The physical symptoms of a panic attack and an episode of low blood sugar, known as hypoglycemia, are often nearly identical, leading many people to confuse the two conditions. Panic attacks are sudden episodes of intense fear that trigger severe physical reactions without an apparent real danger. Hypoglycemia occurs when the glucose level in the blood drops below the necessary range, typically under 70 milligrams per deciliter (mg/dL), which is the body’s primary fuel source. It is rooted in the body’s fundamental survival mechanisms.
The Physical Reality of the Link
Low blood sugar can directly trigger a physiological response that feels exactly like an unexpected panic attack. When the body senses its primary fuel source is dangerously depleted, it initiates an emergency counter-response to restore glucose levels. This metabolic crisis causes a range of physical symptoms that overlap significantly with the symptoms of acute anxiety. Shared physical markers include a rapid heart rate (palpitations), excessive sweating, trembling, shakiness, and dizziness. Confusion, difficulty concentrating, and a sense of impending doom are common to both states, confirming that the physical experience is physiologically grounded.
How Stress Hormones Mimic Panic
The underlying reason for this identical sensation is the body’s release of counter-regulatory stress hormones. When blood glucose falls below the necessary threshold, the brain, which relies heavily on glucose for energy, perceives this as a life-threatening crisis. In response, the hypothalamus activates the adrenal glands to release a cascade of hormones, primarily epinephrine (adrenaline) and norepinephrine. The sudden surge of epinephrine initiates the “fight-or-flight” response, which signals the liver to release stored glucose quickly. This hormonal flood prepares the body for immediate action, causing the heart to race and the palms to sweat, generating the precise physical sensations that define a panic attack.
Differentiating Between Causes
Telling the difference between an episode caused by low blood sugar and one caused by psychological panic requires careful observation of context and timing. A metabolically induced episode is most likely to occur after a long period without food, following strenuous exercise, or after consuming a large amount of simple carbohydrates that lead to a rapid blood sugar crash. Symptoms caused by hypoglycemia will often resolve rapidly—within 10 to 15 minutes—after consuming a fast-acting source of glucose, such as juice or glucose tablets. In contrast, eating a snack will not typically stop a psychological panic attack with the same speed or certainty. Tracking symptoms relative to meal times and measuring blood glucose levels during an episode are the most reliable ways to rule out hypoglycemia and obtain a proper diagnosis.
Stabilizing Blood Sugar to Prevent Episodes
Preventing these panic-like episodes centers on maintaining steady blood glucose levels throughout the day. The most effective strategy involves eating balanced, frequent meals and snacks to avoid the dramatic drops that trigger the hormonal alarm system. Pairing carbohydrates with protein and fiber is helpful because they slow the digestion process. Choosing complex carbohydrates, such as whole grains and legumes, over refined sugars helps prevent rapid spikes and subsequent crashes. Eating every three to four hours ensures a consistent fuel supply, while staying adequately hydrated and avoiding excessive alcohol consumption are also important factors.