Sunday, October 24, 2021

What do hypertension, Alzheimer’s disease, heart disease, arthritis, diabetes, many cancers, migraine headaches and skin tags have in common? They are all highly associated with insulin resistance, as insulin resistance strongly contributes to all of these diseases. When we think of insulin resistance, we think of type II diabetes. In fact, this is the most obvious manifestation of insulin resistance but there are many diseases it causes.

Insulin is a very important hormone that enables us to utilize energy and even to grow. When we eat carbohydrates, especially sugar, insulin production is stimulated. This helps get the glucose into cells, which provides energy. In type I diabetes, the pancreas is unable to make insulin. Without insulin, the cells are unable to utilize glucose and the body wastes away, a condition called cachexia. With the development of insulin by Drs. Banting and Best in 1921, the lives of those with type I diabetes was dramatically extended.

But what happens when there is too much insulin production on a chronic ongoing basis? As a stimulus is repetitively signaling to a cell, the cell becomes less responsive to that stimulus. One example is opioid pain medications. If someone has acute postoperative pain, they may get relief with this medication. However, if they continue to take it they will require higher doses to achieve the same level of relief. This is because the cells become less responsive to the opioid signal.

If someone eats excessive carbohydrates over a prolonged period, they produce enough insulin to get all of those sugars pushed into the cells. The problem is that the cells become less responsive to the insulin. The body then requires more insulin to get the glucose pushed into the cells. This excess insulin creates problems for the body. Remember that insulin gets produced after we eat. This signals to our body that we have energy to use and energy to store. Unfortunately, one of the ways energy is stored is as fat.

When someone with insulin resistance enjoys a meal with excess carbohydrates, all of those extra sugar molecules can’t get pushed into the cells because the cells are resistant. Those sugar molecules will then get redirected to the liver where insulin converts them to fat. Thus, fat accumulates around the liver. When there is too much fat on the liver, excess fat gets channeled to other organs including the intestines and the pancreas.

When these organs get clogged up with fat, this makes it more difficult for the organs to do their basic jobs. The fat around the organs is called visceral fat. This fat does not just sit around but is metabolically active. One of its activities is producing inflammatory cytokines. These are chemicals that create inflammation in the body. This inflammatory environment is a breeding ground for clots to form in the arteries, which can lead to heart attack and stroke.

Insulin resistance in the arteries leads to growth of the cells that line the arteries, called the endothelial cells. This creates increased pressure in the arteries, leading to high blood pressure or hypertension. With insulin resistance in the brain, the neurons (nerve cells) become unhealthy and can even decay, leading to Alzheimer’s disease. In fact, a contemporary term for Alzheimer’s is type III diabetes. When there is insulin resistance in any organ, the excess insulin in the area may signal abnormal growth, which can lead to cancer. Breast cancer, colon cancer and prostate cancer have all been associated with increased insulin resistance. With insulin resistance in muscles, fat deposits will replace the muscle fibers. A common visible manifestation of this is a sagging arm muscle filled with fat instead of muscle fibers.

The good news is that insulin resistance can be dramatically improved with a combination of good diet, a good exercise program and hormone optimization. A good diet is not based on a set formula but should be individualized to match one’s preferences and health situation. For someone with more advanced metabolic problems, a low-carbohydrate diet combined with intermittent fasting will help burn some of the excess accumulated fat. This will help reduce inflammation and reduce insulin resistance. For someone with an aversion to animal fats and proteins, a natural whole foods vegetarian diet can lead to weight loss with reduction of visceral fat and inflammation, thereby improving insulin resistance. Another good dietary principle is to avoid inflammatory foods. This varies among individuals but the most common inflammatory foods are dairy, gluten and sugars. You should feel energetic after eating and not blah or fatigued. As a general rule, processed food is more likely to have unhealthy ingredients in general and stimulate insulin production in particular. In other words, if the food is in a bag or a box, it is probably not good for you.

Exercise is invaluable for improving insulin resistance. Aerobic exercise increases your heart’s output and improves circulation with reduction of blood pressure. Taking a brisk walk after a meal is a great way to improve insulin resistance. Especially after a high-carbohydrate meal, there is an increased insulin load that can lead to insulin resistance. Exercise enables the glucose to be delivered into cells. Muscles act as a huge reservoir to enable entry of that excess glucose into cells. Strength training increases the size of muscle fibers, which also increases the muscle reservoir, which enables energy utilization. Thus, the carbohydrates that are taken in are converted into energy rather than fat. A combination of aerobic exercise and resistance training improves cardiac strength, blood flow with reduced blood pressure and increased energy utilization, which helps reduce insulin resistance.

Without going into too much detail about hormone replacement, I want to emphasize that optimizing your hormones is a key foundation to reducing your insulin resistance and thereby reducing the risks of many diseases. For men, testosterone helps reduce visceral fat and increases muscle mass, which both help reduce insulin resistance. Besides reducing your chances of diseases, you also improve your energy and vitality so you can enjoy being healthy. For women, taking estradiol will also reduce visceral fat and significantly reduce inflammation in the arteries. This is why women lose at least 10-15 pounds when taking hormone replacement and the risk of heart disease decreases by more than 50% for women who take estradiol. Optimizing thyroid will improve metabolism such that energy is better utilized and fat storage is reduced.

When you take in energy in the form of carbohydrates, the energy either gets utilized as glucose or stored as fat. Because our diet has been very heavy in carbohydrates and processed foods, insulin resistance has developed in most of us. While insulin resistance is most known as a cause of type II diabetes, it plays a role in the vast majority of chronic diseases that affect many of us, including hypertension, heart disease, cancer, Alzheimer’s disease, arthritis and even many skin conditions such as skin tags. While improvements in diet and a good exercise program can help with insulin resistance, hormone optimization is an essential piece of the puzzle to help reverse insulin resistance. Because insulin resistance causes so many diseases that affect the quality of life and even shorten life, it is vital that you should check if you have insulin resistance and do all you can to reverse it.

Dr. Slaten is a pain wellness physician in Ridgewood, NJ. For more than 20 years, he has been practicing regenerative techniques with great skill and an open mind. Dr. Slaten can help you reduce your insulin resistance to improve your health. For more information, check out his website www.hormonesnj.com.

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