Friday morning found Gym Buddy Jeni and I shaky, light-headed, nauseated, cold, and mentally foggy. No it wasn’t because we’d just heard that Demi and Ashton might be breaking up. (If they can’t last then what chance do the rest of us have?? Hollywood, hot bods, oodles of money, custom-made kite boards – that’s a recipe for marriage perfection if I ever heard one.) Jeni and I had just finished an hour-long TurboKick class and we had the sugar shakes. 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 thanks to Jeni skipping breakfast and me eating breakfast but leaving my post-workout shake in the car, our blood sugar was all out of whack.
This was not a new feeling for me as 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! Or maybe she’d just been married! She might have had a kid! Or not! Ok, I’m sketchy on the details – forgive me, I was sobbing my guts out. 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. Let me back up.
I’ve always been a fainter. Thanks to a propensity for abnormally low blood pressure – it’s normal for me to be 80/55 and even lower when I’m pregnant – 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 100 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 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.
To prevent this, eat small balanced meals every few hours. 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.
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. (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.)
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.
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. You do not want to mainline the jelly beans though as straight sugar will fix your low blood sugar but the high is very temporary and may cause an even larger dip – the sugar “crash” – when you come back down. 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.
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 someway 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.
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. 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.
for more of my crazy antics and uncomfortable over-shares!
{ 41 comments… read them below or add one }
A little off-topic, but, tearjerker movie? Ugly cry? Terms of Endearment. That is all.
Never seen it! Probably because I’ve heard it’s a sob fest…lol
My ugly cry is “Ol’ Yeller.” OK, I only saw it once, when I was, like, 8, but I cried hard and long, and haven’t been able to watch it since.
I don’t have hypoglycemia, and have (luckily) never fainted. I have seen it, though, and it’s pretty scary. In college a classmate pitched forward from his chair, face-first, onto the floor. Luckily it was in New York, and another student had a (quality!) bagel in his bag. Who knew bagels could be such lifesavers? (Not the candy…)
Oooh yes, Old Yeller was bad! And so was Where the Red Fern Grows!
I’m fairly prone to fainting as well. I fainted just after my wedding and still can’t remember any of the ceremony (we got divorced a few years later, so I guess it wasn’t such a big loss).
Wow that’s the best (worst?) wedding story ever!
I’ve never passed out but I have been so bad I had tunnel vision and what I think was the verge of passing out. My nose, hands and feet got all shakey/tingley and I remember being pretty freaked out. I too usually have low blood pressure and also when I’m pregnant. I’m going to try the chocolate milk thing from now on. I wonder if I’m prone to hypoglycemic episodes. This was very informative!
Steal Magnolias, yeah. I do the ugly cry more so as a mother now because she faints while home alone with her toddler. I always did cry, but now definitely the ugly cry. I don’t know why I watch it every time I see it on tv. It’s almost like I want to make myself cry.
Ohmygoodness, that’s right! Yes, it’s so much more disturbing now that I’m a mom… yeesh. That’s every mom’s worst nightmare!
OK, so in addition to possible food triggered exercise induced anaphylaxis, I have to check for hypoglycemia also? *sigh* At least I won’t feel like it’s a waste of time going in for my next checkup.
My blood pressure is pretty low 90/60, and that’s WITH drinking a lot of water and consciously eating salty stuff. And I’ve fainted before, usually when I forget to eat. It’s pretty embarrassing, because I did it in front of my friends when we went to an exhibit (we had to leave early, so I skipped breakfast). My friends gave me a thorough tongue lashing afterwards about it. Yea, I guess hindsight, I should have at least carried trail mix with me. I guess that can go in my magical handbag.
Haha – we should hang out together, we’d be like those fainting kittens except less adorable;)
I plan ahead always.
snacks sugars proteins carbs BACK ALWAYS PACKED for my emergencies and the familys and, well, strangers as well
See? Reason 2045 why you need to be my neighbor! (I even have a red cardigan…!)
I’m training for my first marathon. While I haven’t fainted, any run longer than 15 miles leaves me a shaking mess on the floor (usually after showering) despite the fact that on paper my nutrition before, during, and after the run looks spot on. I’m still working on this.
My one and only time to faint was after a long flight from Australia to Costa Rica. I didn’t eat enough that day, was exhausted when we got to our hotel and went straight to bed. The next morning, I’m sitting on the toilet when I feel kind of funny and the next thing I know. I’m lying in plastic, getting wet and I hear my husband’s frantic voice. Yep. I fainted from the toilet and fell off into the shower/shower curtain where my husband was showering. (I feel like I should say shower again.) I don’t know who was more horrified. But he helped me back to bed and had food for me as fast as humanly possible.
Wow, as someone who never stops eating for long enough, or who ever exercises hard enough, to have experienced this–very informative! While I don’t think I’ll personally need to deal with this problem, it helps to know what others may be going through. And glad you’ve figured out the steps to keep it under control. Fainting often looks very becoming in movies, as it’s always done gracefully by aristocratic heroines in distress– but I get the feeling in real life, it probably ain’t much fun.
I’ve never fainted in my life. In a weird way, I kind of want to, just to know what it is like. But I have super low blood pressure too. I just had a blood taken last week and now I am dying to know my blood sugar! I love numbers.
Have you ever heard about how coconut oil can regulate your blood sugar? Here’s one of many Google hits on the subject: http://www.coconut-oil-central.com/coconut-oil-diabetes.html (How does it work? Hint: medium chain fatty acids.)
I’m no doctor, but I can tell you that I can exercise vigorously all morning in a fasted state without getting the shakes or bonking. I give credit to the coconut oil. (Of which I take in at least 40g a day.)
I also swear by coconut oil (and also coconut water after a heavy, sweaty workout to replace electrolytes). If I’m going on a long run or bike ride, I’ll take along some dates stuffed with coconut oil (pit the dates first!). They work better for me than gels, gu, etc.
One of the things that I like about eating IF warrior style is because I fuel up and hydrate the night before, I am fit and ready to do my exercise program in the AM. At least it works for me!
I remember how reluctant you seemed to do the protein drink immediately afterward when you were experimenting with Rachel Cosgrove’s book.. Seems like that is one of the things from that experiment that really stuck with you.
I’ve learned that I need to separate my hot baths and showers…If I try to shower right after a bath, I faint every time. Especially if there was wine involved with the bath. I don’t know if it’s blood pressure or sugar related, but i should probably look into it!
And wow, I just realized how wimpy this makes me sound in comparison…Everyone else is like, ‘Yeah, when I run a marathon, I get a little shaky!’ and I come in with, ‘*whimper…When I bathe, I get the vapors!’
Oh well. I have no shame.
no, you’re not a wimp, I get that too. It has something to do with Vasodialation, or something like that. I have to be VERY careful getting out of a hot tub, or I’ll pass out. I also used to faint if I got up too quickly if I was in a warm place and went to a cold one- ie from in front of the fire to anywhere else!
I am a fainter and get the sugar shakes. My BF calles me “hangry” – hungry and angry.
I am interested in trying bikram yoga, but am a little woried the intensity of it will give me the shakes. Suggestions?
My biggest ugly cry in public had to be The Horse Whisperer, but that could have been because my horse was put down shortly before the movie came out. I had the heaving sobs and my mom was embarrassed, but to be fair, those emotions are particularly hard for a teenager.
As far as the “sugar shakes” go, I’ve had them once after a 5k race. I think it was mostly because I wasn’t hydrated well enough and hadn’t eaten anything that morning before the race. Eating a banana after the race made it worse. Luckily I only had to drive 10 minutes before I was able to crash onto the bed and take a two hour nap. Upon waking, I ate some pizza and felt normal again. It was scary but now I know how to properly prepare.
I’ve found I suffer less from low blood sugar since trying intermittent fasting as prescribed by Martin Berkhan and since doing Primal. Sometimes I think that eating a low carb diet has helped regulate my insulin so that I don’t have major spikes or major dips in energy.
It could definitely be a good experiment to try!
I have exactly the same problem. I am a fainter, I have low blood pressure and I easily get low on blood sugar. I always carry something to eat with me, I have to eat even before my morning yoga class and I need my post-recovery shake as well.
Lately, I have had a lot of discussions about this with a friend. She believes it is caused by my former eating disorder, and blames me for having mixed up my digestion, but I am not so sure. It feels like I have always been like this.
Have you found any relation between this condition and eating disorders?
I have this and never had an eating disorder. That doesn’t mean it can’t be caused byone, just that its not necessarily the cause.
ah the sugar shakes… I *was* pretty good about controlling my blood sugar (propensity towards low blood sugar, all the time) by exercising daily, eating smaller more frequent meals and uh, avoiding the white stuff. but now, now I am pregnant. and when you want sugar and you’re pregnant, it’s hard to moderate. really hard. luckily I’ve crashed hard enough (totally mental fog, dizzy, but nothing too terrible, no fainting) a few times that I try to remember that and limit the sugar. but i’ts so hard!
Oh my gosh, Steel Magnolias! I saw it with my best friend, my mom and my mom’s best friend. SOBBING! Another one that was a big cryfest for me around the same time was Beaches. Saw it with the same best friend, and her mom and big sister and THEIR best friends. My excuse is that I think I was 12 or 13 at the time.
Anyway, I am one of those people who has to eat something before working out or I am absolutely guaranteed a migraine a couple hours later. My family is predisposed to sugar sensitivity, so I learned a long time ago that I have to eat something pre-workout, or pay the price afterward. Not much, usually around 100 calories, with a good mix of sugars, protein and fat. I find half a Larabar is just about perfect.
I bonked just yesterday! Cold sweats, dizziness, fatigue, mental fogginess-super fun as always. Fortunately the grocery store was giving away choc chip cookies when you donated to Breast Cancer Awareness at the checkout. It used to happen to me all the time when I was in spin class. I had to switch to Gatorade in my water bottle. You know, instead of working on my eating or dialing down the intensity. It’s happened when I was hiking, when I was roller-blading… I REALLY need to learn to back it off!
Ok, how about fainting in the middle of a major meeting: Our lawyers on one side, the lawyers of a major eastern city on the other, representatives of various companies and what do I do? I slowly slide under the table… And the only ones who noticed were 20 something males who, of course, didn’t have a clue what to do so they spent precious time trying to catch the eye of the (only) female attorney in the room. She of course, sprang into action… I came to a few minutes later with a lot of very concerned people around me. It was probably low blood pressure combined with my body fighting a virus combined with low blood sugar. I discovered that my skin was a lot thicker than I had ever imagined as EVERYONE in the company heard about it and then asked me about it.
So that was my most impressive faint. The worst thing is that I felt it coming and _stupidly_ decided to take another breath instead of putting my head between my legs… I used to faint occasionally as a teen but had not done so in years. Oh, and I do get the low sugar shakes too. And yes, planning is absolutely the right thing to do (as well as keeping your go-to food everywhere -gym bag, car, purse etc. you can always send someone to retrieve it for you).
Am I the only one who didn’t like Steel Magnolias? I found it contrived and playing off emotions in a deliberate attempt to get people to cry. But then again I think Nicholas Sparks movies are the biggest waste of time on the planet,so yeah.
I DO get low blood sugar (and low blood pressure) pretty easy though – I start feeling woozy and light-headed if I go about 1.5 or 2 hours without eating – depending on what I last ate- and then if I still don’t eat, I start to get really dizzy, foggy-headed and weak. I try to keep protein bars or those individual packs of peanut butter crackers on hand, in my purse, etc. I also tend to pass out when I get sick, or occasionally if I stand up too fast while I’m working out. (My blood sugar and blood pressure have been tested and both are in the low range of normal.)
Great article. Thanks for sharing such useful information!
Um, are you forgetting Fried Green Tomatoes??!
I had a giggle at “bonking”. In Australia it means having sex. All the comments saying “I’ve never bonked” has me giggling like a schoolgirl. Small things amuse me !
I fainted once, I’d skipped breakfast, taken public transport (no air-con), it was stinking hot and I walked out into the sun and the next thing I knew these lovely old dears were telling me how gracefully I faint. ‘Cause apparently that makes it much less embarrassing !
I do have to watch my sugar levels. I usually get the shakes and feel horrible if I haven’t eaten all day. I really must stop doing that. I also get the horrible faint feeling in the shower, especially if it’s a really hot one. I now know not to yawn in the shower, that’s a one-way ticket to dizzy-ville !
All my out-right-faints have been related to heat exhaustion. Now I’m more alert to my mental warning signs — the big one being getting fixated on a stopping point (“If I can get to the top of the hill, I can rest. If I reach X, I can slow down. If…”. Now I know that if I start having that “if, if, if” I need to do an assessment of the rest of me — tunnel vision? Shakey? Grumpy as all hell? Time to sit down and have lots of water.
But while all of my looking-up-at-the-sky moments have been heat and water related, I have equal issues with sugar maintenance. All day fencing tournaments in college gave me the shakes something fierce, until I realized I basically had to eat something *between every bout*. It was ridiculous, but it lead to me and our Armourer taking on the task of making sure everyone on the team didn’t attempt to FAST during the tournaments, as had been the unofficial policy before us. I think some of my issues with that (and which I still have with maintaining blood sugar levels), though, are related to my diet. I just read your bit on carb loading — and I think that’s pretty similar (although more abundant) to my actual diet. Being a college student on a really strict budget — Carbs are cheap!. A little bit of meat goes a long way in pasta, veggies on rice, that sort of thing. I’d love to overhaul my diet to make my blood sugar more consistent, but I don’t know how to do it and stay within my budget.
Oh my God- I bonk all the time! Most of what I do is “endurance” activities- mountain biking (for 2-3 hours minimum), hiking, etc. For years, I would go out for hours, and only eat if I got hungry (I’d eat a sandwich if we hiked through lunch) . Of course, I would never get hungry, but for the last hour I’d be exhausted, miserable and on the brink of tears (ok, if I am being honest, I’d usually end up in tears. But I’d try to hide them!). It wasn’t until my sister did a triathlon, and the organizers gave the women a speech about fueling, in which they said women tend to get overly emotional and miserable when bonking (NOT hungry), that I realized what was happening. Now, I bring something like cranberries along for short rides and bars along for longer ones. I try to eat fairly regularly throughout, and less when I am done (I used to eat beforehand, and then pig out after. Works for the guys in my family, but not me). I also try to eat before I feel crappy because I find it takes me a long time to metabolize whatever I eat. And if I DO start feeling like a moaning myrtle I down a handful of something sugary ASAP!
I get this occasionally when going for a brisk walk lasting longer than 30 mins. A stop in the nearest shop for a choc bar or cereal bar seems to do the trick. Its never too bad – but enough to mean I carry emergency snacks around with me if I’m not going to be near a snack.
Nearly fainted after my last smear test. Most unpleasant. It was first thing in the morning before I’d eaten. They gave me a biscuit and I felt better after a few mins.
This doesn’t happen to me too much. When it does it’s not because of a workout (I haven’t worked out in over a week…don’t tell anyone) but because I’ve been too busy to eat. Suddenly, I realized I’ve cleaned my house, ran 10,000 errands, taken care of the boys, but somehow forgot to eat. Duh.
let me just tell you, bonking is the absolute worst feeling, ever. as an avid cyclist [climbing hills and going for hours on a bike], it happens. well once, to me, mind got foggy, started to hyperventilate, my legs totally gave out on me and I started bawling out of no where. I calmed down, got off the bike and stopped the hill climb and ate a bar [and listened to my husband as he told me to breathe]
anyways, you MUST eat during endurance rides/runs, ladies.
oh p.s. you better believe I finished that hill climb
{ 1 trackback }