Blood sugar dysregulation can have many negative consequences. When it is too high, conditions like diabetes can develop, and if left untreated, it can damage the kidneys, nerves, eyes, and cardiovascular system. When it is severely low, it can result in seizures and fainting. Keeping blood sugar balanced is essential for optimal health and well-being.

In this article, we'll cover what blood sugar is, what causes it to be dysregulated or imbalanced, the symptoms of high and low blood sugar, and how to use nutrition to balance blood sugar levels.

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What is Blood Sugar?

Blood sugar, also called blood glucose, is the level of sugar circulating in your blood. It is the primary fuel source your body uses to create cellular energy. Your body attempts to keep your blood sugar within a specific range and has several mechanisms to serve that goal.

While several hormones and body processes assist in regulating healthy blood sugar levels, the two main players are insulin and glucagon. Insulin and glucagon are hormones released by the pancreas, and their primary function is to maintain healthy blood sugar levels.

A rise in blood sugar levels causes the release of insulin, which triggers glucose to enter the cells to be used as energy. As glucose enters the cells from the blood, blood sugar levels decrease.

A drop in blood sugar levels causes the release of glucagon, which raises blood sugar levels in several ways. Glucagon stops the liver from storing glucose that is circulating in the blood, it triggers the liver to convert stored glucose (glycogen) into glucose that can be released into the blood, and it causes the body to create more glucose (called gluconeogenesis) from amino acids (the building blocks of protein).

What Causes Blood Sugar to Be High?

When blood sugar levels are much higher than they are supposed to be, it is called hyperglycemia. Hyperglycemia is a fasting blood glucose test of over 100 mg/dL. Conditions associated with high blood sugar include insulin resistance, type 1 diabetes (T1D), and type 2 diabetes (T2D). With T2D and insulin resistance, the cells become less responsive to insulin resulting in less glucose getting into the cells and more glucose circulating in the blood. Type 1 diabetes is an autoimmune disease. It's a condition where the body's immune system mistakenly attacks the pancreas' insulin-producing cells, so there is less insulin available to get glucose into the cells.

Having a family history of blood sugar dysregulation or diabetes, being over 45 years old, and being of Black, Hispanic, Native American, Pacific Islander, or Asian American descent, increase the risk of hyperglycemia and diabetes.

Several dietary and nutritional factors can cause elevated blood sugar, such as overeating, eating a diet high in unhealthy fats, sugar, refined carbohydrates, and processed foods, and having nutritional deficiencies. Nutritional deficiencies associated with high blood glucose or diabetes include inositol (a type of sugar the body produces that supports insulin and blood glucose regulation), Vitamin D, magnesium, zinc, and chromium.

Certain illnesses like a cold or flu can cause blood sugar levels to be high, as can problems associated with the adrenal glands, such as Cushing syndrome, the pancreas, such as pancreatitis, and the thyroid, such as hyperthyroidism.

Certain medications, such as corticosteroids, phenytoin, and estrogens, can cause high blood sugar levels.

Experiencing high levels of stress also causes high blood sugar levels. Stress results in a rise in the stress hormone cortisol. An increase in cortisol levels causes a rise in blood glucose as it stimulates gluconeogenesis (production of glucose from amino acids). Over time, hyperglycemia from chronically high stress hormone levels can cause type 2 diabetes.

A lack of physical activity and being obese or overweight can cause insulin resistance, resulting in hyperglycemia.

Disruptions in the gut microbiome, called gut dysbiosis, are associated with blood sugar dysregulation and diabetes.

Symptoms of High Blood Sugar

Symptoms of high blood sugar and diabetes can include:

• Fatigue
• Blurry vision
• Increased feelings of hunger or thirst
• Urinating frequently (especially at night)
• Slow wound healing
• Frequent infections
• Numbness, pain, or tingling in the extremities (feet or hands)
• Unexpected weight loss
• Areas of darkened skin (most often around the neck and armpits)

What Causes Blood Sugar to Be Low?

When blood sugar levels get too low, it is called hypoglycemia. Hypoglycemia is a fasting blood glucose test result of below 70 mg/dL. Blood sugar that drops too low can be serious, resulting in seizures or loss of consciousness.

A common cause of hypoglycemia in type 1 and type 2 diabetics is taking too much insulin or other diabetes medication.

Dietary factors that cause low blood sugar include skipping meals, drinking alcohol (especially on an empty stomach; fasting for an extended period of time; malnutrition; inadequate amounts of fat, protein, and fiber in a meal; and surgeries that interfere with normal emptying of the stomach post eating a meal (such as stomach bypass surgery).

Stress and other factors that increase stress on the body, such as illness, overexercise, sleep deprivation, and very hot weather, can cause low blood sugar levels.

Hormone changes associated with puberty and menstruation can cause hypoglycemia.

Symptoms of Low Blood Sugar

Common symptoms of low blood sugar include:

• fatigue
• shakiness
• irritability
• anxiety
• perspiration
• headache
• increased hunger
• nausea
• turning pale
• an irregular or fast heartbeat
• problems concentrating
• dizziness
• Numbness or tingling of the lips, tongue, or cheek

Symptoms of dangerously low blood sugar include:

• confusion
• slurred speech
• strange behavior
• loss of coordination
• vision problems
• seizures
• loss of consciousness

Functional Medicine Labs to Test for Root Cause of Blood Sugar Dysregulation

In addition to standard CBC, CMP, HbA1c, and insulin tests to evaluate blood glucose levels, blood glucose control, and the presence of infection, liver or kidney dysfunction, the following tests help integrative practitioners identify the root cause of blood sugar dysregulation.

Micronutrient Test

Nutritional imbalances can contribute to impaired blood sugar regulation. A micronutrient panel measures 40 different vitamins, minerals, amino acids, and fatty acids that help identify any nutrient deficiencies or insufficiencies contributing to the root cause of blood sugar dysregulation.

Comprehensive Stool Test

Dysbiosis and impaired gut health are associated with blood sugar imbalances. A comprehensive stool test is valuable for evaluating gastrointestinal health and the gut microbiome.

Hormone Testing

The DUTCH Plus™ test is a dried urine test that evaluates sex hormones, stress hormones, and the stress response with a Cortisol Awakening Response (CAR) measurement and allows for an evening cortisol sample when insomnia or sleep disturbances are an issue.

Thyroid Testing

A thyroid panel evaluates the hormones involved in thyroid function to determine whether thyroid dysfunction is the root cause of blood sugar dysregulation.

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How to Manage High Blood Sugar With Nutrition

A nutritional strategy to reduce hyperglycemia and enhance blood glucose control is to follow a Mediterranean diet. This eating style also improves several other factors involved in hyperglycemia, such as regulating the stress response by supporting the HPA axis, boosting the immune system, showing benefits for people with diabetes, and promoting gut health.

This diet is based on the traditional diets of people who live nearby the Mediterranean Sea and emphasizes anti-inflammatory, nutrient-dense foods. Seasonal fruits and vegetables, herbs, legumes, beans, whole grains, and healthy fats, particularly olive oil, are all components of a Mediterranean diet. While high-fiber plant-based foods are the main focus, fish, eggs, poultry, dairy products, and red wine are consumed in moderation.

An essential aspect of managing high blood sugar with nutrition includes avoiding or limiting foods associated with raising blood sugar and causing insulin resistance. This includes refined and processed foods, sugar, and unhealthy fats.

How to Manage Low Blood Sugar With Nutrition

During a hypoglycemic episode in which a person is experiencing symptoms from having low blood sugar, consuming 15 to 20 grams of simple carbohydrates, such as honey or fruit juice, is recommended to raise blood sugar levels to normal ranges quickly. Checking blood glucose levels by using a glucose meter 15 minutes after consuming the carbohydrates will determine whether blood sugar levels are normal, above 70 mg/dL. If blood sugar is still below normal ranges, consuming another 15 to 20 grams of simple carbohydrates and rechecking blood glucose levels should be repeated until normal levels are reached.

However, a long-term nutritional approach for managing low blood sugar shows that the Mediterranean diet is also an excellent option in this situation. Overall this way of eating lowers inflammation and improves blood sugar control, making it an ideal choice for people with high or low blood sugar.

People with low blood sugar should aim to swap simple carbohydrates for complex carbohydrates to prevent blood sugar spikes and dips. It's also essential to balance complex carbohydrates with protein and healthy fats to keep blood glucose in healthy ranges, preventing blood sugar spikes and dips.

Avoiding skipping meals and prolonged fasting can also prevent low blood sugar episodes. Working with a qualified provider is the best way to determine your unique nutritional needs, including optimal amounts of complex carbohydrates, protein, and healthy fats to aim for in your diet.

Supplements and Herbs that Help Balance Blood Sugar

Integrative medicine practitioners use many supplements and herbs to help balance blood sugar. While it's important always to follow the guidance of your healthcare provider, here are three commonly used supplements improving blood glucose control:

Chromium for Balancing Blood Sugar

Chromium is an essential mineral required in trace amounts that supports blood sugar regulation by enhancing the functionality of insulin and the metabolism of carbohydrates, fats, and proteins. It helps improve blood glucose control when it is too low and too high.  

Berberine for Balancing Blood Sugar

The active ingredient in the ancient Chinese herb Coptis chinensis French is berberine which has been used for thousands of years to treat blood sugar dysregulation and diabetes. Along with its antioxidant and anti-inflammatory properties, studies show that supplementing with berberine lowers blood sugar, HbA1c, lipids, and insulin levels. The glucose-lowering effects of berberine are only observed when hyperglycemia is present; studies show it does not pose a risk for hypoglycemia.

Probiotics for Balancing Blood Sugar

Probiotics are strains of bacteria that promote overall health. Supplementing with probiotics supports a healthy gut microbiome while modulating inflammation, reducing insulin resistance, and improving blood glucose control.

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Summary

Blood sugar imbalances, whether high or low, can negatively impact overall health, wellness, and quality of life. Thankfully, blood sugar levels can be regulated with straightforward nutritional modifications and other lifestyle changes, such as physical activity, adequate sleep, and stress management.

If you experience hyperglycemia or hypoglycemia, talk to your healthcare provider or nutritionist about managing your blood sugar with nutrition.