Welcome to Part V of the Sock Doc Essential Guide to Carbohydrates. In Part IV, I discussed the hot topic of ketosis in athletes. Parts I–III discussed the many roles, both positive and negative, of carbohydrates in an athlete’s diet. The gist of the story is that you want to be using fat for fuel as much as possible, especially if you’re an endurance athlete, but even more so for overall good health. Carbs aren’t evil; they’re just overeaten by most athletes, and their bodies rely too heavily on them as an energy source.
So how do you know if you’re using primarily fat or sugar as a fuel source during the day while you’re working, sleeping, or training? It’s very difficult to determine, as the only real way to be absolutely sure would be to have a gas analyzer hooked up to you all day to measure your RER—respiratory exchange ratio. This is the ratio of carbon dioxide production to oxygen consumption, which correlates with the amount of fat and carbohydrates your body is using for energy. Of course, this is not practical, aside from specific spot testing. However, there are symptoms you may experience if your body is running somewhat inefficiently off sugars, and if you know what they are, you can work on correcting the problem.
Are You Burning More Sugar or Fat?
So how do you know if you’re running (literally and figuratively) more on sugar than fat? Well, if you feel like you’re having “blood sugar swings,” then you most likely are not using as much fat for energy as you should. Headaches, mood swings, concentration issues, and fatigue are often signs that your blood sugar isn’t being regulated well. I term this dysglycemia because I’ve seen enough people with these symptoms and upon measuring their blood sugar, I find it to be perfectly normal, yet they think it is low due to how poorly they feel. This is the problem with just taking a spot-check blood sugar reading: It’s an absolute—it just tells you where you are at one specific time. So if your blood sugar is a normal 85 mg/dL, you may feel like it’s low because perhaps it just dropped quickly from 110 mg/dL.
If you’re training consistently and not improving, then you are perhaps using more sugar than fat for fuel. I’ve seen people go from very little training to many hours per week preparing for a marathon or Ironman and not lose one pound because they were burning too much sugar instead of fat. Both the diet and training are often to blame. If you have increased your exercise and aren’t getting leaner (fat loss), then that’s another indicator that your body is using too much sugar for fuel.
Another big indicator is simple—you crave sugar. If you crave sugar, especially after you eat a low-carb meal (say, meat and veggies), then your body is inefficiently running off too much glucose. If you crave sugar after training, then you’re burning too much glucose during that period. Even though you often should eat some carbs after a long-duration or high-intensity workout, you should not crave them!
Tinnitus and Dysglycemia
Another symptom I have personally correlated with dysglycemia is tinnitus. Tinnitus is ringing in the ears. Many people have this high- or low-pitch ringing in their ears either intermittently for perhaps 20–40 seconds at various times during the day, if not all the time. Tinnitus can be caused by a variety of health problems, but it is often at least partially associated with dysglycemia in my experience. I’ve seen people improve their diet and have their tinnitus completely resolved. Actually, as I mentioned in a previous article, my health improved when I increased my high-fat diet to an even higher-fat diet; my tinnitus was one of the symptoms that improved. I used to get a ringing in one ear for about 10–30 seconds, usually two to three times a week, sometimes more if I was pushing my body too hard. Now, I only get this if I am under too much stress and not eating as well as I should be (skipping meals or eating too much sugar).
Zinc is the most common nutrient I see a need for with my patients who have dysglycemia issues and who are also experiencing tinnitus. Typically 25–75mg a day can be beneficial, though some people need more, some less, and some not at all. So if you want to try some zinc, start low and, of course, use at your own risk.
Sleep Problems and Blood Sugar
Sleep problems are perhaps some of the earliest symptoms an athlete will experience when training too hard, too often, or not recovering properly. Insomnia may be a problem (can’t fall asleep or it takes a very long time), or restless nights when you’re tossing and turning or up at various times. The most common time for a person to wake up at night due to increased stress hormones (the cortisol and adrenaline we learned about in the previous carbohydrate articles) is between 1 and 3 a.m. The reason for this is due to the acupuncture meridian system. At certain times of the day, each organ is providing its highest amount of energy, and the liver’s time is between 1 and 3 a.m. So when the liver is dealing with blood sugar problems during the night, outside of what is normal to maintain balance, the hormonal stress affects the liver and disrupts sleep.
Furthermore, poor sleep also affects insulin sensitivity (it makes it worse), creating a vicious cycle of poor glucose regulation affecting sleep quality, which affects glucose regulation—and around and around it goes. If you wake up between 1 and 3 a.m., even a little bit before or a little after, suspect blood sugar problems to some extent. For women, the sex hormones estrogen and progesterone can also stress the liver at this time and cause a restless night.
Numb Hands and Athletes
The final symptom I’d like to mention is one that I’ve personally correlated with dysglycemia after treating many athletes over 15 years, as well as from my own experience. If your blood sugar isn’t exactly where it should be, you might experience numbness in your hands either while sleeping or while exercising (especially racing).
What happens is that if you’re not getting the proper amount of sugar into your tissues, either because it’s not available or it can’t get into the tissues (cortisol, our major stress hormone, is great at blocking this), then a muscle imbalance occurs in your upper arms between your triceps and biceps. There is a muscle-organ relationship between the triceps and the pancreas which causes this imbalance to occur when the organ is stressed. This muscle imbalance can slightly impinge the ulnar nerve (that’s what is commonly called the “funny bone”), resulting in numbness to various levels, particularly in the fifth (pinky) and fourth (ring) fingers. Many people think their hands go numb when sleeping because they are lying on them or the way they have bent their elbows. This is often not the case, just a coincidence. Also, if you’re running (bent arms hopefully) and go to extend your arms, this is where you will feel a slight “shock” in your fingers if you’re having sugar-handling issues. It’s a great way to know you better get some carbs soon before the situation gets any worse, especially if you’re racing.
So now that you know some common (and pretty cool!) signs and symptoms of blood sugar–handling problems, you can address them and become a more efficient and healthy athlete. The more you know! 🙂
