by Marcelle Pick, OB/GYN NP
You feel tired, hungry, and are gaining weight. The afternoon “blahs” are part of your daily life. Maybe you feel thirstier, or wake up at night and need to go to the bathroom. These symptoms are some of the most common we hear at Women to Women, and may be a sign of insulin resistance – a precursor to diabetes, and other major health problems.
Over 80 million Americans suffer from insulin resistance, also known as “syndrome X.” Many people do not even know they have it, so are likely unaware of the health problems associated with the syndrome. Women with insulin resistance have a greater risk of many disorders, including diabetes, hypertension, heart disease, obesity, high cholesterol, breast cancer, and polycystic ovarian syndrome (PCOS) among other things. Because syndrome X poses such risks and is so pervasive, we evaluate nearly every woman who visits our clinic, and many are quite surprised when they learn their symptoms are actually caused by insulin resistance.
The good news is that we can not only treat insulin resistance, but we can heal it. Let’s take a look at what it is and what causes it.
So what is insulin resistance?
Insulin is a hormone produced in the pancreas. It helps control glucose, or blood sugar. Glucose is our body’s key source of energy, fueling our bodies to function. All of the food we eat is broken down into proteins and nutrients, which are used in metabolism, cell replacement, and immune function. The amount of fuel we need varies all the time, but our blood sugar levels need to remain stabilized. Insulin helps regulate those levels.
Normally glucose is carried by the bloodstream to individual cells, and insulin signals the cells to absorb the glucose that fuels our body. But when there is too much glucose in the body, cells become desensitized and the body continues to release more insulin, allowing blood sugar levels to become high. Prolonged high levels of insulin disrupts cellular metabolism, increases inflammation, and eventually the cells quit responding to the signal from insulin — creating insulin resistance. Diabetes is just one of the common diseases resulting from insulin resistance, and occurs when the body is unable to manage blood glucose levels.
The body works hard to balance what is digested, monitor blood sugar levels, meet cell demands, and release insulin in just the right amounts. Metabolism plays a key role in glucose functioning–it defines how the body regulates energy. Our diets affect our metabolism, and a diet consisting mostly of simple carbohydrates found in refined and processed foods, results in the fast break down of sugars that quickly enter the bloodstream. As this occurs, the body releases more insulin to try to control the glucose levels, creating a downward spiral. However, a diet rich in complex carbohydrates, such as whole grains, fruits, and vegetables, aids metabolism and its relationship to insulin, tipping the scales in the right direction.
Signs of insulin resistance
It is estimated that over 30 percent of Americans have insulin resistance or syndrome X. A combination of factors can contribute to this condition:
- Family history of Type 2 diabetes
- Hypertension (high blood pressure – certain high blood pressure medications may mask symptoms)
- High cholesterol
- Gestational diabetes
- Heart disease
- Dyslipidemia (an abnormal ratio of fats and cholesterol in the blood)
- Acanthosis nigricans (darkened patches of skin at the neck, and sometimes the elbows, knees, armpits, and knuckles)
- An apple-shaped body (carrying more weight around the mid-section)
Even without these factors, almost anyone can be insulin resistant because of diet. Refined carbohydrates, found in processed foods, white breads, bagels, pasta, sodas, sugary sweets, and many other foods on America’s grocery lists, contribute to syndrome X. When we eat processed foods, our body requires more insulin to metabolize it, and our cells become less responsive. As we get older, our sensitivity to insulin changes, regardless of our weight. It never hurts to be checked for this condition. Another factor that may contribute to syndrome X is menopause.
Menopause and insulin resistance
For women in menopause, there may be an increase of syndrome X symptoms due to metabolic changes, including fluctuations in adrenal and thyroid secretions. And, since insulin is a predominant hormone, the body may have trouble balancing the subsidiary hormones like estrogen, progesterone, and testosterone. The decrease of other hormones like estradiol can even trigger insulin resistance in some women.
Balancing insulin is key to managing many of the symptoms associated with menopause and even perimenopause (the years leading up to menopause when hormones can frequently vacillate, causing a host of symptoms). Some may even be easily confused with syndrome X, such as fatigue, urinary urgency, difficulty sleeping and mood swings.
A plaguing issue for women in menopause is weight gain. Insulin resistance disrupts metabolism, causing extra glucose to be converted into fat. Since fat cells are loaded with glucose receptors but cannot absorb glucose, this vicious cycle creates fatigue, and a desire for energy which often leads women to reach for foods loaded with carbohydrates.
Not only are fat cells hungry for energy, they also make excess estrogen, which contributes to estrogen dominance, contributing to many symptoms during the perimenopause years leading. When estrogen is finally depleted with the onset of menopause, digestive issues may become more prominent due to inflammation which was once controlled by estrogen. If not tended to, a woman’s health can quickly deteriorate during menopause, and insulin resistance is just one of the hidden culprits.
How to control insulin resistance
As I mentioned earlier, syndrome X is not a life sentence, and so can easily be dealt with because glucose levels can be influenced by lifestyle, proper nutrition, and exercise. This is a primary focus of our practice at Women to Women, and our approach has proven to be so successful. First, we establish whether insulin resistance is indeed an underlying factor by recommending a blood test for glucose and insulin levels. once after fasting for 12 hours, and then again two hours after a meal. If a patient’s blood levels indicate a risk for syndrome X, we recommend ways to help reverse the process, and help bring her hormones back into natural balance. And many of these recommendations are actually easy to do.
- To help balance insulin, consider a diet consisting primarily of lean meats and protein, high-fiber, whole grains, leafy greens, fresh vegetables and legumes, and fresh fruit. Be sure to shop in the outer aisles of the supermarket, avoiding rows of processed, high-sodium, sugary foods, snacks and soda.
- Plan daily meals to consist of breakfast, lunch, dinner, and two snacks. Each meal should contain some lean protein, and no more than 15 grams of carbohydrates, in the form of fruits and vegetables, minimize your grains.
- Each snack should contain only 7 grams of healthy carbohydrates. Be sure to get enough fiber, preferably in the form of vegetables and fruits.
- Essential fatty acids (EFA) or healthy fats, are important to help insulin resistance. These fats include tuna, salmon, and other cold-water fish; fish oil supplements, eggs, avocado, and flaxseed, which can be taken in as a nutritional supplement.
- Taking a pharmaceutical-grade, nutritional supplement can also decrease carbohydrate and sugar cravings. It can also help normalize hormonal function in perimenopausal and menopausal women-a bonus!
- Exercise is an important component to help insulin levels stay normal, maintain hormonal balance, and regulate metabolic function. It also helps decrease stress and lessens the strain on often overworked adrenal glands, which contributes to better health overall.
- Drink alcohol in moderation, get plenty of sleep, and stop smoking. These all help promote a healthier, balanced body.
We at Women to Women want to help all women feel good, healthy, vibrant, and energetic. When insulin levels are off, the entire body works harder, and is out of sync. Reversing insulin resistance will not only help smooth out functioning, it will offer relief for many other symptoms. And sometimes just knowing we can heal it, helps.