How To Reverse Insulin Resistance At Midlife

What is Insulin and How Does It Work?

by Christiane Northrup, M.D.

Insulin resistance has become a huge problem in our culture and it can lead to many of the chronic health problems we see today, including obesity, type 2 diabetes and heart disease. It is also linked to high blood pressure, high cholesterol, thyroid problems, muscle loss, fat gain, fatty liver, breast cancer, endometrial cancer, and other cancers as well. And, insulin resistance has even been implicated in Alzheimer’s disease.

In addition, did you know that insulin resistance can also cause many of the symptoms most women attribute to menopause? It’s true. Insulin has a cascading effect on all of your hormones, including estrogen, progesterone and testosterone.  When insulin isn’t doing its job, it’s nearly impossible to reduce the symptoms of menopause, including hot flashes and night sweats. It also makes weight loss very difficult.

Jason Fung, M.D. – who you can listen to on my radio show, Flourish – has done much research in the area of insulin control.  His work shows that getting insulin in balance can be the key to getting your hormones and your health back in balance.

What is Insulin and How Does It Work?

Insulin is a hormone made by the pancreas.  Its main job is to manage how your body uses glucose for energy. When blood sugar levels rise after a meal, your pancreas releases insulin to help your body’s cells — especially cells in the liver and muscles — absorb glucose. Your liver converts stored glucose to glycogen for future use.

When blood sugar levels are too low, your pancreas releases a hormone called glucagon. Glucagon forces the liver to convert glycogen back to glucose, which causes your blood sugar to rise.  

You always have low levels of insulin circulating in your body. When insulin is out of balance, the result is abnormal blood sugar levels.  High insulin levels can make you feel tired, bloated and cause sugar cravings.  And, the more insulin you have circulating in your body, the harder it becomes to lose weight and burn fat.

What is Insulin Resistance?

Insulin resistance occurs when insulin is released by the pancreas, but your body doesn’t use it properly causing blood sugar levels to stay high instead of going down into the normal range. This can occur if you consistently eat too many carbohydrates.  

Some risk factors for developing insulin resistance include:

  • Family history of diabetes
  • Gestational diabetes
  • Apple shape (more weight around your middle)
  • Polycystic ovaries (PCOS)
  • Diet high in refined carbohydrates
  • Sedentary lifestyle
  • BMI greater than 29
  • Use of antidepressants (especially SSRIs)
  • Use of steroid medications
  • Holding onto fear and anger


Here are some ways to determine if you have insulin resistance:

Find your waist to hip ratio

Measure yourself around your natural waist and also around the widest part of your hips. Divide your waist measurement by your hip measurement.  For women, the ratio should be no greater than 0.8.  If you are above that, it means that you are at risk for insulin resistance. The number for men is 1.0.

Get a fasting insulin test

Ask your doctor to order a blood glucose and insulin test.  Typically, you fast for 12 hours and then have your first blood draw.  Then you will eat a meal and get a second blood draw two hours after your meal. Fasting blood glucose levels should be under 100 mg/dL.  If your levels are 100 to 125 mg/dL you are considered in the pre-diabetes range and are insulin resistant. Fasting insulin levels should be around 5 mcU/ml (microunits per milliliter.) Anything higher indicates insulin resistance.

Get your cholesterol checked

Abnormal blood cholesterol in addition to abnormal fasting insulin and blood glucose, may indicate that you have insulin resistance, especially if you have low HDL and high triglycerides. Typically fasting triglycerides should be below 150.  But, more importantly, you want to look for a 1:2 ratio of triglycerides to cholesterol.

Do a skin check

A skin condition called acanthosis nigricans is associated with insulin resistance. Look for darkened skin patches on your neck, elbows, knees, and armpits. Skin tags are also a sign of insulin resistance.

How To Reverse Insulin Resistance and Improve Your Hormonal Health

An imbalance in insulin and glucose levels can be easily managed with diet and lifestyle changes. If you are diagnosed with insulin resistance, here’s what you can do to reverse its course, reduce the symptoms of estrogen dominance, and stave off the hormonal cascade that causes inflammation and disease:

  • Eat a low carb, moderate protein, high fat (LCHF) diet. Weight loss can help the body respond better to insulin.  Canadian nephrologist Jason Fung, M.D. is a leading expert on low-carb, high fat diets (sometimes called the ketogenic diet.)  For people with insulin resistance he recommends increasing dietary fat while decreasing carbohydrates.  Dietary fat does not increase insulin because it is broken down into fatty acids by pancreatic enzymes (lipases) and bile salts.  In addition, Dr. Fung says that animal protein increases insulin. If you eat animal protein, aim for 0.8 grams (or less) of protein per kilogram of lean body mass. So, if you weigh 150 pounds, you would be getting around 50-55 grams of protein per day.  Of course, you should eliminate all refined carbohydrates, such as white bread, pasta, as well as alcohol and sugary drinks.
  • Start moving. A sedentary lifestyle is a risk factor for many health problems.  If you have been sedentary for a long time, start by walking and build up to more high intensity cardio exercises and some light resistance training. Aim for 30 minutes or more 3–5 times per week.  This will help regulate your metabolic function and support hormonal balance. If you need a bit of motivation, workout with a friend or use an app to set goals and track your progress.
  • Stop smoking. Studies show that smoking is associated with insulin resistance. It is also associated with many other risk factors for disease.
  • Eat raw dairy. Some research shows that dairy intake is associated with a reduced risk of type 2 diabetes. If you want to add dairy to your diet, choose organic, raw sheep or goat milk.  You can also add raw kefir and raw cheese.
  • Get enough sleep. Sleep has a reparative effect on metabolism. Untreated sleep problems can increase the risk of insulin resistance, obesity and type 2 diabetes. Even one night of sleep deprivation can increase insulin resistance by up to 33%.  This is why sleep deprivation often results in weight gain. Plus, when you lose sleep, levels of the appetite-stimulating hormone ghrelin increase, which can stimulate cortisol production and decrease glucose tolerance.
  • Try intermittent fasting. Dr. Jason Fung’s work has shown that 12 hours of fasting per day very effectively lowers insulin levels in almost everyone. It’s easy to do. Just stop eating by 7 pm and don’t eat anything until the following morning at 7 am. That gives you an easy 12-hour fast per day. Over time you can increase your fasts to longer periods of time when convenient. For many, intermittent fasting a couple days per week is part of a healthy lifestyle. Fasting works for everyone. And, contrary to popular belief, it doesn’t lower your metabolic rate or result in loss of muscle. In fact, many athletes train in a fasting state.
  • Reduce stress. The stress hormone cortisol is needed to invoke the “fight or flight” response, which allows high levels of glucose to circulate throughout the body (while insulin is suppressed) during times of extreme danger.  But, constantly elevated levels of cortisol can lead to blood sugar imbalances, weight gain, and diabetes.  There are many ways to reduce stress, such as walking in nature, practicing yoga and meditation, or reading a great book.
  • Practice Mindfulness. Many people don’t know what it feels like to be full so they eat well past the point of satiety until they are actually uncomfortable. Take some time to relax or meditate before you begin eating. Stay mindful of what you are putting in your mouth and how much. Check in with your body every few minutes to assess whether you feel full. Eat smaller meals throughout the day, and try not to let yourself get too hungry, which increases your chances of overeating during your next meal.

Have you ever been diagnosed with insulin resistance?  What have you done to reverse it?

Christiane Northrup, M.D.

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.


Add comment
  1. LeAnn
    1 week ago

    Just received my first bottle of Amata Life. I have been on Serenity progesterone cream for several years, can I use both of these products simultaneously?

  2. Jenna W
    2 weeks ago

    What advice can u give for a recent diagnosis of an “atrophying vaginal wall”? I am 50yrs of age, one year post menopausal. I,’ve been blessed w/ very few Peri, menopausal or post-memo symptoms. What are the bare minimums I ought to be taking/doing now that i.m a year into full menopause to support this change? I am a vegetarian. Thank you!

  3. Jean S.
    3 weeks ago

    As always Dr. Northrup, thank you for such vital and life changing information. My husbands fasting insulin level was 121. That needed to come down! We got rid of all the cruddy carbs, do not eat grains except some organic brown rice from time to time, quit processed dairy and eat raw cheese, olive oil, cold pressed organic coconut oil, avocados, grass fed meats, no chicken as most of it is cheaply produced and fed grains as well, lots of greens, pasture raised eggs, etc. Wow! His level is now 77! Not to mention that his weight is perfect! Thank you, thank you, thank you for spreading the word education people on how to turn their health around. Love you!!!!!

  4. Anne
    3 weeks ago

    Your articles are always wonderful, but please address those of us who need to gain weight, not lose. Our population gets hardly any attention, and there are many of us. Low carb just doesn’t work; without sweet potatoes, acorn squash, breadfruit, carrots, beets, etc., I lose weight. Please count us in and address this very much overlooked quandary. Blood sugar is high from indiscriminate sweets of the past.

  5. Lori L Hill
    3 weeks ago

    Can’t thank you enough. I just went to my library (large library) last week-and guess what? They didn’t have one book- about insulin resistance. Thank God for this article!

  6. star
    3 weeks ago

    I am on metformin for pre diabetes as my Aic is 6….how can I get off and lower insulin….Diabetes in family

  7. Johanne Spenard
    3 weeks ago

    Hello Dr Northrup
    I’m a nutritionnist in Montréal, Québec
    I question Dr Fung’s diet high in fat, especially in presence of metabolic syndrome and obesity. Fat should be mostly unsaturated.
    Patients would benefit nutritional consultation with registered dietician- nutritionist because it is so easy to get confused about what one should eat or not considering health condition.

    I follow you in many ways.
    Thank you for your positive interests in women’s health.

  8. lisa
    3 weeks ago

    This is fabulous. It’s a real up and coming threat to people predisposed to migraines. Thank you.

  9. Kathy Cinquemani
    3 weeks ago

    Hi! I quit smoking years ago with Nicorette, but 7 years later I was still chewing it. So I put a stop to Nicorette Easter 2017. I think I was addicted to sweetness of the gum–or either an oral fixation. I started chewing xylitol gum instead, but then worried it was contributing to my IBS (diarrhea), so I quit it about 3 weeks ago. I’m getting relief with help from you and Dr. Mark Hyman. I’m back to regular BM’s. I drink a cup of herbal tea each night that has stevia in it, could this still be causing insulin resistance problems with my stubborn weight loss? I’ve got to drop this weight! I’m 5’3″ and 162lbs. Help?

  10. Julie
    3 weeks ago

    I am a tall thin woman who has struggled w prediiabetes for 5 years from age 51-56. I reached meapause at 52. I have just turned 56. My naturalist MD put me on the whole 30 program and a Glucose Defend supplement. Since then my fasting glucose went from 125 to 97, and my A1c was reduced from 6.1 to 5.5 as of my last reading end of August. I still practice 12–15 hour daily fasting 6-7 days a week, and mini resets to the whole 30 program. In addition I have reduced my charbohydrate and sugar intake significantly. I do drink wine though and am not so successful in limiting it to 3 servings a week unfortunately.

    Thank you Doctor Northrup for all your contributions to women’s health.

  11. Donna Bishop
    3 weeks ago

    Thank you for that video today. So many pieces of it hit home with me. I have to let go of trying to change someone’s raising of my great granddaughter and the formula she’s putting into her. Today I’m going to take steps to free myself from this pain by getting rid of all thing baby in my house that keeps reminding me of it. I got sick this week and know it’s the stress of this situation. I will still watch her as needed and love her as I do and chant to myself the serenity prayer.

  12. Holly
    3 weeks ago

    I got a glucometer as you suggested and am terrified to see my fasting glucose this am is 126! I do not eat carbs, I use my CSA for fresh vegetables. I’ll start the 12 hour fast today.
    I do have one cup of espresso with almond milk, no sugar or sweetener, each day. Do I need to forego that?
    I’m 5’3″ and weigh 148.6 today.

  13. Karren
    3 weeks ago

    Thank you for helping us to be proactive towards our health. So many problems can be avoided. My grandfather had diabetes and I was always told it skips a generation and so I am careful about what I eat and do. Thank you for sharing your enthusiasm for life. I am always delighted to hear what you have to say.

  14. Lynn W
    3 weeks ago

    Thank you! This is very helpful! I’ve been insulin resistant for a few years and now that I’m over 40 I’m starting to see symptoms. No health professional ever shared all the potential health problems it causes. I will be implementing this plan effective today!

  15. Anne Vanderlaan
    3 weeks ago

    great article know more now then I have ever been able to find out. Thanks Dr. Northrup

  16. Tani
    3 weeks ago

    I was diagnosed with PCOS at the age of 15 based on excess facial hair and periods that were on again off again. I was placed on the pill to help get my periods regulated. My cousin mentioned to me that a friend of hers that was diagnosed with PCOS actually had Cushing’s syndrome. Her gynecologist said that there are a lot of women who have been misdiagnosed with PCOS when what they have is Cushing’s Syndrome.

    My PCOS then lead to insulin resistance and then type 2 diabetes. My endocrinologist said that this was normal and that nothing could be done but increasing medications over the years to come.

    How can one tell if one has Cushing’s rather than PCOS as it seems that symptoms for both are relatively the same. I would like to have some facts to provide to my endocrinologist when next I meet with her.

    Thank you in advance for your assistance,

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