What is the relationship between blood sugar and mood swings?

The most basic relationship between sugar and mood is the fact that the brain runs almost purely on glucose.

When blood sugar is imbalanced, either too high or too low, it can cause negative changes to mood as a secondary effect of brain cells shifting from normal function. Classically, too-high blood sugar (hyperglycemia) presents as anger or sadness, while low blood sugar (hypoglycemia) presents as nervousness or anxiety, but these emotions are not exclusive to either end of the blood sugar spectrum [1]. 

Those with metabolic disease diagnoses, such as diabetes mellitus, are significantly more likely to be diagnosed with a mood disorder, such as depression or anxiety [2,3]. In fact, nearly 70% of examined type II diabetes patients in one particular study reported feelings of depression, 46.2% reported uncontrolled emotional reactions, 44.7% had constant internal tension, 56.2% reported sleep-wake cycle disorders, and 90% reported fatigue [2]. It is highly likely that mood challenges are correlated with diabetes due to the complex relationship between glucose and the brain.

While blood sugar dysregulation is typically associated with diabetes, mood swings can be caused by significant shifts in blood sugar in metabolically healthy individuals too [3]. Therefore, the information presented in this article is valuable for otherwise-healthy individuals and those struggling with metabolic disease.

High Blood Sugar vs. A Blood Sugar Spike

A “sugar rush” after you eat something sweet or heavy in simple carbohydrates is different from having “high blood sugar”. When we eat foods that are high in sugar, (low in fat, fiber, and protein) there is very little work for the digestive system to do before all of the meal’s glucose is available in the blood, all at once. 

A sugar rush is associated with a spike in blood sugar, because if we are metabolically healthy, our pancreas releases an appropriate level of insulin, and our cells take up the glucose from the blood. Blood sugar levels quickly return to the normal range after a spike.

With so much glucose taken up at once, our cells have extra substrate for ATP (cellular energy) production, and we may feel a brief boost in physical energy and a brief boost in our mood. If we don’t eat more for a period of time, however, glucose availability is quickly back to 0. That spike in sugar and energy is likely to be followed by a crash: low energy and low mood.

High blood sugar that stays high (hyperglycemia) is typically associated with metabolic disease. It is most likely to happen when body cells have become “insulin resistant”, or stop responding to the insulin’s signal that glucose is available for pickup from the bloodstream. 

Although “high blood sugar” sounds like it should be associated with an abundance of energy, it is more likely to feel like fatigue. Blood glucose is high because cells are not absorbing the glucose available. In cases of insulin resistance, all that extra sugar in the blood stays in circulation, crosses the blood-brain barrier, and can actually cause damage to the brain [4].

The brains of people with poorly-controlled blood glucose typically show longer connection paths in the global brain network and less efficiency in signaling [4]. 

Low Blood Sugar and Mood

The fact that the term “hangry” exists, is evidence that many of us can relate to low blood sugar affecting our mood. However, hypoglycemia (blood sugar below the normal range) and hunger are not the same. 

Because glucose is the preferred substrate for cellular energy production, when levels in the blood are low, we are likely to feel low physically. Because the brain requires glucose to function, the body has multiple systems in place to keep blood glucose within a normal range, even between meals. 

Hunger pangs are caused by the release of a hormone called ghrelin, due to an empty stomach. One of ghrelin’s roles is to signal the release of any glucose stored in the liver or muscles and activate gluconeogenesis (the production of glucose from amino acids) to provide your brain with some blood sugar, even when you are in a fasting state. Ghrelin’s other job is to signal your brain to feel “hungry” and start salivating in preparation for a meal.

If you do not eat in response to hunger signals (like when you are dieting, fasting, or haven’t been to the grocery store), your body not only releases stored glucose, it also signals to the adrenal glands to release stress hormones. Your body is now entering physiological starvation mode, which is a stress state. In response to cortisol and adrenaline, you may start to feel shaky, anxious, and irritable (hence the term “hangry”).

If you are metabolically healthy, and you eat a healthy meal when you are hungry, your brain and body will get a slow and steady stream of glucose to pull your mood and energy levels back on track.

For those who are not metabolically healthy, low blood sugar, or hypoglycemia, can cause a variety of symptoms beyond mood and energy swings. If you have diabetes, or have developed insulin resistance, this state is more likely to occur after taking too much medication, taking an insulin treatment without eating, or exercising heavily without eating enough. Hypoglycemia may feel like “hanger”, but it can also make you feel sweaty, light-headed, confused, or tingly [5]. In extreme cases, hypoglycemia can lead to loss of consciousness or seizure [5]. 

How can I prevent blood sugar-related mood swings?

When we eat a high-sugar meal (or a savory one that is rich in simple carbohydrates), the body is suddenly flooded with glucose. This can trigger an exaggerated insulin response that quickly turns into acute, reactive hypoglycemia [3]. Cells take up a high level of glucose quickly in response to the high insulin signal, but are then starved without a follow-up supply. When you hear of a “sugar rush” followed by a “crash” in energy and mood, this is the biological reason. 

Alternatively, we can eat meals that are balanced with fiber, fat, and protein. In a healthy balanced meal, simple carbohydrates still provide a little bit of glucose available immediately in the bloodstream, but it is followed by slow and steady glucose availability as the slower-to-digest macromolecules move through the digestive system. There is no rush and crash, just a steady glucose level to be absorbed, as needed, by cells throughout the body and brain.

If you notice that your mood and energy levels are sensitive to changes in your blood sugar after eating (or not eating), you may want to talk to your doctor about being tested for diabetes and other metabolic conditions. If you are metabolically healthy, and just sensitive to blood sugar changes, try carrying healthy snacks (avoid sugar and simple carbs) and eat every two to three hours to maintain balanced blood sugar.

It sounds counter-intuitive, but many people with chaotic blood sugar levels have had success achieving healthier balance with intermittent fasting. If you are interested in reading more, check out our blog article on intermittent fasting for healthy blood glucose balance.

Nutrition for Balanced Blood Sugar and Mood

Certain nutrients are more supportive than others when it comes to balancing your blood sugar and supporting normal insulin response. If you’re looking to boost your diet with some supplementary blood glucose-supportive nutrition, here are some terrific choices:

Alpha Lipoic Acid

Alpha Lipoic Acid (ALA) is a powerful antioxidant and a cofactor for mitochondrial enzymes. ALA is amphipathic, meaning it can work as an antioxidant in both fat and water, and it can cross the blood-brain barrier allowing it to work everywhere in the body [6]. 

ALA plays a key role in glycolysis, the process of breaking down glucose to make cellular energy, and regulates glucose and lipid metabolism [6]. Clinical studies have demonstrated that ALA supports insulin sensitivity and glucose tolerance, as well as healthy weight maintenance and food intake in animal models [6]. Supplementary ALA supports healthy, normal insulin-signaling pathways [6].

Prebiotic Fiber

Gut dysbiosis and metabolic dysfunction are linked [7]. Pathogenic bacterial species in the gut can cause increases in systemic lipopolysaccharide concentrations, changes to bile acid metabolism, alterations in short-chain fatty acid production, alterations in gut hormone secretion, and changes in circulating branched-chain amino acids [7]; all of which negatively affect glucose metabolism. 

When we balance the microbiome, with probiotic supplementation and prebiotic fiber to feed them, we can correct these changes. Prebiotics have been shown to support improved glycemic control and immune responses related to metabolic disease [8].

Chromium

If you’re struggling with sugar cravings or an overactive appetite, chromium may help [9]. Chromium is an essential mineral that has appetite-suppressing actions and is considered to be a cofactor in insulin signalling [9,10]. 

Chromium levels are positively associated with the number of glucose transporters present on cell membranes [10]. Because of this relationship, severe chromium deficiency has been known to cause reversible insulin resistance and diabetes [10]. Therefore, chromium supplementation may support healthy insulin sensitivity and normal glucose metabolism [10].

In conclusion

When dysregulated blood sugar goes unchecked, nerve tissue often suffers damage, especially in the extremities. High homocysteine levels can increase the risk of nerve damage in those with metabolic dysfunction [11].

The B vitamins, and specifically activated forms of B-9/folate, B-12, and B-6, are important for normal homocysteine metabolism and nerve health. Magnesium is involved in the normal transmission of nerve impulses. When glucose levels are high, the body requires more magnesium, which means those with dysregulated blood sugar are at a higher risk of magnesium deficiency [12]. 

If you are concerned with the health of your peripheral nerves, formulas designed with highly bioavailable and bioactive forms of the nutrients described above, and more specifically, for the support of normal nerve function in the face of metabolic difficulties may be beneficial. 

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