Reversing Insulin Resistance: By the time you are diagnosed with insulin resistance, you have probably been in that state for many years, if not decades. Today we explore the widespread modern health challenge of insulin resistance and how to reverse it before it causes you any more problems.
This article has been medically reviewed by Dr. Charles Penick, MD
What is Insulin Resistance?
The hormone insulin helps control the amount of sugar (glucose) in the blood. Whenever you consume glucose-containing foods, or experience bouts of stress (elevated cortisol), the body will release insulin into your blood. With insulin resistance, the body’s cells don’t respond normally to insulin, so the glucose can’t enter the cells as easily, and it builds up in the blood 1.
Chronic insulin resistance can eventually lead to various metabolic diseases like type 2 diabetes. Although the extreme version of insulin resistance is known as diabetes, insulin resistance takes a real toll on health long before getting a formal diagnosis 1.
During the decade before a formal diabetes diagnosis, chronically elevated levels of glucose damage nerve endings in areas like your eyes, feet, and kidneys. High insulin levels affect other hormones, too, like sex hormone-binding globulin, which reduces available estrogen and testosterone. In addition, it elevates TSH levels, which impact thyroid health.
Chronically elevated glucose levels negatively affect various receptors in the body like insulin, thyroid, and progesterone receptors 2. Receptors play a crucial role because they dictate how effective your hormones are. An imbalance of even a single hormone will have a cascading effect on all your hormone levels since they work like a symphony. If you remove one instrument from the band, the others will all sound more dominant. Estrogen dominance, for example, can occur only when estrogen is out of balance with progesterone. It has nothing to do with estrogen levels themselves, simply in comparison to the other 3.
Blunted receptors play a significant role in generating misdiagnosis. When a doctor does a blood test and sees “normal levels” of hormones like progesterone, this does not take into account if the receptors are receiving the hormonal signals 4. Having hormones present is one thing, but having them do their job, is a whole different story.
High insulin levels also depleted magnesium, a critical mineral for getting glucose across the cellular wall. Magnesium is needed for hundreds of other functions in the body, which all get negatively impacted if this crucial mineral is depleted 5.
As you can tell, the problems with chronically elevated blood glucose levels go on and on, and on, long before they get formally diagnosed as a disease. Therefore catching this imbalance in the decades before a diagnosis is crucial.
Reversing Insulin Resistance: Symptoms of Insulin Resistance
The symptoms associated with diabetes (extreme insulin resistance) diagnosis include: 6
- Increased thirst
- Frequent urination
- Extreme hunger
- Unexplained weight loss
- Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin)
- Blurred vision
- Slow-healing sores
- Frequent infections, such as gums or skin infections and vaginal infections
Identifying insulin resistance before that point, however, is not so clear-cut. Many people associate obesity with insulin resistance, but this is not an accurate metric. Many lean people can develop diabetes and complications due to visceral fat (the kind you cannot see visibly, as it exists around organs within the chest cavity).
Some warning signs that you may be developing insulin resistance include:
- Weight loss resistance (despite exercising and eating well)
- Energy crash in the afternoon that has you reaching for caffeine or sugar
- Hunger after meals
- Poor sleep quality
- Inability to skip a meal without massive mood swings
Furthermore, certain habits promote insulin resistance, like snacking all day, chronically elevated stress levels, high sugar consumption, and severe caloric restriction.
How is Insulin Resistance Diagnosed?
In a doctor’s office, insulin resistance is a blood test measured by fasting glucose levels. Fasted glucose levels over 120 or 125 lead to the diagnosis of diabetes, but as a lifestyle disease, the diagnosis has been years if not decades in the making 6. The fasting glucose levels are the last things to change and using this type of diagnosis waits until the symptoms have been going on for a very long time.
Diagnosing insulin resistance before it turns into full-blown diabetes can be done simply by using a blood glucose test after meals. This information helps you understand how your body responds to the foods that you eat in real-time.
How Does Someone Develop Insulin Resistance?
Insulin resistance is a lifestyle problem; it occurs due to chronically elevated insulin levels that eventually dull the insulin receptors to the point of not functioning as they should. Insulin levels are raised due to chronically high blood sugar levels, which occur through a high-sugar (glucose) diet, or chronic stress 6.
Reversing Insulin Resistance: The “How To”
Understanding that insulin resistance is a lifestyle disease also brings hope that reversing it can also be managed through a lifestyle overhaul. Depending on how long the elevated insulin lifestyle has been going on, the reversal process can be longer and more complicated for some than others. If insulin resistance is already chronic, you may undertake the process more gently.
Post-Meal Blood Sugar Testing
Testing your blood sugar levels after a meal is the first way to understand where your body is at in terms of insulin sensitivity. Someone who is highly insulin sensitive can easily burn fat for fuel and tolerate a spike in glucose. This is measures either in blood ketone levels or by measuring glucose levels.
Measuring your blood sugar levels after meals is an excellent measure for anyone embarking on a journey to heal insulin sensitivity. Once you are well fat-adapted, a ketone tracker can help you dial in on how deep into ketosis you get.
The glucose peak after you eat occurs around 30-60 minutes, so take your blood glucose levels every 15 minutes until you start to see it drop. Your blood sugar levels should be back to baseline two hours after a meal, so take it every 15 minutes until it falls, and then again two hours after the meal to ensure it’s back to baseline.
Once you know what time your glucose “peaks,” you can simply test at your peak time and then at the two-hour mark. Your blood sugar levels should never jump higher than 100 or 110 at your “peak.”
Reversing Insulin Resistance: Tailoring Your Diet to Foods that Test Well for Your Blood Sugar Response
While testing your blood glucose levels, you can now use the data to see if your foods help or worsen your blood sugar levels. Real-time feedback will help you see if the lifestyle choices you are implementing to help improve insulin sensitivity are working or not since, ultimately, healing requires an individual approach.
Coffee is a great example that impacts everyone differently. Some people have no problem drinking black coffee without spiking their blood sugar, while others get a massive insulin spike. Having dogmatic beliefs that “coffee” doesn’t break a fast does not serve your body. Don’t guess, test!
Things that impact your blood glucose levels vary and include: 7-8
- Allergies and intolerances
- Macronutrient combinations
- Time of day
- Stress levels
- Processed foods
- Lack of sleep
Any foods that cause inflammation in your body will eventually spike glucose because inflammation triggers cortisol, which triggers an insulin response 7. This is why you must tailor your diet to your body’s individual needs.
Some foods are more typical offenders, including highly processed foods like sugar and flour. These foods cause blood glucose to rise in all humans, because of their overall inflammatory response, on top of their already high glycemic index (GI) 9. But just because a food has a low glycemic index does not mean it is right for you.
Although broccoli, for example, may be considered a typically “healthy” food with a low GI, the key is measuring its glucose response in your body. You may have an intolerance to broccoli which would lead to inflammation and a subsequent cortisol release. Thus, unknowingly, you could be chronically over-spiking your blood sugar without even knowing it.
Finally, the timing and macronutrient balance matter. Our bodies are more or less tolerant to carbohydrates at certain times of day, and you can get to know your rhythm by testing it out for yourself with a blood sugar test after a meal. Balancing out foods with different macronutrient ratios can also shift your response. Coffee, for example, spikes blood sugar for some and not others. For some, black coffee yields no insulin spike, while others keep their blood sugar levels balanced by introducing fat into their coffee.
Reversing Insulin Resistance Through Fasting
Fasting can play an essential role in reversing insulin resistance. In a fasted state, your glucose levels generally naturally drop. However, in some cases, they rise before they fall, in cases where people are overly stressed (causing the body to dump glycogen temporarily). You also get an increase in growth hormone and ketones.
There are many ways you can benefit from the insulin sensitivity that fasting brings, including intermittent fasting, 24-hour fasts, prolonged (3-5 + day) fasting, and the fasting-mimicking diet.
Intermittent Fasting (IF)
Also known as time-restricted feeding, intermittent fasting is simply the daily fasting window you experience within a 24-hour timeframe. The fasting window might be relatively wide for those recovering from extreme insulin sensitivity or a metabolic disorder diagnosis. Start by seeing what time you take your last bite of food or drink (other than water) and how long there is until you have your first bite of food or drink in the morning. That is your daily fasting window.
From there, widen the window little by little. Twelve hours of fasting, and twelve of feeding, is the typical starting point to benefit from IF. As you become more metabolically flexible, this could fluctuate and include the occasional very tight feeding window of only a couple of hours per day 10.
24-Hour Weekly Fasts
After implementing intermittent fasting with ease, you can add in a 24-hour water fast once per week. With experience with IF, this shift should be relatively easy and is simply involves having an early dinner and then skipping breakfast and lunch the following day. These 24-hour fasts increase metabolic flexibility by forcing an even greater adaptation in the body 10.
Prolonged Water Fasting
Once 24-hour fasts become a breeze comes prolonged water fasting. These longer fasts do require a foundation of metabolic flexibility and general mindfulness around adrenal health. Fasting induces stress, so a longer fast may do more harm than good if you are chronically stressed out. Remember that stress raises cortisol, leading to a glucose dump (which we are trying to avoid to promote insulin sensitivity) 11. You should do longer fasts with total relaxation in mind, which means avoiding all vigorous exercise!
The days following a 3-5 day water fast is an excellent opportunity to re-introduce foods and mindfully use blood glucose monitoring to see which foods serve you or abnormally spike your blood sugar.
Fasting Mimicking Diet
The fasting-mimicking diet is a great alternative to reap the benefits of fasting without completely omitting food 12. It follows a precise ratio of caloric restriction for five days, with mostly fat, some protein, and little to no carbohydrates. This can be an excellent tool for anyone already diagnosed with diabetes or very sick and who can’t handle the stress of total fasting.
Prioritize the Parasympathetic
The nervous system operates in a dominantly sympathetic or parasympathetic mode. The sympathetic state can be considered “fight or flight”; we enter the mode when we exercise vigorously or experience fear or stress. In this mode, we release blood glucose to help us effectively “escape” from the stress that we are experiencing. Ancestrally, this stress would probably have been caused by a life-threatening predator. After escaping, returning to a parasympathetic state of “rest and digest” would allow us to relax.
In modern times, our chronic stress has no end. Our fight or flight stress response, therefore, has us constantly experiencing chronically elevated blood glucose levels. In chronic stress, it can be tough, if not impossible, to keep insulin levels down. Thus prioritizing habits that help shift you into a parasympathetic-dominant state is crucial.
Some habits that may promote parasympathetic dominance include:13
- Breathwork like box breathing (4 counts in, 4 count hold, 4 counts out, 4 counts hold)
- Taking a bath
- Spending time in nature
- Spending less time on your phone
- Being barefoot on the earth
- Gentle walking
- Restorative yoga
- Not watching the news
Insulin resistance is a lifestyle disease that occurs as a result of chronically elevated blood sugar levels. By dulling the insulin receptors, the body can no longer safely and appropriately manage a rise in blood sugar, causing an array of health challenges and chronic inflammation. Reversing insulin resistance can be done by dialing your blood glucose levels using a blood test and making dietary changes. Insulin sensitivity is also promoted through regular fasting, starting with intermittent fasting and increasing to longer 24-hour and 3-5 day water fasts as you cultivate metabolic flexibility.
Medical Disclaimer: This article is based upon the opinions of Dr. Daniel Pompa. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Pompa and his associates. This article has been medically reviewed by Dr. Charles Penick, MD for accuracy of the information provided, but Dr. Pompa encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.
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9 Edwin McDonald, MD. “Foods That Cause Inflammation & How to Reduce Inflammation.” Foods That Cause Inflammation & How to Reduce Inflammation – UChicago Medicine, UChicago Medicine, 4 Sept. 2020, www.uchicagomedicine.org/forefront/gastrointestinal-articles/what-foods-cause-or-reduce-inflammation.
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11 Rotllant, J., and L. Tort. “Cortisol and Glucose Responses after Acute Stress by Net Handling in the Sparid Red Porgy Previously Subjected to Crowding Stress.” Journal of Fish Biology, vol. 51, no. 1, 1997, pp. 21–28., doi:10.1111/j.1095-8649.1997.tb02510.x.
12 Wei, Min et al. “Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease.” Science translational medicine vol. 9,377 (2017): eaai8700. doi:10.1126/scitranslmed.aai8700
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