When it comes to metabolism and weight loss, it’s mostly about insulin. Insulin is also a major factor in many women’s health conditions such as PCOS, acne, progesterone deficiency, and heavy periods.
A healthy insulin balance is how you keep inflammation down. It’s how you reduce your long-term risk for diabetes, cancer, osteoporosis, dementia and heart disease.
Do you know if you have a healthy insulin balance? Do you know if you have insulin resistance? If you don’t know, it’s time to find out.
What is insulin resistance?
Under normal conditions, your hormone insulin rises briefly after eating. It stimulates your liver and muscle cells to take up sugar from your blood and convert it to energy. This causes your blood sugar to fall, and then your insulin to fall. When you are ‘insulin-sensitive’, both your sugar and insulin are low on a fasting blood test.
When you are insulin resistant, both your sugar and insulin are high on a fasting blood test. Why? Because your liver and muscle cells do not respond properly to insulin. They cannot take up sugar from your blood, so your sugar stays high. Your insulin stays high. High insulin generates inflammation and pushes calories into fat storage. High insulin impairs ovulation and stimulates your ovaries to make too much testosterone, which is why it is a major cause of PCOS.
Insulin resistance is common and affects at least one in four adults. It is also called pre-diabetes or metabolic syndrome.
How to diagnose insulin resistance
Blood test: Ask your doctor to order fasting insulin or a ‘glucose tolerance test with insulin’. Look at your insulin reading (not just your blood sugar reading). Your fasting insulin should be less than 60 pmol/L (10 mu/L). One hour after the sugar challenge, your insulin should be less than 270 pmol/L (45 mu/L). You can also use a blood test called HOMA-IR index, which is a ratio between fasting insulin and fasting glucose. Higher insulin means insulin resistance. Other useful blood tests include C-reactive protein, liver function, lipid profile, apo-lipoprotein B, and homocysteine.
Measure your waist: Insulin resistance causes apple-shaped obesity, so the larger your waist circumference, the more likely you are to be insulin resistant. As a woman, your risk starts when your waist circumference is greater than 32 inches (80 cm). As a man, your risk starts when your waist circumference is greater than 36 inches (90 cm).
Reverse insulin resistance in 4 easy steps
Insulin resistance can be reversed. My patients do it all the time.
Step 1: Stop eating dessert. High-dose fructose impairs insulin sensitivity more profoundly than any other food. That is why giving up dessert does more for insulin resistance than any other diet change. No desserts. No cakes. No fruit juice. No sweetened yogurts. No granola bars. No dried fruit. No dates. No agave. No honey. No ‘natural fruit sugar’ Paleo desserts. Please see my No-Dessert Diet post.
You can have whole fresh fruit because low-dose fructose improves insulin sensitivity. You can have starch (Gentle Carbs) in moderation. In fact, you need some starch to maintain insulin sensitivity.
If you are frightened by the idea of giving up sugar, then it might be because you have sugar-addiction. I assure you: It IS possible to overcome sugar addiction. It is possible to give up desserts. Please reach out for help. Your body will thank you for it.
Step 2: Supplement magnesium. Magnesium deficiency causes insulin resistance. A magnesium-rich diet has been shown to improve insulin sensitivity and to reduce the risk for diabetes. You can get some magnesium from food (green leafy vegetables, legumes, and nuts), but you probably need to supplement because magnesium is depleted by stress and exercise. Magnesium is my front-line treatment for insulin resistance. It works so well that I refer to magnesium as ‘natural metformin’. Metformin in the insulin-sensitizing drug prescribed for pre-diabetes and PCOS.
The best magnesium supplement is magnesium glycinate at a dose of 300 or 400 mg with food.
Step 3: Sleep. Just four nights of bad sleep (4.5 hours) is enough to reduce insulin sensitivity by 30 percent. Imagine what happens after months or even years of bad sleep. You need 7 or 8 hours of sleep each and every night. Schedule it in.
Step 4: Increase your muscle mass. The more muscle you have, the more sensitive it will be to insulin. You increase your muscle mass by using your muscles. Just a few weeks of strength exercise increases insulin sensitivity by 24 percent. Sign up for the gym, or you start even smaller than that, and still see results. Walk around the block. Climb stairs. Carry some gentle hand-weights.
Insulin sensitivity is improved by many other things including a healthy gut bacteria, and the hormones estradiol and T3. Many nutritional supplements show promise for insulin resistance. The best ones are magnesium (discussed above), berberine, taurine, myo-inositol, chromium, N-acetyl cysteine, and alpha-lipoic acid. I discuss many of the treatments in my book Period Repair Manual.
Yours in Health,