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Helenas Story

This is the story of how I suffered from panic attacks and increasing weight for 17 years. Neither I nor my doctors suspected that the two conditions might be related. Over my many years of illness, because of moving house, I was treated for anxiety by a total of twelve medical experts, under whose care my panic attacks became progressively worse, and more frequent. I had consultations about my weight with my GPs and, despite following their advice, it increased from 140 pounds to over 300

… The weight

Having been a slim child, I began gaining weight for no apparent reason when I was about 16, and by age 19 I
carried 14 stone on my 5ft 5" frame. I tried to lose weight by following various diets popularised by the me-
dia, as well as taking advice from friends, my GP and a dietician. When no diet worked for me, my GP simply
accused me of cheating.

Over the next twenty years I continued to try out various diets from time to time, but I slowly gained weight,
irrespective of whether I was on a diet or not, so I just ate normally, unless I read about a new, "foolproof"
method. One such was the Cambridge Diet, which consisted of three milk-shakes a day instead of food. I lost
weight quickly but the diet caused me to suffer dizzy spells and heart palpitations, As soon as I ate normal
food these symptoms disappeared. However, the lost weight returned, plus some more.

Seventeen years after I started my first diet I took stock: I'd gained 100 pounds and was double my ideal
weight. This affected my life greatly: relationships were made difficult, everything physical became a tremen-
dous effort, and I had to give up many activities and sports.

Having heard people claim that dieting didn't work and that only exercise could cause weight loss, I took up
badminton, playing for two hours almost every day for 18 months, while consciously cutting back on calories.
My weight remained unchanged. My doctor banned me from playing, as I was damaging my knee joints. I felt
exasperated, and at this point I gave up both dieting and exercising.

The anxiety and panic attacks

>From the age of about 23 I began to have panic attacks. They came intermittently and without warning. I'd be
going about my usual daily life, in a supermarket or a cinema, on a bus, or perhaps at work. Suddenly, my
heart would start to pound, my throat would close, and I'd feel giddy and "unreal". When the attack reached
the point of greatest intensity I was completely out of control and would dash outdoors, panic-stricken and
gasping for breath. More than once I abandoned a trolley full of food while in a supermarket queue because I
simply had to escape. Then I became embarrassed to shop there again.

These bouts of terror led me to fear that something was wrong with my heart, but my GP told me that they
were "just" panic attacks. He explained that I had a recognised nervous condition called "anxiety disorder". I
declined to take any tablets, for three reasons. First and foremost, I dreaded becoming a drug-dependent zom-
bie; secondly, I wanted to find the root cause, not just "paper over" the symptoms; lastly, reading the list of
side-effects alarmed me.

Owing to moving house, I changed doctors six times over the next seventeen years. Each gave the same swift
diagnosis while writing a prescription for tranquillising or antidepressant drugs, which I always declined.
Some referred me a psychiatrist, who invariably questioned me about my childhood, my occupation and my
home life, and attributed my anxiety to stress. The cure: drugs. One of them told me to breathe into a paper
bag during a panic attack. Another told me that my craving for sweet things was psychological: everyone
knew they were "comfort foods".

In total I saw twelve medical professionals during my years of illness. I knew they all thought me at best a hy-
pochondriac or, at worst, a psychiatric case who was being uncooperative by refusing medication. Drugs were
the only thing on offer, and declining them meant I had to struggle alone with this debilitating and puzzling
condition.

New symptoms developed: I would have inexplicable weeping fits; I was indecisive; and I developed sudden
phobias. At one point I could not bear to see fish in a tank: they brought tears to my eyes and made me feel
like I was going insane. Worse, knowing that a panic attack could strike at any moment kept me in a constant
state of stress and anticipation.

Because I'd had attacks in a bus, an aircraft and a theatre, it seemed that being trapped was my principal fear.
After having a horrendous panic attack in an express train – during which I experienced an urge to open the
door and jump out – I dared no longer take a train unless the station stops were only minutes apart. One day I
got locked in a sports centre toilet cubicle, immediately became hysterical with panic and tried to smash down
the walls and door before collapsing in a mass of sobs. I was trapped there for three hours. After that, I refused
to bolt any toilet door. Soon I developed a fear of being trapped, and refused to enter any place from which I
could not escape instantly, such as tunnels, caves, the upper storeys of very tall buildings. I ceased flying,
stopped travelling by London Underground and refused to enter a lift. I would only attend a theatre or cinema
if I sat at the end of an aisle and close to the exit. One day I was taken to see the internal workings of a church
organ, but became panicky because I suddenly felt faint and had crushing pains in my chest. I became fixated
on the dark, narrow, stone, spiral staircase that was the only exit, and my only thought was, "if I had a heart
attack now, how would the paramedics get me, on a stretcher, out of this place?" Eventually I worked myself
into such a frenzy of panic that I suddenly just ran down the spiral staircase and emerged into the open air
gasping with relief, as though I'd just had a brush with death.

Because flying terrified me, I used the Eurostar in 1995, and the twenty minutes inside the tunnel felt like a
lifetime of sheer hell. I became obsessed with the idea that the tunnel walls were caving in on the train, and
within one minute had worked myself into a full-blown panic attack. After that I did not go abroad at all.

Very gradually my panic attacks increased in frequency, from occasional in 1983 to several times a week by
the late 1990s. By then new symptoms had emerged: between panic attacks I felt wobbly and unstable. My
emotions were on an endless roller-coaster ride: I'd feel weepy and depressed for hours, then suddenly exu-
berant, without reason. Some people knew me as effervescent while others thought I was a miserable wretch.

My symptoms gradually became more frequent and more intense. As well as having two or three panic attacks
a week, several times a day I'd feel "leaping and falling" sensations, as one does when driving fast over a
hump-backed bridge. When trying to sleep I often experienced a sensation akin to lying in a rowing boat on a
stormy sea.

Embarrassed at the frequency of my visits to the GP's surgery, and knowing the doctor would simply berate
me for refusing medication, and scold me for not losing weight, I tried to help myself instead. From reading
books I discovered that my symptoms matched those of bipolar disorder (manic- depression), panic disorder,
anxiety and depression. I learned relaxation techniques, and these, together with Rescue Remedy and Aconite
(which I carried with me at all times) enabled me to control the worst aspects of my panic attacks for some
years.

Overwhelmed by symptoms

My life took a turn for the worse in July 1998 when, attending a two-week-long musical festival in Buxton, I
became convinced that my guest-house landlady was poisoning me. After each breakfast (typically, orange
juice, cereal, milk, toast, jam, etc) I felt jittery and agitated; my heart palpitated so powerfully it made me gid-
dy, and I felt nauseous. One evening I had chicken korma followed by ice cream, and later awoke with a start
at 2.a.m. with blurred vision and chest pains. Terrified, I called for an ambulance. As the paramedics checked
me all my symptoms went away. They told me there was nothing physically wrong. Suddenly, I blurted out
my suspicions of being poisoned, but that I didn't want to make a false accusation. They suggested I leave the
guest house and go home.

>From then I was scared to go far from home. I had panic attacks anywhere and everywhere, indoors and out,
even at home; what I thought was claustrophobia had turned into agoraphobia. I saw various alternative thera-
pists: a hypnotist, a kinesiologist and a homeopath. The latter recommended Bach Flower Rescue Remedy and
Aconite homeopathic pillules. These quelled the panic attacks temporarily, then an hour later another wave of
panic would terrorise me. I told my doctor the effect these products had, but he said they were "just sugar-
pills, a placebo, in fact, with no active ingredient." He insisted – yet again – that I needed "proper" medica-
tion.

A living hell

By the spring of 2000, my life was a total nightmare. There was always "something" wrong with me, every
moment of every day. I had constant indigestion; I felt sick when I lay down and had to prop myself up on
four pillows to get to sleep. I experienced repeated waves of anxiety, which manifested itself in inexplicable
butterflies in my stomach, lightheadedness and shakiness. Sometimes I'd be out – shopping perhaps – and
suddenly I'd feel "unreal" and as though I was in a dream.

Each moment of my life had become a desperate struggle to act normally, despite how I felt inside. Some-
times I couldn't think straight or talk without slurring my words. My memory played unsettling tricks on me;
for example, in the middle of a sentence I'd forget an everyday word or lose track of what I was saying. I fre-
quently forgot things I'd been asked to do. I tried to keep my illness a secret at work, but that became impossi-
ble and I was dismissed in April 2000.

In addition, I was preoccupied throughout each day and night with managing my panic attacks – now happen-
ing every hour or two. Nighttime was worse, especially as I slept alone. I'd lay awake for hours, a victim of
thumping palpitations in my ears, chest pains, and blood-curdling sensations as though someone had "walked
over my grave". I'd eventually fall asleep from sheer exhaustion, then awake with a huge shudder around 2 to
3a.m., shaking uncontrollably from head to toe, my body shivering with cold and my face burning with heat,
feeling intensely agitated. My throat would feel closed-up and I thought I was about to suffocate. Out of my
mind with panic, I'd dash out to the garden in my nightdress, gasping for breath. Twice I called an ambulance
in the middle of the night, because I thought I was having a heart attack, but the A&E doctor found "nothing
wrong".

The worst daytime attack I ever had involved all the usual symptoms, plus terrifying blurred vision, severe,
almost blinding migraine and numbness all down the right side of my face. In a whirl of alarm, I rushed
straight to my doctor's surgery. Her diagnosis: "just a panic attack".

The Aconite and the Rescue Remedy were no longer enough to quell these attacks. I began to swig, night and
day, from a bottle of sweet wine. The panic ebbed away in minutes, affording me perhaps 60 minutes' respite,
during which I felt dazed and bewildered, and worried that I was becoming an alcoholic. I waited in fear for
the next wave of panic to engulf me, which it always did.

To the brink of suicide

By June 2000 my life was not worth living. I had no choice but to admit defeat and submit to the dreaded
medication. In a two-minute consultation, a locum doctor I'd never met before prescribed Paroxetine. After
taking just one tablet I became uncontrollably agitated, both mentally and physically, for 14 hours, then slept
from 2 a.m. to 5 a.m. When I awoke, I thought I had died and was a ghost. I was mentally floating, and my
vision was all blurry and misty. I could not shake myself back into reality. All alone, I sat on my bed and
sobbed my heart out.

Now I'd discovered that the drug which my doctors had enthused over couldn't help me either. There was,
quite simply, no hope left. I knew I was losing my mind and that these were my last few hours of independ-
ence, of living in my own home. I believed that I would be sectioned under the Mental Health Act and made
to live out my days in a psychiatric hospital, so full of drugs that I wouldn't even know my name.

This prospect was unbearable. I decided to kill myself.

I wanted very much to tell someone – anyone – why I had done it. I could not tell anyone I knew because I did
not want them to stop me. I couldn't see straight to write a suicide note, and so I rang the Samaritans and
somehow, my befuddled brain remembered all the words I needed and my voice managed to whimper out the
whole story. I drank Coca-Cola during the phone call and perked up considerably. The Samaritan asked
whether I had explored every possible avenue. I explained that friends had long been suggesting that I see a
certain kinesiologist but, as three complementary therapists had simply taken my money and failed to cure me,
I could not be bothered. He urged me to see her, just in case she had something new to say. After so long on
the phone the Paroxetine had worn off and it was daylight at last. I made an appointment to see the kinesiolo-
gist.

The bus journey there was an absolute nightmare: I was wobbly and panicky and had to fight the urge to leap
out of the doors as they opened at each stop. I was on the kinesiologist's treatment couch for five minutes
when she announced that I was "hypoglycaemic". I had never heard of it.

What is hypoglycaemia?

She explained that my pancreas produces too much insulin in response to refined carbohydrates – that is, sug-
ar, white flour and white rice, and also to caffeine. This overproduction of insulin drives the blood-glucose
down very fast. The body perceives itself to be in a state of emergency and secretes adrenaline, which is what
causes the feelings of panic. As the brain cannot store blood-glucose it is the first organ to malfunction, hence
mental confusion, forgetfulness and, eventually, blurred vision. The rapid drop in blood-glucose was also the
cause of my trembling fits, palpitations, in fact, everything that had been tormenting me for seventeen years.

She said that my pancreas malfunctioned because it had been damaged by overgrowth of an intestinal yeast
called candida. This overgrowth was caused by antibiotics killing off the beneficial bacteria which normally
keep candida in balance. I had taken antibiotics just four months before.

She told me to keep to an anti-candida diet for a few weeks, then to a hypoglycaemic diet. Above all, no sug-
ar. She also told me to convalesce: my internal organs had undergone terrible stress for many years. I had to
take vitamins and get plenty of rest.

It is indicative of my sheer desperation that I agreed to try her suggestions, although they sounded bizarre at
the time: how could food be the cause of such horrendous nervous and mental symptoms?

I immediately eliminated sugar, caffeine, white flour and rice from my diet. The panic attacks disappeared
within 48 hours. All the other symptoms (e.g. indigestion, depression, anxiety, insomnia, etc) decreased and
disappeared within about three weeks.

Realising I was not mentally ill brought forth tears of relief. I later proved by experiment that sugar both
caused and quelled my panic attacks.

I searched the Internet and found many sites, support groups and books about hypoglycaemia (some are listed
at the end of this booklet). When I saw the classic symptoms of the condition I was really angry: I had been
describing these very symptoms for over seventeen years without one of twelve doctors recognising that it
was a textbook case of hypoglycaemia!

My hitherto unquestioning belief in doctors was shattered.

Put in simple terms, hypoglycaemics produce too much insulin. Insulin is a hormone that (among other
things) causes the blood-glucose levels to fall, meaning that hypoglycaemics have chronically low blood-glu-
cose levels.

At first, one thinks "well, why don't they just eat more glucose – i.e., sugar?" The answer is, because:

1 – Eating sugar raises their blood-glucose, making them feel better

2 – Eating sugar also stimulates the pancreas to overproduce insulin

3 – Insulin removes too much sugar from the bloodstream

4. Blood-glucose plummets

5 – Plummeting blood-glucose stimulates a gush of adrenaline, which signals the liver to release emergency
sugar (glycogen) to prevent further insulin shock

6 – The rush of adrenaline causes panic attacks

7 – Eating sugar ends the panic attack by raising blood-glucose but also causes an insulin surge

8. The surge of insulin quickly pushes glucose levels back below normal causing the unpleasant symptoms
and the need for a sugar fix begins again

Therefore, the hypoglycaemic should exclude sugar (and other refined carbohydrates) altogether and eat only
slow-release foods such as wholemeal bread and pasta, brown rice, proteins and fats. These do not cause
"spikes" in insulin production. It is also important to eat smaller and more frequent meals. Caffeine and alco-
hol also affect blood-glucose levels and this may be the cause of the "shakes", so common amongst people
who suddenly cease drinking coffee or alcoholics who stop drinking (see page 20).

Over time, the frequent outpouring of adrenaline to prevent insulin shock takes its toll on the adrenal glands,
which are our buffer against stress. When exhausted, they no longer have the strength to respond properly.
This condition, called hypoadrenocorticism, interferes with the ability of the adrenals to protect us from stress,
and also causes emotional instability.

I also found out that the condition should, more accurately, be called insulin resistance, or hyperinsulinaemia:
the production of too much insulin. It is also related to Syndrome X and to polycystic ovary syndrome
(PCOS).

Completing the jigsaw puzzle

Thinking back over my life, everything began to fall into place. The quirks I attributed to personality were in
fact symptoms of low or unstable blood-glucose. For example, I was "not a morning person": upon waking I
was grouchy, sensitive and lethargic (I realise now that my blood-glucose was at its lowest ebb) till after I'd
had breakfast.

Clement Martin MD, in his 1969 book Low Blood Sugar: The Hidden Menace of Hypoglycaemia, describes a
man who before lunch was "nervous and jittery, irritable and crabby", yet after lunch was "happy, joking and
brilliant". Apparently, this is a classic sign of hypoglycaemia.

Over the course of a day I'd swing from bad-tempered to lighthearted; from depressed to boisterous, for no
apparent reason. All day I'd be "self-medicating" with a regular intake of sugar, in particular, chocolate. My
favourite main courses were all the sugar-laden ones: chicken korma, sweet-and-sour pork, barbecued ribs. I
even put sultanas in Bolognese sauce! Salad was always saturated with Salad Cream and everything else was
served with a generous dollop of Tomato Ketchup or pickle. (All of these condiments contain sugar.)

I felt indignant when I recalled how a former doctor had dismissed Aconite as "mere sugar pills". Indeed, ho-
meopathic pillules are made of sucrose (a sugar) – that's why they worked for me. And now I understood
why alcohol (the sweet wine) quelled my nighttime panic attacks; it wasn't because it "calmed my nerves" at
all – it was because it raised my blood-glucose so quickly! Similarly, I realised that it was probably the brandy
in the Bach Rescue Remedy that perked up my blood-glucose, rather than the collection of flower-essences
having an effect on my nervous system.

I realised that I craved sweet foods not for psychological comfort but because my body was instinctively lead-
ing me to sugar to raise my blood-glucose. Once I ceased consuming sugar and other refined carbohydrates,
the mood swings, the weepiness, the morning sensitivity and the lethargy ceased as well. The transformation
was extraordinary: I became a new person and had to get to know myself all over again – a strange experience.

Weight problems

>From websites and books on hypoglycaemia I learned that a leading cause of obesity is an excess of insulin,
commonly known as the "fat-storing hormone". Eighty percent of hypoglycaemics are overweight. This was
the first link I'd found between panic attacks and weight gain.

All the weight-loss advice given by doctors and dieticians, as well as slimming magazines and books, had
made my condition worse. Their diet sheets included breakfast cereals, baked beans, fruit juices, fruit and
white bread, all of which contain sugar. Furthermore, eating fats and oils slows down the process of metabo-
lism, and so cutting down on fat causes sugars and starches to be metabolised even faster. Despite the fact that
Dr Robert Atkins has proved that "it's not fat that makes you fat, but carbohydrates", current NHS advice is
to eat thick slices of bread, spread with jam, in order to lose weight!

Doctors' responses

In their book (see page 18), Saunders and Ross quote one man as saying, "Why didn't my doctor do anything
years ago when I first started complaining?" and comment that, "the diagnosis is not complicated, yet day af-
ter day, year after year, people suffer because their doctors did not diagnose and treat the condition properly".
Later they add, "To dismiss the disease with 'I don't believe in hypoglycemia' is incomprehensibly arrogant".

However, that is exactly what most doctors do. One man wrote, on his website on reactive hypoglycaemia:
"If you are like most sufferers of hypoglycemia, you have at this point seen at least two or three doctors and
all of them tell you that nothing is wrong with you, that you are in perfect health … I was once told by an en-
docrinologist that I did not have hypoglycemia. He told me that he saw a lot of people like me, and that they
did not have hypoglycemia either. I asked him that if so many people had similar symptoms, didn't that show
that there was something there that needed to be investigated. That was about the point that he quit listening to
me".

Another site quotes "James" as remarking that: "Little has changed in the medical community regarding hy-
poglycemia during the past ten years. The doctors are still ignoring the syndrome…or blaming…emotional
problems. And they are ignoring the most obvious cause of "idiopathic" hypoglycemia: overconsumption of
sugar… And real hypoglycemics are still going into mental institutions or are being driven to suicide by this
eminently treatable disorder".

In an interview under the patients' complaints procedure, my doctor denied that non-diabetic hypoglycaemia
exists. When asked to explain why all my symptoms had disappeared since I eliminated certain foods, she
simply said she was "glad I was feeling a bit better".

My medical records still show that I suffered from a nervous disorder for seventeen years.

A normal life once more

Within two or three weeks of starting my non-sugar diet, I re-visited places where I'd had panic attacks. I was
a little apprehensive, till I found that I felt no anxiety and did not panic even when sitting mid-row in a
crowded theatre, trapped in each direction. Once, this would have terrified me, but now I felt totally calm. I
knew my nightmare was truly over.

For seventeen years I'd been too terrified to consider entering an aeroplane, as it is the ultimate in being
trapped; yet just 16 weeks after seeing the kinesiologist I flew to Holland. Eight weeks after that I took a holi-
day to China and New Zealand. This involved ten flights, four of which exceeded eleven hours" duration, and
one of which was in a tiny Cessna Seaplane.

I could not recognise myself as the same person who, just six months before, had panic attacks on a local bus.

References

Books

There is no shortage of books on hypoglycaemia. Here are some published during the past thirty-six years.

Charles Weller & Brian Richard Boylan, How To Live With Hypoglycemia. Doubleday, 1968.

Clement Martin MD, Low Blood Sugar: The Hidden Menace of Hypoglycaemia. Simon & Schuster, 1969.

Peter J Steincrohn, Low Blood Sugar. New American Library, 1974.

Dr Robert Atkins, Super Energy Diet. Bantam, 1977. Dr Atkins devotes the whole of chapter two to hypogly-
caemia. He describes the symptoms as: nervous anxiety, racing pulse, dizziness, lightheadedness, blurred vi-
sion, mental confusion, mood swings and fainting. Chapter three is dedicated to the evils of sugar, which he
terms, "The World's Most Dangerous Food Additive." The Atkins Diet is currently the UK's best-selling
book.

Jeraldine Saunders and Dr Harvey Ross, Hypoglycemia: The Disease Your Doctor Won't Treat. Kensington
Books, 1980. (Revised and updated 2002). The authors remark that, "Treating the psychological symptoms of
hypoglycemia without treating the hypoglycemia itself is like treating a headache caused by a brain tumour
with an aspirin".(p24)

Fred D. Hofeldt, Preventing Reactive Hypoglycaemia: Great Medical Dilemma. Warren Green, 1983.

Carlton Fredericks, New Low Blood Sugar and You: The Startling Facts of How Millions of People Suffer
from Hypoglycemia (Low Blood Sugar) Without Knowing It (1985). This book contains many stories of hy-
poglycaemics who have been misdiagnosed.

Edward Krimmel, The Low Blood Sugar Handbook (Franklin, 1992) and, with Patricia Krimmel, The Low
Blood Sugar Cookbook (Franklin, 1992).

Martyn Budd MD, Low Blood Sugar: How to Understand and Overcome Hypoglycaemia (Thorsons Health
Series, 1995). Dr Budd also followed this up with a Low Blood Sugar Cookbook.

Miryam Ehrlich Williamson, R. Paul St. Amand M.D. Blood Sugar Blues: Overcoming the Hidden Dangers
of Insulin Resistance. Walker & Co, 2001.

Cheryle R. Hart M.D. and Mary Kay Grossman R.D. The Insulin-Resistance Diet : How to Turn Off Your
Body's Fat-Making Machine. McGraw-Hill/Contemporary Books, 2001.

Burton Berkson and Jack Challem, Syndrome X: The Complete Nutritional Program to Prevent and Reverse
Insulin Resistance. John Wiley & Sons, 2001.

Roberta Ruggiero, (founder and president of The Hypoglycemia Support Foundation), The Do's and Dont's
of Hypoglycemia: An Everyday Guide to Low Blood Sugar. (2003) Ruggiero writes: "If you think you may
be going crazy; if you have thoughts of suicide; if you're constantly exhausted, anxious and depressed; if you
go weeks without a decent night's sleep; if your personality changes like the flip of a coin; if a counter full of
munchies doesn't satisfy your sweet tooth; and if your doctor thinks you might be a hypochondriac because
medical tests don't show anything physically wrong with you – don't despair, there's hope!"

Websites

The National Diabetes Information Clearinghouse (NDIC), an information dissemination service of the Na-
tional Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains about non-diabetic hy-
poglycaemia at: http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/#nodiabetes

The Hypoglycemia Association:

http://hypoglycemia.itgo.com/

The National Hypoglycemia Support Foundation:

http://www.hypoglycemia.org

The Net Doctor, a website written by over 250 of the UK's and Europe's leading doctors and health profes-
sionals.

http://www.netdoctor.co.uk/diseases/facts/bloodsugarlow.htm

Helena