I don’t focus on blood sugar enough here, and it’s time to change this. Did you know that blood sugar dysregulation represents the most common hormone imbalance nowadays? You may not think of blood sugar dysregulation as a hormone imbalance, but it is. The hormone we are talking about that is out of balance is insulin.
Insulin is the hormone that manages blood sugar. It helps you burn sugar (glucose) for energy, and when there’s too much to burn, it helps you store it away as fat (triglycerides). This is a beautifully intelligent mechanism that helps us in times of feast or famine. When there’s no food around we have energy stored as fat that we can break down and use. Brilliant, right?
Except nowadays this thrifty metabolic design backfires because we simply have too much access to foods that crank up our blood sugar on a 24-7 basis. Our insulin receptor sites become desensitized, or resistant, over months and years of blood sugar going too high.
40% of the adults in the United States have insulin resistance, and this percentage gets higher as we get older. You have at least a 1 in 2 chance of becoming insulin resistant in your adult life. It can start with genetic tendencies (got type 2 diabetes or PCOS in your family?), and it’s compounded by lifestyle habits over your lifetime. Sometimes it starts in childhood.
Think of insulin resistance as a spectrum of sugar-insulin dysregulation. This includes hypoglycemia (low blood sugar), pre-diabetes, gestational diabetes, and most women with PCOS.
Who does this apply to?
People of all ages and all body sizes. Large people can have perfect blood sugar and insulin, and thin people can be insulin resistant. Signs of insulin handling problems in teenagers are “male patterned” hair growth and irregular periods for teenage girls, sugar cravings, and an apple-shaped body where belly circumference is larger than hips.
Insulin resistance is so pervasive across populations, that really all adults, and some teens, should test for this on annual bloodwork. I unfortunately am often the first to diagnose it in the populations I work with. People almost never come to me to balance blood sugar and insulin. However, they come for PMS, irregular cycles, hot flashes, mysterious weight gain, brain fog, energy swings, headaches, poor sleep, and many many symptoms that are driven by blood sugar dysregulation.
Definitely get checked if you are in one of these situations:
- PCOS – the majority of women with PCOS have a sugar-insulin imbalance, including thin women.
- Perimenopause – this is often the time of life when insulin resistance starts showing up, with telltale signs of new abdominal weight gain that doesn’t feel right, and hormone symptoms like hot flashes and night sweats.
- PMS – sugar-insulin dysregulation can wreak havoc on hormone balance before your period.
- Inflammation – often insulin resistance is one of the root causes of inflammation, and it’s hard for your immune system to reduce inflammation if insulin resistance is not addressed.
- Mood swings & anxiety – When blood sugar is unstable, it’s harder to be emotionally regulated.
- Post-menopausal – Your risks for insulin resistance go up when you are postmenopausal, as your natural estrogen offered some protection before.
- Pregnancy – Often insulin resistance shows up for the first time during pregnancy when it’s normal for glucose to go higher.
- ADHD – Blood sugar balance is a huge player in mental focus. Often people with ADHD need to modify eating habits to improve focus.
- Energy swings and cravings – Insulin resistance can cause cravings, energy slumps after meals, and feeling low blood sugar “hangriness” between meals.
- Cognitive decline and dementia – highly associated with sugar and insulin dysregulation.
- Rapid aging signs (joints breaking down, skin wrinkles, etc) – Insulin resistance upregulates molecules called AGES (advanced glycation end products) that accelerate aging.
- Mysterious weight gain – This is usually due to IR showing up visibly, however, it’s been years in the making prior to this. There can be other reasons for odd weight gain though, so be sure to check thyroid as well.
When people come to see me with anything on the above list, blood sugar and insulin are top on my list to check.
How do you test for insulin resistance?
The basic labs to start with include hemoglobin A1C, fasting insulin and glucose, and a lipid panel. These are common on annual bloodwork, however usually fasting insulin is left out – even though it’s so important!
The problem with lab reference ranges is that they rarely red flag your results until you’re out of range. The ranges are wide, and once you’re out of range, it means that insulin resistance has progressed for years. It’s much easier to reverse it when your lab markers are trending in that direction as opposed to already there. Some people need more advanced labs, such as a glucose tolerance test with insulin, to really see what insulin is doing.
As a medical provider, it’s my responsibility to assess and address sugar-insulin balance with all my patients, for these reasons:
- It is so epidemic.
- Chances are, it’s hasn’t been sufficiently assessed and addressed in their conventional care.
- If insulin resistance turns into full-blown diabetes with damage to your pancreas, it can be irreversible. Think cardiovascular disease, neuropathy, dementia, and loss of limbs.
- In the long years and decades leading up to it, insulin resistance (and sometimes type 2 diabetes) are 100% reversible.
Balancing blood sugar and becoming insulin sensitive again
This is a priority in my Reclaim Your Hormones Program. We start off with a 4-week module called Reclaim Your Insulin (which you can take as a single module). Balancing blood sugaI’m doing this differently than I ever have before, since as of 2021 I’m all about ditching diets and diet culture, and teaching intuitive eating instead. Can you heal insulin resistance without dieting? The answer is yes, you can. You can eat your favorite foods and heal insulin resistance at the same time. You can do this by tuning into your own body to feel and assess the nuances of your metabolism while applying gentle nutrition guidelines.
You don’t need to suffer, be rigid, or go on a diet to heal insulin resistance. In fact, science shows that diets don’t work, and they increase risks for disordered eating and a generally messed-up metabolism. We are meant to enjoy eating and take pleasure in food! Healing insulin resistance doesn’t equal losing weight either. You can have sugar insulin dysregulation at any size, and you can heal it at any size.
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