Blood Sugar’s Wild Ride: How Autonomic Dysfunction Throws Glucose Off Track

Autonomic dysfunction, often characterised by an imbalance in the autonomic nervous system (ANS), can significantly impact health, especially in people with Postural Orthostatic Tachycardia Syndrome (POTS). The ANS controls involuntary bodily functions like heart rate, digestion, and blood pressure regulation. It comprises two primary divisions: the sympathetic and parasympathetic nervous systems, which work together to maintain balance in the body.

When this system malfunctions, as seen in POTS, it can lead to a variety of symptoms and disrupt essential processes, including blood sugar regulation.

How Autonomic Dysfunction Affects Blood Sugar Control

People with POTS often experience symptoms like dizziness, fainting, excessive sweating, and abnormal heart rates. These symptoms result from the ANS's inability to respond appropriately to stimuli, affecting the body’s stability. Autonomic dysfunction can impair glucose metabolism and insulin sensitivity, making blood sugar regulation more challenging. Poor ANS function can hinder the body's response to insulin, causing increased glucose levels and raising the risk of prediabetes or type 2 diabetes.

The ANS plays a crucial role in glucose metabolism by influencing insulin secretion from the pancreas and the body’s response to glucose intake. When the sympathetic nervous system becomes overactive, it may lead to insulin resistance, where cells do not respond effectively to insulin, destabilising blood sugar levels further.

Mast Cells and Blood Sugar Regulation in POTS

Mast cells, an integral part of the immune system, play a vital role in inflammatory responses and may influence metabolic processes, including blood sugar regulation. Emerging research suggests that mast cell activation could contribute to insulin resistance and glucose variability, which are common concerns for individuals with POTS.

Personally, I noticed significant improvements in my symptoms when I started using ketotifen, a mast cell stabiliser. Mast cell stabilisers, such as cromolyn sodium and ketotifen, prevent the release of inflammatory mediators from mast cells. By reducing inflammation, they may help improve insulin sensitivity and support more stable blood sugar levels. This dual action of managing both inflammation and glucose regulation makes mast cell stabilisers a potential adjunct therapy for individuals with POTS experiencing blood sugar dysregulation.

Given the connection between mast cells, autonomic dysfunction, and metabolic health, further research is needed to explore how mast cell stabilisers could be used in clinical settings to aid blood sugar control. Individuals considering this treatment option should consult healthcare professionals to evaluate its suitability for their specific condition.

Using Continuous Glucose Monitors (CGMs) to Track Blood Sugar

Continuous Glucose Monitors (CGMs) have transformed how people manage their blood sugar, especially those with POTS who may experience erratic glucose levels due to autonomic dysfunction. Unlike traditional finger-prick tests that provide single data points, CGMs offer continuous real-time insights into glucose fluctuations throughout the day and night. These devices consist of a small sensor placed under the skin, tracking glucose levels in the interstitial fluid.

CGMs such as the Abbott Freestyle Libre offer several benefits beyond convenience. For individuals with POTS, whose symptoms may vary between hyperglycaemia and hypoglycaemia, CGMs help by detecting patterns that might otherwise go unnoticed. Additionally, they come with alerts that notify users when their glucose levels are outside of target ranges, enabling timely intervention. This feature is especially valuable for those who may not feel symptoms of changing glucose levels due to autonomic dysfunction.

Moreover, CGM data can be integrated with smartphone apps and diabetic management systems, allowing users to track glucose levels alongside lifestyle factors such as diet and exercise. This comprehensive approach empowers individuals to take proactive steps in managing their condition.

Strategies for Controlling Blood Sugar Levels

Effective blood sugar management in POTS involves a combination of dietary changes, physical activity, stress management, and regular monitoring.

1. Balanced Diet: Eating a balanced diet rich in complex carbohydrates, fibre, lean proteins, and healthy fats can help stabilise blood sugar. Focus on whole grains, legumes, and vegetables, while avoiding refined sugars and highly processed foods that cause rapid spikes in glucose levels.

2. Regular Exercise: Physical activity improves insulin sensitivity and helps maintain stable glucose levels. Incorporating both aerobic and resistance exercises into a weekly routine—aiming for at least 150 minutes of moderate-intensity exercise—can be highly beneficial.

3. Stress Management: Since stress can cause glucose fluctuations, stress reduction techniques like meditation, deep breathing, yoga, and relaxation exercises are vital. Identifying personalised stress-relief methods can enhance overall well-being and support blood sugar control.

4. Regular Monitoring: Frequent blood sugar monitoring, especially using CGMs, allows individuals to make timely adjustments to their diet and activity levels. This practice can prevent large glucose swings and improve overall stability.

The Role of Endocrinologists in Managing Blood Sugar

Endocrinologists are key specialists in managing blood sugar levels for those with POTS and autonomic dysfunction. These healthcare professionals focus on hormone-related conditions and metabolic health. By assessing hormonal imbalances, they can identify issues that may contribute to poor glucose regulation.

Treatment plans developed by endocrinologists typically include lifestyle changes, medication, and continuous glucose monitoring. They also collaborate with other healthcare providers, such as primary care physicians, dietitians, and diabetes educators, to offer comprehensive care tailored to each patient’s needs.

Exploring Low-Carb Diets for Better Blood Sugar Control

Low-carbohydrate diets have gained popularity for their potential to stabilise blood sugar levels. These diets limit carbohydrate intake, reducing the likelihood of glucose spikes after meals. Research suggests that low-carb diets can improve insulin sensitivity, promote weight loss, and reduce overall blood sugar levels.

When adopting a low-carb diet, it’s essential to maintain nutritional balance by focusing on non-starchy vegetables, lean proteins, and healthy fats. Planning meals and tracking carbohydrate intake can help ensure consistency and prevent nutritional deficiencies.

Nutritional Supplements for Blood Sugar Support

Certain vitamins and supplements may aid in blood sugar management, particularly for individuals with autonomic dysfunction. Key nutrients include:

• Chromium: Enhances insulin sensitivity. Dosages typically range from 200 to 1000 mcg per day.

• Magnesium: Supports insulin action and glucose uptake. Recommended intake is 310–420 mg daily.

• Alpha-Lipoic Acid: An antioxidant that improves insulin sensitivity. Common dosages range from 300 to 600 mg daily.

• Vitamin D: Essential for metabolic health. Daily intake recommendations vary, but higher doses may be required for those with deficiencies.

Before starting any supplements, it’s crucial to consult a healthcare professional to avoid adverse effects and ensure proper integration with existing treatments.

Hormonal Influences on Blood Sugar in Women

For women with POTS, hormonal fluctuations during the menstrual cycle can further complicate blood sugar management. Estrogen and progesterone levels shift throughout the cycle, affecting insulin sensitivity. During the follicular phase, higher estrogen levels improve insulin sensitivity, while increased progesterone during the luteal phase may reduce it, leading to glucose variability.

Monitoring blood sugar closely and adjusting dietary intake during different phases of the cycle can help women manage these changes more effectively.

Summary

Managing blood sugar in POTS requires a multi-faceted approach that includes lifestyle adjustments, regular monitoring, and medical support. Understanding how autonomic dysfunction, mast cell activity, and hormonal fluctuations affect glucose regulation is vital for creating effective strategies. By working closely with healthcare providers, adopting practical management tools like CGMs, and making informed lifestyle choices, individuals with POTS can take control of their health and reduce the impact of blood sugar fluctuations on their daily lives.

Sharing my own experience, I found that incorporating ketotifen, tracking my blood sugar with a CGM, and making thoughtful dietary changes helped me gain better control over my symptoms. Everyone’s journey is unique, so it’s important to explore various approaches and find what works best for you.