Any chronic fatigue doctor will tell you that sugar is a poison that everyone with this illness should avoid completely. Glucose is sugar in its simplest chemical form. Carbohydrates are all foods that break down into glucose when eaten and include sugar and starch. They are broken down into glucose –the only form in which it can be absorbed by the body and turned into energy. This glucose enters the bloodstream as soon as digestion is complete. Normally, the pancreas then reacts by producing a hormone called insulin, which takes the glucose out of the blood and into the cells. The body is constantly attempting to regulate the blood glucose levels. For optimum health, it must provide energy to the cells which need it without leaving unwanted glucose circulating in the blood.Blood Sugar and GlucoseWhen carbohydrates are eaten in their refined form, as in white sugar, sweets, chocolate, white flour, the body digests it extremely quickly. Because it is processed so rapidly, the glucose enters the blood in a violent rush. Every time these foods are eaten, the blood sugar levels rapidly rise. In a panic, the pancreas can over-react and produce too much insulin.Blood glucose then takes a dramatic drop, and can end up being for too low for the body to function and feel good. This is called hypoglycaemia. When this happens, the body believes that there is not enough energy, and begins to cry out for more carbohydrates. This is when most people experience intense cravings. Eventually this can lead to weight gain amongst many other problems including exhaustion, foggy head, premature aging, and all symptoms associated with ME. This is why any chronic fatigue doctor will recommend avoiding sugar.If this over stimulation happens too often, the pancreas can become exhausted. Eventually it may start to produce too little insulin and then too much glucose remains in the blood (hyperglycaemia). In its most severe form, this condition can become diabetes and increased risk of cardio-vascular disease.What Can Go Wrong?Low blood glucose (hypoglycaemia) and high blood glucose (hyperglycaemia) can have similar and wide-ranging effects. These may include irritability, aggressive outbursts, nervousness, depression, crying spells, vertigo and dizziness, fears and anxiety, confusion, forgetfulness, inability to concentrate, fatigue, insomnia, headaches, palpitations, muscle cramps, excess sweating, sugar cravings and weight gain, digestive problems, allergies, blurred vision and lack of sex drive, dizziness or irritability after 6 hours without food, being addicted to sugar or having cravings for carbohydrates, needing more than 8 hours sleep at night, needing stimulants to get you going in the morning, low energy, feeling drowsy during the day, feeling too tired to exercise, having lower energy than you used to, sweating a lot, excessive thirst or sometimes losing concentration.SymptomsGlucose intolerance will most likely correct itself in time, if you follow the nutritional diet that is recommended by your chronic fatigue doctor. Avoiding sugar and carbohydrates with a high glycemic load is an important part of the dietary recommendations. It is advised to:

• Eat protein with breakfast lunch and dinner. If you snack include protein in the snack e.g. nuts, seeds, fish, poultry, eggs, organic red meat
• Learn to read labels: 4 grams of sugar = 1 teaspoon.
• Always eat breakfast preferably with some protein.
• Avoid sugar, and foods containing sugar such as honey, alcohol, dried fruit and fruit juice.
• Avoid foods containing preservatives.
• Avoid convenience foods. They are almost certain to contain refined carbohydrates and various harmful chemicals.
• Avoid tea and coffee. Caffeine causes your body to release sugar from storage into your blood stream, causing a rapid rise in blood sugar levels. Decaffeinated coffee is also best avoided, as it still contains other stimulants which cause the body to raise blood sugar again.
• Avoid (or cut down) cigarettes.
• Do all you can to avoid stress (as it also raises blood sugar levels).
• Take regular exercise.
• Eat moderate and low glycemic foods and avoid the refined and processed high glycemic ones . If you eat high glycemic unrefined carbohydrates (like potatoes or parsnip), eat them with protein to slow down the sugar release.

It is important to remember that not all carbohydrates are the same. Traditionally carbohydrate foods have been classified according to their glycemic index. The glycemic index measures how quickly each carbohydrate is broken down into sugar by the body, causing a rise in blood sugar levels. The higher the index the higher the impact on blood sugar and insulin levels.The glycemic index, however, is only provides information on the speed of release of the carbohydrate, either ‘fast’ or ‘slow'. Unfortunately, it doesn’t tell how much of the food actually IS carbohydrate. The glycemic load of a food is the quantity of carbohydrate times the quality (the glycemic index).In general, most green vegetables, beans and pulses and most fruit have a low glycemic load. Refined carbohydrates including white breads, some pastas, grains, rice, sugar and all processed foods with sugar added have a high glycemic load. Talk to your chronic fatigue doctor for more information.