Insulin is a hormone that is very important to overall health over the course of your lifetime. Unfortunately, it’s something that’s always regular checked by the vast majority of the medical community so you may not realize that you’re having issues with it.
Insulin resistance is a condition that is caused by too much insulin circulating through the bloodstream, which can cause cascade reactions and if left unaddressed, can lead to conditions such as:
- Metabolic syndrome (a combination of high blood pressure, abnormal cholesterol/triglycerides, and elevated blood sugar levels, and having a large waist size)
- Compromised immune system
- Cardiovascular disease
- Fatty liver disease
- Dementia/Alzheimer’s disease
- Early death
It is important to note that you don’t have to be considered obese to have insulin resistance. Skinny people can have the condition as well. Your waist size is what puts you at higher risk; for men, if your waist size is over 40 inches, and for women, if your waist size is over 35 inches, chances are that you are at high risk for this condition. Insulin resistance is a condition that occurs over a long period of time and progresses through various stages, all of which increase the risk for compromised health and disease. The good news is that it can be reversed!
What is Insulin?
Insulin is a hormone that is made in the pancreas. (The liver can also produce small amounts of insulin which is needed when you are fasting or between meals). It’s released in response to energy taken in as food. Whenever you have a meal, it’s natural for insulin levels to rise. Its job is to take all of the energy (glucose, etc.) from the nutrients taken in and distribute them throughout the body. An analogy would be to think of insulin as being the bus that transports energy and nutrients to the muscles and organs so that they can function properly.
The first stop is the muscles; and insulin acts like a key to open the channels so that energy can enter the muscle cells. The second stop is the organs, where energy is needed to perform their particular job. As long as there is balance between the energy being taken in to the body and the energy being used by the body, there aren’t any issues. Once the digestive process is complete and the nutrients and energy have been delivered where they need to go, then insulin levels will decrease again.
Insulin resistance is becoming an epidemic in the United States. This is largely because millions of people consistently eat the “Standard American Diet” which consists of high sugar/starch foods with few nutrients. Additionally, not all folks are getting out and moving their bodies and exercising in order to burn this extra fuel. These two things alone are largely responsible for so many Americans becoming overweight and obese.
When you have more fuel coming into your body than is expended, insulin levels will start to stay elevated. If you are overeating the wrong types of foods, insulin still carries out the role that it’s supposed to by transporting the energy to the cells, however, the muscles and organs will become saturated, which means there’s nothing more that can fit. Once this happens, this “energy” will be stored as fat, especially around the abdominal area. The cells become so saturated that they are “resistant” to the insulin. Belly fat, also referred to as visceral fat, is particularly harmful because it causes the organs in the abdominal region to become fatty as well, especially the liver. A fatty liver impedes its ability to function normally.
When this overall process continues over long periods of time, high fasting insulin levels will continue to wreak havoc. Blood sugar levels remain elevated which leads to pre-diabetes, and then full-on Type 2 diabetes. Because insulin also transports cholesterol/triglycerides, elevated levels of insulin will increase the number of triglycerides. Triglycerides are the dangerous, fatty parts of cholesterol, which can lead to build up of fatty plaque throughout the vascular system. Damage to the blood vessels can also occur which contributes to cardiovascular disease and high blood pressure and risk for other diseases.
High levels of insulin in the bloodstream also cause cortisol levels to rise. Cortisol is a stress hormone that is in part responsible for the fight/flight response. Ironically, higher cortisol levels propel the body into a constant state of stress, which signals the body to hold on to fat cells to survive. Additionally, higher insulin levels also cause inflammation to occur everywhere in both the body and brain, and inflammation is a precursor for many serious diseases including cancer.
The Four Stages of Insulin Resistance
In the earlier stages of insulin resistance, there aren’t any symptoms. If you aren’t seeing a physician or provider who is testing your insulin levels on a regular basis, you may not even know that you have it until it’s progressed into serious, sometimes life-altering complications such as diabetes.
The only change that occurs during stage 1 insulin resistance is that there’s too much energy coming into the body via the food that you are eating and a lack of exercise. You may have slightly elevated fasting insulin levels on your lab work, but everything else will appear normal.
In Stage 2 insulin resistance, your internal fat stores will start to surge and fat cells will get larger. The liver has to process extra molecules of glucose so the body will start to put on fat. There may begin to be some dysfunction occurring in the lining of the blood vessels. Higher levels of insulin will also increase cortisol levels, which increases the formation of glucose. Higher cortisol increases the stress response on all levels – physical, mental, and emotional. Stress of any kind will affect your entire body and brain in adverse ways, and in and of itself can cause inflammation levels to rise and a lower immune response. In this stage, your triglyceride and blood sugar fasting levels will still appear normal on a blood screen, but the vicious cycle has started.
Stage 3 is where things start to get more perilous. You will begin to see changes in your other labs showing that your blood sugar levels are elevated, and Hemoglobin A1C levels are higher; you will either be in a pre-diabetic state at this point, or you will be diagnosed with Type 2 Diabetes. Inflammation will become much more marked, and cardiovascular disease and cancer risk greatly increase during this stage.
By stage 4, even your liver will be resistant to insulin. Blood sugar levels will be consistently high which causes oxidation throughout your entire body and you will have overwhelming amounts of inflammation which means that you will have very little resistance to any kind of infection or disease process. Your body is so busy fighting what is already happening to it, that it has nothing left to defend against anything else. At this stage of the game, you are in overall very poor health.
Additionally, cytokine levels increase (high cytokine levels have been linked to an increase risk of contracting the COVID-19 virus). A cytokine storm such as this increases your heart rate, causes hypertension, damages your organs, and puts you at a very high risk for a cardiovascular event, cancer, or stages of dementia and/or Alzheimer’s disease, among others.
The good news is that Insulin Resistance is reversible and it’s never too late to make lifestyle changes regarding your health. The two most important things you can do are to eat a healthy diet and exercise, however, here are some additional tips:
- See a physician or provider who regularly tests for Insulin Resistance
- Put some thought into an eating plan that is healthy and sustainable for you; fad diets are just that – fads, and the weight loss from them usually doesn’t last. The Mediterranean eating plan and low carbohydrate plans usually work well. Incorporate healthy fats and proteins into your meals, and cut out processed and sugary, carb-laden foods.
- EXERCISE – not only is exercise a magic elixir for your whole-body health, it’s also a great stress reliever, and will make you more insulin sensitive as opposed to insulin resistant. Start with baby steps and do something that you enjoy. That can include walking, hiking, swimming, yoga, going to the gym, etc. The goal is to get up to about 5 hours of exercise per week, but you can spread this out into smaller increments.
- Drink alcohol in moderation; red wine has been shown to be healthy for you! Moderation means 1-2 drinks for men per day, and 1 per day for women.
- If you smoke, get help, and stop.
- Learn how to relax more and make time to do things you enjoy doing! It seems silly to say, but in our go, go, go work world, it’s easy to let relaxation efforts become the last thing on your list. Meditation, yoga, practicing mindfulness (even for 5-minutes a few times a day) can help you to relax. Spend time on hobbies or doing other things you enjoy!
- Have a support system in place. Spending quality time with friends and family can do wonders for your mental health and spirit. If you don’t have that kind of support system, join a group of like-minded people who enjoy doing what you do, and make some new friends!
Our Providers Can Help You!
Both Dr. Casad and her very knowledgeable Nurse Practitioner, Melissa Lang, are specialists in looking for the root causes of disease. We do test insulin levels in our regular lab panels, offer hormone therapy, and provide medications when needed. But we also want to spend the necessary quality time with you to get to know you as a patient so that we can help identify any areas that need addressing, help you to meet your health goals, and provide guidance along the way so that you can live a quality and healthy life!
We look forward to meeting you!