Celiac disease and gluten sensitivity are treated through dietary shifts— but that doesn’t mean that the process is easy! Many foods in restaurants contain hidden gluten (one-third of gluten free dishes in US restaurants have been found to contain gluten) and package labels in the grocery store are not always accurate. Cross-contamination in manufacturing plants is common, so it’s rarely safe to rely on an ingredient list unless the packaged food is certified “gluten-free.” And, many people who are aware that gluten trashes their health still cannot resist the siren song of pizza and freshly baked bread, which is where enlisting the help of a health coach may be extremely helpful. Going gluten free is definitely a lifestyle shift, but if you have celiac disease or gluten sensitivity, it’s the only way to heal. Give your body and mind three months to adjust to the change, and be patient with yourself as you navigate living in a gluten-free world. It’s not easy, but the boost to your wellbeing may be considerable!
Reactive Hypoglycemia, also known as the great mimicker of depression and anxiety, is a little known yet increasingly common condition where blood glucose levels become dangerously low three to four hours after eating a meal. There are a few different types of hypoglycemia and while some are associated with pre-diabetes, non-diabetic reactive hypoglycemia is simply caused by low blood sugar without the highs. Symptoms include weakness, shakiness, dizziness, headache, sweating, anxiety, irritability, heart palpitations, insomnia, a sense of doom, hallucinations, extreme fatigue and loss of consciousness. Studies conducted on the prison population found that reactive hypoglycemia was linked to violence among inmates, and it is often misdiagnosed as chronic fatigue, subclinical hypothyroidism, depression, bipolar disorder, alcoholism, anxiety, and others.
Hypoglycemia can also drive alcohol use disorders and eating disorders because temporary relief from symptoms is usually dependent on the ingestion of sugar, creating a vicious cycle. This may be why Alcoholics Anonymous often pushes donuts and juice on the newly sober to counteract the terrible effects of decreased glucose in the body!
Testing for reactive hypoglycemia is straightforward, although few doctors look for it. If you suspect you may have reactive hypoglycemia, you will need to ask an experienced endocrinologist for a Mixed Meal Tolerance Test, which involves swallowing a sweet drink containing fat, protein and sugar. This will raise your blood glucose and force your body to pump out more insulin. Then, you’ll be given several blood tests over the five hours following ingestion to see how your body reacts.
If you test positive during this test for reactive hypoglycemia, your endocrinologist will likely implant a blood glucose monitor into your arm and ask you to eat a wide variety of foods over a period of a few weeks, taking note of when your blood glucose drops and symptoms appear. He will then analyze this data and work with you to create a nutrition plan of action, as well as discussing medication options. You can usually treat non-diabetic reactive hypoglycemia through dietary changes alone, but patience and persistence is key. While some do well on a nutrition plan that incorporates moderate complex carbohydrates ingested every few hours, others cannot tolerate any carbs and may find relief on a Paleo approach to eating, the “keto diet” or a “zero carb” meal plan, which stabilizes insulin levels and trains the body to turn fat into ketones for energy production, rather than relying on glucose. Regular exercise and daily glucose monitoring are also important! Nutritional changes and lifestyle adjustments can completely reverse this frustrating condition.
Not Eating Enough is a surprisingly common reason for why people experience symptoms of decreased mental wellness.
The dieting industry and weight loss culture that has predominated over the past thirty years taught millions of women that if they wanted to shed pounds, they’d need to eat somewhere between 900 to 1200 calories per day. This ludicrous suggestion has given rise to an increase in eating disorders, slowed metabolism, suboptimal health and self-loathing.
When we do not eat enough to support bodily functioning, we rob our organs of the macro- and micronutrients they require, which can lead to a host of pretty scary symptoms, including severe depression, anxiety, fatigue, and insomnia. In my coaching practice, about thirty to forty percent of the women I work with are not eating enough, and have been living that way for years and even decades. There is so much confusion over how many calories we actually need to perform at our best. A simple way to figure this out is to use something called the Mifflin St. Jeor equation:
For women, the equation is: 10 x weight (kg) + 6.25 x height (cm) – 5 x age (y) – 161.
For men, the equation is: 10 x weight (kg) + 6.25 x height (cm) – 5 x age (y) +5
Your result will give you the amount of calories you a recommended to ingest in order to support your Basal Metabolic Rate (or BMR, your metabolism at complete rest).
From there, you’ll want to multiply that number depending on your daily activity level, which is called your basic activity factor, as follows:
1.2 if you are sedentary (little or no exercise = BMR x 1.2
1.375 if you are lightly active (exercise 1-3 days/week) = BMR x 1.375
1.55 if you are moderately active (exercise 3-5 days week) = BMR x 1.55
1.75 if you are very active (hard exercise 6-7 days week) = BMR x 1.725
1.9 if you do very hard exercise on a daily basis and work a physical job BMR = 1.9
Using this formula will give you a pretty good idea of how many calories you need to consume daily in order to keep your body functioning optimally, assuming that you do not wish to lose weight and that there are no serious underlying health problems. If you are trying to shed some body fat, a certified and experienced health coach can help you figure out how to adjust your caloric intake and still keep your body in a happy place.
Behavioral health issues like depression and anxiety can be tricky to treat, and their underlying causes are not always straightforward. I know that if my nutrition is on point and I’m exercising regularly, I generally do not experience any symptoms of depression and anxiety, but if I consume sugar or carbohydrates, skip my workouts, and surround myself with negative people, I’m in for trouble. For many of us who have faced mental health issues, a cure does not exist in a pill, but rather in the way we eat, move and live. If you’re struggling with a drug resistant mental health condition, consider consulting an endocrinologist and a registered dietitian to investigate potential physical underlying causes. A skilled, experienced health coach or nutritionist can also be helpful in crafting a plan of action while providing support and accountability as you move into a more peaceful and contented frame of mind—and body!
As always, thanks for reading! I have not posted in a long while - between mamahood, health coaching, consulting, school, long-form writing and self-care, my priorities have changed. Social media/blogging doesn’t happen often these days! I do, however, continue to work with a small number of health and behavior change coaching clients, so if you’re curious about how coaching may help to improve your energy levels and overall well-being, email me at firstname.lastname@example.org. Please be aware that I am only taking clients in Singapore at this time.