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Why do I feel so weak and shaky when I'm hungry?

Low blood sugar triggers a “must eat now” type of hunger – we feel shaky, weak, lightheaded and irritable because our body wants us to correct the problem. However, overcorrecting and running a high blood sugar can make cravings worse.

wexnermedical.osu.edu - Always hungry? There could be medical reasons why

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Author: Michael Langan, MD

No matter how you’re fueling your body, or how often, it still isn’t enough. Food is always on your mind, or there’s a nagging lack of feeling satisfied. The big question is: why?

Hunger is complicated. It’s both biological – we need to eat to live, and psychological – eating often results in pleasure. There are many factors that can affect hunger, and I think of them in four categories.

Medical conditions that can drive hunger and weight changes

Hunger may be a symptom of several medical conditions, so a change in your appetite isn’t something to take lightly. The thyroid produces hormones that maintain body metabolism, so when something goes wrong here, you may notice a change in appetite, among other symptoms. If you’re always eating and somehow dropping weight, your thyroid could be overactive. Alternatively, if you continue to gain weight without obvious explanation, an underactive thyroid may be a contributor as well. Insomnia and chronic lack of sleep cause hunger hormones to rise as the body fights to stay awake during the day. When we’re tired, we’re more likely to go for a high-calorie sugar boost as a pick-me-up. However, that’s going to backfire and leave you more sluggish in the long run. Obesity itself can make you feel hungrier. Excess fat and weight gain leads to decreased sensitivity to insulin, which may result in the sensation of increased hunger. This can also result in a decreased sensitivity to hormones that help you feel satisfied by food, leading to a vicious cycle. Type 1 and type 2 diabetes affect blood sugar levels and hunger. Low blood sugar triggers a “must eat now” type of hunger – we feel shaky, weak, lightheaded and irritable because our body wants us to correct the problem. However, overcorrecting and running a high blood sugar can make cravings worse. Those with diabetes have to work to keep a steady blood sugar and avoid highs and lows. There is also truth to the cravings that happen during menstruation. Hormonal changes during a woman’s period can cause increased appetite. If you notice a change in the amount of food you’re eating and you haven’t changed your activity level, that’s something to have checked out by your doctor.

Side effect of medication

Certain medications can affect your metabolism or hormones associated with hunger and satisfaction. This can lead to overeating and weight gain. Steroids, some antidepressants and diabetes medications can increase appetite, as well as medications for seizures and some psychiatric disorders.

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Any time you start a new medication, talk with your doctor about the potential side effects. If a medication causes increased hunger for you, don’t stop taking it without talking to your doctor. There may be an alternative with fewer side effects.

Mental strain feeds hunger

Eating is so strongly associated with feeling good that we’ve coined a phrase for it: comfort food. We often reach for high-fat, high-carbohydrate comfort food to help us cope during times of mental strain – anxiety, stress, depression, etc. The brain doesn’t like feeling bad from an imbalance of hormones and chemicals, and it manifests in physical symptoms such as hunger. Comfort food hits the pleasure receptors in the brain and makes you feel better. This is a very common reason for otherwise unexplained hunger, and it’s more challenging to correct.

Cultural cues increase consumption

Finally, the American culture is overrun with cues pushing us to eat rich, unhealthy foods. Think about all of the ways you’re tempted in a day: layers of advertising, office doughnuts, vending machines, fast food drive-thrus, social eating, concession stands and snacks while watching TV. Our brain is designed to respond well to what makes us feel good and reminders of that. Food companies know this and use all sorts of tricks to increase hunger for their products. The problem is the reward is short-lived, and we get caught up going from one trigger to the next.

When to see the doctor

How can you tell if hunger is a problem for you? Keep track of objective measurements like your weight and BMI. If it’s increasing, note the speed of change. Regardless of whether you’re eating more, if your weight trajectory is moving upward by 10-15 pounds and it’s unintentional, it’s time to talk with your doctor. If you’re eating significantly more than what you’re used to, or you’re hungry more frequently and you’re not gaining weight, see your doctor. Addressing a problem sooner rather than later will be easier, especially if it involves weight gain.

wexnermedical.osu.edu - Always hungry? There could be medical reasons why

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