Dr. Amy Nett: There are so many different options for sugar cravings, and really difficult food cravings are hard to overcome, but glutamine isn’t really something I’ve used for sugar cravings. Glutamine I have seen for some gut-healing protocols with some variable success. Overall, glutamine is not a supplement I use a whole lot, and similarly Chris doesn’t use it all that much, but again, sometimes with gut healing.
Things that I would think about for strong sugar cravings: Sometimes we tell patients to take a tablespoon or just whatever kitchen spoon you have and dip it in some coconut oil and just sort of slowly work on that coconut oil and see if that gets rid of sugar cravings. Sometimes the fat in it and just a little bit of sweetness with that coconut oil is enough for sugar cravings, so that’s one of my first recommendations.
The other thing I think about, two things: You’re saying the person tends towards low blood sugar, so I would think about cortisol, and I would think about a higher-protein diet. Whenever I see HPA axis issues, cortisol, or blood sugar issues, we generally suggest starting with a high-protein breakfast, so starting the day eating within about one hour of waking and starting with a high-protein breakfast. That might even be something like 30 to 50 grams of protein. Protein seems to have a stabilizing effect on blood sugar, so you would start the day with a high-protein breakfast within one hour of eating, and then if the patient is eating snacks, those snacks should have 10 to 15 grams of protein. Similarly, subsequent meals should have probably 15 to 25 grams of protein, depending on overall caloric intake. So try using a higher-protein diet to stabilize blood sugar throughout the day.
The other question, though, is what’s going on with cortisol? Have you done a cortisol test? Can you just stabilize their cortisol? Do you want to do things like meditation, mindfulness practice, and supplements, adrenal adaptogens, something like that, to support normal cortisol levels, and will that bring the blood sugar into balance?
The one other thing I would probably think about if there are strong sugar cravings is, is this patient getting enough carbohydrates in their diet? You mentioned a Paleo diet. Some people come to our clinic and they seem to think that Paleo is synonymous with low carbohydrate. I have some ideas where that association comes from, but I’m not entirely clear, to be honest. I often clarify with patients, “What do you mean by Paleo? What is your carbohydrate intake?” I would think about what carbohydrate intake looks like, maybe shifting carbohydrates to dinner because if you are working on HPA axis, cortisol balance, you still want to do a high-protein breakfast, so your carbohydrates are probably going to be coming in later in the day, probably mostly at dinner. That’s where I like to put them. It helps with sleep. Sometimes at lunch, but you don’t want to get that post-lunch sleepiness. That’s what I would do for sugar cravings.
Oh, gymnema. I’m probably mispronouncing that. I apologize, for those of you who know how to pronounce that correctly! I think it’s called gymnema, and that’s a supplement that sometimes helps to stabilize blood sugar and reduce cravings as well. Depending on what this patient’s weight looks like and the overall blood sugar balance, think about doing a supplement, something like GlucoSupreme, getting some kind of herbs in there to help with glucose stabilization or glucose balance. I would try all of those things before I went to glutamine. If they fail, well, then glutamine is a relatively benign supplement. You can give it a try. I just don’t have a lot of experience with using it for sugar cravings. Hopefully some of those will help. And sometimes, too, it’s just if you can talk patients into, like, “Can you do two weeks or four weeks just really strictly without sugar?” Sometimes your tastebuds will sort of adjust and you need to reset, but I hear you. Sometimes we have a limited amount of willpower, and it’s not always worth it, so you can try those other tricks and see how that goes.