The Surprising Link Between Low Blood Sugar and Panic Attacks
You’re going about your day, then suddenly a familiar feeling starts creeping up. Your palms are clammy, you can’t stop trembling. Your heart starts racing, and you suddenly feel very, very faint. It’s the familiar start of a panic attack.
Or, wait, is it low blood sugar?
Here’s what you need to know about panic attacks and low blood sugar, and how you can take a proactive stance in dealing with both.
Need help with stress hormones?
Take the Base quiz to get a personalized hormone test recommendation and improvement plan.
Can low blood sugar cause anxiety and/or a panic attack?
Yes, it can.
For some people, panic attacks, which are instances of sudden and unexplained fear and anxiety, can happen without any warning, especially if you suffer from a panic disorder or from a history of clinical anxiety. But if you also deal with issues managing your blood sugar levels, you might be able to draw a connection between the two.
This is because low blood sugar, also known as hypoglcyemia, not only has many similar symptoms of panic attacks (shaking, weakness, dizziness, etc), but there is also evidence that it can actually contribute to the onset of these anxiety symptoms and make them worse.
Take this case study, which evaluated the symptoms of a fifteen-year-old patient with a history of both generalized anxiety disorder and hypoglycemia. Prior to her treatment, her diet consisted largely of refined sugars and processed carbohydrates. When she was introduced to a diet that included more protein, fats, and fiber, she found that both her anxiety symptoms and her hypoglycemic symptoms substantially decreased. And when she returned to her previous diet, those benefits went away, suggesting that her diet was important for both.
So why does this happen? The answer might boil down to your hormones.
Your body is constantly engaged in a battle of homeostasis, in which it tries to keep everything at a normal healthy level. So when your blood sugar (which your brain relies on for energy) dips low, your body has to counter this dip somehow — and one of the ways that it does this is by pumping out more hormones.
Two of these hormones are adrenaline and cortisol, both of which are partially responsible for your “fight and flight” response. These hormones send signals throughout your body to free up more glucose, the form of carbohydrates that your body uses for energy. But that subsequent “adrenaline rush” leads to some of those classic panic attack symptoms, like sweaty palms and a racing heart. Studies have also found that high cortisol levels have been found to increase during panic attacks as well.
What about the other way around: can panic attacks or anxiety cause low blood sugar?
As for whether or not the relationship works both ways, the answer is a little less clear-cut, and scientists are still trying to understand exactly how stress, anxiety, and panic attacks affect your blood sugar.
For example, there’s evidence that panic attacks can actually increase your blood sugar readings, especially among people who have Type 2 Diabetes, a disease marked by insulin resistance and poor blood sugar control. Again, we can thank our “fight or flight” instincts for this. To reiterate the point, your body starts pumping out both adrenaline and cortisol in response to a perceived danger. But these hormones do more than just instill fear and panic: it also starts to make metabolic changes, so that you have the energy to act on that flight instinct.
These hormonal changes are actually meant to increase your blood sugar so that you have access to a quick source of energy. What this means:
- Adrenaline acts immediately on your liver to release more blood sugar
- Cortisol works more slowly, acting on your liver, pancreas, and stored energy in your muscle and fat tissue to give your brain access to glucose, the form of carbohydrates that your body uses for energy.
So biologically, a panic attack or instances of anxiety, both of which are stressful events by nature, is more likely to increase your blood sugar rather than cause it to dip too low.
Even still, there definitely does seem to be an interesting correlation between anxiety and poor glycemic control, especially among people who have diabetes (whether it’s Type 1 or Type 2). After all, the surge of hormones during a stressful period can make managing your blood sugar much more difficult, especially if you have to use a specific dose of insulin to help your body manage your carbohydrate intake. Ultimately, though, more research needs to be done before we can conclusively say whether or not anxiety and panic disorders can cause low blood sugar.
How to tell the difference between low blood sugar and a panic attack
So because the symptoms of low blood sugar and panic attacks overlap in so many places, it can sometimes be hard to decipher whether that moment of panic you’re feeling is stemming from anxiety or from your blood sugar (or maybe from a little bit of both).
Let’s start by looking at the symptoms. Some symptoms you might find in both hypoglycemia and panic attacks include:
- Weakness
- Racing heartbeat
- Sweatiness
- Trembling or shaking
- Nausea
- Dizziness
- Blurry vision
- Tingling
But if your symptoms are caused by hypoglycemia, you might also notice:
- Hunger
- Irritability or confusion
While symptoms stemming from a panic attack could include:
- Chest pain
- Shortness of breath
- Fear
- A sense of impending doom or of losing control
You might also be able to address these two different episodes in different ways. Generally speaking, because hypoglycemia symptoms are caused by low blood sugar, you might be able to solve your hypoglycemia “attack” by eating something with carbohydrates, since that can help balance out your blood sugar. Meanwhile, this tactic probably would not stop a panic attack, but it might instead be helpful to try deep, slow breathing to manage any shortness of breath you might be experiencing.
It also helps to look at the instance in context. For example, if the symptoms start shortly after a particularly strenuous exercise session, it’s a possibility that the intense physical activity caused your blood sugar to take a dive. Meanwhile, panic attacks can be harder to predict, especially if you suffer from panic disorder which can lead to panic attacks without warning, but you might be able to gauge whether or not it’s happening if you’ve just experienced something particularly stressful.
How lab testing can help you manage both anxiety and blood glucose levels
Deciphering whether those instances are due to your blood sugar or a panic attack (or both) can come down to keeping an eye on those biomarkers in your blood that predict them.
Take blood glucose (aka blood sugar) tests, for example. Diabetics, who already deal with issues managing their blood sugar levels, need to take regular blood glucose readings HBA1C so that they know exactly where their blood sugar levels are at and take the appropriate steps to keep them balanced. But when you also suffer from issues with anxiety and panic attacks, it’s also worth keeping an eye on your cortisol levels, the “stress” hormone that increases during intense, stressful moments, and which plays a role in increasing your blood sugar and manipulating your metabolism in the process.
If you’re looking for a way to manage both your blood sugar and your cortisol levels, consider taking the Base quiz, which will recommend a personalized at-home blood test and improvement program based on what you’re doing with. With lab results delivered straight to your smartphone, you can have a better understanding of your anxiety and your blood sugar on a biological basis. Lab tests also come with a specific plan of action to increase any suboptimal blood sugar or cortisol levels, so that you can have an active hand in managing symptoms that might otherwise be hard to manage gauging from how you feel alone.
Bottom line
The overlapping symptoms of panic attacks and low blood sugar levels are no coincidence, especially when you take a look at how they can affect each other. If you struggle with anxiety and/or panic attacks, checking in with both your HBA1C readings and your cortisol levels can help key you in to what specific issues are happening in your body and leading to those shaky, faint, scary moments.
Need help with stress hormones?
Take the Base quiz to get a personalized hormone test recommendation and improvement plan.
