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Hypoglycemia Without Diabetes: Symptoms, Causes, and Prevention

October 26, 2021
Written by
Team NutriSense
Reviewed by
sticky notes with question marks and a note with "Hypoglycaemia" printed on it

You've likely heard of hypoglycemia as low blood sugar or low blood glucose levels. Although it's typically associated with people who have diabetes, it's a condition that anyone can experience. While it's not a disease per se, it can indicate health issues, so it's crucial to stay on top of it. You should know enough about the condition so you're aware of the symptoms, what can cause it, and what you can do to prevent it from happening. Read on to find out all this and more!

What Hypoglycemia Means

Before we walk through the signs and symptoms, it's essential to understand what this condition is. Hypoglycemia, or low blood sugar, is a condition that people experience when blood sugar reduces to dangerously low levels. This is the opposite event of hyperglycemia or high blood sugar

While it's normal for glucose values to rise and fall, extremely low blood sugar can cause adverse side effects. And, while you can track some of the symptoms of hypoglycemia, they usually vary depending on the individual and the severity of how the body handles the glucose reduction. 

Signs and Symptoms of Hypoglycemia

Since not everyone has the same symptoms of hypoglycemia, it's not always easy to pinpoint when you're experiencing them. There are also varying levels of severity for these symptoms and a difference in severity in the condition itself. There's hypoglycemia, and then there's severe hypoglycemia. 

Severe hypoglycemia occurs when blood glucose values drop so low that you require assistance administering either medication or fast-acting carbohydrates. You can alleviate these hypoglycemic symptoms (and often even prevent them) in less severe cases through simple diet and lifestyle modifications.

It's always a good idea to be aware of all the possible symptoms so you can address them before they become an issue. Whenever you experience the following, consider noting down the occurrence and severity so you can keep track:

  • Hunger
  • Dizziness/lightheadedness
  • Shakiness
  • Excess sweating
  • Anxiety
  • Headaches
  • Blurred vision
  • Inability to concentrate
  • Weakness
  • Pale skin

Common Causes of Hypoglycemia in Non-Diabetics

a person laying on their hands on a table among pills, syringes, a glucose monitor

Now that we've taken a look at the signs and symptoms, we're sure you're wondering what causes them. Is it unhealthy food choices? What about your routine and lifestyle choices? Does medication affect your levels too? It can be challenging to keep track of everything going into your body. Still, an easy way to do this is to get a continuous glucose monitor to see what your body is reacting to in real-time. In the meantime, here are some of the most common causes of the condition to focus on: 

Reactive Hypoglycemia and Pre-diabetes

There are many reasons why hypoglycemia may occur among people who don't have diabetes. One of the most common causes is something called reactive hypoglycemia. It occurs after a meal that is typically high in refined carbohydrates. In these cases, your body overproduces the amount of insulin that it needs to process the meal, which results in your glucose dipping too low. Reactive hypoglycemia may be an early sign that you're at a higher risk of developing diabetes.

Medications

a person holding a lot of different pills on their palm

Many types of medication can cause hypoglycemia, especially if you have diabetes. For example, if someone with diabetes takes too much of their insulin or other diabetic medications, it can cause hypoglycemic events. While medication-induced hypoglycemia is less common among those without diabetes, it's still a risk if you're taking certain medicines. Here's a list of drugs that are known to cause drug-induced hypoglycemia:

  • Diabetic medications and insulin (if the dosage is too high or not appropriate for meals/activity)
  • Antibiotics (like quinine, Bactrim, gatifloxacin, pentamidine, fluoroquinolones)
  • Indomethacin
  • Beta-blockers
  • Cibenzoline
  • Quinidine
  • Bile Acid Sequestrants (like Welchol)
  • ACE/Inhibitors
  • Salicylates

If you have questions about any of the drugs you’re taking and whether they put you at risk of hypoglycemia, it’s best to discuss them with your medical provider.

Liquor Consumption

If you've been fasting when you consume alcohol, or you have a history of alcohol abuse, liquor will increase your risk of developing hypoglycemia. As with most other factors, it's more of a risk for those with diabetes, but those who don't have diabetes are not in the clear here. 

So, why does alcohol affect this condition so much, and how? The primary cause of alcohol-induced hypoglycemia is the inhibition of gluconeogenesis, or the creation of glucose from non-carbohydrate substrates. Alcohol may potentially increase endogenous insulin secretion, contributing to the risk of hypoglycemic events in some individuals.

Disorders of the Organs That Control Glucose Regulation (Kidney, Liver, Heart)

Several key organs play a role in glucose regulation. If you have a history of kidney, liver, or heart issues, this may disrupt glucose regulation and increase your risk of experiencing hypoglycemia. Let's break this down a little more:

Kidneys: Your kidneys play a vital role in glucose homeostasis. They're responsible for a hose of processes including gluconeogenesis, glucose filtration, glucose reabsorption, and glucose uptake. Some studies have found that the kidneys are responsible for about 20% of glucose production via gluconeogenesis.

Liver: Your liver plays a vital role in multiple glucose homeostasis pathways, including glycolysis, gluconeogenesis, glycogenesis, and glycogenolysis.

Heart: We don't always think of the heart as a glucose regulator, but the circulatory system plays a significant role in blood glucose regulation. Hormones such as glucagon are carried via blood, which then signals other organs to regulate blood glucose. If there is any damage to the circulatory system, it can negatively impact your health.

Eating Disorders and Diet

There's no doubt diet plays a distinct role when it comes to hypoglycemia. Unbalanced diets that are higher in refined carbs (candy, crackers, sugar-sweetened beverages) and low in protein and fat are often associated with hypoglycemic events and 'energy crashes.'

On another note, if someone is fasting or skipping meals, the body may not be able to handle long periods without incoming carbohydrates. People who don't have diabetes but struggle with frequent hypoglycemic events may want to focus on increasing their metabolic flexibility as a long-term preventive plan.

Pregnancy

Hypoglycemia during pregnancy is more common than you'd think. It often occurs during the first trimester, when nausea and vomiting are most prevalent. However, it can also occur at any time during a pregnancy. During this time, a growing baby requires constant glucose and will siphon as much as they need from the mother. For this reason, eating frequent meals, maintaining a balanced diet, and replenishing those glucose stores are essential to help you prevent the condition. 

The Biggest Risk Factors in Determining Who Experiences Hypoglycemia

a doctor writing "Risk Factor" on glass

By now, we know what hypoglycemia is, what the symptoms are, and the causes to watch out for. And we also know that it's not a condition that only those with diabetes experience. But are there any other risk factors? Are some people more at risk than others? Here's what you need to know: 

Obesity

Obesity is a complex health condition that's linked to insulin resistance. People with insulin resistance may have imbalanced hormones, making it difficult for their bodies to maintain normal glucose levels endogenously. High insulin levels, which often occur among insulin-resistant people, may lead to low glucose drops during fasting times.

Family History of Diabetes

Yes, a family history of diabetes does put you at a higher risk of developing pre-diabetes and experiencing hypoglycemia. Learning more about your family's health history (specifically related to diabetes) can provide great insights into whether you should get a diabetes screening. Taking preventive measures to ensure that your glucose values are in an optimal range will also help reduce your risk of diabetes.

Stomach Surgery

People who have undergone bariatric surgery often have a higher risk of hypoglycemia, reactive hypoglycemia, and hyperglycemia. This is because of dumping syndrome and reduced stomach size. Dumping syndrome, or the rapid emptying of the contents of your stomach, can lead to excessively high and low glucose values. Reactive hypoglycemia is also very common and is thought to be caused by hyperinsulinemia and an altered GLP-1 response.

Pre-diabetes

Pre-diabetes means that your blood glucose is above the normal range, but below the diabetic range. When your glucose values see an elevation over a long period, your pancreas will secrete insulin to help lower these values. Circulating insulin allows glucose to enter the cells, which will help blood glucose values decrease. When your glucose values drop, your pancreas slows down the production of insulin. For those who have pre-diabetes, this process does not work as well as it should. Eventually, this leads to an overproduction of insulin and poor glucose regulation.

Ways to Diagnose Hypoglycemia

a doctor looking at notes

Diagnosing and treating hypoglycemia typically involves three steps that your doctor will likely need to help you out with. These include measuring low blood glucose, pinpointing the symptoms of hypoglycemia, and finally, finding relief from the symptoms by treating the hypoglycemia. There are two primary tests that your doctor can do to diagnose hypoglycemia.

Fasting Tests

You may need to undergo a fasting test since hypoglycemia can occur in a fasted state (long periods without eating). During this test, you would fast overnight or up to 72 hours. Your blood will be drawn at different times during this period to measure your blood glucose levels. If you see blood glucose values of <55 mg/dL with symptoms, you likely have hypoglycemia.

Talk to your medical provider about the testing before you decide. Ideally, you should undergo the tests when you experience the symptoms, but this isn't always possible. In some situations, you can also receive these tests during a prolonged fasting state under the supervision of a health professional. 

Mixed-Meal Tolerance Test

Another test to diagnose hypoglycemia is a mixed-meal tolerance test. This is a good option for people who experience reactive hypoglycemia, or hypoglycemia symptoms, after a meal. It's important to note that this test is not well standardized. 

Typically, the test is performed after an overnight fast. In the morning, you're given a meal that's similar to one that triggers hypoglycemic symptoms. A medical professional will observe you for several hours while labs are drawn every 30-60 minutes for a total period of five hours. Similar to fasting tests, your physician orders all labs.

Helpful Strategies for Preventing Hypoglycemia

Understanding the root cause of your hypoglycemia will help you prevent these events from occurring. So, when you're creating a preventive plan with a healthcare professional, address every factor, including medication, diet, exercise, your health history, and your family's health history. Here are some other changes you can incorporate into your routine to prevent the condition:

Eat Balanced Meals Consistently

a simple meal planner

One of the leading causes of hypoglycemia among people who don't have diabetes is going without food for extended periods. To help prevent hypoglycemic episodes, eating smaller, more frequent meals will help. In addition to meal timing, meal content also plays a significant role. Make sure you include protein, natural fat, and non-starchy carbohydrates in every meal you eat. Here are some examples to help you start planning your meals:

Breakfast: A spinach-and-egg omelet cooked in grass-fed butter, with a handful of berries on the side.

Lunch: Wild tuna with olive oil, sesame seeds, almond crackers, chopped raw veggies, and a handful of raspberries. 

Snack: An apple with almond butter.

Dinner: Grilled chicken with sweet potatoes along with an arugula and cherry tomato salad drizzled over with olive oil.

Alleviate Symptoms With the Correct Foods

a person siting on a sofa and looking at a glass of juice f

It's also a good idea to know what to do to correct things as soon as you experience symptoms of hypoglycemia. An easy fix is to immediately consume 15 grams of fast-acting carbohydrates. These can include:

  • 4 ounces of fruit juice
  • 1 small piece of fruit
  • 1 tablespoon of sugar or honey
  • 3-4 glucose tablets
  • 3 peppermint candies (not sugar-free)

Have Healthy Snacks on Hand

While these foods are a helpful way to correct hypoglycemic symptoms, you shouldn't make them a regular part of your diet. For good long-term health, it's best to focus on prevention and avoid consuming too much of these high-sugar foods. Remember that even if you have a set diet plan for every meal of the day, you should keep healthy snacks on hand. This way, you're not reaching for anything too unhealthy when you feel hungry in between meals. This will help avoid hypoglycemic episodes and keep you healthier. Here's a good starter list of healthy snacks: 

  • Edamame + blueberries
  • Cheese + an apple
  • Nuts + berries
  • Nut butter + fruit
  • Plain Greek yogurt + nuts
  • Hummus + vegetables (cucumbers, celery, cherry tomatoes)
  • Avocado + almond crackers

Engage with Your Blood Glucose Levels with Nutrisense

Your blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing.

With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.

When you join the program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals.

Ready to take the first step? Start with our quiz to see how Nutrisense can support your health.

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Hypoglycemia Without Diabetes: Symptoms, Causes, and Prevention
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Understanding the Relationship Between Menopause and Metabolic Health
Understanding the Relationship Between Menopause and Metabolic Health

Did you know that menopause can affect your metabolic health, and vice versa? Read on to understand the relationship between metabolic health and menopause, and how to manage metabolic health during your menopausal journey. 

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7
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Understanding The Effects of Sugar on the Brain According to Research
Understanding The Effects of Sugar on the Brain According to Research

What really happens to your brain when you consume sugar? Review how interesting the relationship between the brain and sugar is, and why it’s important to control your blood sugar.

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9
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Understanding the Causes and Symptoms of Endometriosis
Understanding the Causes and Symptoms of Endometriosis

Endometriosis is a common yet often ignored condition. Learn more about the symptoms to watch out for, how you can seek treatment, and read first-hand accounts from two women who have dealt with endometriosis.

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6
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Understanding Hyperglycemia vs. Hypoglycemia and How to Recognize the Differences
Understanding Hyperglycemia vs. Hypoglycemia and How to Recognize the Differences

Quickly understand the differences between hyperglycemia and hypoglycemia, how to recognize the signs, and key prevention tips.

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6
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Triglycerides and Blood Glucose [+Tips to Lower Triglyceride Levels]
Triglycerides and Blood Glucose [+Tips to Lower Triglyceride Levels]

Learn everything you need to know about the relationship between triglycerides levels and blood glucose.


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7
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Tips and Tricks for Staying Healthy in the Summer
Tips and Tricks for Staying Healthy in the Summer

If you're gearing up to travel or spend more time outdoors this summer, here are a few tips to help you stay safe and hydrated in the sun.

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7
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Tips for a Healthy, Happy Purim
Tips for a Healthy, Happy Purim

Purim, a joyous occasion celebrated around March or April every year, is just around the corner! Read on to learn more about the holiday and the delicious foods that accompany it.

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5
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Thoughtful Valentine's Day Gift Ideas from NutriSense Dietitians
Thoughtful Valentine's Day Gift Ideas from NutriSense Dietitians

Still haven't settled on the perfect gift for your Valentine this year? Take a look at our Nutrition Team's favorites for some thoughtful ideas.

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10
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The Warning Signs of Nerve Damage You Should Watch Out For
The Warning Signs of Nerve Damage You Should Watch Out For

Because nerve damage can have many silent symptoms, it often goes undiagnosed in the early stages. Read on to learn more about what causes nerve damage and some warning signs to watch out for.

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7
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The Ultimate Guide to Fiber and its Effect on Metabolic Health
The Ultimate Guide to Fiber and its Effect on Metabolic Health

Ready to learn all about fiber beyond just the basics? In this post, we dive deep into the different kinds of fiber and health benefits of each. From functional fiber to fermentation, we break down all the jargon into a layman's language.

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8
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The Relationship Between Cardio and Blood Sugar
The Relationship Between Cardio and Blood Sugar

Did you know that cardio can help you lose weight as well as optimize your health and blood glucose? Here's everything you need to know about cardio and its relationship with blood sugar.

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7
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The Side Effects of Unhealthy Weight Loss
The Side Effects of Unhealthy Weight Loss

Find out what unhealthy weight loss is and learn more about its side effects and what you can do to prevent them.

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6
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The Relationship Between Low Blood Sugar and High Blood Pressure
The Relationship Between Low Blood Sugar and High Blood Pressure

Learn about the warning signs of low blood sugar and the relationship it has on blood pressure.

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10
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The Positive Impact Weight Lifting Has on Blood Sugar
The Positive Impact Weight Lifting Has on Blood Sugar

Here is everything you need to know about the relationship between weight lifting and blood sugar.

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7
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The Relationship Between Cholesterol and Blood Sugar
The Relationship Between Cholesterol and Blood Sugar

Cholesterol plays a very important role in the human body, contributing to the structure of the cells, helping with vitamin D synthesis, and also promoting the production of steroid and sex hormones, like cortisol, aldosterone, testosterone, and estrogen. But how exactly is cholesterol connected to blood glucose levels?

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8
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The Link Between Sleep Apnea and Diabetes
The Link Between Sleep Apnea and Diabetes

NutriSense dietitian Katrina Larsen, MS, RD,N, LD, CDCES discusses the risk factors for sleep apnea and how this disorder is linked to other health conditions.

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The Paleo Diet and Blood Glucose Levels
The Paleo Diet and Blood Glucose Levels

The premise of the paleo diet is that the body can handle a mix of meats, fruits and vegetables, eggs, fish, and complex carbohydrates better than processed meats, refined fats, grains and simple carbohydrates because it evolved to eat the first category as hunter-gatherers.

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8
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The Health Benefits of Winter Squash
The Health Benefits of Winter Squash

A common ingredient in cozy winter recipes, winter squash is one of our favorite foods this time of year. Read on to learn more about how it can benefit your health.

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6
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The NutriSense Holiday Gift Guide: Stocking Stuffers We Love
The NutriSense Holiday Gift Guide: Stocking Stuffers We Love

Haven't finished your holiday shopping yet? Pick from this list of NutriSense-approved holiday gifts to find some great last-minute stocking stuffers for everyone on your list!

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8
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The NutriSense Holiday Gift Guide: Health-Focused Gifts They’ll Love
The NutriSense Holiday Gift Guide: Health-Focused Gifts They’ll Love

Still haven't bought all your holiday gifts this year? Don't worry—there's still time to find the perfect gift for everyone on your list. Read our guide for some great ideas!

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9
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The Link Between Inflammation and Blood Glucose
The Link Between Inflammation and Blood Glucose

Learn more about inflammation, how it affects blood glucose levels and what you can do to prevent and manage it.

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9
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The Health Benefits of Adding Fermented Foods to Your Diet
The Health Benefits of Adding Fermented Foods to Your Diet

Fermented foods have a range of health benefits. Read on to learn more about what they are and why you should be adding them to your diet.

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9
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The Health Benefits of Potatoes, Yams, and Sweet Potatoes
The Health Benefits of Potatoes, Yams, and Sweet Potatoes

Potatoes, yams, and sweet potatoes are similar in usage, but pretty distinct in taste, texture, appearance, and even nutritional content! Read on to find out more about each one.

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8
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The Health Benefits of Living With Pets
The Health Benefits of Living With Pets

Did you know that living with a pet can do more than just put a smile on your face? Read on to learn all the ways living with pets improves your wellbeing.

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7
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The Health Benefits of Cooking With Herbs and Spices
The Health Benefits of Cooking With Herbs and Spices

Herbs and spices are a great way to add flavor to dishes, and also have a range of health benefits. Learn more about a few of our favorites.

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12
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The Health Benefits of Beans
The Health Benefits of Beans

Learn about the health benefits of beans and how they can help you live a healthier, longer life.

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6
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The Guide to Metabolic Diets: What Are They, Do They Work, And Who Should Try Them?
The Guide to Metabolic Diets: What Are They, Do They Work, And Who Should Try Them?

Review our guide to metabolic diets to help get a better understanding of what they are and whether they might be right for you.

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The Foods and Traditions of Kwanzaa
The Foods and Traditions of Kwanzaa

Learn about the traditions and nutrient-dense food commonly enjoyed during Kwanzaa. 

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9
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The Blood Sugar and Joint Pain Connection
The Blood Sugar and Joint Pain Connection

Have you ever wondered how your glucose levels might be connected to joint pain? We'll take a deep dive into this connection and share tips for reducing pain.

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10
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The Best Diet for Non-Diabetic Hypoglycemia
The Best Diet for Non-Diabetic Hypoglycemia

This article explores hypoglycemia in non-diabetics, how to manage symptoms through diet, and the advantages of glucose monitoring.

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6
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The Effect of Aging on Your Blood Glucose Levels
The Effect of Aging on Your Blood Glucose Levels

Take a look at how aging can affect your blood glucose levels.

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9
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The Best Diet to Increase Your Vitamin D Levels
The Best Diet to Increase Your Vitamin D Levels

Read on to learn more about vitamin D-rich foods and what you should include in your diet to make the most of this vitamin’s health benefits.

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10
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The Best Diet for Menstruation
The Best Diet for Menstruation

When it comes to your menstrual cycle, what you eat can significantly impact how you feel. Read on to learn more about the best foods to add to your diet to help during that time of the month.

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8
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The Benefits and Risks of Popular Ayurvedic Herbs and Spices
The Benefits and Risks of Popular Ayurvedic Herbs and Spices

Ayurveda is an ancient Indian holistic healing system that dates back over 5,000 years. In the second installment of our series on the practice, review the benefits and risks associated with popular Ayurvedic herbs and spices.

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9
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The Beginner’s Guide to the Low FODMAP Diet
The Beginner’s Guide to the Low FODMAP Diet

In this article, we break down what a low FODMAP diet looks like for beginners, and its potential benefits and drawbacks for gastrointestinal health.

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The 6 Worst Foods for Osteoporosis
The 6 Worst Foods for Osteoporosis

When it comes to bone health, good nutrition is absolutely critical. Read on to learn what osteoporosis is and why some foods may increase your risk of or worsen the condition.