can stress cause low blood sugar?
Yes, in his view, and he saw it most in women. Cortisol, your stress hormone, has a job: to raise blood sugar so you are ready for fight or flight. When stress never lets up, the rise keeps coming, and so does the fall.
Dr. Martin, The Doctor Is In, Episode 1136So if your blood sugar's going up because you're stressed, you're getting ready for fight or flight, your insulin is taking that elevated blood sugar and lowering it sometimes way too fast. That gives you hypoglycemia.
He says he found this most often in patients he described as having adrenal exhaustion, the ones who were tired all the time.
Dr. Martin, The Doctor Is In, Episode 1733Blood sugar goes up, you secrete a lot of insulin and your blood sugar comes down and sometimes it comes way down. And thus, the exhaustion. Thus, the hypoglycemia.
More on that side of it in chronic fatigue in women over 60.
Why do you crave sugar after a crash?
When a listener asked whether adrenal trouble makes you crave protein, he said no. It makes you crave a quick fix.
Dr. Martin, The Doctor Is In, Episode 1050They want a quick fix because their sugar went up. Now they're suffering from hypoglycemia, low blood sugar because their sugar crashes down. What goes up must come crashing down.
Sugar sends you back up, insulin brings you back down, and the cycle starts again. He explains the cravings side in why you get sugar cravings after 60.
What does a blood sugar swing feel like?
Dr. Martin does not give a chart of numbers for this. He describes what his patients and listeners told him:
- Tired and worn out, not feeling good (episode 1136).
- Hungry all the time (episode 801).
- Anxious, nervous or lightheaded first thing in the morning (episode 1158).
- Reaching for something sweet for a quick lift (episode 1050).
One kind of lightheadedness he does not worry about. When people first cut carbs, he says the body is switching fuels.
Dr. Martin, The Doctor Is In, Episode 1064So it's the body changing fuel. So it can give you lightheadedness, but it's going to go away.
What to eat for high or low blood sugar
You might expect opposite advice for a high and a low. He gives the same advice for both.
Dr. Martin, The Doctor Is In, Episode 801But let me share this; whether you are hyperglycemia, which is high blood sugar, or you have low blood sugar, the eating is the same because what's going to save your bacon is when you eat protein and fat.
In episode 848 he said that if your blood sugar is ever that low, carbs, like an orange, would be temporary. Then he asked the bigger question: why does it go that low in the first place? His long-term answer is always food.
Dr. Martin, The Doctor Is In, Episode 1238And look, I don't want anybody to get into trouble with their blood sugar, but if you eat a lot more protein, eggs, meat, and cheese, that will help to stabilize your blood sugar a lot longer and it's better for you in the long run.
If you take medication for your blood sugar, none of this replaces what your own doctor has told you. If you are at the earlier stage, his first steps are in prediabetes at 60.
Common questions
Is high blood sugar worse than low blood sugar?
Dr. Martin does not rank them. He says whether blood sugar goes low or high, it is not normal, and both are a problem of insulin.
Can high blood sugar cause low blood sugar?
Yes, in his view. He says hypoglycemia really comes from hyperglycemia: what goes up must come down, and for some people it comes down too low.
Why does my blood sugar drop when I'm stressed?
He says cortisol raises blood sugar to get you ready for fight or flight, then insulin lowers it, sometimes way too fast. That drop is the low.
What should I eat if I have low blood sugar?
Protein and fat. He says the eating is the same for high and low blood sugar, and points to eggs, meat and cheese to keep it steadier.
Can cutting carbs make you lightheaded?
He says it can in the first week or so, because the body is changing fuel, and that it goes away.
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