Unfortunately many people don’t notice the arrival of insulin resistance symptoms before it’s too late, because they have been educated that their symptoms are caused by other more popular conditions, i.e. Hypothyroid and Polycystic Ovarian Syndrome have the same symptoms. Many do not fit the physical stereotype of – Female, Fat and Forty. If they do – the gallbladder is removed and hormones are prescribed. The early influence of insulin resistance usually manifests in the middle-aged man, but young men in their late 20’s may also have functional imbalances in their hormone physiology resulting in Andropause or more popularly known in advertising as “Low-T”.
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How Do You Know If Insulin Resistance is involved?
Symptoms of Insulin Resistance
- Brain fogginess and inability to focus. Sometimes the fatigue is physical, but often it is mental.
- High blood sugar. Mild, brief periods of low blood sugar are normal during the day, especially if meals are not eaten on a regular schedule. But prolonged hyperglycemia with some of the symptoms listed here, especially physical and mental fatigue, are not normal. Feeling agitated, jittery, moody, nauseated, or having a headache is common in Insulin Resistance, without immediate relief once food is eaten.
- Intestinal bloating. Most intestinal gas is produced from dysbiosis.
- Insulin Resistance sufferers who eat carbohydrates suffer from gas, lots of it.
- Sleepiness. Many people with Insulin Resistance get sleepy immediately after eating a meal exceeding their Carbohydrate Tolerance.
- Fatigue after meals, craving sugar after meals, must have dessert
- Weight gain, fat storage, difficulty losing weight. The fat in IR is generally stored around the midsection in both males and females.
- Increased cholesterol and triglycerides.
- Increased blood pressure. It is a fact that most people with hypertension have too much insulin and are Insulin Resistant. It is often possible to show a direct relationship between the level of insulin and blood pressure: as insulin levels elevate, so does blood pressure.
- Depression. Because carbohydrates are a natural “downer,” depressing the brain, it is not uncommon to see many depressed persons who also have Insulin Resistance.
- Insulin resistance symptoms listed above.
- Few or no menstrual periods. This can range from less than nine menstrual cycles in a year (more than 35 days between cycles) to no menstrual periods. Some women with PCOS have regular periods but are not ovulating every month. This means that their ovaries are not releasing an egg each month.
- Heavy, irregular vaginal bleeding. About 30% of women with PCOS have this symptom.
- Hair loss from the scalp and hair growth (hirsutism) on the face, chest, back, stomach, thumbs, or toes. About 70% of women in the United States with PCOS complain of these hair problems caused by high androgen levels.
- Acne and oily skin, caused by high androgen levels.
Insulin Resistance/PCOS symptoms that may develop gradually include:
- Weight gain or upper body obesity (more around the abdomen than the hips). This is linked to high androgen levels.
- Male-pattern baldness or thinning hair (alopecia). This is linked to high androgen levels.
- Repeat miscarriages. The cause for this is not known. These miscarriages may be linked to high insulin levels, delayed ovulation, or other problems such as the quality of the egg or how the egg attaches to the uterus.
- Inability to become pregnant (infertility). This is because the ovaries are not releasing an egg (not ovulating).
- Symptoms of too much insulin (hyperinsulinemia) and insulin resistance, which can include upper body weight gain and skin changes, such as skin tags or dark, velvety skin patches under the arm, on the neck, or in the groin and genital area.
- Breathing problems while sleeping (obstructive sleep apnea). This is linked to both obesity and insulin resistance.
Early symptoms of Insulin Resistance induced Andropause (Low-T) in Men
- Insulin resistance symptoms listed above.
- Decrease in libido or desire for sex
- Decrease in spontaneous morning erections (most common early sign)
- Decrease in fullness of erections
- Difficulty in maintaining or starting full erection
- Baldness and/or extremity hair thinning
- Fat accumulation around the waist
- Urinary symptoms; dribbling, pain and/or frequency; urgency; interrupted stream
- Changes in sleep habits
- Spells of mental fatigue and inability to concentrate
- Depression; Lack of enthusiasm for life
- Changes in sleeping habits
- Decreased initiative
- Muscle soreness
- Decrease in physical stamina
If men experienced the monthly ebb and flow of hormones, they may be more inclined to recognize the impact hormones have on their body. Most of the symptoms caused by the insulin resistance are chalked up to the male aging process. Andropause usually manifests in the middle-aged man, but young men in their late 20’s may also have functional imbalances in their hormone physiology. Again it’s just men being moody and not the early onset of insulin resistance.
Is it the Insulin Resistance or the PCOS(women) / Low-T(men)
This is the old chicken or the egg argument. Take out the influence of the insulin resistance and the likelihood of having hormonal issue is greatly diminished.
Insulin Resistance and High Cholesterol
High cholesterol is the major problem with insulin resistance. The most common lifestyle recommendation is low fat/high carbohydrate diet which many find unsuccessful in lowering their cholesterol. Drugs are prescribed to lower the cholesterol. The blood glucose component is ignored until a pre-diabetic stage is reached.
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Until recently, blood sugar and cholesterol were looked at as separate issues. Now, we know they are directly related. Remember, when an individual loses the ability to transport glucose into their cells, the body will resort into shifting the blood sugar into fat (lipogenesis) and therefore abnormal cholesterol levels will be seen. Elevation in cholesterol and triglycerides are very helpful in identifying stages of blood sugar disorders.
Clinical nutrition will fail. Insulin resistance cannot be corrected by diet alone. There are several “MUST DO’s” for the person with insulin resistance to get better
- Eat within your carbohydrate tolerance.
- Take nutritional compounds and supplements as directed
- Follow your Functional Medicine physician’s recommendations
- Contact your physician if you are experiencing problems
Insulin Resistance and Flax Seed
The ligans in Flax Seed oil are useful in helping insulin bind to receptor sites. Insulin Resistance doesn’t respond well to Flax Seed oil because inflammation will cause a shift into inflammatory pathways, thus increasing inflammation in the body. If a person responds well to aspirin, it is likely that this is occurring. Use high amounts of OmegaCO-3 fish oils, Green Tea, and Garlic to quench inflammatory aracodonic pathways with Insulin Resistance.
Insulin Hormone Metabolism Disorders In Women
Insulin resistance appears to play a major role in a vicious cycle that alters female hormone metabolism towards androgen dominance. Androgen dominance may eventually lead into Polycystic Ovary Syndrome (PCOS). It is the most common female hormone disorder in menstruating aged women. It is estimated that androgen disorders occur in as many as 4-10 percent of women of reproductive age and it is the most common of female infertility in the United States.16 PCOS is primarily characterized by excess male hormones, insulin resistance and chronic menstrual issues. Symptoms of androgen disorders tend to appear gradually over a number of years and range from the mild to serious. They include irregular periods, fibroids, infertility, unexplained weight gain, fluid retention, fatigue, mood swings, and acne beyond puberty, hair loss, and unwanted hair growth. Note the similarity to insulin resistance.
It appears that insulin resistance creates a vicious cycle that shifts into androgen excess and the androgen excess promotes insulin resistance. This syndrome presents with elevated testosterone, elevated estrogen, decreased sex-hormone binding globulin, increased androstenedione, increased DHEA, increased 17-hydroxprogesterone, and increased LH.20 In contrast to insulin’s role in causing an androgenic shift in metabolism, elevated androgens appear to decrease insulin receptor sensitivity.
The conventional pharmaceutical based therapy to treat this disorder does not seem to treat the underlying cause of insulin resistance and adrenal dysfunction. Instead, bio-identical hormones are used to over-ride physiology to change metabolism. Many drugs are being used to treat PCOS and androgen disorders in women. The most common treatment is the use of oral contraceptives. Oral contraceptives contain high amount of hormones used to take the pituitary feedback loop out of the picture. The birth control pill suppresses the secretion of hormones and therefore decreases ovarian androgen production. It should be noted that chronic use of the pill will inhibit the natural hypothalamus-pituitary-ovarian feedback loop. The condition called “POST-BIRTH CONTROL SYNDROME”, which is classified by inability to regain normal menstrual cycles, is increased with chronic use of oral contraceptives. For every year you are on the pill there is a 2% increase in breast and uterine cancer.
Other forms of therapy include androgen antagonist drugs such as ketoconazole and finasteride and insulin sensitizing drugs such as metformin. These drugs come with serious side effects. Metformin may cause lactic acidosis, malabsorption, and B-12 deficiency. The anti-androgen drug ketoconazole suppresses cortisol synthesis and healthy adrenal function and has been shown to cause severe liver toxicity. The list of side effects for these drugs is long and serious. In most cases, the pharmaceutical approach as the first line therapy seems illogical, especially when diet and nutritional management cannot only change the symptoms associated with androgen disorders, but actually change the abnormal alterations in metabolism and enhance normal physiology.
INSULIN RESISTANCE AND MICROBIAL OVERGROWTH
The elevated testosterone in women increases the activity of Clostridia, which are inhabitants of our gastrointestinal tract. The overactive Clostridia start converting primary bile salts into secondary bile salts. Secondary bile salts are toxic, damage your ability to use Vitamin D, promote the formation of gallstones.
This is commonly seen with insulin resistance markers in the Metabolic (Category VII) & Neurotransmitter (Section C2) Assessment forms, Blood Laboratory Evaluations (elevated cholesterol, triglycerides, LDL, Chol/HCL ratio; low HDL; normal or low glucose). Combined with markers in Metabolic (Category III) Assessment form; high or low WBC, neutrophils, lymphocytes, monocytes, eosinophils, AST, ALT indicated microbial firmicute overgrowth.
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 Huang I, et al. (2007). Endocrine disorders. In JS Berek, ed., Berek and Novak’s Gynecology, 14th ed., pp. 1069-1135. Philadelphia: Lippincott Williams and Wilkins.
Elsenbruch S, et al. (2003). Quality of life, psychological well-being, and sexual satisfaction in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 88(12): 5801-5807.
 Speroff L, Fritz MA (2005). Anovulation and the polycystic ovary. Clinical Gynecologic Endocrinology and Infertility, 7th ed., pp. 465-498. Lippincott Williams and Wilkins.
 Elsenbruch S, et al. (2003). Quality of life, psychological well-being, and sexual satisfaction in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 88(12): 5801-5807.
 Ehrmann DA (2005). Polycystic ovary syndrome. New England Journal of Medicine, 352(12): 1223-1236.
 Ridlon JM, Kang DJ, Hylemon PB. Isolation and characterization of a bile acid inducible 7alpha-dehydroxylating operon in Clostridium hylemonae TN271. Anaerobe. 2009 May 21.