You might be surprised to hear that blood sugar is more complicated than diet alone. Several factors influence blood sugar outside of that sugar-loaded donut and Coca Cola. But what about stress? Does stress raise blood sugar? It seems today, in our modern world, plenty of people are stressed, and stress has been shown to cause a plethora of symptoms, from insomnia, headaches, and digestive issues to poor concentration, fatigue, and ulcers.
Lots of keto dieters transition into a low-carb lifestyle to help regulate their blood sugar levels and achieve certain health or fitness goals. When you’re following a ketogenic diet, you’re on the right track to stabilizing your blood sugar, but other factors could be affecting it. Let’s discuss the relationship between stress and blood sugar.
The Problems with High Blood Sugar
High blood sugar doesn’t just increase your risk of diabetes, it also increases your risk of the symptoms and conditions that come along with it, such as:
Frequent need to urinate
Recurrent infections, such as bladder and skin infections
Stress is split into two categories: physical stress and emotional or mental stress. Mental or psychological stress can occur for various reasons, such as:
Nervousness before a job interview or exam
An argument with a spouse or loved one
Going through a traumatic event or loss
Physical stress comes from external sources, such as:
Physical traumas, injuries, and accidents
Excessive physical activity
Studies show both types of stress, when experienced long-term, can exert negative health effects and increase the risk of diseases like cancer, cardiovascular events, diabetes, and immune system suppression. 
Can stress cause diabetes? Diabetes is multifaceted and complex, but many studies suggest chronic stress contributes to the onset of type 1 diabetes in those who are already susceptible to developing the condition. 
Can Stress Raise Blood Sugar?
The short answer to this question is, yes, stress can spike your blood sugar levels. Physical and emotional stress can be detrimental to your body. Of course, chronic stress paired with an unhealthy sugary diet is a lethal combination.
How Does Stress Raise Blood Sugar?
Your body synthesizes cortisol from cholesterol and releases cortisol from your adrenal glands. Cortisol is the primary stress hormone.
When your body sends physical or emotional stress signals, your adrenal glands release certain hormones, namely cortisol, aldosterone, and adrenaline, to help you respond to the perceived threat. This is also known as the fight-or-flight response. Cortisol can prompt your liver to secrete glucose (sugar) and fatty acids to provide energy to deal with the emergency. 
During the fight-or-flight response, adrenaline and noradrenaline hormones accelerate blood flow to your muscles and brain, increase your heart rate, and relax your airway, so you’re better able to move around.
Chronic stress causes high cortisol levels that trigger glycogenolysis and gluconeogenesis, which mess your blood sugar up even with a well-formulated ketogenic diet. 
During glycogenolysis, your body breaks down glycogen (stored glucose) in your muscles and liver into glucose (sugar) to give you immediate energy.
During gluconeogenesis, your kidneys and liver convert dietary protein or fat into glucose to use for fuel. Most cells in your body don’t need sugar to survive, but a small number do. Gluconeogenesis is the internal process and your body’s backup sugar source to prevent your blood sugar from dropping too low. It’s dangerous when blood sugar is way too high or way too low.
The HPA Axis
The signaling between your adrenal glands and your brain is called the hypothalamic pituitary adrenal (HPA) axis. During times of stress, the hypothalamus in your brain sends signals to your brain’s pituitary gland, and your pituitary gland communicates to your adrenals to release cortisol. Over time, your adrenal glands and thymus gland (an organ of your immune system) can gradually shrink with excessive stress and weaken your immune system.
The Role of Insulin
Your body decreases insulin secretion when you have a higher serum cortisol level. Insulin is the digestive hormone that helps scuttle blood sugar into your cells to keep your blood sugar in check at safe levels. If insulin isn’t being released properly, blood sugar levels become unbalanced. 
Chronic stress takes you on the road to chronically high levels of cortisol and lowered insulin secretion over time. High cortisol levels cause your body tissues to be less sensitive toinsulin, so there’s more blood sugar available in your bloodstream. When this occurs, blood sugar levels can become dangerously high, particularly if left untreated.
Stress is especially dangerous for those with diabetes because a blood sugar spike could cause too much sugar in the blood to pass into the urine and trigger the body to filter out fluid, potentially resulting in a diabetic coma or dehydration.
Stress and Behavior
Stress can also lead to blood sugar spikes in other ways. People who feel stressed are more likely to participate in behaviors that could lead to high blood sugar. For example, people who feel stressed might engage in emotional overeating of processed and refined carbohydrates and foods that are loaded with added sugars.
People might give up on exercise and become more sedentary or forget to take medications if they’re supposed to. Stress can put a damper on your healthy habits.
Because your HPA axis plays a role in stress and sleep, if you’re under high stress, your HPA axis may be prompting the production of extra cortisol, leading to changes in the HPA axis. Research shows stress could impair restful sleep and change sleeping patterns. Not getting sufficient sleep can cause glucose intolerance, resulting in a dysfunctional metabolism and high blood sugar levels. 
Stress is normal from time to time, and some types of stress can’t be avoided, such as an accidental physical injury. It’s best to focus on better managing other day-to-day stressors, such as work stressors or taking care of the family.
Proactively plan ahead, manage your time, set realistic and manageable goals, and welcome calming exercises into your life, for instance, yoga and meditation, which have been proven to lower stress levels. Emotional freedom technique (EFT) or tapping is another promising calming exercise that works for many people.
Here are some other top tips to better manage stress:
Outdoor activities in fresh air
Spend leisure time with pets, friends, or family
Enjoy soothing music and candlelight
Try to avoid engaging in unhealthy behaviors like emotional overeating and find comfort elsewhere, such as a warm bath, a talk with a friend, or healthy ketogenic comfort food that doesn’t spike your blood sugar.
Steph Green is a content writer specializing in and passionate about healthcare, wellness, and nutrition. Steph has worked with marketing agencies, written medical books for doctors like ‘Untangling the Web of Dysfunction,’ and her poetry book ‘Words that Might Mean Something.’ In 2016, after four years of struggling with her own health problems and painful autoimmune disease, Steph developed a life-changing and extensive knowledge of keto, nutrition, and natural medicine. She continues on her healing journey and enjoys helping others along the way.
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