How Low Blood Sugar Causes Insulin Resistance

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“Blood sugar” refers to how much glucose is in your bloodstream.

When blood sugar levels are low, this sends an alert signal to your body to start breaking down stored energy into glucose. 

Low blood sugar will also stimulate hunger so that you’ll eat. This can show up as cravings for sweets in particular, although sugar cravings can also be caused by other imbalances.

Both of these responses are attempts to normalize your blood sugar levels.

After eating or releasing stored glucose into your bloodstream, your pancreas secretes insulin. Insulin helps transport glucose from your bloodstream into your cells, where a series of chemical reactions will turn that glucose into adenosine triphosphate, or ATP. 

ATP is THE energy/fuel source used by every cell in your body (except red blood cells) in order to function. This is why blood sugar that’s too low is life threatening!

Hypoglcyemia vs. Functional Hypoglycemia

Conventional medicine diagnoses low blood sugar (hypoglycemia) when serum glucose levels are lower than 65 mg/dL.

But looking through the lens of optimal health, a reading less than 80 mg/dL, along with other signs + symptoms (more on that shortly), is suggestive of functional hypoglycemia and a need to make some changes before things progress.

I’ve talked about how blood sugar spikes lead to insulin resistance over time—which can cause a whole host of chronic health issues like elevated blood pressure and cholesterol, hormone imbalances, inflammation, difficulty detoxing, chronic immune system dysfunction, migraines, osteoporosis, arthritis, depression, adrenal dysfunction, and more!

But did you know that chronically lower blood sugar levels can also cause insulin resistance?? Yep! (And yikes!)

Types of Low Blood Sugar

Low blood sugar falls into two main categories: hypoglycemia and reactive hypoglycemia.


Hypoglycemia occurs when blood sugar is low or suboptimal (which is better termed “functional hypoglycemia”), and chronic hypoglycemia is due to inadequate nourishment on a regular basis. 

Typically the person dealing with hypoglycemia goes too long between meals and/or doesn’t eat sufficient quantities of food, especially protein and healthy fats. 

Chronically low or suboptimal blood sugar creates a scenario of excessive insulin release in response to consuming food and beverages because the body is desperate to get as much glucose as possible into the cell, where it’s needed. 

(And if high-sugar or high-carb foods or drinks are being consumed, this only exacerbates the insulin surge.) 

These insulin surges flood the cells, and eventually, the cells become resistant to insulin. So more and more insulin has to be released in order for cells to respond, open the gates, and let glucose in.


Reactive hypoglycemia can occur in response to chronic insulin surges. The person dealing with reactive hypoglycemia typically consumes foods and beverages that result in blood sugar spikes (most commonly added sugar and refined carbohydrates), which then cause surges in insulin. 

When this mechanism occurs frequently, the pancreas starts to overcompensate and release too much insulin, causing glucose to enter the cells at a higher rate. In response, blood sugar drops too low, and decreased energy and other symptoms of lower blood sugar will occur as a result. 

A less than optimal fasting glucose, along with fatigue 2-5 hours after eating and other signs and symptoms of hypoglycemia, can point to reactive hypoglycemia. 

With reactive hypoglycemia, blood sugar is swinging from high to low. It’s an earlier stage of insulin resistance, and as reactive hypoglycemia continues, the insulin resistance will worsen.

How to Know if You Have Low Blood Sugar

Insulin resistance is involved in both types of hypoglycemia, and everyone who is dealing with hypoglycemia has some degree of insulin resistance, and vice-versa. (This is a major reason why calorie-deficient diets screw up your metabolism and can actually lead to weight gain.)

As you learned in Why Your Blood Sugar Matters SO Much, insulin resistance can lead to SO MANY chronic symptoms and conditions, so this is definitely an issue you want to address if optimal health is your goal!

Here are some of the main clues you’re dealing with low blood sugar (keep in mind that some symptoms can stem from other imbalances, too):

  1. Frequently missing meals
  2. Eating high-sugar or high-carb foods
  3. Depending on caffeine for energy
  4. Craving sweets and salt during the day
  5. Having a hard time waking up in the mornings or sleeping through the night
  6. Decreased energy, mood, or mental cognition 2-5 hours after meals
  7. Feeling grouchy in the mornings
  8. Waking up nauseated
  9. “Spacing out” easily
  10. Poor memory, forgetfulness
  11. Irritability if meals are missed or you wait too long between meals
  12. Becoming light-headed if meals are missed
  13. Eating relieves fatigue
  14. Feeling shaky or jittery
  15. Feeling agitated and nervous
  16. Energy crash in the afternoons, especially around 3-4p
  17. Headaches
  18. Blurred vision

How to Correct Low Blood Sugar

You absolutely have the power to correct low blood sugar and the insulin dysregulation that’s caused by it, but it does require that you make changes to your food and lifestyle choices. Following are some of the most effective ways to rehab low blood sugar:

  1. Eat adequate protein daily. Research suggests that the average adult needs at least 1.2-1.6 grams of protein per kilogram of body weight. Focus on consuming at least 2/3 of your daily protein goal from high-quality animal sources: pasture-raised meats and organ meats, wild caught cold-water fish, pasture-raised dairy (if tolerated, preferably raw forms of dairy), and pasture-raised eggs (if tolerated).
  2. Don’t go more than 2-3 hours without eating protein. When you are recovering from hypoglycemia and reactive hypoglycemia, more frequent intake of protein is therapeutic. Focus on high-quality animal protein, since plant proteins tend to be quite processed or high in carbohydrates (which can worsen blood sugar swings and insulin surges).
  3. Enjoy healthy fats, which improve satiety (the feeling of being full and satisfied) and help blunt rises in blood sugar. Healthy fats include tallow, lard, wild caught cold-water fish, organic nuts + seeds (if tolerated), cold-pressed organic extra virgin olive oil, organic avocados, organic unrefined virgin coconut oil, pasture-raised eggs (if tolerated), pasture-raised meats + organ meats, and pasture-raised dairy (if tolerated). 
  4. Embrace routine. Lower blood sugar is viewed as a stressor, which recruits your adrenal glands to respond by pumping out stress hormones. Over time, chronic stress from blood sugar dysregulation can lead to adrenal dysfunction, which can then worsen blood sugar issues in a vicious cycle. Your adrenals love routine, so to help nourish them, develop a consistent schedule for eating, waking up, and going to bed.
  5. Get a handle on stress, and rehab the adrenals if necessary. Stress reduction practices are non-negotiable if you want to stay healthy! Deep breathing, guided meditations, and yoga are examples, but figure out what works for YOU! You may also benefit from taking supplements to help rehab the adrenals. B vitamins, magnesium, adaptogenic herbs, and other nutritional compounds can help to support + normalize adrenal function. Learn how to heal adrenal dysfunction here.
  6. Avoid intermittent fasting and longer fasts until your blood sugar is more stable. Fasting when you are dealing with hypoglycemia can trigger inflammation that causes and worsens chronic disease. I’m a huge fan of fasting—it can be incredibly therapeutic when done correctly! But this is one scenario when fasting can be counterproductive.

Don’t Let Low Blood Sugar Cause Insulin Resistance

Just like high blood sugar can cause insulin resistance, so can low blood sugar!

Unfortunately—and I think this is largely because of toxic diet culture—many women that I work with are dealing with some level of hypoglycemia as part of their blood sugar dysregulation picture.

If optimal health is your goal (and this includes optimal hormone balance because blood sugar is the foundation of hormonal health), then make sure you’re addressing your blood sugar dysregulation, including low or suboptimal blood sugar! 

(And check out my free guide 4 Steps to Skyrocket Your Energy, where I teach you two of the most effective ways to support your blood sugar AND improve your energy!)

Don’t forget to check out the other articles in this Blood Sugar Series:

Want more personalized guidance? Learn how my approach can help you optimize blood sugar regulation and overall health here.

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tree hugger, potato lover, health detective, empath, NATURE + science

Hi, I'm Mamie.
I'm a different kind of doctor.

I'll take the time to listen to your concerns, understand your whole health picture, teach you what your symptoms mean and why they're happening, and empower you to rebuild your health and care for your body. I'll help you reclaim your rightful place as the leading expert on YOUR health!

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