Hello everyone! Welcome back to another Friday blog. Today I want to take a deep dive into Insulin Resistance - What exactly is it and why should we be paying very close attention to this? Let's delve in.

Insulin resistance (IR) means there is "an impaired biologic response to insulin stimulation of target tissues," primarily involving liver, muscle and adipose (fat) tissues. This means that insulin is not effectively able to get glucose - fuel - out of the bloodstream and into the cell to burn for energy - consequently, blood glucose and insulin levels rise. This is a fundamental problem with metabolism and mitochondrial function. As mitochondrial function declines and glucose is not efficiently processed into usable energy, the cell naturally begins to resist more fuel from coming in. In this situation, we have plenty of "potential energy" but are not able to convert it to "usable energy." This potential energy can get shunted to "stored energy" - or fat, such as triglycerides. IR puts us at increased risk for CHD (coronary heart disease), CVD (cardiovascular disease), NAFLD (non-alcoholic fatty liver disease), CKD (chronic kidney disease), digestive problems, stroke, cancer, Alzheimer's, PVD (peripheral vascular disease) T2D (type 2 diabetes), HTN (hypertension), obesity, high uric acid, and hyperlipidemia (high triglycerides). IR negatively affects our hormones, sleep quality, energy level, immune function, lymphatic drainage, our hunger, and ability to maintain a healthy weight. 

Your body wants to maintain roughly 1 teaspoon of sugar in the blood at all times, which is a baseline blood sugar of about 70-80. When blood sugar is elevated above this, the beta cells in the pancreas are stimulated to produce insulin to bring the blood glucose back to baseline (70-80). If insulin is blocked - due to cells not being able to process glucose efficiently - more insulin is required to force glucose into the cell. As blood sugar levels rise, the pancreas works harder to pump out even more insulin to get glucose out of the blood and force it into the cell - insulin levels RISE...and stay high just in case there's another big sugar load.

Why is the pancreas working so hard to get blood glucose down? Sugar is very damaging to tissues. Sugar is sticky and sticks to whatever it comes in contact with, such as our proteins - rendering them dysfunctional or completely non-functional - this is glycation. Think of that crunchy outer layer on Crème Brûlée - that is glycation. Glycation of your retina, for example, results in cataracts. Glycation of your hemoglobin results in hypoxia (low oxygen). This is reflected in a hemoglobin A1C test - a 3-month average percent of hemoglobin with sugar molecules attached - rendering them unable to deliver oxygen. Understand that if a high percentage of your hemoglobin is glycated and unable to deliver oxygen, ALL other tissues are being impacted at the same level. Damage is being done to your arteries, your hemoglobin can't deliver oxygen to the most distant parts of the body, and you begin to experience neuropathy in your feet and hands as you become diabetic. You want your HbA1C to be < 5.0. Think of what can happen to your brain that uses roughly 25% of the body's total oxygen and energy...

There is a range or spectrum in the severity of IR - the more cells that are dysfunctional and unable to process glucose for energy - the more severe the IR. Over 10-15 years as this process continues to progress, all organs and tissues are impacted - resulting in T2D (type 2 diabetes). "The metabolic consequences of insulin resistance can result in hyperglycemia, hypertension, dyslipidemia, hyperuricemia, elevated inflammatory markers, endothelial dysfunction, and a prothrombotic state." This means we end up with high blood sugar, high blood pressure, imbalance of cholesterol and triglycerides, high uric acid, high CRP, vascular problems and increased blood clotting - which increases the risk of heart attacks and strokes. Did you know that 93.2% of the US population is metabolically unwell? "U.S. cardiometabolic health has been poor and worsening, with only 6.8% of adults having optimal cardiometabolic health, and disparities by age, sex, education, and race/ethnicity." Currently in the US, 50% of adults and 30% of teens are either prediabetic or diabetic, 75% of adults are overweight or obese, 40% have a fatty liver, sperm count is declining, meanwhile infertility, autoimmune, mental illness and cancer are all significantly rising. This is shocking - we spend the MOST money on healthcare - spending $12,555 PER PERSON - more than double the average for other wealthy countries - and yet we have the most chronic disease and shortest lifespan. Obviously, we are not doing things correctly or reversing these trends.

Okay, so how do we know if we are metabolically unwell? Most of us don't have a clue what level of IR we have and how much it impacts our health. This is totally being missed because physicians are not taught to look at this. A simple fasting insulin test will give you incredibly valuable information about your metabolic function. MDs generally decline to order fasting insulin because they have no clue how to read the test and insurance may not pay. However, you can do this on your own for about $25 through an independent lab. It's worth it! Why would this be so important?

Let's say you get your typical bloodwork done and they test fasting glucose but not fasting insulin. In this scenario you see that your fasting glucose is 95. Your MD will tell you everything is fine since your glucose is <100. However, this doesn't tell you the level of insulin it takes to bring the glucose down to 95. [Ideal fasting insulin should be between 1-3, according to Boston Heart]. When >3, you have an increased risk for all the chronic diseases we previously mentioned. Your fasting insulin may be 20 while your friend's may be 3 - therefore VERY different metabolic function. Let's continue along this scenario and calculate your level of IR with HOMA-IR (homeostasis model of insulin resistance)

HOMA-IR: fasting glucose x fasting insulin/401.85 = level of IR (insulin sensitive = <1.0, moderate IR = 1.9, severe IR = 2.9).

Let's calculate your IR: 95 x 20 /401.85 = 4.7 This is SEVERE IR. Damage is being done to your arteries and organs, meanwhile you have NO idea because your MD only looked at your fasting glucose. You may be puzzled as to why out of the blue you begin to experience one or more chronic diseases like fatty liver, elevated blood pressure or stubborn weight around the belly that won't go away.

Let's calculate your friend's IR: 95 x 3/401.85 = .71 - they do NOT have IR. How would you ever know without actually testing fasting insulin? Your doctor is NOT catching this - in fact he/she is completely unaware and not doing anything about this until you become diabetic. Once you become diabetic, severe damage has been done to your arteries and all your organs. Your pancreas may be failing and unable to keep pumping out the level of insulin required to lower that blood sugar, so fasting glucose gradually goes up. Once it reaches 126, you are considered diabetic. Your pancreas fatigues and begins to fail in producing the high level of insulin - due to damaged beta cells. When your pancreas can no longer make insulin, you become type 1 diabetic and require insulin injections, which continues to cause damage throughout the body.

Elevated fasting insulin may be the reason you can't lose weight or may experience hormonal issues like PCOS. Insulin is a growth hormone that, when elevated, stimulates thickening of the arterial smooth muscle and damages the large blood vessels causing heart disease, Alzheimer's and cancer. Meanwhile, elevated blood glucose is damaging the smaller micro-vessels causing neuropathy, nephropathy, retinopathy and organ damage - due to glycation of our tissues. This is not a good situation. Fuel is getting stored, not used for immediate energy - we stay hungry because our cells are not getting their needs met and a viscous cycle ensues.

Okay, we know to ask for fasting glucose and fasting insulin on our bloodwork - or go get it on our own - but there are other things we can look at to give us a snapshot of our metabolic health. I'm going to give you the "ideal" range according to the literature - this is not the same as the "normal" range listed on bloodwork. I don't want to be "normal" since 93.2% of normal is sick. Here is the OPTIMAL range I shoot for - As always, this is meant to inform the public and does not constitute medical advice, so please discuss this with your physician or healthcare practitioner.

• Fasting Insulin = 1-3 
• Fasting glucose = 70-85
• HbA1C = <5.0
• Triglycerides = 40-60 (above 60 vascular damage begins to occur)
• HDL = 90-105
• Total cholesterol = 220-260 (your body can't make new cell membranes, make hormones or repair. The brain needs a lot of cholesterol, and we need cholesterol to help prevent cancer.)
• waist circumference = men <40, women < 35
• waist/hip ratio = men <.90, women <.80
• Blood Pressure = <120/80
• HOMA-IR = [(f)Glucose x (f)Insulin/401.85] = <1.0
• Triglyceride/HDL = <1.0

So, how can we reverse IR and get into the optimal metabolic ranges so we can feel confident our health is moving in the right direction? Get right to the source of the problem - mitochondrial function. We need our mitochondria to make our energy efficiently, and we need a large mitochondrial team to make optimal energy to power the brain and body. Let's look at some strategies to make this happen and literally correct our poor metabolism.

• Optimize Circadian Rhythm
  • See the Sunrise - this is the highest quality red light that "renovates" your heme proteins. Red light sensing cytochromes in the mitochondria REQUIRE this early morning light to allow the mitochondria to use oxygen to burn fuel optimizing our energy production. It also produces biological water.
  • Get optimal Sunlight - get as much sun as possible. Eat your lunch outside. There are photoreceptors in our eyes and skin. We need quality full-spectrum light - synthesize vitamin D and activate sulfur in the skin for detoxification and sulfation of cholesterol and vitamin D. Build your solar "callus" (tan) to allow longer periods of natural sunlight exposure to get the full spectrum.
  • See the Sunset - much like sunrise light, but not as intense. This red light fading into dark helps to initiate a rise in melatonin. Melatonin is one of the 2 antioxidants mitochondria use to protect themselves from damage, as they produce a lot of ROS (reactive oxygen species) when making ATP. 
  • Obey the dark - avoid light after sundown - particularly blue light as it tells the master clock in the brain (supra chiasmatic nucleus) that it is midday noon. Every time you look at your screen, this is the message you are giving your master clock - Use red/amber bulbs, light a fire or non-toxic candles.
    
  • Optimize Sleep - get to bed early around 9-10pm to get a full 8 hours before the sunrise. Wake up with sunrise. getting into deep sleep to allow the glymphatic system to wash the brain of debris and inflammation to enhance mitochondrial function. We burn fat when we sleep - if you aren't sleeping well, that will drive cortisol which drives blood sugar and insulin.
• Cold Thermogenesis
  • Cold plunge is the fastest way to burn fat and increase your mitochondrial team. It signals mitochondrial biogenesis - literally tells our mitochondria to increase their numbers to produce more heat. 
• Grounding
  • Get your bare feet on the wet ground or ideally in the ocean. This enhances electron uptake from the earth. We have sweat glands on our palms and bottom of our feet to make better contact with the earth.
• Food
  • Omega 3s- DHA - Our brain, nerves, blood vessels and every cell in our body needs DHA in the sn-2 form. This means eat the actual fish. Don't take a supplement fish oil. 
  • Eat real local food - vegetables grown in the area you live. They are receiving the same signature 'bar code' of light from the sun as you are where you live. Eating foods that don't match your environment creates chaos at the mitochondria - this is inflammation.
    
  • Change your oil - remove inflammatory seed oils from your diet - these negatively change the dynamics of cellular membranes - making insulin unable to do its job. Consume healthy fats like EVOO, avocado oil, grassfed butter and Ghee, coconut oil.
  • Reduce the glucose/carbohydrate load - carbohydrates lead to dehydration as it only produces ~ 55g DDW (deuterium depleted water) vs fats and proteins that produce ~ 105g DDW.  
  • Remove highly processed foods - high in deuterium, chemicals, sugar and fructose, - they are full of chemicals our body doesn't recognize and drive inflammation and cravings that damage mitochondria
  • Take a shot of ACV (apple cider vinegar) in water before your meal. This feeds the microbiome, acidifies the stomach, inhibits amylase (the enzyme that breaks down complex sugars into glucose) thus blunting the glucose spike.
• Time-restricted eating/Fasting 
  • narrow your eating window allowing longer time without food
  • stop eating at least 3 hours before bed, ideally when the sun sets. 
  • Autophagy - 17-18hr overnight fasting allows access to your body's clean up mode. 
• Exercise 
  • Get at least 30 minutes in zone 2 - 3-4 days per week.
  • Move - 10 min after meal exercise such as walking, cleaning or dancing - your muscles soak up the glucose like sponges decreasing the need for insulin and can blunt the spike in glucose by 30%.
  • Breathwork - practice breathing techniques to stimulate the parasympathetic nervous system and shut down cortisol. Chronic stress drives blood sugar up triggering insulin.
• HP-EVOO - (high polyphenol extra virgin olive oil)
  • polyphenols in EVOO enhance mitochondrial function including biogenesis, uncoupling, and efficiency. 
  • HP-EVOO shot first thing in the am goes to the liver and signals the brain to burn fat.
  • production of ketones to fuel the brain and other organs
  • enhances the production of biological water
  • epigenetic protection - turn on protective genes and turn off cancer genes. It is a powerful tool in reversing metabolic dysfunction and insulin resistance.

So, until next time my friends…Drink, Drizzle, Digest HP-EVOO at least 4 TBS raw daily, - use more for cooking and drizzling onto your food - eat the rainbow of LOCAL organic or wild-sourced veggies and fruits - eat according to what is growing at your latitude and location in season - eat wild-caught, pasture-raised, grass-fed - get early morning sunrise light, plenty of sunshine during the day, sleep in the dark, check your vitamin D3 level and supplement if needed: D3, K2, magnesium, zinc, and boron (- get your trace minerals and electrolytes with good sea salt - Celtic is hand-harvested and Himalayan was formed before plastics - eat foods high in lutein - drink plenty of filtered water. consume digestible and indigestible fiber for your gut microbes - adaptogens (such as mushrooms) and methylation donors (kale, beets, spinach, cruciferous, lion’s mane…), marjoram, rosemary, oregano, parsley and other herbs to detox, enhance overall health and reverse aging and disease - exercise your body and mind - ground barefoot to gain as many electrons as possible, add a few minutes of mindful meditation and breathing exercises to your day to combat stress - take a hot Epsom salt bath and follow with a cold shower/ice plunge - remove EMF (electromagnetic frequency) devices and blue light - use IR (infrared) from incandescent lighting, non-toxic candle or light a fire to enhance sleep and...turn off the light!!   #HP-EVOO 

This blog is intended for informational purposes only. Discuss strategies with your Healthcare Practitioner.