Low Blood Sugar: Symptoms and When to Seek Help - Internal Medicine

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Understanding low blood sugar, or hypoglycemia, is crucial, especially when experiencing symptoms that may indicate a drop in blood glucose levels. Based on your description, it seems you are experiencing some concerning symptoms, particularly the feeling of being "spaced out" or disoriented, especially in the evenings. Your blood pressure reading of 90/60 mmHg is on the lower side, and your blood sugar levels hovering around 70 mg/dL could be a sign of hypoglycemia, particularly if you are experiencing symptoms.


Symptoms of Low Blood Sugar
Common symptoms of low blood sugar can include:
1. Sweating: Excessive perspiration without physical exertion.

2. Trembling or Shakiness: A feeling of jitteriness or shakiness in the hands.

3. Hunger: An intense feeling of hunger, often accompanied by cravings for sugary foods.

4. Dizziness or Lightheadedness: A sensation of spinning or feeling faint.

5. Confusion or Difficulty Concentrating: Trouble focusing or feeling mentally foggy.

6. Irritability: Increased moodiness or irritability.

7. Fatigue: A general feeling of tiredness or weakness.

In more severe cases, hypoglycemia can lead to:
- Loss of consciousness
- Seizures
- Coma

When to Seek Help
Given your symptoms and the readings you provided, it is advisable to seek medical attention if:
- Your blood sugar levels consistently drop below 70 mg/dL, especially if you are experiencing symptoms.

- You have difficulty managing your symptoms with food or glucose tablets.

- You experience severe symptoms such as confusion, loss of consciousness, or seizures.


Possible Causes
Several factors can contribute to low blood sugar, including:
- Dietary Choices: Skipping meals, consuming too few carbohydrates, or not eating enough can lead to low blood sugar.

- Physical Activity: Increased physical activity without adequate food intake can deplete glucose levels.

- Medications: Certain medications, especially those for diabetes, can cause hypoglycemia.

- Hormonal Imbalances: Conditions affecting hormone levels, such as adrenal insufficiency, can impact blood sugar regulation.

- Underlying Health Conditions: Conditions like liver disease, kidney disease, or certain tumors can affect glucose metabolism.


Recommended Actions
1. Dietary Adjustments: Ensure you are eating balanced meals that include carbohydrates, proteins, and fats. Complex carbohydrates, such as whole grains, can provide a more stable source of energy.

2. Frequent Monitoring: Keep track of your blood sugar levels, especially before and after meals, and during periods of increased activity.

3. Consult a Healthcare Provider: Given your symptoms and blood pressure readings, it would be wise to consult a healthcare provider, preferably an endocrinologist or a general practitioner. They can conduct a thorough evaluation, including blood tests to check for underlying conditions that may be contributing to your symptoms.

4. Emergency Plan: If you experience severe symptoms, it’s important to have a plan in place. Carry glucose tablets or sugary snacks with you to quickly raise your blood sugar levels if needed.


Conclusion
In summary, your symptoms and blood sugar readings suggest that you may be experiencing low blood sugar. It is essential to monitor your condition closely and seek medical advice to rule out any underlying issues. A healthcare professional can provide personalized recommendations and treatment options to help manage your symptoms effectively. Remember, maintaining a balanced diet and being aware of your body's signals are key to preventing hypoglycemia.