Insulin Resistance and Everything You Need to Know
This picture was taken after we climbed the hill (felt like a mountain!) on Pigeon Island in very hot St Lucia last Monday. I am so grateful that I now have the energy and strength to be able to do this at age 48. I hope I have lots more adventures left in me.
Are you frustrated with how your body is not changing (or moving in the opposite direction you want it to) despite your best attempts to live a healthy lifestyle? You aren’t alone. It is one of the most common concerns I hear from the women I work with. And despite what you may have been told, the successful solution is not to just eat less and exercise more.
So why is this happening to so many women? I find it is often due to insulin resistance that is often caused by the hormonal changes and resulting muscle mass decline that happens in peri/menopause. Insulin resistance is a major contributor to the annoying abdominal weight gain so many women experience, as well as high blood pressure, elevated cholesterol and overall increased inflammation leading to achy joints and many of the common chronic health conditions that can happen as you get older.
The good news: you do not have to simply accept feeling this way because you are over 40. I believe this is such an important topic for all women to know about. Even if you don’t currently have insulin resistance, it is still important for you to know what it is, how to check for it, and what to do to prevent it from happening. In order to make the information more easily digested (bad pun intended), I am going to break the topic up into 3 newsletters (hopefully in a way that is interesting and makes sense):
This week I am going to talk about what insulin resistance is and what to test to to see if you have it.
Next week I will share some of the natural approaches that are helpful to prevent and treat insulin resistance.
The third week will be about a hot topic (I think it was the hottest one of 2023!) that is related to insulin resistance: Ozempic and the other similar drugs in its class. I will discuss how it works, the pros and cons, and what I believe is essential to do along with it if someone makes an informed choice to take it.
Let’s start with a quick discussion on what insulin is, what it does, and what happens when insulin resistance develops.
All of the carbohydrates you eat get broken down into simple sugars when they are digested and released into your blood stream. If you need a refresher on what carbohydrates and the other macros are, you can read last week’s newsletter on macros here: https://www.drjenniferhaesslernd.com/blog/menopause-akmta).
The presence of sugar in your blood sends a message to your pancreas to produce insulin. The more sugar there is, the more insulin that is needed.
Insulin is like a key that opens the lock in the outer wall of your cells. When it binds, sugar is able to move out of your blood and into your cells where it can be used to make energy. That’s why it’s rarely productive to really restrict all carbs - they are a very efficient source of energy for your body.
Insulin resistance occurs when insulin stops being able to bind efficiently to the cell wall. In response, your body will produce more and more insulin in order to increase the chances that something will bind so that blood sugar levels don’t get too high. I think of it like when my kids are trying to get my attention, but I’m busy so they keep repeating “Mom! Mom! Mom!” until finally I stop and ask “What?!?” .
Type 2 diabetes results if the body can no longer produce more insulin or the receptors become so unresponsive (mom has fallen asleep and isn’t replying at all ) that blood sugar levels increase.
Many of the women I work with have normal blood sugar levels, but their body is working hard producing lots of insulin in order to do that. Even though they don’t have diabetes, the elevated insulin levels still have a domino like effect on the function of lots of different areas in the body.
What blood work can be done to check if you have insulin resistance? (Side note: some of you have asked if I am able to order blood work as a Naturopathic Doctor. The answer is yes if you live in Ontario, which is where my license is held.)
Many medical doctors only look at your blood glucose. This will be elevated if someone has type 2 diabetes, but it will completely miss all of the people who are insulin resistant and have normal blood sugar (which is the majority of the women I see). So you can’t rule out insulin resistance if that is the only piece that has been checked.
The best blood test for insulin resistance and that one that I like to check is an oral glucose challenge test that also checks insulin at the beginning and end of the 2 hours. If you have been pregnant in recent years, you may remember drinking the grossly sweet orange drink (it reminds me of the McDonald’s drink they used to give us at school which I hope no longer exists). Again, conventionally this test often only checks blood glucose at the beginning and end of the test, but adding in the insulin levels tells you how much insulin had to produced in order to handle that sugar challenge. If it is elevated, then that is indicative of insulin resistance.
If that test isn’t possible, then there is a calculation called HOMO-IR that can be done using fasting blood glucose and fasting insulin.
Since insulin resistance also contributes to elevated cholesterol and inflammation, I also like to look at a fasting cholesterol panel and inflammatory markers like ESR and CRP.
I think it’s important for everyone to be tested for insulin resistance versus waiting until you have elevated blood sugar and type 2 diabetes. Having that information allows you to be proactive and take steps to reverse it. By doing that, I have seen many patients and FASTer Way clients (spoiler alert for next week - the right nutrition and strength training are SO helpful) improve their metabolism and say goodbye to the extra abdominal fat, reduce their blood pressure and cholesterol, increase their energy, and be able to move without pain.
Our bodies are like a puzzle , and I see it as my job is figure out what piece or pieces are missing or out of place, and help you put it back together. It is not in your head. You are not “just” getting old.
If you feel something is off, don’t give up and keep looking for the answer. Message me if you would like to discuss doing the insulin resistance testing or any other blood work that is helpful to establish your health baseline (that’s a great future newsletter topic!). I’m here to help.
If you’d like some help knowing which foods are high in which macros, comment below and I will send you my macro cheat sheets, as well as some delicious, simple recipes.