Wednesday, November 26, 2008

Anxiety, Rage/Panic Attacks

On a winter morning in 1981, I squeezed some oranges from my yard into a 16 ounce glass and made that my breakfast.  3 hours later, in my office, I suddenly had my first anxiety attack.I thought it might be a heart attack, but no chest pain or arm pain, and I almost passed out.This worried my office manager. Several minutes later it passed.  When I was able to think clearly again, I realized that it was a hypoglycemic "dip" or “episode”.  That fresh orange juice was very sweet.

The medical term for low blood sugar is Hypoglycemia.  The brain requires large amounts of glucose, and when it goes below a certain point, a hypoglycemic episode occurs.  This can become almost any symptom up to and including coma and even death.A hypoglycemic episode only causes drowsiness or sleepiness for most people, but passing out or fainting is also possible.  Also, as a result of a hypoglycemia episode, both adrenalin and testosterone may be released (in men primarily) causing undifferentitated rage in some men/boys.  This may also be part of the current "road rage" problem as well as childhood tantrums. bar fightrs, spouse abuse. etc.

This same hypoglycemia episode may cause panic attacks, and even be the base cause of phobias.  It seems that if the blood sugar goes very low, and the body response is too slow, the person either may pass out or "nearly pass out".  If the person happens to be driving over a bridge, this might cause a driving phobia connected with bridges.  I've seen several such cases.

Glucose is the form of sugar in the blood.  This has been transformed in the digestive process from other sugars and starches into glucose then passed into the bloodstream.

Hypoglycemia is usually caused by too much insulin driving too much glucose into the body cells, which depletes the supply of glucose available to the brain (and other areas).

Since glucose is as necessary to proper brain function as is oxygen, there are many different symptoms possible.  These can range from a simple yawn about a half hour to an hour after eating, to a full-blown anxiety attack, or even a real depression (the term "sugar blues" has a basis in real fact), or even death for diabetics, or almost anything in between.  Sometimes, allergies can cause similar symptoms, or even cause an hypoglycemic episode!

Too much insulin can be the result of a sugar overload, and this may cause hypoglycemia in "normal persons".  To some "sensitive persons", this can be as simple as eating a doughnut or drinking a full glass of orange juice on an empty stomach.  (Happened to me!) The response to low sugar/glucose is individual, and everyone reacts slightly differently.  Also, one person can eat a dozen doughnuts one time with no bad effects, and have a hypoglycemic episode from just one doughnut at another time.

A simple example will help clear up some of the confusion around this subject.  If a normal (whatever that is) person eats an apple, he/she will gain approximately the equivalent of 3 teaspoons of sugar.  It will take about 3 hours to digest the apple in the following way:

1. As sugar is absorbed in the mouth, in the stomach, and the small intestine, the amounts are measured and the brain determines how much insulin to release into the blood.Let's call this process a "sugarstat" for illustration.While we don't fully understand how it works, we do know the effects.

2. From millions of years of evolution, the sugarstat "knows" that with the amount of sugar absorbed over a certain time it needs an equivalent amount of insulin, and releases that amount accordingly.

3. Now, it takes 3-4 hours for all the sugar to be digested from the apple fiber as it passes thru the digestive system.  It's a downward curve, and the insulin released also has a similar downward curve, and it lasts about the same 3 hours in the blood, as it's used.

So, eating an apple has an immediate effect of raising glucose (blood sugar) somewhat, and this "blip" is fast compensated for by insulin release, and from that point the incoming sugar is pretty well balanced by insulin release over the three or so hours of digestion.The sugarstat is working as designed - there is ittle change in blood sugar as nature intended.

If we "pre-digest" the same apple by squeezing it in a cider press, the situation is much different.  In effect, all we have removed is the fiber, and retained all the sugar, vitamins/minerals, etc.One glass of apple juice could contain the juice of 10 or more apples - 30 teaspoons of sugar.  Now, there is much more sugar absorbed very fast, and the sugarstat is "fooled" into releasing many times the amount of insulin actually needed as a result.

(Remember that for millions of years of evolution, we didn't have cider presses, let alone the "designer" apples of today.)

This "overdose" of insulin drives blood sugar into body cells at a furious rate, and even though the blip is now much larger, it quickly lowers it.

Enough insulin has been released for 3 hours of digestion, but the sugar is digested in 15 minutes and into the bloodstream quickly.The result - too much insulin - enough released for 3 hours of this huge intake.  The sugarstat has been "fooled", by not evolving far enough to handle our "modern" food processing.

This excess insulin "drives" all the glucose it can find in the blood into the body cells (its job).The result - a severe shortage of glucose in the brain.

The brain MUST have glucose as well as oxygen for fuel, so several body mechanisms go into action to raise the glucose.  (Few people realize that without BOTH glucose AND oxygen, brain cells start to die in about 5 minutes).

The body defenses against hypoglycemia are many and range from release of stored glucose to release of some fatty acids and hormones that can be conferted to glucose.

It can be seen from the above that hypoglycemia isn't really a "disease", but is quite normal for we humans not designed for our high carb diets. The effects vary from one individual to another.The real culprit here is our modern sugary diet full of processed (pre-digested) food.

These body defenses against low blood sugar also cause some very different symptoms in different individuals.  Usually, this is about 3+ hours after eating a sugary processed meal.

One symptom that is not uncommon in women is an panaic/anxiety attack, or even fainting.Men may experience these symptoms, but less often.

An anxiety attack caused by a hypoglycemia episode while driving might result in a phobia of driving, or if driving in a tunnel, a phobia about that, or if on a bridge, a phobia about that.  In practice, I've seen all three of these phobias generated by hypoglycemic episodes!

Men have another common symptom.A combination of adrenalin and testosterone can trigger "undifferentiated" anger in some men.  He will have a "rational" reason for the anger, but bystanders can't understand how he got so angry for "no real reason".A dramatic change of personality while drinking is a clue this type of man.This type is clearly shown as "pseudoschizophrenic" on the MMPI (Personality Test).

By simply advising the husband to eat a handful of peanuts and raisins every two hours after lunch, I helped to save a marriage.  (He was her boss, and at 3PM, she couldn't do anything right according to him - his lunch included a candy bar and a soda!!)

Anyone who has a sugar handling problem might be well advised to carry a bag of peanuts and raisins around, and make sure that they eat a handfull every two hours or so. (ratio of about 1 raisin to 5 peanuts).Fast glucose is provided by the raisins in a fairly short time, while the peanuts take much longer.  This was what I usually advised hypoglycemic sensitive persons to do, and it works well.  Really sensitive persons should know to eat 6-8 small meals every day.  A meal might be a hard-boiled egg, or half an apple, etc.

On the usual Glucose Tolerance Test (for diabetes or hypoglycemia), the subject is given a measured dose of glucose in a sickenly sweet soda type of drink, and measurements are made before this drink, 1/2 hour after drinking, at one hour, and then every hour until either 5 or 6 hours have passed.

This test is more often done wrong than perhaps any other medical test used.  These are the common mistakes made by medical practicioners and hospitals:

1.  They just give the standard 10 oz bottle to anyone, and it's way too much for a child or a small person.  There is a weight/volume slide rule that should be used, but usually isn't.  At 6' tall and 200 pounds, I should take only 7 ounces!

2.  The measurements are too mechanical.  I (and most other knowledgeable practicioners) believe that the patient should be advised strongly to let the person (usually a nurse) giving the glucose test know if they experience any symptoms at all from yawning to headaches, etc.

3.Around 3-4 hours into a GTT is the most likely time for most people to show hypoglycemia symptoms, even passing out at times.  If no symptoms are noticed, it is a good idea to test at the 3 1/2 hour mark.

4.Don't let the patient leave immediately after concluding the test. Have them eat some fast digesting food. I often used a small glass of freshly squeezed orange juice, in season, and out of season the handful of peanuts and raisins. Many persons have left a clinic/office and passed out on the street, or perhaps had an auto accident.

The above applies primarily to GTT's where diabetes is not a factor.  A fasting glucose test will find diabetes instead, and is much safer.

In Orlando, where I checked on all the hospitals, and several MD's offices, I found none that did all the above correctly, and most made all the above mistakes.  Be advised.

I hope this helps you in your quest for better health.

Phil Bate PhD - Retired Orthomolecular Psychologist
Inventor of Neuroliminal Training solving
ADD/ADHD/Autism, depression, insomnia, etc
http://DrBate.com

No comments: