After our hormone dysregulation episode, a fan reached out and wanted more information about insulin resistance. Insulin resistance is a root cause of chronic disease and one that is exceptionally prevalent in the US. 40% of the population is insulin resistant, and our lifestyle is the major driving factor! You’ll hear some startling statistics in this episode, how you can check to see if you are insulin resistant, and what you can do to reverse insulin resistance.
Lifestyle Medicine with Dr. Harris
Join me. Doctor Richard Harris, as we strive to unlock the secret to the human body. Strive for wellness, strive for great health. Follow the show on iTunes, Spotify, Google and Android, and Patreon. [00:00:30] Hello, and welcome to this episode of the Strive For Great Health Podcast. I’m your host doctor Richard Harris, and we’re going to do another fan request.
And we talked about this briefly in the six root causes of chronic disease insulin resistance, and I had someone come up to me and say, “Hey, can you go a little bit more into insulin resistance. I want to know more [00:01:00] about that.”
Insulin resistance is one of the six root causes of chronic disease. When we typically think of insulin resistance, you typically think of diabetes. It is the underlying cause behind diabetes, and we’ll get into that more in a minute.
Insulin resistance is extremely prevalent. It’s estimated that about 40% of the adult population is insulin resistant. 10% is diabetic. Another 30% is insulin resistant. That’s almost 85 million people in the US.
[00:01:30] And most don’t even know it. There are so many times we see people who are diabetic, who don’t even know they’re diabetic until they have a stroke, or a heart attack, or come into the ER and their blood sugar is undetectable. It’s above 500.
These things can be very, very silent. Other people just feel fatigued, or have neuropathy, or notice that they’re starting to urinate less and then they have kidney problems. Insulin resistance can be silent.
A more concerning [00:02:00] thing, is that 23% of teens are pre-diabetic. That’s 10 million kids in the US, are pre-diabetic. And when you are pre-diabetic, when you already have that insulin resistance you have a 25% chance of converting the diabetes within five years.
And that goes up as years and years go on. Let’s start from the beginning. What is insulin? Insulin is a hormone that’s released by our pancreas. Our pancreas is an organ in the abdomen, [00:02:30] and there is two functions to the pancreas, mainly.
One of them is to help us digest foods. It secretes things into the gastrointestinal tract that helps us digest carbs, and fats, and proteins. And then there’s another portion from the beta cells of the pancreas called insulin.
And so, insulin’s main job, is after you eat carbohydrates and they’re broken down into glucose, or sugar, that insulin’s job is to get that sugar [00:03:00] out of the blood and put it into fat, muscles, and the liver.
That is the main job of insulin. To help the body take up the sugar, excess sugar in the blood in the form of glucose from the metabolism of carbohydrates. When does the body release insulin?
Well, number one, if you eat carbohydrates. There’s actually something called the cephalic response. And this happens when you actually anticipate eating food, [00:03:30] you get release of insulin in preparation for that food. If you’re someone who’s chronically been eating a lot of carbs, you’ll get a stronger cephalic response because your body’s used to you eating a lot of carbs. Initially. Until the pancreas burns out, and we’ll talk about that later.
Of course, you release insulin in response to elevations in glucose. In blood sugar. And there’s even some evidence that with some of the fake sugars you can get an insulin response, [00:04:00] because they’re sweet. And this is in addition to that cephalic response.
That’s why we typically recommend erythritol, stevia, monk fruit, because these seem to be insulin neutral. Meaning that they don’t cause a response in insulin secretion. Why is excess sugar in the blood bad? Right? You’re like, “Why is this a problem?”
The problem is, that there’s a process called glycosylation [00:04:30] and this is a very fancy word for the sugar attaches to things it’s not supposed to attach to. Other proteins. Now, we have proteins in our cells, proteins outside of our cells. It’s something called the glycocalyx. That’s the fancy term for the proteins outside our cells.
And sure molecules can attach to these. Okay, well why is that bad? Because that induces inflammation. The immune system comes in, recognizes this is a problem, and starts [00:05:00] the inflammatory cascade. Now we’re dealing with another root cause of chronic disease. Inflammation.
In the liver the excess sugar or glucose gets stored as another thing called glycogen. And we also store some glycogen in our muscles as well, but we don’t have much glycogen in the body. On average, you have about 2,000 calories of glycogen stored. And then in fat [00:05:30] cells, the fat cells will take up the excess sugar and then convert them into body fat.
Insulin also helps with protein and fat synthesis. It is an anabolic hormone. Anabolic meaning growth promoting. Body builders for years have used insulin, they’ve injected themself with insulin after workouts that promote muscle synthesis.
But it is completely anabolic, so it causes all things to grow as well. That’s why [00:06:00] too much insulin can be a problem. And this is why we develop insulin resistance. Eventually in the excess presence of carbs, excess carbs, excess calories, you start secreting more and more insulin.
Well, because there’s more sugar around, and not all of it’s being used, and not all of it’s being taken up, we’re turning that sugar into free fatty acids to be deposited in the liver and [00:06:30] in the fat stores.
Well, new evidence shows what happens is, some of those excess fats that aren’t taken up by the liver, aren’t taken up by fat cells, gets deposited in the pancreas. And once the fats gets deposited in the pancreas, it leads to beta cell dysfunction.
And beta cells secrete the insulin, now they’re problematically secreting insulin. They may be over secreting, they may be under secreting. What also happens at the cellular level, [00:07:00] is on the cells there are receptors for insulin.
And so, these receptors are like lock and keys. This is how a lot of things work in the body, but the molecule is the key and the receptor is the lock. You have to have the right key for the lock. The key goes in the lock, turns it open, it causes something to happen in the cell.
And with chronically elevated insulin levels what happens is, that lock stop listening to the signal, because it is anabolic. It is a growth promoting factor. [00:07:30] What happens is, you get insulin resistance. There may be insulin there knocking at the door saying, “Hey, I have the key. Open up.” But the cell’s like, “You know what? I can’t listen to you right now. Listening to you is causing too much harm.”
And then the excess blood sugar piles up, the excess glucose in the blood, then you have that converting into fatty acids, which all cannot be stored in the liver and in the fat cells. And then they get stored in other organs like the pancreas and that leads to the beta cell dysfunction.
[00:08:00] Other things that can lead to insulin resistance are fructose intake. High fructose intake, think about high fructose corn syrup, that’s mainly where people get their fructose intake nowadays, is from processed foods, can promote insulin resistance.
Inflammation. Inflammation can be caused by insulin resistance, or inflammation can cause insulin resistance. And like we talked about in the six root causes podcast, a lot of these root causes can cause the other root cause [00:08:30] or be caused by the other root cause.
Microbiome. Your microbiome is huge in your insulin sensitivity. Our microbiome does so much for our bodies, helping us metabolize, helping us fight off infections, helping us send signals to other parts of the body, “Hey, what’s going on in that part of the body?” And if you have dysbiosis, if you have abnormal gut bacteria you can get insulin resistance.
Inactivity. Being sedentary. Not [00:09:00] exercising. This also can lead to insulin resistance. And then of course you have genetic risk, and that’s one of the risk factors for me, and why part of my wellness plan makes sure that I’m taking care of insulin resistance. I’m being insulin sensitive, because of genetic risk. My grandfather’s diabetes, my dad diabetes. And I do not want to get diabetes.
There is a genetic susceptibility to this. What diseases are linked to insulin resistance? We [00:09:30] talked about diabetes. But what you may not know, is Alzheimer’s is as well. Some people call Alzheimer’s type three diabetes. And one of the types of Alzheimer’s, there’s three types, there’s one that’s most likely caused by infections, one that’s caused by lack of trophic factors. And trophic factors are things that help the brain grow and maintain, like plant food. That’s a way to think about trophic factors.
And then one that’s caused by [00:10:00] insulin resistance. Other things linked to insulin resistance, cardiovascular disease, cancer, obesity, hormone disruption, inflammation, alteration to the microbiome. The list goes on and on. How can you test for insulin resistance? How do you know if you’re insulin sensitive?
And for people, it can vary between individuals with different foods. Some people can eat a sweet potato and their blood sugars do not rise. [00:10:30] And some people can eat a sweet potato and their blood sugars skyrocket. A lot of what you’re seeing in the functional space now, especially with the bio hackers, they’re doing continuous glucose monitoring themselves, and they’re seeing how they respond to certain foods.
And for some of the people who I’m coaching through keto, I tell them, “Check with certain foods, because certain foods may increase your blood sugars more than others.” And it may increase it more for you than for other people. [00:11:00] The best, easiest way you can do this at home, just buy a glucometer and you can check your blood glucose, fasting, meaning in the morning when you haven’t eaten anything, or your blood glucose one to two hours after eating certain foods.
And what you should see is, if you are insulin sensitive, your blood glucose should be less than 140 one hour after you eat.
And 120 two hours after you eat. And then fasting, it should be less [00:11:30] than 86. About seven to 86. One study showed that fasting blood glucose above 95 actually tripled your risk of developing diabetes in the future.
Blood sugar elevations post meal, above 140 consistently caused damage to nerve tissue, caused damage to nerves, to tissues and to pancreas beta cells. Another study showed that levels above 160 correlated [00:12:00] very strongly with increased cancer rates. And then levels above 155 one hour post meal intake have a higher cardiovascular disease risk. And by cardiovascular disease, I typically mean heart disease, plaque buildup in the arteries, in the heart, in the legs, and then strokes.
Conventional medicine says an A1C up to 5.7 is normal. But really, what we found with continuous glucose monitoring studies, [00:12:30] is that a normal A1C is actually 4.6 to 5.3, and let’s back up for a second. An A1C is a measure of your blood sugars over the last three months. And what it does, is it looks at how much sugar is attached to your red blood cells. And the reason it’s three months, is because your red blood cells live for about 120 days on average. Or so.
That’s what we use for [00:13:00] measuring your control of blood sugars. Now, there’s some caveats with that, and we’ll talk about that in a minute. It can be unreliable with inflammation in diabetics, in anemia, and if you have inherited blood disorders, like in thalassemia, because there’s increased red cell turnover. We’re basing it upon an average life of 120 days, but if you [00:13:30] have these conditions they may turn over faster.
And so, the A1C may be unreliable in these situations. It may not be as accurate. What some people will do in this situation, is use something called fructosamine. Fructosamine is developed by a reaction between fructose and ammonia. And it’s not dependent upon those other factors, so it can be more accurate and it looks at about your average blood sugars over the last three weeks.
Now, another caveat with [00:14:00] this is low carb and keto nutrition plans. You may actually have a higher fasting glucose.
And the reason for this is insulin levels are low. You’re not eating carbs, therefore your insulin levels are low. What happens is, as you become dependent on fatty acids you activate a hormone called hormone sensitive lipase. And this breaks down fatty acids for fuel to go to the muscles and other organs.
There’s less insulin around, meaning your blood sugars are actually a little bit [00:14:30] higher. For people who are doing keto, it’s not uncommon to see fasting sugars in the 90s. That’s okay, because of what we just talked about. The best way to know what is really happening with your blood sugars, because no real one test is perfect, is to get that A1C, get the fasting, get the post meal. And take them all together, because you may have [00:15:00] two that are normal, one that’s slightly abnormal.
For instance, if you have a A1C’s fine, your fastings fine, and your post meal occasionally goes to 145 or 150, that’s probably okay. You need all of these measures, because they measure slightly different things to really take in totality are you insulin sensitive or are you insulin resistant?
Another mechanism that you can use is something called the HOMA IR or LPIR. HOMA [00:15:30] IR stands for homeostatic model of insulin resistance. It’s a measure that looks at how insulin sensitive you are, if it’s less than one you’re very insulin sensitive, if it’s between one and 1.9 that’s borderline, if it’s above 2.9 you’re insulin resistant.
And this is something that can be done on routine blood work. You have to do this fasting, but one of the things that goes into the HOMA IR, is your insulin levels, so if you’re on insulin or on medications that increase [00:16:00] insulin secretion it may not be as accurate. The LPIR is used in an NMR lipoprotein profile. It’s where you’re looking at your lipoproteins, your cholesterol in totality.
And they look at, okay all these markers on your cholesterol and say, “Based upon all these markers it looks like you may be insulin resistant.” A quick and dirty way that you can tell this, is by looking at your standard cholesterol panel, which we don’t recommend. [00:16:30] I recommend everyone gets that NMR. It gives you more information.
If you’re looking at a standard panel, if your HDL is high and your triglycerides are low, that’s a sign that you are most likely insulin sensitive. If your HDL is low, and your triglycerides are high that’s a sign for insulin resistance. How do you fix insulin resistance? Number one. Eat whole foods. Most important thing. We’ve talked about this over, and over, and over again. Most [00:17:00] important thing that you do, as far as your health is concerned, every single day is what do you put in your body? Eat whole foods.
We’ve seen lots of people, and by we I mean the functional space. I’ve seen lots of people reverse insulin resistance and diabetes, type two diabetes with a low carb, a ketogenic diet. Ketogenic nutrition plan. A group called Virta Health has done wonders with diabetics. [00:17:30] Mainly through lifestyle with the cornerstone being a ketogenic type plan.
Exercise. You want to get into exercise. Why? Well, if you have high blood sugars, you want to put them to work. Exercise. Get your muscles to suck up more of those sugars. If you exercise, if you do weigh bearing exercise like lifting weights or body weight, or HIIT type workout, what happens is, you actually suck up more nutrients from [00:18:00] the blood, more sugars, more glucose, for 24 to 48 hours, as your muscles start to repair themselves.
It’s a powerful stimulator to make you more insulin sensitive. And then your non-exercise movement time. One study showed that simply by walking 30 minutes a day you can cut your risk of diabetes by 50%. Massive. Just by walking 30 minutes a day. Now, what I’ve been recommending for [00:18:30] your non-exercise movement time, is that 28-2 method. Sit for 20, stand for eight, walk for two.
Sleep. Sleep is a big, big thing when it comes to insulin resistance. There’s data that shows that even one night of poor sleep dramatically increases your insulin resistance the next morning. Make sure we’re getting plenty of sleep. Stress. Another big factor with insulin resistance. When you’re stressed out, you release cortisol. [00:19:00] We’ve talked about cortisol a lot. That elevates your blood sugars. Elevated blood sugars, that’s going to lead to insulin resistance.
Moderating your stress through meditation, mindfulness, yoga, gratitude practice. Whatever it is, make sure that we’re handling our stress. That will also help with insulin resistance. It also helps through the microbiome. By fixing the microbiome through moderating stress, through what you’re eating, you’re also going to make yourself more insulin sensitive.
[00:19:30] Toxins. We’ve talked about how toxins can disrupt normal systems in the toxin podcast, but BPA. BPA from plastics has been shown to reduce adiponectin, which is the major hormone that controls burning of stored fat. And then it causes stress on those beta cells. That will further promote insulin resistance.
And BPA is just one of these things in plastics. In general just avoid plastics. [00:20:00] Get those glass or stainless steel containers. Pesticides. Some of these organic pesticides, and by organic I mean organic acid pesticides, have been shown to reduce insulin secretion from the pancreas. And there’s a whole class of molecules called phthalates. These are found in personal care products, children’s toys. They disrupt glucose receptors in the pancreas.
And so, that’s why we talked [00:20:30] about, in the toxins podcast, taking a look at Environmental Working Group, so you know exactly what’s in the product that you’re getting. And avoiding those products that have been shown to have endocrine disruptors. What are some supplements to help fix insulin resistance?
The most popular one is Berberine, and this works through AMP Kinase. AMP Kinase is the master metabolic switch. [00:21:00] We know that this lowers blood sugars, it also is an antioxidant, so it can help fix some of the inflammation, if that’s around. Vitamin D. Another popular one. Vitamin D is a hormone, has many different effects in the body. It’s anti-inflammatory, also helps with our metabolism.
Helps lower obesity, so this is something that a lot of practitioners will use for insulin resistance. Magnesium. Magnesium, we’ve talked about before in nutrient [00:21:30] deficiencies. Magnesium deficiencies are not uncommon. Mainly due to soil depletion and the high intake of processed foods.
Magnesium’s a co-factor for over 300 different reactions in the body. Some of these reactions are involved with metabolism. Sugar metabolism, glucose metabolism, fat metabolism, protein metabolism. B vitamins. A large portion of what B vitamins do in our bodies, is help us metabolize carbohydrates.
[00:22:00] And B vitamin deficiencies, again, are not that rare, because of the foods that we’re eating or some nutrition plans. Like we’ve talked about in nutrient deficiencies. Vegans tend to have a lot of B vitamin issues. Supplementing B vitamins can help you metabolize sugar, metabolize glucose, and help with insulin resistance.
And then another one, alpha lipoic acid. Alpha lipoic acid is a powerful antioxidant. [00:22:30] Very powerful antioxidant. And it’s an AMP Kinase regulator as well. Just like the berberine we talked about earlier. A lot of times you’ll see these together in products, because they work synergistically. And then another thing that people will recommend too, is probiotics and prebiotics. And that’s to help fix the dysbiosis that we talked about in the dysbiosis podcast.
Interesting enough, the article that we’re going to talk about [00:23:00] today relates to diabetes, and relates to something simple that you can do to decrease your risk of developing diabetes by 3%. Super simple. Brush your teeth two or three times a day. People with poor oral hygiene have an increased rate of diabetes, cancer, Alzheimer’s. Why? Because it’s, the microbiome is disrupted. Your mouth microbiome, your oral microbiome [00:23:30] talks to your gut microbiome. They all talk.
And so, if you get dysbiosis in the mouth, you can get dysbiosis in your intestines. They send signaling molecules to each other. It’s quite fascinating. Take care of that oral hygiene. Go see your dentist every six months. Brush your teeth two to three times a day. Floss and be careful when using mouthwash, because you don’t want to kill the good gut bacteria. You don’t want to overdo it.
[00:24:00] I don’t actually use mouthwash. I just brush two or three times a day. I floss, and I go see my dentist. And this is actually life saving material here. Go see your dentist, get that oral hygiene. It’s important for your overall health. Well, I hope you found this informative. I love getting the fan requests, if you have any other questions please join our Strive For Great Health insider group.
By joining, you also help support the podcast. [00:24:30] There’ll be more information on how to join in the outro. Thank you all for listening and have a blessed day. Thank you for listening to the Strive For Great Health Podcast with doctor Richard Harris, if you’d like to support the podcast you can do so by becoming an insider. Insiders get early access to episodes, behind the scene’s information, take home points, and links to the articles and supplements mentioned in each podcast.
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