Hypoglycemia and Anxiety

Shared Symptoms of Hypoglycemia and Anxiety

When blood sugar drops, the body responds by releasing adrenaline, cortisol, and glucagon—stress hormones that try to raise glucose levels quickly. This surge of hormones also creates symptoms nearly identical to anxiety and panic.

Symptoms that Overlap:

• Shakiness or trembling
• Rapid heartbeat or palpitations
• Sweating
• Dizziness or lightheadedness
• Fatigue or weakness
• Irritability or mood swings
• Difficulty concentrating
• Nervousness or restlessness
• Feeling faint or panicky

This similarity can cause confusion: Am I having a panic attack, or is my blood sugar low? Sometimes, the answer is both.

The Hypoglycemia-Anxiety Feedback Loop

For those already prone to anxiety, hypoglycemia can be a trigger, initiating a cycle that looks like this:

• You skip a meal or go too long without eating.
• Blood sugar drops.
• The body releases stress hormones to fix it.
• You start feeling shaky, nervous, dizzy—like an anxiety surge.
• Worry kicks in: “What’s happening to me?” or “Am I going to faint?”
• Anxiety escalates, making symptoms worse.

And round it goes.

This loop becomes especially frustrating for those with panic disorder, health anxiety, or trauma because the body feels “in danger” even when it isn’t, which can reinforce the brain’s belief that something is wrong.

Anxiety Can Worsen Blood Sugar Regulation

The relationship goes both ways. Chronic anxiety and stress can also impact how the body handles blood sugar. Elevated cortisol levels (a hallmark of chronic stress) increase insulin resistance and make blood sugar swings more likely.

Other ways anxiety can contribute to hypoglycemia include:

• Skipping meals due to nausea or loss of appetite
• Increased energy expenditure through nervous tension
• Overreliance on caffeine
• Sleep disturbances that affect glucose metabolism

In short, unmanaged anxiety can set the stage for more frequent blood sugar crashes—and more crashes can lead to more anxiety.

Diagnostic Challenges: Anxiety or Hypoglycemia?

Because the symptoms of both conditions are so similar, it’s easy to misattribute one for the other.

To help tell the difference:

• Use a glucometer: If symptoms strike, a quick check can confirm whether blood sugar is low.

• Consider timing: Hypoglycemia often occurs after fasting, intense exercise, or a carb-heavy meal (in reactive hypoglycemia). Anxiety may strike in response to specific stressors or thoughts.

• Observe how symptoms resolve: Hypoglycemic symptoms usually improve within 10–15 minutes of consuming carbohydrates. Anxiety symptoms may take longer and often benefit from relaxation techniques or cognitive strategies.

Still, it’s common for the two to overlap—which is why both blood sugar management and anxiety recovery strategies are important.

The Psychological Impact of Recurrent Hypoglycemia

For people with diabetes or frequent low blood sugar episodes, the fear of hypoglycemia can itself become a source of anxiety—known as hypoglycemia-associated autonomic failure (HAAF). Individuals may become so afraid of symptoms that they:

• Overeat to avoid lows
• Avoid exercise or daily activity
• Experience anticipatory anxiety (worrying they’ll “crash”)

Over time, this can lead to avoidance behaviors, lower confidence in managing health, and even an increase in panic attacks. This highlights how important it is to address both the physical and emotional components of these experiences.