How Low an HbA1c Blood Sugar is Too Low?
I was reading about HbA1c and diabetes at Forks over Knives (see https://www.forksoverknives.com/health-topics/vegan-diet-and-diabetes/). They discuss what HbA1c levels are too high, but not what is too low.
This is a strange one for me. I’ve done really well these past 5 years on WFPB (whole food plant based), losing 140 lb and currently maintaining at 144 lb. I was even interviewed by Chef AJ and Dr. McDougall, of Starch Solution fame, asked me in email if I would be a star McDougaller!
Anyway, my HbA1c started at a dangerously high 11.8 some years ago. Over time it came down to 5.1 and I’ve been off all sugar meds for over 3 years now.
Since my next blood test isn’t until June (if then – the doctor at the hospital I periodically visit said I may not need more blood tests) my local clinic, which I also visit regularly, wanted to do a new blood test just to see how things are. I got the results yesterday:
(normal ranges are in parentheses)
Total cholesterol: 139 (130-219) – great!
Triglycerides: 73 (30-149) – great!
HDL (good cholesterol): 42 (40-79) – great!
LDL (bad cholesterol): 76 (70-139) – great!
Uric acid: 5.9 (3.6-7.0) – great, I guess, I never noticed before!
Glucose (an hour after breakfast): 87 (70-109 after a long period of no eating) – great!
HbA1c: 4.5 (4.6-6.2) – what the…???
The last one was… whoa. Why is it down so much? Why is it out of the normal range? And what does it mean if your HbA1c is too low – which I’ve never had to wonder about my whole life! In my last blood tests it had been 5.1, which was great!
I feel great. Lots of energy. Lots of walks. Doing great for 66 years old. But after some Internet searches of “low HbA1c” I was feeling a bit worried. (No need to send me Google search results about low blood sugar. I have searched everything.)
I also wondered if it could be because I’ve been using a lot of cassia (i.e. regular) cinnamon this last half year or so. Apparently it has positive effects on blood sugar. I really like it, but hear can also be dangerous if used too much. I don’t like Ceylon cinnamon though. People suggested I ask Dr. McDougall directly.
I’m excited to report Dr. McDougall’s response. He is always so responsive and helpful:
Please tell FOK I was happy to answer your question.
Congratulations on your success. You are a star mcdougaller.Lab values are based on the population average. This population is sick from the food and as a result the “normals” are high.
A value of a HgB1c of 4.5% should be given an “extra great” rating.
On medication you might be able get this reading or with an insulin producing tumor.
With your history of excellent health and your other lab values the lower reading is easy to explain.
John McDougall, MD
This was very reassuring. He didn’t specifically mention the cinnamon in his answer though. I’m not the type to dwell on things like this, but I’m still curious. I really don’t like Ceylon cinnamon. If I shouldn’t be using cassia cinnamon at all it would mean giving up cinnamon altogether and just using something altogether different. (No search results on cinnamon needed either – I did a lot of searching myself.)
Anyway, I’m seeing my other doctor (the one I visit quarterly at the hospital) early next month, so I can show him these results and get his opinion as well. Whoever thought I’d be concerned about my blood sugar being low? Especially with all the starches and fruits I eat! But as Dr. McDougall says, the overall population is sick from food and as a result the “normals” are actually high.
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