How To Tell Whether a Symptom Is Blood Sugar or Adrenaline

One of the most confusing parts of living with IPS or reactive hypoglycemia is trying to figure out whether what you are feeling is an actual blood sugar drop or an adrenaline surge that only feels like one. The sensations overlap so closely that even experienced doctors struggle to explain the difference. You might feel dizzy, shaky, hollow, lightheaded, weak, buzzy, or emotionally fragile, and each of those sensations can come from either system. It can make you second guess your body, your instincts, and even your sanity. But there are patterns. And once you learn them, the entire experience becomes less frightening.

Real low blood sugar tends to build slowly. It feels like your energy is draining away rather than exploding all at once. You may feel hungry in a deep, primal way. Your thinking may get cloudy or slow. You might have trouble finding words. Your vision can feel dim or unfocused. You may notice a softness or heaviness in your limbs rather than a jittery buzz. If the numbers are truly low, your body wants one thing: food. Once you eat, the symptoms usually improve within fifteen to twenty minutes. There is a gradual lifting of fog, a gentle returning of energy, and a sense that your system is refilling itself from the inside.

Adrenaline is very different. It arrives fast. It does not wait or build. It hits like a wave. One moment you are fine and the next you feel a sudden jolt that shoots through your stomach, chest, or legs. You might get shaky, but it feels more like nervous shaking than weak shaking. Your stomach may drop as if you are on a roller coaster. Your heart might beat faster or harder. You may feel wired, agitated, or shaky without hunger. Your brain feels too alert, not foggy. Some people describe it as feeling “charged” in a way that feels wrong. Adrenaline makes you feel like you need to move or escape, even if you are sitting at a table.

There is also a timing clue. True low blood sugar usually appears one to three hours after eating, especially after a high carb or high sugar meal. Adrenaline episodes often appear thirty minutes to an hour after eating, especially if your nervous system is sensitive. Many people with IPS notice that the first half hour after eating is the most unpredictable. If symptoms come quickly after a meal, adrenaline is more likely the cause.

Another important difference is hunger. Low blood sugar usually creates an almost desperate hunger, a sense that your body urgently needs fuel. Adrenaline can suppress hunger or even create nausea. You may feel hollow, but not necessarily hungry. You may feel shaky, but also too anxious or wired to eat. These two experiences feel similar but come from completely different systems.

The emotional tone can also help you distinguish them. True hypoglycemia often feels like exhaustion, depletion, or fading. Adrenaline feels like panic, urgency, or overstimulation. Hypoglycemia feels low. Adrenaline feels high.

Even your thought patterns give clues. Low blood sugar makes your thinking slow and muddled. Adrenaline makes your thoughts race.

It is important to remember that both sensations are real and both are valid. The difference is that one means your body needs fuel, and the other means your nervous system needs safety. Some people experience both at different times, and some experience adrenaline so intensely that it mimics true hypoglycemia perfectly. There is no shame in not being able to tell the difference right away.

Over time, as you heal, your body becomes easier to read. Patterns become clearer. You learn the difference between the soft pull of low glucose and the sharp surge of adrenaline. And once you learn this, something shifts. The episodes become less terrifying because you understand what your body is trying to say.

You are not imagining your symptoms. You are not overreacting. Your body is sending signals that make sense once you know how to interpret them. And every step you take toward understanding those signals brings you closer to steadiness after eating.