Different investigators have found 50% to 96% of alcoholics are hypoglycemic. Poulos, J, et. al. (1979) administered a 6 hour glucose tolerance test to 50 halfway house alcoholics and 50 outpatient alcoholics. All 50 fifty outpatient alcoholics were hypoglycemic and 46 of 50 halfway house alcoholics were hypoglycemic, with one diabetic and 3 pre-diabetic halfway house alcoholics. Whether this is a result of the alcohol or they were treating hypoglycemia with alcohol is perhaps irrelevant once they become alcoholics. The symptoms of hypoglycemia in many cases are identical to what is called dry drunk syndrome in Alcoholics Anonymous. Depression, irritability, anxiety, insomnia, impaired concentration, dizziness, and headache are common hypoglycemia symptoms.

 Hypoglycemia is evident in Alcoholics Anonymous groups. At AA meetings, regulars are commonly seen drinking colas, and other soft drinks, which contain up to 10 teaspoons of sugar or filling a styrofoam coffee cup one-quarter to half-full of white sugar and topping it off with regular coffee, which will increase insulin and glycogen release to rapidly raise blood sugar. Hale F., et. al., (1981) measured mental performance of 67 patients, during a five hour glucose tolerance test. Hypoglycemic patients required significantly (p=0.0002 ) more time to perform serial sevens subtractions, than non-hypoglycemic patients."The crux of the alcoholic problem is hypoglycemia-whether it occurs in the predisposed person with genetic factors influencing his physical and emotional growth, in the social drinker aggravating his already disturbed carbohydrate function, in the chronic alcoholic in the General Adaptation Syndrome (Hans Sleye, M.D.) stage of resistance or fatigue, or in the recovered alcoholic with his psychic and physical complaints. Even in the normal person, a temporary hypoglycemia develops following a debauch. (In 1968 Bill W., Founder of A.A., pleaded with physicians in a 48 page, 81/2" X 11" booklet to use the hypoglycemia diet and vitamins, especially B3, in the treatment of alcoholism. (This is out of print but we have one copy which we xerox from time to time.) Title "The Vitamin B-3 Therapy; A Second Communication to A.A.'s Physicians From Bill W." February, 1968. Bill W. wrote, after a description of the hypoglycemic condition, "The victim is alternately whipsawed between too much insulin and too much adrenalin. Unconsciously, we alcoholics try to cure these conditions-first by sweets, and then by coffee. The sweets temporarily raise our blood sugar, and be (sic) feel better. Coffee also gives us a temporary boost because it lessens the shock of the blood sugar drop. In exactly the wrong way, we are unconsciously trying to treat ourselves for hypoglycemia. If you are on B-3 and Vitamin C already, then add the dietary discipline.

If you have hypoglycemia to any extent, the dividends are apt to be very large." Hypoglycemia Association, IncBulletin #200 July/Aug/Sept.1996 Box 165, Ashton, MD Glucose is derived from three sources: from food; from synthesis (manufacture) in the body; and from the breakdown of glycogen, a form of glucose that the body stores in the liver. Hormones help to maintain a constant concentration of glucose in the blood. This is especially important for the brain because it cannot make or store glucose but depends on glucose supplied by the blood. Even brief periods of low glucose levels (hypoglycemia) can cause brain damage. Two hormones that are secreted by the pancreas and that regulate blood glucose levels are insulin and glucagon. Insulin lowers the glucose concentration in the blood; glucagon raises it.

Because prevention of hypoglycemia is vital for the body, several hormones from the adrenal glands and pituitary back up glucagon function. Alcohol consumption interferes with all three glucose sources and with the actions of the regulatory hormones. Chronic heavy drinkers often have insufficient dietary intake of glucose (8). Without eating, glycogen stores are exhausted in a few hours (1). In addition, the body's glucose production is inhibited while alcohol is being metabolized (2). The combination of these effects can cause severe hypoglycemia 6 to 36 hours after a binge- drinking episode (1). Even in well-nourished people, alcohol can disturb blood sugar levels. Acute alcohol consumption, especially in combination with sugar, augments insulin secretion and causes temporary hypoglycemia (9). In addition, studies in healthy subjects (10) and insulin-dependent diabetics (3) have shown that acute alcohol consumption can impair the hormonal response to hypoglycemia. ALCOHOL ALERT. National Institute on Alcohol Abuse and Alcoholism No. 26 PH 352 October 1994. Alcohol is very high calorie substance. Fats contain 8 calories per grams, which are released slowly. Proteins and carbohydrates (including white sugar) contain 4 calories per gram. Alcohol contains 7 calories per gram and 20% of the alcohol is absorbed through the stomach lining. For the hypoglycemic whose blood sugar is low and who is experiencing uncomfortable symptoms, alcohol is the quickest way to increase blood sugar. Hypoglycemia is fairly easily identified with the five or six hour of glucose tolerance test. Hypoglycemia often responds well to chromium, zinc, glutamine, and magnesium supplementation and sometimes to vitamin B3 supplementation. Rogers and Pelton, (1957) found glutamine supplementation reduced anxiety, desire to drink and improved sleep, in a 6 week double blind crossover trial, with 7 men and 3 women. Glutamine produced improvements in 9 out of 10 drinkers who used it. During the crossover phase of the study, only 2 or 3 subjects responded to the lactose placebo. G lutamine is the most abundant amino acid, in the human body and the body contains approximately 100,000 milligrams of glutamine. Glutamine probably helps the alcoholic in at least three different ways. It can be transformed into blood glucose and blood glucose is the only fuel of the brain, which uses at least 20% of the body's energy and requires a constant supply of blood glucose. Unlike fats and carbohydrates, when glutamine is not metabolized to supply blood glucose, glutamine increases protein production and release of human growth hormone. Glutamine also can transform to the excitatory neurotransmitter glutamate or the inhibitory neurotransmitter gamma-aminobutyric acid depending on what arousal level is needed. Glutamine also speeds repair of the intestinal lining, which is damaged by alcohol.