Hypoglycemia

Reactive hypoglycemia in binge eating disorder, food addiction and intense sugar cravings, and how glutamine stops the cravings

February 9, 2024 By Trudy Scott 6 Comments

A number of years ago a woman came to see me looking for help for her anxiety, insomnia and out of control sugar cravings which she described as an “almost demonic urge to eat sugar and all things sweet.”

Before working with me she had been trying to control her low blood sugar levels (or hypoglycemia) by eating the right foods at the right times i.e. healthy fats and quality protein especially at breakfast. But this wasn’t enough to eliminate her intense sweet cravings. She would make and eat sweet treats all day long, using “healthier” sweeteners like monk fruit and maple syrup.

I had her complete the brain chemistry symptoms questionnaire and she scored high on all the low blood sugar symptoms as well as low GABA and low serotonin. We focused on low blood sugar first and the solution for her cravings was using 500 mg of glutamine opened onto her tongue.

Initially she was sure this would NOT work – how would she possibly be able to use glutamine in the midst of experiencing reactive hypoglycemia or low blood sugar?

I had the same conversation that I have with all my clients who would obviously rather eat something sweet than open a glutamine capsule onto their tongue: “If you have an intense craving for something sweet, tell yourself that you’re going to indulge, but also humor your nutritionist and take the glutamine anyway. You may be surprised to find your urge completely disappears.”

She did that and it worked time and time again, ending her demonic urge to eat something sweet every time and very quickly. And it helped her with all her low blood sugar symptoms.

This blog addresses the role of low blood sugar or reactive hypoglycemia in intense sugar cravings, binge eating disorder and food addiction, and how glutamine helps.

Research: Reactive hypoglycemia in binge eating disorder and food addiction

The 2023 paper, Reactive hypoglycemia in binge eating disorder, food addiction, and the comorbid phenotype: unravelling the metabolic drive to disordered eating behaviours, highlights the fact that “impaired metabolic response” such as fasting blood glucose fluctuations are a factor in binge eating and food addiction, driving out of control and “repetitive consumption of highly processed food.”

The researchers “investigated hypoglycemia events during a 5-hour-long oral glucose tolerance test” in 200 participants and “the association between the severity of eating psychopathology and the variability in hypoglycemia events was explored.”

The authors conclude as follows:

People with binge eating disorder/BED or food addiction/FA are prone to experiencing reactive hypoglycemia; food addiction severity may predict early and symptomatic hypoglycemia events. This can further reinforce disordered eating behaviours by promoting addictive responses, both biologically and behaviourally.

You can read the study here.

It’s worth noting that the participants did not have diabetes. I mention this because most of the reactive hypoglycemia research looks at diabetic patients. Reactive hypoglycemia in the non-diabetic population is considered controversial even amongst functional medicine and/or integrative practitioners. This paper stands out for this reason.

It’s also recently published which makes me excited. This research is confirming what we see clinically.

This research is very much in line with the demonic urge my client described, and directly tied to her low blood sugar and blood sugar swings. My client did not do a 5 hour oral glucose tolerance test. Instead we used the low blood sugar symptoms questionnaire (see below) and a trial of glutamine.

My client was also not diagnosed with binge eating disorder or food addiction but didn’t have to be for us to recognize the issue and have her benefit from nutritional support in the way of glutamine and learning to eat for blood sugar stability.

Unfortunately the authors do not discuss glutamine as a solution in this particular paper or in any other research on human participants who are non-diabetic. There are a few animal diabetes studies, with this 2013 study reporting that “glutamine was more effective in promoting glycemia recovery if compared with glucose, lactate, glycerol, or alanine.” The authors call for further investigations which I look forward to reading.

Low blood sugar symptoms and a glutamine trial

As a reminder here are the signs of low blood sugar:

Sugar cravings, binge eating and addiction symptoms:

Crave sugar, starch or alcohol any time during the day
Very intense cravings for sweets/sugar
Binge eating and/or food addiction (updated with this based on this research)

There are also anxiety, mood, sleep and energy symptoms when you have low blood sugar:

Nervous, anxious, panic attacks
Irritable, shaky, headachey – especially if you go too long between meals
Lightheaded if meals are missed
Agitated, easily upset
Eating relieves fatigue
Waking in the night or early hours with a jolt of anxiety/shakiness (I blogged about this here)

As I mention in the waking with a jolt/low blood sugar blog the good news is it’s relatively easy to figure out if low blood sugar is causing your symptoms. First I have clients rate their symptoms on the low blood sugar questionnaire and do a trial of glutamine. Next is figuring out the dosing and timing of glutamine, looking at a current food log and making dietary changes as needed.

Glutamine is always best opened on to the tongue but it must be used this way for stopping the intense sugar cravings quickly – as in immediately. It’s also used away from meals like all the amino acids.

If you notice improvements it’s very likely that reactive hypoglycemia or low blood sugar is a factor.

Glutamine for low blood sugar cravings: dosing and timing

As I share in my book and other blog posts, typically 500 mg glutamine is a good starting dose for intense cravings for sugary foods. We may increase based on individual needs and you may find you do need to use 500 mg -1000 mg two to three times a day when the intense desire for something sweet strikes – as blood sugar dips. Using a glutamine powder is a great way to use it especially if you find you do need more than 500 mg each time.

As I mentioned above when you use glutamine powder directly on the tongue (rather than mixed in water), the benefits are seen almost immediately and even if you don’t believe it could possibly work – like my client – your desire for sugar disappears.

GABA and serotonin support too

My client also needed GABA and serotonin support for her anxiety and sleep issues. Again, we used the low GABA and low serotonin symptoms questionnaire and did trials of GABA and tryptophan for her which helped further.

Sugar cravings and binge eating with other neurotransmitter imbalances too

Keep in mind that there is a sugar cravings aspect to all the neurotransmitter imbalances. The type of craving can be found on the above symptoms questionnaire. It’s not uncommon to need support more than one area:

Low blood sugar /hypoglycemia – glutamine for intense cravings at any time of the day
Low serotonin – tryptophan or 5-HTP for afternoon/evening cravings
Low endorphins – DPA for comfort/reward eating
Low catecholamines – tyrosine for low energy sugar cravings
Low GABA – GABA for stress eating

Glutamine product options – capsule vs powder

Products I recommend include Pure Encapsulations 500 mg l-glutamine (capsules opened on to your tongue) and Designs for Health l-glutamine powder as you find you need higher amounts. You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).

If you’re not in the US, Now l-glutamine 500 mg and Doctor’s best l-glutamine powder are products I recommend on iherb (use this link to save 5%).

Additional resources when you are new to using glutamine and other amino acids as supplements

We use the symptoms questionnaire to figure out if low blood sugar and/or low serotonin and/or low GABA and other neurotransmitter imbalances may be an issue for you.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues. The importance of quality animal protein and healthy fats is also covered.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you had success with glutamine for blood sugar stability and binge eating, food addiction and intense cravings for sugar and carbs?

Have you also found it helps with sleep, leaky gut and anxiety during the day?

If yes, how much helps you? And how often do you use it? And what sugary foods have you been able to stop eating?

If you’re a practitioner do you use glutamine and with clients/patients with these low blood sugar cravings? Do you recognize reactive hypoglycemia as a very real issue in non-diabetics?

And please let me know if it’s helpful that I’m now including product recommendations and where to get them?

Feel free to share and ask your questions below.

Waking with a jolt, feeling shaky and anxious: low blood sugar/hypoglycemia, glutamine and eating for blood sugar stability

February 2, 2024 By Trudy Scott 22 Comments

Low blood sugar is one of a number of causes of waking in the night or early hours, often with a jolt and feelings of anxiety or feeling like you’re having a panic attack. As shared in a recent blog post, cortisol that is high at night can cause very similar symptoms.

Because of a low blood sugar question on the high cortisol blog, today I’m explaining the very different solutions to each root cause: glutamine and eating for blood sugar stability when you have low blood sugar versus Seriphos when you have high cortisol.

Katherine shares that she has low cortisol and suspects hypoglycemia or low blood sugar, and is hesitant about using Seriphos:

My last 4 point cortisol test showed mine is low throughout the day. But I’m having episodes where I’m waking up in the mornings feeling a jolt (every time I wake up from sleeping) and sometimes also shaky and anxious.

A functional pharmacist suggested my blood sugar may be dropping during the night and hypoglycemia could cause an adrenaline surge.

I don’t know. I’m nervous to try something [such as Seriphos] to lower cortisol when it seems mine is already too low.

I agree with her functional pharmacist that hypoglycemia is likely a factor as it often is with adrenal dysfunction and low cortisol. And I am glad Katherine is being cautious about using Seriphos.

I shared that Seriphos is not the solution in this instance because she doesn’t have high cortisol based on her adrenal saliva test (4 collections). Instead, she has low cortisol throughout the day and using Seriphos would lower her cortisol even further. What many folks don’t realize is that high cortisol and low cortisol can lead to similar symptoms of anxiety, shakiness and waking in the night and early hours.

The good news is it’s relatively easy to figure out if low blood sugar is causing your symptoms. First I have clients rate their symptoms on the low blood sugar questionnaire and do a trial of glutamine. Next is figuring out the dosing and timing of glutamine, looking at a current food log and making dietary changes as needed.

If Katherine notices improvements – typically seen within a week – it’s very likely that hypoglycemia is a factor.

Finally, if additional support is needed for her anxiety I’d consider looking at low GABA and low serotonin symptoms and doing a trial of GABA and/or tryptophan.

Longer term solutions include all the dietary changes mentioned in my book – gluten-free, no sugar, no caffeine or alcohol, using nutritional support for the adrenals and addressing toxins, infections, trauma etc.

Low blood sugar symptoms

First I have clients rate their symptoms on the low blood sugar questionnaire and do a trial of glutamine if they have low blood sugar symptoms.

Here are the low blood sugar symptoms which are rated on a scale of 1 to 10, with 10 being most severe:

Crave sugar, starch or alcohol any time during the day
Irritable, shaky, headachey – especially if too long between meals
Intense cravings for sweets
Lightheaded if meals are missed
Eating relieves fatigue
Agitated, easily upset, nervous
Waking in the night or early hours with a jolt of anxiety/shakiness

If the ratings indicate the possibility of low blood sugar i.e. any cluster of the above symptoms, we do a trial of the amino acid glutamine on the tongue and record before and after ratings of a few symptoms.

Glutamine is a key amino acid for blood sugar stability and helps quickly while the adrenals heal and the dietary changes are figured out.

Glutamine for low blood sugar: dosing and timing

Typically 500 mg glutamine is a good starting dose. I see many folks start too high, like 5000 mg / 5 g and up multiple times a day, and it’s not necessary. However, we increase based on individual needs and you may find you do need to use 500 mg -1000 mg two to three times a day. Using a glutamine powder is a great way to use it especially if you find you do need more than 500 mg each time.

When you use glutamine powder directly on the tongue (rather than mixed in water), the benefits are seen almost immediately.

For someone like Katherine, using glutamine throughout the day may set her up for night time or early morning low blood sugar. She may also find she needs to use some glutamine just before bed too.

GABA and/or serotonin support too?

Depending on the causes of her anxiety and shakiness, in addition to glutamine, Katherine may need to consider GABA and/or tryptophan too. We use the low GABA and low serotonin symptoms questionnaire and do trials of GABA and/or tryptophan/5-HTP.

All three amino acids can be used before bed and during the night if needed but trials are best done one at a time.

Glutamine for low blood sugar, healing the gut, to reduce sugar cravings and for better sleep

In addition to helping with blood sugar stability and sleep issues, glutamine also helps to heal the gut and helps reduce sugar cravings. Laura shared how it’s been helping her with all of this on another blog:

I am currently struggling with gastritis (inflammation of the stomach lining) as well as a lifetime of low blood sugar and irritability. I started glutamine a few days ago (15 grams a day) and I am amazed at how it has calmed my gut as well as calmed the sugar cravings. I am also sleeping better!

I did share that 15 g is considered a high starting dose of glutamine. She may well get similar benefits with much less.

Glutamine for early morning low blood sugar and headaches

As you can see in this case, Cat finds 500 mg glutamine just once a day works well for her unique needs:

I found a powder that I mix approximately 500 mg of with water. It works within about 15 minutes and keeps me going for about 2 – 3 hours — long enough to reach a reasonable time for lunch.

I’m thrilled to have this option as anytime that I travel, low blood sugar becomes a huge issue as I suffer from ketotic hypoglycemia and end up with massive headaches and vomiting for 6-8 hours.

Dietary changes for blood sugar control and adrenal support

All my clients keep a food log and we look at what they are eating on a typical day and when. It’s key to eat in a certain way in order to control blood sugar:. breakfast on waking, healthy snacks 3 to 4 x day and some folks do well with a snack before bed. These meals and snacks should include quality animal protein and healthy fats. This is all outlined in detail in the diet and low blood sugar chapters in my book “The Antianxiety Food Solution”.

A protein smoothie in the morning is a good option too and especially helpful if you have the social anxiety condition pyroluria, where morning nausea and a low appetite is common initially. This blog highlights a research paper about breakfast smoothies helping to reduce anxiety and hypoglycemia symptoms.

Nutritional support for adrenal function includes a good B vitamin complex, extra vitamin B5/pantothenic acid, vitamin C and adaptogenic herbs such as rhodiola and ashwagandha.

Glutamine product options – capsule vs powder

If you’re not in the US, Now l-glutamine 500 mg and Doctor’s best l-glutamine powder are products I recommend on iherb (use this link to save 5%).

Additional resources when you are new to using amino acids as supplements

We use the symptoms questionnaire to figure out if low blood sugar and/or low serotonin and/or low GABA and other neurotransmitter imbalances may be an issue for you.

Have you had success with glutamine for blood sugar stability and waking with a jolt of anxiety/panic at night or in the early hours?

Have you used it for blood sugar stability, reduced cravings, leaky gut and anxiety during the day?

If yes, how much helps you? And how often do you use it?

Have dietary changes and adrenal support helped too?

If you’re a practitioner do you use glutamine and dietary approaches with clients/patients with low blood sugar?

And please let me know if it’s helpful that I’m now including product recommendations and where to get them?

Feel free to share and ask your questions below.

Glutamine for hypoglycemia/low blood sugar: “500mg mixed in water works in 15 minutes and keeps me going for 2 – 3 hours”

November 3, 2023 By Trudy Scott 27 Comments

Cat shared this feedback about how effective just 500mg of glutamine is for her low blood sugar and how quickly it helps:

I recently followed one of your posts on GABA down the rabbit hole to a linked blog post and then to another post where I found a mention of using glutamine for hypoglycemia. This is the only reference that I have read on this in 35 years of research on the subject. I follow a low carb, higher protein, healthy fat diet, but still suffer low blood sugar issues consistently at one particular time of the day. After so many years of eating a second breakfast to prevent the lows, I was ready to give any other healthy option a try.

It works!!! I found a powder that I mix approximately 500 mg of with water. It works within about 15 minutes and keeps me going for about 2 – 3 hours — long enough to reach a reasonable time for lunch.

I’m thrilled to have this option as anytime that I travel, low blood sugar becomes a huge issue as I suffer from ketotic hypoglycemia and end up with massive headaches and vomiting for 6-8 hours.

You have freed me from a huge weight! Thank you and hugs!

(And thank you for researching and sharing the tremendously helpful information in your books, webinar presentations and blogs.)

Thank you Cat for sharing your success and you are most welcome! I’m sharing this as a blog post because you may also be new to this.

Glutamine dosing, using powder vs capsules and using it on the tongue

Cat finds 500 mg glutamine works well for her unique needs. This is a good starting dose. I see many folks start too high, like 5000 mg / 5 g and up multiple times a day, and it’s not necessary. However, we increase based on individual needs and you may find you do need to use 500 mg -1000 mg two to three times a day.

Using a glutamine powder is a great way to use it especially if you find you do need more than 500 mg each time.

One thing I mentioned to Cat is when you use glutamine powder directly on to the tongue (rather than mixed in water), the benefits are seen more quickly i.e. right away rather than having to wait 15 minutes.

If you do start with glutamine capsules, be sure to open the capsule on the tongue too, But watch for fillers which can be irritating to some folks. Powders are typically glutamine-only and don’t taste bad at all. But when traveling, capsules may be a better option (at least when on a plane).

Ketotic hypoglycemia, adrenal dysfunction and breakfast

Ketotic Hypoglycemia International defines ketotic hypoglycemia as “a condition characterized by low blood sugar (glucose) and elevated ketones, typically occurring after fasting, like sleeping overnight. Ketotic hypoglycemia (KH) is not a disease itself but rather a symptom or a clinical presentation that can occur as a result of various underlying conditions.” I’ve asked Cat if she is aware as to what is causing her ketotic hypoglycemia and I’ll report back.

I have also asked if she has had salivary cortisol testing done as adrenal dysfunction plays a role in all types of low blood sugar and will need to be addressed. This can take awhile to test and figure out nutritional support. Until then, glutamine is wonderful for preventing low blood sugar episodes.

I’m also curious what her breakfasts look like and will update the blog when I find out. Cat does mention that she follows “a low carb, higher protein, healthy fat diet” so I assume her first breakfast is a good one. But it’s always something to confirm. As you can see on this blog, Anxiety and Hypoglycemia Symptoms Improve with Diet Modification, a healthy breakfast is key for blood sugar stability and preventing anxiety.

Low blood sugar symptoms and all the ways glutamine may help

This is the blog she commented on: Glutamine for calming, intense sugar cravings, gut healing and low blood sugar

I share all the symptoms we see with low blood sugar:

Crave sugar, starch or alcohol any time during the day
Irritable, shaky, headachey – especially if going too long between meals
Intense cravings for sweets
Lightheaded if meals are missed
Eating relieves fatigue
Agitated, easily upset
Nervous, anxious, panic attacks

As you can see, in addition to helping with low blood sugar symptoms, glutamine has calming properties (low blood sugar can also cause anxiety and panic attacks), helps reduce intense sugar cravings (sometimes described as a demonic urge to eat all things sweet and also helps with healing a leaky gut. Be sure to read these two blogs I’ve linked to above.

Glutamine has also been researched to help with addiction recovery. In this blog, An amino acid supplement with DLPA, glutamine and 5-HTP eases alcohol withdrawal symptoms at an inpatient detoxification program, glutamine is paired with two other amino acids.

Resources if you are new to using glutamine and other amino acids as supplements

We use the symptoms questionnaire to figure out if low blood sugar may be an issue for you.

If you suspect blood sugar or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this topic has an entire chapter), sugar cravings, anxiety and mood issues.

I really appreciate Cat for sharing her story and giving me permission to share as a blog.

Has glutamine helped you with low blood sugar/hypoglycemia? If yes, in what way has it helped – reduced anxiety, less sugar cravings (or other addictions), and not as irritable and cranky/angry?

And how much helps and how quickly? Are you using it on the tongue?

Has glutamine also helped with leaky gut?

If you’re a practitioner are you using glutamine this way with your clients/patients?

Feel free to share and ask your questions below.

Anxiety and Hypoglycemia Symptoms Improve with Diet Modification

August 12, 2016 By Trudy Scott 15 Comments

strawberry-smoothie

A paper published by the Canadian College of Naturopathic Medicine last month supports what I see with my clients on a daily basis: when it comes to anxiety caused by low blood sugar (or hypoglycemia) the correct diet can have a huge impact. And this means is the inclusion of enough protein, fats and fiber, especially at breakfast.

Here is the abstract from the paper: Generalized Anxiety Disorder and Hypoglycemia Symptoms Improved with Diet Modification

Observational evidence suggests that a relationship may exist between high glycemic index diets and the development of anxiety and depression symptoms; however, as no interventional studies assessing this relationship in a psychiatric population have been completed, the possibility of a causal link is unclear.

AB is a 15-year-old female who presented with concerns of generalized anxiety disorder and hypoglycemia symptoms. Her diet consisted primarily of refined carbohydrates. The addition of protein, fat, and fiber to her diet resulted in a substantial decrease in anxiety symptoms as well as a decrease in the frequency and severity of hypoglycemia symptoms.

A brief return to her previous diet caused a return of her anxiety symptoms, followed by improvement when she restarted the prescribed diet.

This case strengthens the hypothesis that dietary glycemic index may play a role in the pathogenesis or progression of mental illnesses such as generalized anxiety disorder and subsequently that dietary modification as a therapeutic intervention in the treatment of mental illness warrants further study.

Here are some details about this case report for AB, who was a 15-year-old female student of south-Asian descent:

she had anxiety (rated as 8/10 with 10 being the highest level of anxiety), worried excessively, experienced heart palpitations, shakiness, discomfort in her stomach, and muscle tension and often missed school because of how she felt
she experienced symptoms of hypoglycemia/low blood sugar and when her blood sugar dipped too low she experienced muscle weakness, headaches, nausea, anxiety, and poor concentration
when she felt anxious she would eat she would eat chocolate, chips, fruit and when her blood sugar dipped she would eat a granola bar

As you can see from her typical daily diet she was eating mostly carbohydrates, with very little protein, fat or fiber:

Breakfast: fruit smoothie containing fruit, fruit juice, and water.
Morning snack: bagel with margarine.
Lunch: pasta or white rice with vegetables.
Afternoon snack: granola bar or cookies or gummy candies.
After school meal: white pasta; it may include meat.
Dinner: white rice or spaghetti; it may include meat.
Evening snack: cookies and toast.
Beverages: 2 liters of water, 1 cup of juice, 1 cup of lactose-free milk, and 1 cup of tea.

She made the following changes in her diet adding protein at breakfast, lunch, dinner and at snack time, and adding healthy fats like flax seeds, olive oil and nut butters:

Breakfast: includes a smoothie containing fruit, water, 1 scoop of protein powder, and 1 tablespoon of flax seeds or olive oil.
Lunch and dinner: include a serving of protein (meat, legume, and soy) and a serving of vegetables.
Snacks: include protein when possible (e.g., apple with sunflower seed butter, vegetable sticks with hummus, and pumpkin seeds).
Continue to eat carbohydrate-containing snacks as needed for the management of hypoglycemia symptoms.

Over a 4-week period she made a few simple dietary changes and saw profound results: her anxiety decreased significantly from 8/10 to 4 or 5/10, she had more energy, she had fewer headaches, better concentration and improved mood.

The interesting factor is that when she slipped up for a week and went back to her old diet she felt more anxious within a day, but felt better within 2 days of adding back protein, fats and fiber.

These results are very typical with my clients and getting a handle on stabilizing blood sugar is the first thing I do with all my clients. Believe it or not, for some people this is ALL they need to do. I would add that I recommend making these changes in conjunction with the removal of gluten and caffeine.

I also like to see animal protein (and fat) as part of the snacks: like grass-fed beef jerky, grass-fed beef sticks, boiled eggs or pemmican. AB was allergic to eggs, nuts, and fish so these were not an option for her. Soy is often as issue so would need to be watched.

So this case study supports the fact that we must not forget the basics like blood sugar control. It’s very common for me to get questions like this on my blog: “I’m anxious, which amino acid should I use?” I always reply: focus first on real whole food and eating to balance blood sugar, remove sugar, gluten and caffeine, and then look at doing a trial of one or more of the amino acids

I do like to make things easier for my clients and this is where an amino acid like glutamine is very helpful in terms of providing added blood sugar stability, a calming effect and help with gut healing

Adding the glutamine and also doing a trial of an amino acid like GABA Calm may get the anxiety down a few more notches because we are always aiming for zero.

Addressing adrenal issues (which are closely related to blood sugar issues), and of course addressing all the other possible factors like thyroid health, gut health, other food sensitivities and so on would be the next step.

Have you see the positive impacts of keeping your blood sugar stable? What makes the most impact for you?

If you are a practitioner, how do you help your clients or patients address blood sugar issues?