top of page

Diet and Dysautonomia: Blood Sugar Regulation

In this blog post, we will be talking about blood sugar regulation, its role in brain health, and how it relates to diet and dysautonomia.


Food = Fuel

Everything we put into our bodies is made for one thing: Fuel. Food is crucial for our bodies to survive because it is how we receive our macronutrients such as carbs, fat and proteins. It is also how we receive our micronutrients, such as vitamins and minerals.


When a person has dysautonomia, it usually leads to their system being in a fight or flight state, this results in blood not circulating adequately throughout their body. Glucose is transported through our bloodstream to reach cells all over the body and provide nutrients. This means that when someone has dysautonomia, oxygen and glucose are not being adequately transported throughout their system. This can lead to deficiencies of iron, B-12, proteins and other vitamins and nutrients.


It is very important for dysautonomia patients to maintain their blood sugar constantly (keep blood sugar levels stable) throughout the day and avoid any blood sugar dysregulation or reactive hypoglycemic bursts. This will help maintain fuel delivery of glucose around your body.


It is important to note that, when discussing blood sugar dysregulation, this is not referencing the topic of diabetes or individuals who are diagnosed with hypoglycemia. Blood sugar dysregulation is referring to the functional shifts of blood sugar throughout someone’s day. Fluctuations in blood sugar, including reactive hypoglycemia (where blood sugar drops after eating), can worsen symptoms of dysautonomia. Maintaining stable blood sugar helps ensure that glucose is continuously delivered to cells throughout the body.


Blood sugar dysregulation symptoms include:

  • Waking up with nausea

  • Loss of appetite in the morning and throughout the day

  • Energy bursts and/or crashes after eating

  • Sleep difficulties like waking up in the middle of the night

  • Unexplained anxiety throughout the day

  • Fatigue throughout the day


Reactive Hypoglycemia

Reactive hypoglycemia is when blood sugar drops between meals. This is usually due to insufficient cortisol release. Between meals, our blood sugar lowers the brain signals to our adrenal glands to release cortisol. Cortisol then signals to the liver to break down and release glycogen and turn it into glucose to circulate around our system. This keeps our blood sugar constant throughout the day.


Symptoms that are consistent with reactive hypoglycemia include:

  • Increased energy after meals

  • Craving for sweets between meals

  • Nausea in the mornings

  • Irritability if meals are missed

  • Eating relieves fatigue

  • Feeling shaky, jittery if meals are missed

  • Poor memory

  • Blurred vision


Insulin Resistance

You do not need to be diabetic to have insulin resistance! Yes, you read that correctly. Insulin resistance is a requirement to be considered diabetic, but not vice versa. Diabetes does not manifest overnight; it is caused by many years of insulin resistance! 


Symptoms of insulin resistance include:

  • Chronic acne

  • Crashing in the afternoons and/or after meals

  • General fatigue

  • Craving for sweets after meals


Frequent high blood sugar levels, and the resulting constantly high insulin levels, can cause the body to become resistant to insulin. This means that glucose from food isn’t effectively taken up by cells (since insulin is what moves glucose from the bloodstream into cells, insulin resistance means that cells will no longer effectively absorb glucose).


Hypoglycemia

Hypoglycemia is when we are spiking blood sugar so frequently that insulin is released in response. Once the blood sugar drops suddenly, cortisol is released in its place to stabilize blood sugar and fuel our bodies. The release of cortisol can lead to further symptoms of hypoglycemia.


Symptoms of hypoglycemia include:

  • Irritability or anxiety

  • Difficulty concentrating

  • Dizziness or lightheadedness

  • Shakiness

  • Sweating

  • Headache

  • Nausea

  • An irregular or fast heartbeat

  • Fatigue


Sugar and Carbohydrates

The autonomic nervous system, overall brain function, and the immune system work very closely together. If your diet consists of a lot of foods that are high in sugar (both natural and artificial) and carbohydrates, then you may not be getting enough fiber, protein, and fat. This leaves you more susceptible to increasing inflammation, which can affect your dysautonomia and make you feel more symptomatic. This is because your immune system is constantly trying to reduce the inflammation that affects the autonomic nervous system.


A few studies have been conducted to examine this:

  • A 2022 study found that after glucose intake, upright heart rate significantly increased in POTS patients. (HYPERTENSIONAHA.121.17852)

  • A 2016 study found a strong relationship between POTS and carbohydrate metabolic dysfunction; with a considerable number of patients exhibiting a substantial improvement in symptoms with dietary changes to address reactive hypoglycemia. (Endocrine Abstracts (2016) 41 EP235)

  • A 2019 review in the Journal of The American College of Cardiology recommended that large meals be avoided, especially those high in fat and complex carbohydrates, because these can lead to postprandial aggravation of symptoms due to increased blood flow to the gut. (PMID: 30871704)


Why Fasting May Not Be Good

We do not recommend fasting for our dysautonomia patients. Fasting is not usually beneficial for individuals who suffer from dysautonomia because it is important to maintain fuel delivery throughout your body.


Also, if you experience jitters, lightheadedness and shaking between meals, then fasting will further these symptoms and can further hypoglycemic reactions.


Next Steps for Dysautonomia Patients

Keeping blood sugar levels stable is very important for dysautonomia patients. We recommend taking the below steps to assist with blood sugar regulation. Before making any changes, however, It is important to work with your providers closely to decide which diet changes are best for you.


  • Switch to 6 small meals per day.

  • Your first meal of the day should be protein rich, ie. eggs, chicken, turkey, avocado

  • Zero sugar, even fruit, before noon

  • Stick to foods lower on the glycemic index

  • Chew your food completely and mindfully

  • In between meals sip on bone broth (unless you have histamine issues, do not consume bone broth) and lemon water

  • If you can tolerate it, drink 1/2 ounce of apple cider vinegar before meals

  • Eat vegetables and protein before consuming carbs

  • Drink more than half your body weight in ounces of water per day.

  • Cut out all added sugar (read labels carefully)

  • No alcohol of any kind

  • When eating fruit it is helpful to pair it with protein and stick to fruits lower on the glycemic index, ie. almond butter and apple

  • Check out Glucose Goddess for additional education and resources


We are Here to Help!

At CFNC, our doctors work closely with their dysautonomia patients to determine the best diet for them. Please contact us to schedule a consultation and discuss your specific case.


We also offer a Diet Protocol Coaching Program through the Virtual Lab @ CFNC. This program enables you to work with our health coach and receive customized guidance and support with implementing a new diet protocol. For more information, click here.

bottom of page