The similar physical sensations experienced during low blood sugar (hypoglycemia) and panic attacks often lead to confusion. While distinct conditions, their symptoms can overlap. This article explores the physiological mechanisms behind both conditions and their shared symptomatic expressions.
The Body’s Response to Low Blood Sugar
Hypoglycemia occurs when blood glucose levels drop below a healthy range, typically below 70 mg/dL. Glucose is the primary energy source for the body, and the brain is particularly dependent on a continuous supply, consuming 20% to 25% of the body’s total resting glucose.
When blood sugar levels fall too low, the body initiates a rapid response. This physiological reaction can manifest through various physical and mental symptoms that often come on quickly.
Common physical signs include shakiness, sweating, a fast or irregular heartbeat, dizziness, and hunger.
Mentally, individuals might experience irritability, nervousness, trouble concentrating, confusion, or lightheadedness.
The Nature of Panic Attacks
A panic attack is characterized by a sudden, intense surge of fear or discomfort that peaks within minutes. These episodes can be frightening and may occur without warning or clear trigger. Most panic attacks typically last between 5 and 20 minutes, with symptoms peaking within the first 10 minutes.
During a panic attack, various physical sensations can emerge, including palpitations, an accelerated heart rate, sweating, trembling, shortness of breath, or a choking sensation.
Beyond physical symptoms, mental and emotional distress can be profound, encompassing a sense of impending doom, a fear of losing control, or a fear of dying.
Unraveling the Link: Why Low Blood Sugar Can Feel Like Panic
The striking similarity between low blood sugar and panic attack symptoms is rooted in the body’s stress response system. When blood glucose levels drop, the brain detects this as a threat to its energy supply.
In response, the body releases stress hormones, primarily adrenaline (epinephrine) and cortisol, as part of its survival mechanism. These hormones help raise blood glucose levels by signaling the liver to release stored glucose.
However, the release of adrenaline and cortisol also produces physical effects that mirror acute anxiety, including increased heart rate, sweating, and shakiness.
The body’s emergency reaction to restore glucose balance can therefore mimic or even trigger a panic-like experience. Although the underlying cause for these symptoms differs—one stemming from a metabolic imbalance and the other from a psychological response—the physical sensations can be indistinguishable to the individual experiencing them.
Knowing the Difference and When to Act
Distinguishing between low blood sugar and a panic attack can be challenging due to their overlapping symptoms. One practical approach is to consider recent food intake, as hypoglycemia often occurs after a long period without food or strenuous exercise. If symptoms arise and low blood sugar is possible, checking blood glucose levels with a meter can provide a definitive answer. A key differentiator is that symptoms caused by low blood sugar typically improve rapidly after consuming sugar, whereas anxiety symptoms may persist.
For suspected low blood sugar, immediate action is important. The “15-15 rule” is a widely recommended guideline: consume 15 grams of fast-acting carbohydrates, such as 1/2 cup of fruit juice or regular soda, three to four glucose tablets, or one tablespoon of sugar or honey.
After 15 minutes, recheck blood sugar levels; if they remain below 70 mg/dL, repeat the process until levels rise.
Seek medical attention for recurrent episodes of symptoms, if symptoms do not improve after consuming sugar, or for persistent anxiety or panic. In cases of severe hypoglycemia, where an individual may be disoriented or unconscious, do not attempt to give food or liquid; emergency medical help should be sought.