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How Insulin Resistance and High Blood Sugar Affect Women’s Hormone Health

In the landscape of women’s health, the interplay between insulin resistance, high blood sugar, and hormonal balance is crucial yet often overlooked. Hormone balance is dependent upon healthy blood sugar levels. The relationship between blood sugar and hormones is bidirectional. Insulin itself functions as a hormone with broad systemic effects. When insulin resistance sets in, it can affect the entire endocrine system, which includes hormones like Thyroid, Cortisol, Estrogen, Progesterone, and Testosterone. Understanding how these factors interrelate can help women better manage their health and hormones. In today’s article, I will review some of the tests that help identify insulin resistance, some of the most common womans health problems caused by insulin resistance and high blood sugar. Lastly, I will include recommendations for diet and some of my top strategies for lowering insulin resistance for better womans health and hormones.

Insulin Resistance and Womans Health 101 

Insulin is a hormone produced by the pancreas allows cells to absorb glucose from the bloodstream to use for energy. Insulin resistance occurs when cells in the muscles, fat, and liver start responding poorly to insulin, making it difficult for glucose to enter cells, thereby causing a rise in blood sugar levels.

Over time, the pancreas produces more insulin to compensate for this decreased efficiency, but eventually, it can’t keep up, and blood sugar levels remain consistently high. This condition can lead to prediabetes and type 2 diabetes if left unchecked.

The Centers for Disease Control and Prevention (CDC) estimates that four in five people with insulin resistance don’t know they have it. Early insulin resistance symptoms include: Low energy levels relieved by eating. Excessive sleepiness midday or after eating.

Insulin resistance and high blood sugar are more than just markers of chronic health conditions; they play a pivotal role in disrupting hormonal balance in women. Hormonal imbalances brought on by insulin resistance not only affect menstrual cycles and ovulation but also significantly impact mood and mental health.

Testing for Insulin Resistance

Testing for insulin resistance typically involves a combination of medical history assessment, symptoms, and specific blood tests. 

1.Fasting Blood Glucose Test: This test measures your blood sugar level after an overnight fast. Elevated fasting blood glucose levels may indicate insulin resistance. A fasting blood glucose level of 100-125 mg/dL is considered prediabetes, while levels of 126 mg/dL or above may suggest diabetes. In functional medicine we want to see fasting blood sugar (glucose) levels between 85-95mg/dl

2. Fasting Insulin Test: Measuring fasting insulin levels alongside fasting blood glucose levels can provide valuable information about insulin resistance. High fasting insulin levels in conjunction with normal blood glucose levels are indicative of insulin resistance. In functional medicine we want to see fasting levels between 5-6.

3. Oral Glucose Tolerance Test (OGTT): During an OGTT, you will consume a sugary drink after fasting, and your blood sugar levels will be monitored periodically over the following hours. This test can help detect how well your body processes glucose and can identify insulin resistance.

4. Hemoglobin A1c Test: The hemoglobin A1c test provides an average of your blood sugar levels over the past two to three months. It can indicate if your blood sugar levels have been consistently high, pointing to potential insulin resistance.

5. Insulin Sensitivity Index: More specialized tests, such as the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) or Quantitative Insulin Sensitivity Check Index (QUICKI), calculate insulin sensitivity based on fasting insulin and blood glucose levels. These indices can provide a more precise assessment of insulin resistance. Here is a HOMA-IR calculator you can use. 

6. C-Peptide Test: C-peptide is a protein produced at the same time as insulin. Measuring C-peptide levels can help determine how much insulin your body is producing. Low C-peptide levels may indicate insulin resistance or impaired insulin production.

7. Lipid Profile: Insulin resistance is often associated with abnormal lipid profiles, including high triglycerides, low HDL cholesterol, and high LDL cholesterol. A lipid profile test can help identify these abnormalities and assess cardiovascular risk associated with insulin resistance.

8.Triglyceride to HDL Ratio: The ratio of triglycerides to high-density lipoprotein (HDL) cholesterol in the blood. A high ratio suggests insulin resistance. Levels above 3.5 are usually concerning.

If you suspect you may have insulin resistance, it is important to consult with a Functional Medicine Practitionerl for proper evaluation and diagnosis. Early detection and management of insulin resistance are crucial for preventing complications such as type 2 diabetes and cardiovascular disease. I have created a quiz that helps you evaluate your blood sugar stablility. You can take the Quiz here.

Insulin Resistance and Your Menstrual Cycle

High insulin levels can disrupt the normal regulation of the menstrual cycle. Insulin influences the pituitary gland to secrete more luteinizing hormone (LH) while decreasing follicle-stimulating hormone (FSH), both of which are critical for normal menstrual cycles. Such disruptions can result in irregular periods, anovulation (lack of ovulation), or amenorrhea (absence of periods), impacting fertility.

High Blood Sugar, Elevated Insulin and Thyroid Disease

There is increasing evidence that diabetes, prediabetes, and insulin resistance, affect many areas of thyroid function(*). If you have Thyroid disease, understanding this vital connection between your blood sugar and your thyroid cant be overstated.

First and foremost, hyperglycemia disrupts the delicate balance of the hypothalamic-pituitary-thyroid (HPT) axis, the master regulator of thyroid hormone production. Chronic high blood sugar can impair the responsiveness of the pituitary gland to thyroid-stimulating hormone (TSH), leading to suboptimal stimulation of the thyroid gland and reduced thyroid hormone synthesis. This disruption can result in imbalances in thyroid hormone levels, potentially manifesting as hypothyroidism or subclinical thyroid dysfunction in individuals with uncontrolled high blood sugar. In other words… Hyperglycemia causes low thyroid hormones.

Elevated insulin levels can lead to a decrease in the production and secretion of thyroid hormones, particularly T3 (triiodothyronine). Insulin resistance, a condition where cells become less responsive to insulin’s actions, can disrupt the conversion of the inactive thyroid hormone T4 (thyroxine) into the active form T3(*). This can result in lower levels of circulating T3 also known as Low T3 syndrome.

You can learn more about the relationship between insulin resistance and thryoid disease here.

Endometrial Health

High insulin levels can have several effects on the endometrium, the lining of the uterus, in women. These effects are primarily related to the role of insulin in regulating various hormonal and metabolic pathways that can impact the endometrium. High insulin levels, which can occur in conditions like insulin resistance or diabetes, can lead to elevated estrogen levels.

Estrogen is a hormone that plays a critical role in the growth and proliferation of breast and endometrial cells. Prolonged exposure to high levels of estrogen, due to insulin resistance, can promote excessive growth of the endometrium,  leading to conditions like endometrial hyperplasia.(*),(*),(*)

While high insulin levels can tell the ovaries to make more testosterone, like I mentioned above it can also lower Sex Hormone Binding Globulin. When a woman has low SHBG, the result is an estrogen dump. Excess estrogen, better known as estrogen dominance can lead to symptoms like sore breasts, fibroids, and heavy periods. If you are postmenopausal woman, studies show excess estrogen promoted by Insulin resistance, increase breast, cervical and uterine cancer as well as affect the Risk and Survival Outcome (*),(*)

One of the reasons why woman who have estrogen receptor positive breast cancer are put on drugs like tamoxifin is to prevent excess estrogen production. Interestingly, insulin resistance increases the coversion of testosterone into estrogen and its this conversion, that the drug tamoxifen is designed to block. These drugs block estrogen production which is wny they cause symptoms such as hot flashes, night sweats, and vaginal dryness.

In conclusion, high insulin levels can affect the endometrium through various mechanisms, including altered hormone levels, menstrual irregularities, increased risk of endometrial hyperplasia and cancer, inflammation, and implications for fertility. Managing insulin levels through lifestyle modifications, such as a balanced diet, regular exercise, supplments, and weight management, as well as seeking appropriate medical care and monitoring, is important for supporting endometrial health and overall well-being in women.

Insulin Resistance and Your Liver

Insulin resistance can have significant implications for a woman’s liver health. When the body becomes resistant to the effects of insulin, the pancreas produces more insulin to compensate. This increased insulin level can lead to several changes in the body, including effects on the liver. For starters its very common to see something known as Non-Alcoholic Fatty Liver Disease (NAFLD)

Insulin resistance is a key factor in the development of non-alcoholic fatty liver disease. When cells become resistant to insulin, the body produces more insulin in an attempt to regulate blood sugar levels. This excess insulin can promote the accumulation of fat in the liver, leading to NAFLD. Over time, NAFLD can progress from simple fatty liver to more severe conditions such as non-alcoholic steatohepatitis (NASH) and liver cirrhosis.

Insulin resistance is associated with higher levels of inflammation. One of the blood tests I run on new patients is a test called C-reactive protein or just CRP for short. CRP is a protein that your liver makes. Normally, you should have low levels of C-reactive protein in your blood. Your liver releases more CRP into your bloodstream if you have inflammation in your body or the liver. High levels of CRP may mean you have a serious health condition.

Insulin resistance is often a component of metabolic syndrome, a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. Woman with metabolic syndrome are at higher risk of developing liver-related complications, including NAFLD, due to the combined effects of insulin resistance, obesity, high blood pressure, and abnormal lipid levels.(*)

High Blood Sugar and Adrenal Fatigue

Insulin resistance and high blood sugar can have significant effects on those suffering with adrenal fatigue and dysregulated cortisol levels. There is a complex relationship between high blood sugar and our cortisol levels. The adrenal glands are responsible for producing hormones like cortisol, which plays a key role in regulating metabolism, immune response, and stress response. Prolonged insulin resistance can place stress on the adrenal glands as they work to maintain hormonal balance. The more erratic your blood sugar the more stress placed on the adrenal glands.  Blood sugar and cortisol have a bidrectional relationship. This is why problems with high blood sugar exacerbate adrenal problems and adrenal fatigue exacerabtes blood sugar problems.

The body’s response to high blood sugar involves releasing insulin to facilitate glucose uptake into the cells. This process can lead to fluctuations in blood sugar levels and, in turn, affect the adrenal glands. Chronic exposure to high blood sugar levels can strain the adrenal glands and contribute to adrenal fatigue, a condition characterized by reduced adrenal hormone production and symptoms of fatigue, stress, and poor resilience to physical and emotional stressors.

Insulin resistance and high blood sugar levels are associated with increased systemic inflammation and oxidative stress, which can further impact adrenal function and cortisol regulation. Chronic inflammation and oxidative stress can also contribute to adrenal fatigue by placing additional burden on the adrenal glands and disrupting hormonal balance. This can create a cycle of dysfunction in which insulin resistance, high blood sugar, and adrenal fatigue mutually reinforce each other.

Consulting with healthcare providers and specialists in endocrinology and functional medicine can help tailor interventions to address the complex interactions between insulin resistance, high blood sugar, adrenal fatigue, and cortisol dysregulation. If you need help putting together the pieces of your health puzzle contact our office and schedule a free 15 minute discovery call.

Common Symptoms of Adrenal Fatigue

  1. Morning or early afternoon fatigue
  2. Brain Fog
  3. Trouble sleeping at Night
  4. Feeling Wired and Tired at same time
  5. Depression and Anxiety
  6. Low Energy
  7. Blood sugar cravings.
  8. See a more extensive list of Adrenal Fatigue Symptoms here.

High Blood Sugar and Insulin Resistance affects on Testosterone

Insulin resistance and high blood sugar can have a significant impact on a woman’s testosterone levels, often leading to hormonal imbalances associated with conditions such as Polycystic Ovary Syndrome (PCOS). Insulin can stimulate the ovaries to produce more androgens, including testosterone. High levels of circulating insulin, a hallmark of insulin resistance, directly encourage ovarian androgen production.

Enzyme activity: Insulin increases the activity of enzymes like 17α-hydroxylase, which is involved in androgen production.

Reduction in Sex Hormone-Binding Globulin (SHBG)

SHBG and testosterone: SHBG is a protein that binds to sex hormones like testosterone, making them biologically inactive when bound.

Insulin’s effect on SHBG: Elevated insulin levels decrease SHBG production in the liver, leading to higher levels of free (unbound and active) testosterone in the blood.

Impact on Luteinizing Hormone (LH)

Hormonal balance: Insulin resistance can alter the normal balance of reproductive hormones, increasing LH levels. Higher LH levels further stimulate testosterone production from the ovaries.

Adipose Tissue and Androgen Conversion-Fat cells and testosterone**: Excess adipose tissue, particularly visceral fat, can also contribute to elevated testosterone levels. Aromatase enzymes in adipose tissue convert androgens to estrogens; however, the balance can be disrupted in insulin resistance, further affecting hormone levels.

Inflammation-Chronic inflammation: Insulin resistance often goes hand in hand with chronic low-grade inflammation, which can also affect endocrine function and contribute to the dysregulation of androgen levels.

Conditions Commonly Linked to Increased Testosterone Due to Insulin Resistance

  1. Polycystic Ovary Syndrome (PCOS):The exact mechanisms that connect insulin resistance with PCOS are not entirely understood, but there is a well-established link between the two. Women with PCOS often have high levels of testosterone, which can lead to symptoms such as:
  2. Hirsutism: Excessive hair growth on the face and body.
  3. Acne and oily skin
  4. Menstrual irregularities Such as oligomenorrhea (infrequent periods) or amenorrhea (absence of periods).
  5. AnovulationAbsence of ovulation, leading to infertility.

Mood and Mental Health

High blood sugar and insulin resistance can have significant impacts on mood and mental health.(*) These conditions are often associated with metabolic disorders such as type 2 diabetes and are linked with various mental health issues, including depression, anxiety, and cognitive impairment. Chronic high blood sugar levels can lead to inflammation, which is a risk factor for various mental health disorders.(*) Inflammation can affect brain function and has been associated with depression and anxiety. High levels of glucose in the blood can lead to the production of reactive oxygen species (ROS) which can cause oxidative stress and damage to brain cells. (*)  This neurotoxicity can negatively impact cognitive function and mental health. Hyperglycemia (high blood sugar) can affect blood vessels, reducing blood flow to the brain and potentially impairing brain function and mood regulation. Insulin plays a role in modulating the neurotransmitter glutamate, which affects brain function. Dysfunctional glutamate signaling is associated with psychiatric disorders.(*)

Research indicates that there is a bidirectional relationship between high blood sugar levels/insulin resistance and depression.(*) Chronic high blood sugar can lead to changes in the brain that increase the risk of depression, while depression can lead to poor lifestyle choices that worsen blood sugar control.

Insulin resistance has been shown to regulate the dopamine pathways negatively, particularly in the mesolimbic system, which is involved in the reward and pleasure circuits of the brain. This can lead to decreased motivation and pleasure, symptoms commonly observed in depression.

Serotonin is another important neurotransmitter involved in mood regulation. Some studies suggest that high blood sugar and insulin resistance might influence serotonin levels, possibly by affecting the synthesis or the receptors for serotonin in the brain. Low levels of serotonin are associated with depression and anxiety.

Heres an article I wrote about Insulin Resistance affect on Neurotranmitters and Dopamine levels.

How to Reverse Insulin Resistance Key Strategies and Tips

The good news is that insulin resistance and high blood sugar levels can be managed, and in some cases, reversed through lifestyle modifications and early interventions. Now that you know the importance of reversing insulin resistance, the next step is to change your lifestyle and make it happen. Here’s what to do:

  • Eat fewer calories overall: Reducing your caloric intake is the number-one way to lose weight, which helps improve insulin sensitivity.
  • Eat more nutrient-dense and fiber-rich food: Consuming more vegetables, lean meats, whole grains, and legumes regulates your blood sugar levels and improves insulin function.
  • Low Glycemic Index Foods: Choose foods that have a low glycemic index, which help in maintaining stable blood sugar levels.
  • Reduce your sugar and carbohydrate intake: At the same time, limit the amount of added sugars and refined carbohydrates in your diet to prevent blood sugar spikes and reduce the demand on your pancreas.
  • Get the right amount of sleep: Aim for seven to nine hours of quality sleep each night to balance your hormones and support overall health.
  • Exercise more: Regular physical activity promotes weight loss, improves insulin sensitivity, and lowers blood sugar levels. Strive for 3-5 days per week of moderate-intensity aerobic exercise and two-three strength-training sessions per week. Dont avoid Strength training! your mucles are like sponges for glucose.
  • Fiber Intake: Increase fiber intake as it slows down glucose absorption and helps in better glycemic control

How Fiber Helps Insulin Resistance

Dietary fiber can help manage insulin resistance since it slows carbohydrate digestion and sugar absorption. This process helps prevent blood sugar spikes and promotes good blood sugar management. There are two types of fiber: soluble and insoluble. Both types are beneficial, but soluble fiber in particular is known for its positive effects on insulin resistance. Soluble fiber absorbs water and forms a gel-like substance in the digestive tract. This slows down digestion and helps regulate blood sugar levels.

Sources of Soluble Fiber:

  1. Oats: Oats have a high soluble fiber content and can be an excellent choice for individuals dealing with insulin resistance.
  2. Legumes: Beans, peas, and lentils are also high in soluble fiber.
  3. Fruits: Fruits like apples, blueberries, strawberries, and citrus fruits contain soluble fiber.
  4. Vegetables: Non-starchy vegetables like broccoli, carrots, and Brussels sprouts pack plenty of soluble fiber.

Increasing fiber in your diet may reduce the risk of developing type 2 diabetes. Remember to add fiber gradually to your diet to avoid any discomforts like bloating or gas and drink plenty of water to aid in digestion. Regular physical activity and maintaining a balanced diet are also key factors to manage insulin resistance. As always, individual dietary needs can vary, so it’s essential to speak with a healthcare provider or nutritionist for personalized advice.

Final Thoughts about Insulin Resistance and Womans Hormones

Understanding the intricate relationships between insulin resistance, high blood sugar, and hormone health is vital for women. Proactive management through lifestyle changes and medical intervention can significantly improve quality of life, reduce symptoms, and prevent long-term complications.

By addressing insulin resistance early and maintaining balanced blood sugar levels, women can achieve better hormonal health and overall well-being.

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