A coworker is pale, confused, sweating and says they feel shaky. What is the likely cause of these symptoms?

• A. Heat stroke
• B. Low blood sugar
• C. Dehydration
• D. Anxiety attack

Answer: (B)

Recognizing hypoglycemia, or low blood sugar, is what these symptoms point to. When blood glucose drops, the body releases adrenaline, which can cause sweating and shakiness. The brain also needs glucose, so not having enough can lead to confusion or trouble concentrating. Pale skin fits with the body’s adrenergic response during a low sugar episode.

These signs don’t typically fit heat-related illness or dehydration as neatly. Heat stroke usually features a very high body temperature and hot, dry skin, not sweating paired with confusion in this exact way. Dehydration brings thirst and dry mouth and may cause dizziness, but the combination of sweating with clear confusion and pallor is more specific to hypoglycemia. Anxiety attacks can include sweating and shakiness, but they don’t routinely include confusion or pallor from low brain glucose.

If you suspect low blood sugar, offer a fast-acting carbohydrate if the person is conscious and able to swallow (for example juice, regular soda, or glucose tablets). If symptoms don’t improve quickly or the person becomes unconscious, call for help right away. Keep them safe, monitor their condition, and avoid giving anything by mouth if they’re not fully awake or able to swallow.