This morning dawned (?) dark, rainy and cold – the perfect time for my scheduled park workout! Because I’m bad at planning! After dragging myself out of bed at the crack of black and convincing my friend to as well, we did a quick half hour circuit of body weight exercises and sprints. It was one of those workouts that doesn’t feel too rough when you’re doing it but really takes a lot out of you, especially if you’re not used to high-intensity interval training. So when my friend texted me a half hour later saying she was shaky, couldn’t get warm and also couldn’t lift her arms over her head, I felt bad for not warning her about the possibility of getting the dreaded sugar shakes.
You know, how you sometimes get shaky, light-headed, nauseated, cold, and mentally foggy during or right after a workout? That completely miserable feeling like you kinda want to puke or die? Yep, sugar shakes. I’ve so been there. Which makes it sound like we’re sugar junkies jonesing for our next hit of the white granulated stuff (confession: I kind of am) but in reality something as simple as an early morning workout before breakfast can throw your blood sugar was all out of whack.
I used to get low blood sugar – or hypoglycemia if you want to get all technical about it – all the time. If you grew up in the 9o’s then surely you’ve heard of hypoglycemia as it’s the condition that killed Shelby (Julia Roberts) in Steel Magnolias and made me do my first-ever ugly cry in public. (Was that not the saddest scene ever done in a movie? I get choked up just remembering it! She was about to get married! Solidarity, Liz!) When you’re diabetic, having your blood sugar get too low can be fatal. Thankfully for the rest of us who experience a little hypoglcemia thanks to exercise or some other outside factor – called reactive hypoglycemia – it’s not usually deadly, just uncomfortable. And with a little planning the sugar shakes are totally manageable.
I’m not a great planner, remember? Let me back up.
I’ve always been a fainter. Thanks to a propensity for abnormally low blood pressure if I stand up too quickly, kneel down too long or lock my knees while singing just like my choir teacher always told us not to, I’ll hit the ground. The faint is over as soon as I’m down usually. So it’s really more like swooning?
My most spectacular faint was in college right after a swing dance competition thing (it was our first and if I remember correctly we really kinda sucked) and thanks to nerves – and let’s be honest, my raging eating disorder at the time – I hadn’t eaten anything all day and then we’d danced for 6 hours straight. I don’t remember all the details except that we were walking back to our car and I got dizzy and nauseous and sat down on the curb. I think they left me? And came back for me? Anyhow, I’d fainted clean out on the concrete. Next thing I knew I was at a gas station, my friend friend Janette was pouring orange juice down my throat and my other friend had confiscated my keys and had to drive us all home in my car.
Janette, who was majoring in nutrition, asked me if I was hypoglycemic. I had no idea. So I went to the doctor and after a blood test the verdict was that yes, I am more predisposed to it than most people (yay me!) as my normal blood sugar is 75 mg/dl which apparently is right on the border of low. Did I bother to learn about my new condition? Take steps to prevent it? Dump the stupid boyfriend who left me on the curb for my girlfriends and/or a scary murderer to retrieve? No, no, and I wish. For years afterward, I just kind of muddled through my “episodes” mistakenly carrying candy to fix them. That is, until I got into this whole health and fitness jag I’ve been on for the past 7 years. It turns out lots of people, especially us fit folk, are prone to episodes of low blood sugar and while it makes you feel like TOTAL CRAP, it’s fairly easy to prevent and remedy.
What Is Exercise-Induced Low Blood Sugar?
The primary source of fuel for our muscles is glycogen and when we exercise very hard or very long (or both), both our muscles and our liver – the storage of the all-important glycogen – get depleted. When you’re a little depleted you experience the symptoms I described above: shakiness, dizziness, disorientation, nausea, chills, fatigue etc. When you’re super depleted during an endurance exercise that’s when you “hit the wall” or “bonk” which is an utterly craptastic feeling as anyone who’s been there can tell you. I don’t know that I’ve ever felt worse in my life, frankly. In addition to the above, you may lose the ability to regulate your body temperature, vomit, faint, lose control of your bowels (oh yes), be unable to stand unsupported and have an irregular heart beat among other scary things.
This effect can be exacerbated by how well (or not) you fuel your workouts.
How to Prevent Low Blood Sugar*
As I understand it, our bodies store glycogen as fuel in our muscles and liver. When we need it, it is broken down into glucose (a sugar) and then metabolized into immediate energy via glycolisis. (I could be totally wrong – if I am, feel free to educate me in the comments and I’ll bump your explanation up here!) However, not all glycogen can be immediately accessed and so depending on how much food we’ve eaten, when we last ate and what we ate, we could have quite variable stores. What you want to avoid is the blood sugar roller coaster where you skyrocket your blood sugar up only to have it come crashing down shortly later, starting a vicious cycle.
1. To prevent this, eat small balanced meals every few hours. While I’m not a huge fan of the mini-meal mentality – contrary to popular belief, the research does not necessarily support this as a good weight-loss tool and it’s a pain in the butt to plan – if you’re prone to blood sugar swings this can help you stop the roller coaster. Also, emphasis on the balanced. Simple carbs like most processed foods (including, incredibly, whole wheat bread!) skyrocket your sugar only to crash 30 minutes later. Hello, afternoon nap.
2. Eat something about an hour before you workout and bring something to eat right after your workout. This last piece has been critical for me. If it’s an easy day, I don’t really worry about it but I’m lifting heavy or doing something high intensity, downing the protein/carb smoothie right after I finish is the difference between feeling like crap the rest of the day and bouncing right back. I can’t even tell you how much this has helped me.
3. If you know you will be exercising longer than an hour, it’s smart to bring something to refuel during. Sport gus (goos), gels, beans, blox and drinks are popular options. Or just bring candy. They’re basically the same as the “sport” stuff but way cheaper. (If you’re Gym Buddy Allison you stick a chocolate protein bar down your cleavage only to discover that when you most need it, it has melted into a pile of goo inside your top.)
4. The practice of “carb loading” before a race – eating a large amount of simple carbohydrates in the few days before the race in order to stockpile glycogen in the muscles – is controversial. I know a lot of runners that swear by the pre-marathon spaghetti feed but the research on its effectiveness is mixed, possibly because many athletes do not do it properly. For myself, carb loading has never seemed to make much of a difference but I know people who swear by it.
5. Try intermittent fasting. It sounds counter-intuitive but abstaining from food for an extended period of time (usually 18-24 hours) every once in a while trains your body to be more insulin sensitive, which is a good thing as that means your body is learning to be more efficient at metabolizing your food. Insulin resistance is the precursor to diabetes and so IF can not only help prevent hypoglycemia but can also help prevent diabetes!
How to Treat Low Blood Sugar*
But what if you’re already in swoon city? Do not, I repeat, do not sit down on a concrete curb and wait for your friends to notice you’re missing. Actually, if you just have the sugar shakes taking a rest and eating something right away usually takes care of it in just a few minutes. If you’re really bad off, go for the straight sugar (that’s why diabetics carry glucose tablets… Shelby!!) But if it’s a milder case, something with some easily absorbed protein and carbohydrate works well. Chocolate milk has been shown to be particularly effective (although I gotta say that for me, after a long, hard workout milk does not sound at all good). Think of the kinds of things you see in the finishing race chutes: bananas, salted nut rolls, Muscle Milk, bagels etc. I also find it helps me to keep a sweatshirt handy, even on a warm day, as being cold and sweaty seems to make it harder for me to recover. I’ll warn you that if you’re pretty shaky you’ll likely feel pretty nauseous as well and eating will not sound fun. Do it anyhow.
If however, you are past shaky and all the way to sickville you need to get attention immediately. This is a hard call because from my personal experience, the mental disorientation makes it really hard to make a rational assessment of your situation. If you run with a friend, make a pact to look out for the other one. If you are in a race, there should be medic tents every so often and if you’re in doubt, go ahead and stop. But make a plan in advance of some way you can find help if you need it. Usually the support people will have you lie down, wrap you in blankets, and get you to eat or drink something. If you’re really bad off you may need to go to the hospital. That’s never happened to me (knock on wood) but I have heard of it happening to other exercisers!
Conclusions
From my experience, the best option is to plan ahead. Carry a few gels on you. Bring a protein shake to the gym. Be aware of what your limits are and what your body feels like when you hit them. Know what the sugar shakes feel like. A little advance planning is totally worth it.
Do any of you get the sugar shakes? Have you ever “bonked”? What’s your method for dealing with low blood sugar? And did anyone else ugly cry through Steel Magnolias?!
*All of this is based off of my own reading and personal experiences. I am in NO way a doctor, nutritionist, chemist or even all that smart-ist so if you think you are prone to hypoglycemia, please go see a medical professional. This is not meant to be medical advice.
Spin class does this to me 50% of the time. I’ve learned to prepare for it but it was terrifying the first few times. I would sit on my kitchen floor and shake while I waited for water to boil for instant mashed potatoes. Nutritionally devoid, but full of carbs and required minimal brain power.
It is terrifying isn’t it?? Especially when you don’t know what’s happening to you. So glad you figured out a good solution!
The text book Im reading right now is all about diabetes and hypoglycemia. It seems the the main nutrient the brain needs to function is glucose which is why dizziness, headaches and fogginess usually occur. I’d recommend keeping oneself fuelled. I’m also no expert, but good carbs and low glycemic index foods like carrot sticks, a boiled egg, apples, homemade granola bars, and nuts pre and post workout I think would help.
Hilary x thehealthycollective.com
I’m no expert either but I like your menu!
Never. I’m actually one of those freakish people who crash after a meal and need an empty stomach to function clearly. My parents were thankfully supportive and never forced me to eat when I didn’t want to. I haven’t eaten breakfast or lunch in years.
Interesting! I don’t have a problem with having an empty stomach (in fact some foods – like a really high fat, high carb meal make me feel groggy) normally. It’s just after an intense workout. I’m also iffy on breakfast. Some days I’m hungry and I eat but there are plenty of days where I wake up and my tummy is like “Nope. Not having it.”
I’m happy to say I have never experienced the slightest blood sugar issues myself, but I do have a friend whom I once had to revive by pouring some orange juice (rather messily) down her throat when she was in a scarily bad condition.
(Ah, I’ve gotta be honest – I’m really only posting a comment so I can seize the opportunity to be extremely childish and snigger about Americans’ cheerful use of the term “bonk”, which can be quite hilarious to other English speakers of the world. Let’s just say that, to the rest of us, the word means something *entirely* different …)
::: giggles like a 5-year-old and runs away :::
Oh no- I had no idea “bonk” was a euphemism until someone on my FB pointed that out too! Of course now that I know, did I change it? Nope. ::giggles like a 5-year-old too::
As a fat-adapted, paleo-diet eater, I never, ever get the sugar shakes. I get pretty darned hungry after a vigorous workout, but I can keep going all day if need be on my morning bacon and eggs cooked in coconut oil.
I’m glad you brought this up! While paleo didn’t have this effect for me (maybe I didn’t do it long enough?) I’ve heard enough people talk about this being one of the best benefits of that way of eating. I think it’s definitely worth a try!
It definitely took a while for me to get to this stage, almost a year of seriously sticking to the high fat, low carb aspect of it. Once getting to this point, though, I am able to deviate quite a bit from what I’m supposed to eat without reverting to carb dependence.
To be fair to Shelby, the low blood sugar attack before her wedding wasn’t what killed her; it was carrying a child to term later. Love that movie! Anyway, thanks for the very informative post! I didn’t know that about wheat bread. My grandmother was hypoglycemic, and I remember her morning snack was always a PB sandwich and a V8. No sugar ever, except in her daily bourbon on the rocks!
Ooooh you’re right! See, I only saw the movie once and I was sobbing like ridiculously hard so the plot is a little fuzzy…
My husband the diabetic says he’d rather die than eat glucose tablets. I guess they’re pretty nasty? In any case he always carries starbursts or lifesavers (aptly named!). They’re fast and easy to eat and don’t melt like chocolate. We have them stashed everywhere: in my purse, in the glove compartment, in our luggage, etc. It’s dangerous when I’m craving sugar!
Luckily I seem to have a pretty stable blood sugar. The only time I thought I had low blood sugar after HIIT class I ended up having a stomach bug and puking for the next 24 hours. I think I’d have prefered the low blood sugar.
Stomach bugs are the worst!! I’d rather have just about any sickness than the pukes. Ugh. But on the other hand starbursts are delish and now I totally want to stash them everywhere;)
I get hypoglycemic as well and need to eat at least a piece of fruit every few hours in between meals. I usually work out after work and before dinner – so a good 7-8 hours after lunch. I definitely need to eat a snack (usually some nuts and dried fruit) beforehand so that I don’t get dizzy while exercising. But I suffer the shaking, headache, dizzy, nausea symptoms just from not replenishing every few hours in daily life. It’s become a bit of a joke with my husband that we have to pack a snack bag for me whenever we go anywhere. But in all seriousness, I do have to keep last resort fruit and nut bars in easy reach in the car in case I get hit with a vicious low sugar attack during my commute.
That stinks that your blood sugar is so persnickety but I love that you pack yourself a snack bag – my kids would approve;)
I am extremely prone to low blood sugar – and unfortunately have a low and scattered appetite. They do not go well together… And to just keep it low, blood pressure is also at the bottom line. So, exercise goddess 😉 , how do I do yoga?? I’m supposed to focus on that with the lame-o adrenals not working, but I black out if I bend over. A thicker mat with pillows surrounding me? 🙂
Oooh swooning yoga – it will be the next big thing!! Seriously though, I’m not sure what to tell you. I have low blood sugar and low blood pressure too so I know that feeling – although I don’t actually black out in yoga but I do get pretty dizzy changing positions sometimes. Maybe start by focusing on the breathing/meditation aspect of yoga? Can’t hurt and you’re already on the ground;)
My hypoglycemia is hormonal 100%. different times of the month it is worse than others. Glycogen stores and carb loading.. I know this works.. because it takes a few days for me to bounce back after a heavy workout.. like about 36 hours of extra eating and loading to stop the shakes. The other horrible thing is inflammation now.. I am working on lighter training and lighter cardio keeping things under a half hour.. or else I’m ruined. I don’t like gatorade.. but preempting with water mixed does help manage to prevent dips and following up with something substantial immediately after. I live on peanut butter. … and hard boiled eggs… pretty much.
huh, that’s what that was, I always thought it was that I didn’t drink enough… lol, had it a couple weeks ago, you are right, don’t feel like ingesting anything…
It could be dehydration too, lol! So many ways to get shaky after a workout;)
Shelby didn’t die right before her wedding. She was on life-support then died after her newly transplanted kidneys started to fail after she had her son. Obviously I’ve seen the movie way too many times haha.
Hahah! I love you. See, I only saw the movie once and I was sobbing like ridiculously hard so the plot is a little fuzzy…
I’m with you! The best option is to plan ahead! If you’re keeping on top of things it’s a lot easier than if you’re trying to pull yourself out of that bonk.
Random tip – if you’re feeling the bonk and you’re nauseous and nothing sounds good to eat even though you know eating will solve your problem, smell a little tiger balm. (Not to be confused with Charle Sheen’s tiger blood method) For some reason the smell of that makes my nausea subside and then I can eat something and I feel better faster.
Also, I wish I wasn’t so familiar with that feeling that I knew stuff like this.
I would never have thought to use Tiger Balm in that way but I love it! I’ll totally have to remember that. Where were you when I was preggo?!? 😉
Probably hiding under a bushel.
Sadly this isn’t something I knew during my pregnancies either.
My biggest “hit the wall” moments happened right after my intense boxing classes. As soon as I would stop at the closest gas station for my chocolate milk, I was fine.
Weirdly enough, I have ALWAYS craved chocolate milk following intense workouts (distance running, boxing, etc). Can’t argue with what the body truly needs!
Chocolate milk is amazing! I miss it. Chocolate coconut milk is also good but it’s not the same…
I am the worst. I have extremely low blood pressure and I tend to go really low on blood sugar. My doctor says that they tend to be correlated.
Apart from fainting and getting the shakes, I also get in a really bad mood. My teenager son says ALL our fights have occurred right before a meal. I am not sure, but I think he might be right.
He also says that he can tell right away when I am low on blood sugar.
So to be a good enough mother, and professor, I have to snack all day!
Hahah too funny about the fighting. My brother is the same way!
My family learned when Mama gets crazy, feed her fast. The problem is I don’t want to do what anyone says and I am not nice when it happens. I am really careful. But I have just started exercising more and I am really struggling. Even when I eat regularly I am in trouble. That is why I am reading this, to get some good ideas.
Very comprehensive article!
I was pleasantly surprised to see IF in there since I practice that 🙂
Aw thanks! I’m sure you would do a better job with the topic though!!
I wasn’t feeling well on the day of the last mud run I signed up for,but they’re expensive so I did it anyways. We ran at 4:30 and I’d had 2 chicken Mcnuggets all day (I know, OK? Gross.) I bonked about halfway to the first obstacle…on a 4 mile course. Not fun.
My hubby and boys get SO ORNERY when their blood sugar is low. They are all prone to it when they get hungry, which is often. I can almost be ready to divorce my husband, and then realize he hasn’t eaten. A bit of food later and there’s my awesome guy back like he was never gone. Same with my kids.
I don’t get low blood sugar easily, but when I do I also have low blood pressure and I just drop like a sack of potatoes. I get tunnel vision, my ears ring and bang. Doesn’t happen very often though.
This: ” I get tunnel vision, my ears ring and bang.” Yep, yep. NOT PLEASANT. And I get pretty cranky too…
yes and yes. I either have a protein shake or a banana right after i work out and it seems to do the trick for me.
I really need to get back in the groove with my protein shakes…
I heart you Charlotte but I wonder if you are mis-remembering your blood sugar results? If the test is fasting 100 is the cut off for normal before you are too high. Low would be around 60. Even not fasted 100 would be normal? Good post though. 🙂 I struggled with the shakes in high school (when I lived on refined carbs, go figure!) And they have returned in third trimester of my second pregnancy. Fun.
I’m sure I am. I just looked up my last blood sugar test (which isn’t the one I was talking about) and that was 88 and listed as “normal” so… yeah. Sorry about that. Next time I’ll actually get up and look it up instead of guessing. I’m a dork sometimes. 🙂
Thanks for the insight. After long runs over 6 miles, I always would get the chills, nausea and be completely useless the rest of the day. Not to mention being really irritable too. I’d have to take a hot bath just to be able to function. I actually stopped running because this was so awful. Now I know why. After reading this, I tested it out yesterday at spin class. I only ate Cheerios (about 120 calories) before a class and weight session. Stupid I know but wanted to test it.I downed a protein shake right afterward but I think it was too late. I got really sick about 30 minutes later while I was at the grocery store. Ugh- there is def something to your post and I feel enlightened. Thanks!
Hahah – your test sounds exactly like something I would do! Gotta see for myself! Glad that it was useful info for you but I’m sorry you felt so icky!
I get low blood sugar easily and I have low blood pressure too 🙁
Such a lovely combo (not)… I don;t even have to workout to feel the effects. If I have a long stressful day without eating properly, I start feeling faint and unwell. My husband has a hard time taking this seriously.
Anyhow, I know now to pack myself a snack, like fruit and nuts, and to eat proper meals before going anywhere.
Again, my husband who doesn’t do breakfast always makes fun of me for being so religious about it. But ti’s still better than crashing out and getting all teary and moody.
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Thank you so much for this witty first hand account of hypoglycemia and how you deal with it. I’ve just been diagnosed with it after thinking that the shakes, nausea, sweats and dizziness were just daily anxiety attacks all this time. Being a soy-free vegetarian means I eat lots of carbs all the time, so this is all new to me. Of course, I’m seeing a doctor for this and have been reading up on medical sites (what grim places to get information!) But I have to say, your post is probably the best and most entertaining help for a newbie like me. Thank you.
After running my first 1/2 marathon I had a major bonk. I was throwing up, had low blood pressure, was out of it and my legs were shaking uncontrollably. But I did finish the run and my time wasn’t too bad for a first timer! The crash was the worst feeling ever…but after refueling in the medic tent I felt much better. I did get tested afterwards and am prone to hypoglycemia. I always pack my snacks and plan out my meals all day long. I’m now training for another 1/2, and then a full marathon in the spring. I never leave for a run without electrolights and a snack. My second 1/2 I got through just fine!
I’m a little late reading your post, looks like the last comment was almost a year ago. I am trying multiple things to control my hypoglycemia during workouts, but failing miserably. I could really use some advice. I tried eating whole grain toast with 1 tbs natural peanut butter and a banana (yummy). Got my level up to 102 when I got to the gym, but 5 min into cardio it dropped to 62! I’ve tried adding more protein with eggs as well as carbs, but same result. Tried drinking G2 Gatorade during workout, same result. I can’t seem to prepare correctly. I eat throughout the day and eat clean about 95% of the time. Any ideas on ways to get through a workout without crashing within the first 10 min!? VERY frustrating especially when I want to push myself harder in the gym, but can’t if I want to keep from falling out.
PS – I <3 Shelby too 🙂
I too am a bit late in reading this! But it has saved me from what started out as a major downer on my day. After an hour of Kettlebells today at gym class (on just a banana and a coffee) I had a pretty awful blood sugar drop. Vision went funny, ear popped, shaky, fuzzy brain…it was awful. Several hours later and I’m still feeling sleepy and weak, after crying a few times too (lol!). I’ve been diagnosed reactive hypoglycaemic for a few years now and am on Metformin, but my personality appears to clash with the organisation necessary to not feel like s**t all the time. Todays experience, and reading this, has made me realise I need to sort myself out properly as its now seriously affecting my life. I guess I just hate that everyone else can eat what they want when they want and I have to now force myself to eat certain things at certain times! Sound like such a spoiled brat lol. I also thought (was told by my doc) that my symptoms were in fact anxiety and not anything physically wrong for 3 years, which in the end caused actual anxiety that continued even after I was diagnosed – still working on that now, for example I find driving on motorways really stressful because before I was diagnosed I’d had a few episodes while driving so now worry it could happen again. What a pain this condition can be! But it sounds like people here have managed to control its effects quite well with proper planning, next stop docs and referral to nutritionist!
Thank you all for having bodies that don’t quite work properly too :0)
For the past six years I have been treated with meds and diet by an endocrinologist for “reactive hypoglycemia”. All meals should have protein and complex carbs. Snacks should be healthy protein with complex carb. This is nothing to laugh about. Really Low blood sugar can make you go into a coma. When my sugar drops below 70, I drink a small apple juice (4 oz) or 4 oz of coke and IMMEDIATELY follow that with a complex carb and protein. For me it is usually a piece of whole wheat with peanut butter or ham or turkey. I always have glucose tablets or candy with me plus the individual cups of peanut butter and crackers or nuts with raisins. My purse is heavy because of the food supplies and testing kit I always have with me. Remember juice or glucose first followed by complex carb with protein!!
Got a bad hypo while running a half marathon. Had drank coffee prior to it, which does not hrlp me. I collapsed 100 metres from finish and was carried over line. I was fairly bad for last 4km but too confused to realise despite staggering etc… I only found out recntly (2yrs later) that it was a hypo after having a few others, not necessarily while running. Frightening. A low carb high fat diet seems to help keep this under control so far ….
What’s a good protein shake ?