Hypoglycemia and aggression: a review.

The popular notion that a tendency to develop low levels of blood glucose is the cause of a range of behavioral problems is reviewed. It is concluded that it is inappropriate to use the glucose tolerance test as a test of the tendency to develop reactive hypoglycemia. Instead, a meal tolerance test, in which glucose is administered in the presence of fat and protein, should be the method of choice. The use of a meal tolerance test strongly suggests that reactive hypoglycemia rarely results, except in a few exceptional individuals. Three situations are described in which a correlation between a tendency to develop moderately low levels of blood glucose during a glucose tolerance test (not hypoglycemic values) and the tendency to act aggressively have been reported. The significance of these data is unclear but several possible mechanisms by which glucose may influence behavior are discussed.