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
Fear and anger are present in all diseases. This is because emotions, such as fear and anger, when held too long, create chemical reactions in your body that do not support your health. In this video, I share how fear and anger can manifest in your body. I also tell you how you can learn to peel back the layers and release your fear and anger to bring more love and light into your life.
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 90 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.
7 Ways to Combat Menopausal Weight Gain Due to Insulin Resistance
Many women find that they gain weight– sometimes a significant amount – during menopause. And, to make matters worse, their old tried and true ways of getting the weight off simply don’t work.
There are many theories regarding the causes of weight gain (and other symptoms) at menopause. It’s a complex issue that includes a combination of poor diet (i.e. eating too many of the wrong carbohydrates,) sedentary lifestyle, stress, and many other factors. But, the truth is, whatever the underlying cause, insulin resistance is the primary driver of menopausal weight gain. And, the key to reversing it and achieving lasting weight loss is to keep insulin levels low.
Now, to be clear, menopause does not cause insulin resistance. Insulin resistance is the result of overall poor hormonal health. If you are struggling with post-menopausal insulin resistance and weight gain here are some additional recommendations:
- Get your cortisol levels checked. Stress during menopause can cause steroid sex hormones, such as estrogen, to be metabolized into cortisol. Increased cortisol levels stimulate sugar to be released into your bloodstream, increasing insulin and ultimately thwarting your efforts to lose weight. Ask your health care provider to prescribe the DUTCH test to track and evaluate your hormone levels, ensuring they are at their optimum balance. If your cortisol levels are out of balance (i.e. not high enough in the morning and too high later in the day), be sure to avoid caffeine and other stimulants. You may also want to try an adrenal support supplement and or adaptogenic herbs, such as ashwaganda or maca to help balance your cortisol levels.
- Take a magnesium supplement. Fully 80 percent of people have a magnesium deficiency. If you have a high sugar diet or take certain medications, you can become deficient in magnesium even if you eat foods that contain the mineral. And, according to Carolyn Dean, M.D., many symptoms attributed to menopause are actually identical to symptoms of magnesium deficiency, including hot flashes, night sweats, insomnia, and anxiety.
- Salt your food. Sodium supports adrenal function. And, despite what you have probably heard about sodium intake, most people do not get enough sodium in their diet. It’s easy to become sodium-deficient, especially if you exercise or are under stress. When you are sodium-deficient your cortisol and insulin levels will be out of whack, and your muscles can become stiff. (Sodium relaxes soft tissue.) Try adding a good Celtic sea salt to your food (not regular table salt.) You can also put 1/4 tsp of Celtic sea salt in warm water first thing in the morning. Gargle then swallow.
- Don’t over exercise. When it comes to exercise and weight loss, one size does not fit all. And, some forms of exercise can actually put an increased demand on your body increasing cortisol and insulin. If you are working out a lot and are not losing weight– or you’re actually gaining weight or fat, especially around your middle — you may need to adjust your exercise routine and frequency. Try different types of low-intensity workouts, such as walking, yoga or Pilates. Adjust the frequency and intensity of your workouts based on your body’s needs, the amount of stress you are under, and your overall health. Your goal should be to feel energized afterward, not exhausted.
- Eat enough calories. When you were in your twenties, you probably lost weight easily by restricting calories. But, caloric restriction puts increased stress on your body and when you are menopausal it can backfire, increasing cortisol and insulin, and decreasing thyroid function causing you to gain weight. This is especially true if you are restricting calories and exercising more. Be sure to get enough calories from real whole foods to provide your body with the building blocks for energy production.
- Skip alcohol. Alcohol is sugar. Drinking alcohol regularly causes insulin resistance and weight gain. In addition, alcohol is processed through the liver. When your liver is busy breaking down alcohol, it can’t process hormones, creating further imbalances in estrogen and cortisol and converting the excess glucose it stores to fat. Remember fat cells are loaded with glucose receptors so they crave more sugar. If you do have the occasional drink, take fiber to help stabilize your blood sugar and slow down the absorption of alcohol.
- Check in with your emotions. Creating health at mid-life requires learning to take care of yourself instead of everybody else. This includes regaining body acceptance and the self-esteem that many of us lose in adolescence, or if we’ve been in relationships with energy vampires. Are you in a relationship with someone out of fear of being alone? Do you constantly seek approval of others? If so, why? Are you afraid to take care of yourself? What might happen? Remember, emotions are energy. Unresolved emotions stagnate the energy in your body. Releasing them can do wonders for helping to also release the unwanted pounds.
Do You Have a Meno Belly?
Many women—even those who have been thin and fit for their entire lives—reach menopause and then notice they have developed the dreaded “Meno Belly.” And this can occur even if the number on the scale has not changed significantly. It’s as if suddenly your waist disappeared, and you can’t button the pants you wore just last week.
For many women this increased fat in the midsection occurs without weight or fat increase anywhere else in their bodies. And diet and exercise don’t seem to help. So what can you do?
When it comes to Meno Belly, there can be a few different factors at play—and you may need to address each of them.
- Keep insulin levels low: Typically insulin resistance plays a role. So you want to do what you can to keep your insulin levels low. When insulin levels are low, it’s much easier to lose weight and belly fat. The good news is everything I have mentioned above, including the dietary guidelines I’ve outlined will help you keep your insulin levels in check.
- Balance your hormones. Studies show that post-menopausal women with low estrogen levels have higher levels of abdominal fat. This is due to the higher number of estrogen receptor in abdominal fat cells compared to fat cells in other parts of the body. So as estrogen levels decline, your fat cells grow, and your body attempts to store more fat to keep estrogen levels balanced.
- Try a probiotic. According to studies, low estrogen levels can lead to an overgrowth of certain bacteria in the gut causing dysbiosis and leading to sugar cravings, poor digestion, and weight gain.
Another thing I highly recommend is that you eat purposefully. Slow Down. Chew your food. Take notice of how you feel after each bite. Stop when you are full to prevent overeating, indigestion, and bloating. If you are an emotional eater or someone who is in the habit of eating a pick-me-up snack every day at 3 pm, ask yourself “why?” You may learn that you are in the habit of doing this out of stress or boredom. So you may want to take a short walk instead.
What About Meno Apron?
Some women start to notice sagging of the lower belly, often called “Meno Apron.” The term for this is pannus stomach. It is not related to menopausal changes directly, but it can occur at the same time as Meno Belly. Meno Apron occurs with weight changes as the fat deposits underneath the abdominal muscles and in front of the intestines in an area called the omentum sag. This is not unique to women—even men can experience it. But menopausal weight gain can make a small pannus stomach grow larger. Pannus stomach can also occur after pregnancy.
A mild case of pannus stomach can be improved with diet and exercise. However, because it’s caused by excess fat deposits and loose skin sometimes other procedures are needed to reduce or remove a larger pannus stomach, especially if it gets in the way of daily activities.
Have you ever been diagnosed with insulin resistance? What have you done to reverse it?
Additional Resources from Dr. Northrup