5 things that can mess with your blood sugar that have nothing to do with food, according to a dietitian

Sorry, green juice: It seems that everyone in the wellness world is currently focused on optimizing their blood sugar levels. People are all about eating low glycemic index foods for stable energy levels, mental health experts stress the surprising connection between sugar and anxiety, and some people even advocate for everyone to regularly track their blood glucose—not just diabetics—as a preventative health measure.

The fixation on blood sugar (or blood glucose) makes sense, given that how much you have in your system can have a trickle-down effect on health. When blood sugar levels rise, this signals the release of the hormone insulin to transport glucose from the blood and into your cells to be used for energy. This is a normal, essential, and healthy bodily process, but it becomes a problem when blood sugar levels rise too high and too quickly—like after eating a high sugar, low fiber food. If you have a very steep and quick rise in blood sugar, that drop will follow, which can leave you tired, cranky, and craving more sugar, says Charlotte Martin, RDN.

Constantly high (or spiking) blood sugar levels can have long-term consequences, too. “Consistently elevated blood sugar levels—known as hyperglycemia—can damage the vessels that supply blood to vital organs, which can increase the risk of chronic illnesses such as heart disease and kidney disease,” says Martin.

One of the biggest factors that directly impacts blood sugar levels is, well, food—particularly carbohydrates that lack fiber or protein to help slow down the absorption of sugar, says Martin. However, there are some other factors beyond what you put on your plate that can disrupt your natural blood sugar balance. Here’s what you need to know.

1. Chronic stress

Surprise, surprise, stress is the worst. When you are stressed, the body responds by releasing the hormone cortisol (also known as the stress hormone) in order to give you the energy you’d need to escape or fight back against a threat.

This isn’t necessarily a bad thing, per se. “[Cortisol] causes changes in our blood flow and stimulates the liver to produce glucose, which is meant to fuel the muscles and give the body a natural energy boost for a quick reaction to a threat,” Martin says.

However, if you’re chronically stressed, you’re regularly releasing cortisol, and thus regularly asking your liver to make glucose, gradually increasing the amounts of sugar you have in your bloodstream—and the amount of insulin required to remove it from your blood. This can have serious future implications for health if gone unchecked, Martin says. “Chronic stress and chronically elevated cortisol and insulin levels can contribute to sustained insulin resistance,” she says, a condition that is a precursor to type 2 diabetes and other health issues.

That’s why it’s essential to prioritize self-care, good sleep, and regular exercise in order to combat the effects of chronic stress.  Adding certain things to your diet, like magnesium-rich foods, ashwagandha, and omega-3s (from fatty fish or a supplement) can also help you prevent and cope with stress, Martin adds.

2. Poor sleep

The relationship between sleep and blood sugar levels can be a vicious cycle. “The body perceives lack of sleep as a stressor, and responds to it in a similar way,” Martin says. A bad night of sleep can lead to high blood sugar levels as well disrupted hunger hormones ghrelin and leptin, which can make you eat more than you normally would during the day, further raises your blood sugar. High blood sugar levels can then impair sleep quality and duration, continuing the cycle. Consider this yet another reason to ensure you have good “sleep hygiene.”

3. Having a cold

When you get sick, whether it’s a minor cold or something more serious, the body handles it as a stressor. “This causes the body to release hormones that help control stress and fight the illness,” says Martin. “As a part of the body’s defense mechanisms for handling stress and fighting illness, glucose is released into the bloodstream, causing higher blood sugar levels,” she says.

It’s always best to try and nip the sickness in the bud ASAP—so you a) feel better and b) can keep your blood sugar and heart health in check. “Things you can do to prevent or shorten the duration of a cold include staying hydrated, resting, and taking an elderberry supplement,” Martin says. Elderberries are a natural immune booster packed with antioxidants to help prevent and ease cold and flu symptoms—just talk with your doctor before taking one to ensure it won’t mess with any other medications you’re taking.

4. Not working out

Regular exercise is one of the best ways to increase insulin sensitivity and to stabilize blood sugar. “During exercise, your body burns glycogen, the storage form of glucose in the muscles,” Martin says. “After exercise, it helps move glucose in the bloodstream into the muscles to replenish these glycogen stores, and promotes an immediate increase in insulin sensitivity.”

Conversely, a sustained lack of physical activity can cause your blood sugar levels to spike, so you don’t want to be too sedentary unless you’re sick or recovering from an injury. In fact, one study found that just three days of inactivity caused an increase in blood sugar levels in otherwise healthy individuals. Yikes.

Exercise can also help you cope with stress and improve sleep quality, two other factors that can impact blood sugar balance. But don’t feel like you need to sweat for hours in order for your workout to “count,” says Martin. “Even a walk around your neighborhood, a quick 15-minute workout video, or household chores like gardening and vacuuming can get your heart and muscles pumping,” she says. Aim for at least 150 minutes of moderate-intensity exercise per week.

5. Your period

Hormones control the various stages of a person’s menstrual cycle (specifically, estrogen and progesterone, along with a few others), and the fluctuations in those hormones can trickle down to your blood sugar levels. “Different stages of the menstrual cycle can have different effects on blood sugar levels, and this can vary from [person to person],” says Martin.

For example, some small studies have reported elevated blood glucose levels in women right before their periods, likely because of the rapid decrease in estrogen and progesterone that happen during that time. Other research has found that women with Type 1 diabetes are particularly sensitive to hormonal fluctuations and their impacts on blood sugar—especially right before their periods.

“Although these fluctuations are very normal, if high blood sugar levels are of concern to you, greater emphasis on diet control and exercise during the week before your period can help stabilize blood sugar levels,” Martin says. People with type 1 or 2 diabetes in particular should talk to their doctors about management strategies.

Looking for better sleep tonight? Here’s the perfect snack for you. And if you’re interested in regular blood sugar control, here’s what you should know about the glycemic index.