Insulin: The marker I end up supporting in nearly every protocol
I had a consult with someone last week who was semi-shocked by her new nutrition plan.
Her top goals for that call:
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Improve energy and cognitive function
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Address some concerning cholesterol and testosterone numbers
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Get her body ready to start trying for a family next year
What she didn't realize was her high cholesterol, brain fog, low hormones, aches and pains, and the one she was most embarrassed about (late night bingeing) were all boiling down to one marker. And I'm so glad she had truly comprehensive blood work done because it's normally missed on a standard panel.
Fasted insulin. Elevated or not , I feel like every single protocol I write up as a coach involves supporting blood sugar and metabolic function. And often my recomendations shock people because they equate improving this with restriction. But often that's the "strategy " that their body got here in the first place.
But first, let's back up.
Insulin signals liver, muscle and fat cells to take up glucose. After you eat, blood sugar rises as your body breaks down carbohydrates into glucose that circulates in your bloodstream. Your pancreas releases insulin, which takes that glucose out of your bloodstream and into your cells, to be used for energy or stored for later as glycogen in the liver or muscle. Anything extra beyond that gets converted to triglycerides and stored in fat cells.
Ideally we want to see insulin under 6 uIU/mL.
Her levels? 12.5 uIU/mL.
Most providers wait to check insulin until they see blood glucose elevated. But glucose can stay in a normal range for a while because the body is cranking out insulin to keep it there. Blood glucose looks normal while insulin is silently creeping up in the background. That won't last, because the beta cells in the pancreas eventually burn out. Monitoring early means catching it earlier and improving both symptoms and trickle down health issues sooner.
High insulin or unmanaged blood sugar is often the driver behind the most common complaints I hear on calls like this:
Dyslipidemia . Cholesterol elevated ? Triglycerides high? LDL up? If you've had an ApoB run (more on that marker in another post), that's a strong predictor of cardiovascular disease risk. With this client, all 4 were elevated.
High Cortisol and inflammation. Elevated insulin and mismanaged blood sugar drive both up. Why you may feel puffy and stressed .
Reproduction and Fertiltiy Goals . High insulin can impact ovulation and raise androgen levels. Hyperinsulinemia also arrests cell proliferation and follicle growth. Fertility goals ? that needs to be addressed
Anxiety and PMS. Estradiol rising improves insulin sensitivity (which is why insulin creeps up in menopause ) . If someone is underfueled or inconsistent with meals, this can feel like jitteriness or internal revving instead of clean energy. The brain is getting strong stimulation at a time when fuel may not be steady, and that mismatch can create the "wired" sensation.
Feel out of control around food. Women especially come to me reporting they feel anxious and wired when they get in the kitchen and end up bingeing. My first question is always: when was the last time you ate, and what did that meal look like? If it's been six hours since your last meal and you've been running on coffee since noon, your body is stressed and looking for glucose. It's not a willpower problem. It's a meal structure and timing issue. Those binge episodes can further contribute to elevated insulin.
Acne, insulin resistance, hormone imbalances, weight gain, low energy, and frequent infections can all show up when blood sugar is dysregulated.
In this case, and others like it, my advice often shocks people, because we're working on eating more. Everything in her Strategy Session plan, the nutrition changes, the training, is aimed at keeping blood sugar balanced, lowering her insulin and inflammation load so her body isn't running in a state of stress. That stress state is what contributes to low hormones, brain fog, and poor energy, and it's what shows up on the lipid, blood sugar, and hormone panels . All of it puts her in a strong spot heading into her TTC goals
