Discomfort from Skipping Meals: Causes and Solutions - Internal Medicine

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Experiencing discomfort from skipping meals can be quite common, and your symptoms suggest a physiological response to hunger that is exacerbated by your anxiety. When you skip meals, especially if you go for an extended period without eating, your body reacts in several ways that can lead to the symptoms you described: intense hunger, shaking hands, facial tingling, dizziness, and increased heart rate.


Understanding the Symptoms
1. Hunger and Blood Sugar Levels: When you skip meals, your blood sugar levels can drop. Although your fasting blood sugar of 92 mg/dL is within the normal range, it’s important to note that this measurement reflects your blood sugar after a period of fasting, not necessarily how your body responds to hunger throughout the day. When you don’t eat for several hours, your body may not have enough glucose available for energy, leading to symptoms like shakiness and dizziness.

2. Adrenaline Response: Skipping meals can trigger a stress response in your body. When blood sugar levels drop, the adrenal glands release adrenaline (epinephrine) to help raise blood sugar levels. This can lead to symptoms such as increased heart rate, shaking, and anxiety, which may be particularly pronounced in individuals with anxiety disorders.

3. Anxiety and Panic Disorders: Given your history of anxiety and panic disorders, it’s possible that your symptoms are compounded by psychological factors. Anxiety can cause physical symptoms such as trembling, rapid heartbeat, and feelings of dizziness, which can mimic or exacerbate the physical sensations of hunger.


Solutions and Recommendations
1. Regular Meal Schedule: To prevent these uncomfortable symptoms, try to maintain a regular eating schedule. Eating smaller, more frequent meals can help stabilize your blood sugar levels and prevent the extreme hunger that leads to discomfort. Aim for balanced meals that include carbohydrates, proteins, and healthy fats.

2. Healthy Snacks: Keep healthy snacks on hand, such as nuts, yogurt, or fruit, to help manage hunger between meals. This can prevent the feeling of being overly hungry and the subsequent discomfort.

3. Hydration: Sometimes, feelings of hunger can be confused with thirst. Ensure you are drinking enough water throughout the day, as dehydration can also lead to symptoms like dizziness and fatigue.

4. Mindfulness and Stress Management: Since you have a history of anxiety, incorporating mindfulness practices such as deep breathing, meditation, or yoga can help manage anxiety levels. This may reduce the physical symptoms you experience when you skip meals.

5. Consult a Healthcare Professional: If these symptoms persist or worsen, it’s important to consult with a healthcare professional. They can assess whether there are any underlying conditions contributing to your symptoms, such as reactive hypoglycemia or other metabolic issues.

6. Cognitive Behavioral Therapy (CBT): If anxiety is a significant factor in your life, consider seeking therapy. Cognitive Behavioral Therapy can help you develop coping strategies for managing anxiety and its physical manifestations.


Conclusion
In summary, the discomfort you experience from skipping meals is likely a combination of physiological responses to hunger and the effects of anxiety. By maintaining a regular eating schedule, staying hydrated, and managing stress, you can mitigate these symptoms. However, if you continue to experience significant discomfort, it’s advisable to seek further evaluation from a healthcare provider to rule out any underlying issues.