Do you have blood sugar regulation issues?
If you have hypoglycemia, relate to the word “hangry” (hungry+angry), have huge ups and downs with your energy throughout the day. If you are hungry ALL the time, rely on a steady stream of snacks, get shaky or lightheaded when you don’t eat. If you wake up in the middle of the night wide-awake OR can’t go for more than a few hours without being hungry, it can be assumed you have some blood sugar regulation issues. The more symptoms or the more severity, the more you can see the significance blood sugar plays a roll in your life... for the worse.
Also, if you follow a low fat diet or even find yourself under-eating or slashing calories and still gaining weight or maintaining, you can also assume you’re in this club due to something called insulin resistance. Insulin resistance is directly related to poor blood sugar handling and if unchecked will lead to PCOS, pre-diabetes, and eventually diabetes. In these cases you most definitely can assume you’re in this category.
If you've woken up in the morning for a fasting blood test (where you don't eat beforehand) so they can test your glucose levels, which ended up "fine", you may think you're in the clear. Here's the thing, that test will often will only catch blood sugar issues once they become incredibly severe, like how cancer is often only diagnose after it's metastasized all over. If you want to stop the issue before it gets to that stage, read on :)
What the heck is blood sugar regulation? I promise not to bore you
Have you ever cut yourself and noticed the blood was sticky? Congratulations, you've meet your blood sugar. Sugar in its simplest form is called "glucose", and your body needs glucose to function. Your blood acts like a glucose ATM, allowing any part of your body that needs energy at anytime to have access.
Blood sugar regulation, then, is how your body responds to surges in sugars (glucose) that you consume so that the glucose in your blood remains at a very precise level. All carbohydrates break down into glucose, so this could also be said it’s how your body keeps the level of blood sugar stable.
Your body wants to have a very steady amount of glucose in the blood at any given moment, 80-100 mg/dL to be exact. If it goes to high your blood is way to sticky and will cause big time problems (#diabetes), if it goes way too low you can faint or pass out (#hypoglycemia). So to maintain this amount without enormous fluctuations, your body must be constantly doing an eloquent dance to always be fueling cells without huge surges or crashes. To do this is relies mainly on the pancreas, adrenals, and liver.
Let’s introduce the players
Do you know what your pancreas does? Do you know how it affects your adrenals, or your liver? No? Cool, let's get down to business and learn some cool stuff then! Here we'll look at the three main organs that work all day long to keep your blood sugar stable. Or, they try to :)
This incredible organ is part of both the digestive system, and endocrine/exocrine system, meaning it makes hormones amongst other things. In the case of blood sugar regulation, the pancreas makes insulin after glucose consumption, and also makes glucagon when the body is in need of glucose (when someone hasn't eaten glucose in a while). It's the head messenger in this system.
The adrenals make over 200 different hormones, including the well know sex-hormones estrogen, progesterone, and testosterone. Additionally, they make cortisol which is triggered by the pancreas when there’s not enough glucose in the blood. Cortisol alerts the liver there’s not enough, which then releases the tiny stores it has before breaking down muscle to turn into glucose.
If the stores run out (you can only store a tiny amount of glucose in the body), your adrenals bring out the big guns and pump adrenaline into the system. Adrenaline forces the last reserves of glucose into your muscles in a fight-or-flight response. This used to only happen during majorly stressful events, like a tribe attacking your village, but now can happen over dessert.
The liver stores extra glycogen for emergencies, but only a small amount (the average person only has 1,500-2,000 calories worth of glucose stores). When that storage gets low the liver then makes glucose from amino acids in the blood, and by breaking down more muscle to free up even more amino acids when necessary.
Look at the Cool Graphs I Made
Want to see a visual of the delicate dance your body does to maintain levels at a very precise 80-100 ml/dL? Good, because I made some graphs to show you :)
See, when properly functioning that purple line is your energy, smooth and constant throughout the day. Your organs aren't overworked, your stress levels aren't rising, all is well.
Now see that red line? That's your energy levels when your body isn't functioning properly. All organs here are on Red Alert, working overtime to try to get the blood sugar back in that healthy range. This alone, without any stressful job or home life, can make your body very very stressed.
Poor Blood Sugar Regulation Severely Affects Endometriosis
Blood sugar regulation is quite the process, but I hope you better understand the basic process now. To summarize, when your body is overwhelmed processing too many carbohydrate rich foods (which is the first time in history this has happened) it wears out the pancreas, the adrenals, and the liver. This in turn affects your endo, and it can affect it a lot.
The pancreas and endo belly
You know digestive enzymes you buy at the store? Your pancreas should be making these in abundance, for free. When it’s overworked it can strongly minimize it’s capacity to help digest. Most if not all women with endo have severely impacted digestion that requires lots of pancreatic support.
Additional food for thought, carbohydrates are only broken down in 2 places. A) your mouth through chewing and saliva enzymes, and then b) in your small intestine with pancreatic enzymes. Because most of our carbohydrate rich foods today aren't very chewy - imagine leaves, roots, and shoots - we basically swallow completely whole carbohydrates without breaking them down first (think, did you really chew that oatmeal this morning?). This puts another enormous burden on your pancreas and when you can't digest carbohydrates correctly do you know what they do? Ferment. Literally. Insert endo belly here.
The adrenal glands are vital for hormone control. When they're off, so are your hormones. Many women with endo suffer from too low of progesterone, often seen through spotting during the luteal phase and severe PMS. Moreover, healthy adrenals mean healthy stress levels, so if you’re burning out your adrenal function with excess carbohydrate consumption your body will be overall more stressed… potentially even stuck in a stress-based mode that it can’t turn off. This is serious, and will not only make your endo hurt more, but will enable it to spread more rapidly.
Think you're tired? Imagine your liver. Your liver is responsible for over 500 functions essential to the body, but its main job (like all your organs) is to keep you alive in the moment. That means if it’s getting a fight-or-flight response from your adrenals it’s thinking there’s some serious sh*t going down — maybe you’re being chased by bandits or something — so it drops everything to bring the glucose levels back up from the hypoglycemic state. In dropping its other responsibilities it won’t be detoxing or removing those excess estrogens from your system. Did you know in Chinese medicine there’s no word for endometriosis, but instead seen as weakness in the liver?
Deep Deep Fatigue:
The processing of carbohydrates in this excess can severely deplete your body of vital nutrients. Being in a stressed state burns through your vitamin and mineral stores like a wildfire, so if you’re not only burning stores but then ingesting more nutrient-less carbohydrates at the end, you will continuously be depleting your body of what it needs to survive. It can be summed up as Stuffed yet Starved, and will lead to total exhaustion.
Additionally, to bring it back to "spoons", how many of us only have so many "spoons" to give. Your body was only wired to deal with so many stressors, and like how many internet tabs you have open affecting your computer, when you have too many stressors your body starts slowing down with overburdens. The adrenals are a big part of this, they're frazzled at this point, not to mention the enormous body burden of being undernourished. Deep fatigue sets in.
You’ve heard stress affects fertility, so what if unknowingly to you your body was fighting a ninja assassin all day? The processes within the body may be complex, but its thought process is very simple: when our signals say "stress!", we stress. The body doesn’t differentiate whether the stress is a ninja assassin or an ice cream sundae or a huge cold pressed carrot-orange juice. As the blood sugar rollercoaster ensues, your body reacts the same to all three, and it gets s-t-r-e-s-s-e-d. There are remarkable stories of recovery from plaguing infertility, even the IVF resistant ones, by simply controlling blood sugar and increasing healthy fats. This is especially important if you have PCOS (the only way to really manage it is through diet changes like the ones here), but truly just as important for endo.
OK ok, I have the symptoms, but I don’t eat much sugar at all! I mean, do I?
Let’s go back to the basics: all carbohydrates are broken down into glucose. The ones with fiber will break down much slower, yes, but overall if you’re diet is exceedingly high in carbohydrates, blood sugar issues will still arise. That’s why if your diet is based on grains or starchy carbs, if you’re a vegetarian, vegan, or on a low fat diet you can have severe blood sugar regulation issues, even if you’re eating “healthy”.
And if we go back and dissect our childhood history, many of us endo girls ate wayyyy too many carb as children and young adults, then had a “health revival” with endo and became vegan or vegetarian. That seems to be the story for about 90% of women I’ve met with endo, certainly me. That means our blood sugar has been out of control for decades, and many of us may never even enabled the fat burning side of our biology kick in.
If you’re still in question, go back to the beginning: do you have symptoms? Hangry, hypoglycemic, always needs snacks, shaky when hungry, big energy surges and crashes, PCOS, insulin resistance, incredibly reliant on caffeine. These are the signs that your blood sugar regulation is out of whack and your body needs to be nurtured and retrained.
And just so you know, you can also have blood sugar issues if you don’t eat enough food overall - even if it includes fat + protein - or if you’re not digesting fats or proteins properly.
Why this can make you gain weight… even if you’re eating 1200 calories a day
Remember, the pancreas makes insulin, and this insulin shuttles the glucose to cells. But, the cells can only use so much glucose. When they’re “full”, so to speak, but the glucose keeps arriving at the door like an annoying salesman, the cells mark the insulin as spam and starts to make the receptors resistant. So the insulin, being turned away from cells, stores it instead. How? By turning it in to fat. Yes, fat is the stored form of glucose.
When functioning optimally, your body can then turn the fat back into energy when it needs … if it remembers how. This is what’s referred to as “fat burning”. But, because so often we’re eating carbohydrates in excess at every meal and throughout the day, the body forgets how to make this conversion. Why should it, if it has excess glucose around all the time?? This, then, is referred to being a “sugar burner” — when your body has forgotten how to burn fat for fuel and demands constant glucose to run. Hence, the constant need to eat carbohydrates (It’s not in your head, your body is literally demanding it of you).
You need this fat conversion system to be primed and ready because, as I mentioned before, you body cannot store much glucose at all. Remember, only 1,500-2000 calories worth. Instead it stores fat, the main source of energy the human body is meant to run on. That means every time you eat an excess of carbs for your energy needs, the cells only use so much, and then all the rest of it is stored as fat. This is why you can be eating a maintenance diet or even a starvation diet and still GAIN weight. Yes folks, it’s totally possible. And the more insulin resistant you are the worse it become.
How to get off the blood sugar rollercoaster
Now that you know how debilitating this stressful rollercoaster can be, it’s time to jump off. A nice thing about controlling a blood sugar system out-of-whack is that it doesn’t often need supplements to heal like the digestive system. It will most often respond incredibly to diet alone. The hard thing is, though, that you have to change your diet. And if you’re addicted to sugar, this won’t be very fun.
At first! Not fun at first! But then I promise you’ll feel better. And remember, this from the girl who gagged at the idea of eating eggs without sweet ketchup. Honestly, the cravings for sugar disappear. Instead, you end up eating a lot of delicious, rich, satiating foods.
The main gist? Remove all sugar and processed foods from your diet (even “healthy” processed foods like gluten free pastas, breads, and baked goods), increase protein and fat.
Recipe Makeover #1:
Blood Sugar Spiker: Fat-free yoghurt with bananas and gluten free granola.
Better choice: Full fat yogurt with a tbsp cold pressed flax oil mixed in. Blueberries, chia, and pumpkin seeds on top.
Recipe Makeover #2:
Blood Sugar Spiker: Gluten free pasta with vegetable and tomato sauce on top.
Better choice: Steamed squash, drizzled with a 1-2 tablespoons of butter or olive oil, topped with sauce of choice (make sure no sugar added)
BUT don't be afraid of carbs :)
This is by no means trying to make you scared of carbohydrates, we need them! This is more about balance. It’s just getting down the to basics of how many and in what combinations. Increasing protein intake is often a big shift many endo-ladies (who became scared of meat and dairy) can make that will help pretty quickly, Making sure when you eat carbs that you do so with fat will aid your assimilation. Fat slows blood sugar spikes, which is why eating carbs with a fat (think apple and peanut butter, strawberries with cream) will keep your levels more stable. A low fat diet based on grains, fruits, low fat products, starchy carbs, juices, and fat free smoothies will eventually overload the system just like candy.
Women especially need carbohydrates for hormone regulation, so if you're of childbearing age then a longterm ketogenic diet most likely isn't going to help your endo-hormone balance. But the goal is to re-boot your fat burning capabilities so that your organs can relax, your liver can focus, your food can digest, and your body can reclaim its fertility :)