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Insulin Resistance: Disease or Ancestral Perfection?

“You’ve got a 790.6 and 277.7—and if you don’t change you’ll get a 250.02.” Disease codes and medical language infect our healthy lives daily, but fire-and-brimstone threats of medical codes don’t work to improve our health.

What does work? When we live in accordance with our unique gifts and strengths—only then will we experience real vibrant health, now and in our future. One such strength many of us carry is insulin resistance, and if you’re lucky it could be you.

Insulin resistance: What is it?

Insulin is the anabolic hormone that responds to three components of your diet: volume, carbohydrate and protein content. Anabolic hormones like insulin send the message to build tissue. Lifestyle and diet will direct whether the tissue created will be muscle or fat. Insulin resistance is when your body hears insulin’s call, but does not respond quickly or very effectively, thereby leaving glucose laying around in the bloodstream. It’s like an uncooperative child hearing a command but remaining obstinately uncooperative. Your goal is to create an insulin response that is like a skilled teacher who masterfully controls a roomful of kids with a quiet indoor voice.

Nearly 50% of Americans are insulin resistant, and many populations carry a higher percentage, such as those from Mexico and Asia. This common trait adapted to allow survival in a physically demanding world with unreliable food – especially carbohydrate intake. Despite ominous-sounding medical codes, insulin resistance is not a disease. My own insulin resistant trait explains why, historically, I could “play through” without a meal and still concentrate and feel OK. I can work out for one to two hours on an empty stomach and not “run out of gas.” There is always enough glucose for my body and brain. This is a kind of supernatural power; I just need to know how to use it.

If you express insulin resistance, like me, you can handle infrequent food intake and increased physical exertion. After long bouts of exercise, it isn’t carbs that you need—it’s protein and fats. Dietary protein triggers enough insulin and helps you maintain a healthy, insulin-sensitive muscle mass.

Insulin Resistance: What Does It Mean For You?

Given current trends in the U.S. diet and lifestyle, most people with insulin resistance will develop type 2 diabetes in their lifetime. Those who don’t progress to type 2 diabetes still carry a higher risk of countless chronic illnesses. Remarkably, a third of people who develop type 2 diabetes are lean. Therefore, without profiling body size, how do you know where you are on the predictive health continuum of insulin resistance?

First, why should you care if it’s not causing a problem now? Unchecked and unresolved high blood sugar results in substantially higher risk for strokes, heart attacks, Alzheimer’s, dementia and numerous cancers. Weight gain and type 2 diabetes become incidental end-points. It’s important for you to discover whether this is your trait, and blood test results are a viewing window into your innate metabolic environment.

Blood test results are informative and empowering—they are like the displays on the dashboard of your car. If you are going to be in the driver’s seat, you’d better know what’s going on in your vehicle. Your job is not to diagnose what you “have”—it is to discover your metabolic superpowers and to discover how to live in accordance with them.

Your Metabolic Blood Tests

In my book, the Blood Code, I discuss three panels: Discovery, Progress and Thyroid Activity. These three provide maximum information about your health and metabolism while remaining affordable and understandable. The essential Progress Panel results are summarized here. Ranges are in U.S. Standard Units and in parentheses are International S.I. Units. All tests are fasting—no food or significant exercise 10 or more hours prior to the draw.
1. Complete Blood Count (aka, CBC or Hemogram) with Differential: Anemia lowers the accuracy the HgbA1C test, therefore anemia must be corrected first.
2. Comprehensive Metabolic Panel (CMP): Contains several results that survey different organ systems. For metabolism: glucose and liver enzymes are recognized.

AST and ALT (Liver Enzymes): 10–40 U/L is normal: If the liver gets bogged down with fats—a result of one’s physical inactivity and high insulin, it is aptly called fatty liver. Fatty liver is marked by ALT > 40 U/L.

Glucose, fasting.  Baseline pre-meal circulating glucose. It’s helpful to realize that fasting glucose normally rises in the morning and more-so with panic, anxiety, stimulant medications and exertion.

75–95 mg/dL is optimal (4.2-5.3 mmol/L)

<75 mg/dL is too low (<4.2 mmol/L)

96–100 mg/dL is borderline (5.3-5.6 mmol/L)

101–125 mg/dL is high blood sugar, but not “yet” diabetic (5.7-7.0 mmol/L)

>125 mg/dL is a diabetic level (>7.0 mmol/L)
3. HgbA1C / HbA1c / Hemoglobin A1C: Also known as glycosylated hemoglobin, A calculation that reflects your eight to twelve-week average blood glucose. Mildly elevated HgbA1C signals disease risks in non-diabetics.

4.5–5.7% is normal (26-39 mmol/mol)

5.8–6.4% indicates significant insulin resistance (40-46 mmol/mol)

>6.4% indicates diabetes (>46 mmol/mol)
4. Serum Insulin: The Blood Code reference range for insulin is based upon current evidence and differs substantially from outdated lab ranges.

Low is <3 uIU/mL (<18 pmol/L)

Optimal 3–8 uIU/mL (18-48 pmol/L)

High is >8 uIU/mL (>48 pmol/L)

 

Insulin & HOMA IR: on U.S. standard units [Gluc X Ins ÷ 405]

0.5-1 indicates insulin sensitivity, unless high blood sugar is present

1-2 Indicates a normal healthy insulin response

>2 indicates insulin resistance (IR)

>3 indicates substantial disease risk
*Insulin: Your Blood Code’s most important indicator

Insulin is the primary hormone that responds to your diet and that:

1 – Restores glucose to the muscles and the liver, predominantly as glycogen.

2 – Stimulates fat production (triglyceride) and prevents stored fat from releasing.

3 – Triggers cellular uptake of amino acids (and magnesium)—to restore and re-build.

Low insulin makes it hard to restore glycogen and repair muscles after exertion. You likely struggle to maintain muscle mass and therefore need dietary carbs and proteins to stimulate insulin after workouts. If low insulin and high blood sugars—strenuous, strength-building exercise is critical to correct the insulin resistant high blood sugar.

High insulin makes either a stronger or a fatter body—it is an anabolic hormone. If your baseline insulin is high, watch your meals—carbs raise insulin a lot, proteins raise insulin a little, and stretching the stomach raises insulin.But dietary fat does not raise or require insulin. Therefore a low carb and high fat, LCHF, diet works great—how low carb depends upon your Blood Code results. Gentle exercise doesn’t lower insulin—it has to be strenuous.

Your HOMA-IR maps your location on the continuum of desirable insulin sensitivity versus problematic insulin resistance. While the list of diseases associated with high HOMA-IR is staggering–the opposite expression, insulin sensitivity is associated with health and longevity. [A HOMA-IR calculator is available at TheBloodCode.com]

5. Lipid Panel: Triglyceride (TG) indicates your metabolic trend toward fat storage. HDL levels will drop as TG storage in the liver builds up, the TG : HDL ratio tells this story.

TG: Too low and your body is running lean, with few circulating fats to burn following a 12 hours fast. Too high and your body carries excess calories.

40–100 mg/dL (0.45-1.1 mmol/L) is optimal.

HDL: Your fasting HDL cholesterol represents liver function not diet. As fatty liver and insulin resistance progresses, HDL drops: Despite the HDL-raising effect of exercise, I have seen honed athletes with low HDL due to a dietary discordance with their IR trait. [Clinically, this resolves with less carbs and more dietary fats.]

>44 mg/dL (>1.14 mmol/L) is normal in Men

>50 mg/dL (1.3 mmol/L) is normal in Women

TG:HDL: Done on mg/dL. This simple ratio marks heart disease and stroke risk.

0.5-1.5 is optimal.

>2 borderline insulin resistance

>3 indicates excessive fat storage and IR
A Case of Insulin Resistance / Metabolic Syndrome

Mark S. 35 years old.

Mark came into my office not because of his weight, but because he didn’t feel right and was genuinely concerned for his health. After we ran his Progress Panel, the solution was clear—he expressed moderate insulin resistance and accordingly restricted carbohydrates and followed a strenuous fitness routine that required only 15 minutes 4 days per week. September marked six months, not perfect but good enough! Mark has shared his pictures athttp://www.thebloodcode.com/real-stories/

Mark thought avoiding snacks would be hard, but with the higher fat intake, “I felt more steady and happier throughout the day.” Mark’s living more of the life he was meant to live. “I lost tons of useless body fat. But more importantly, my health and wellness improved a hundredfold. I became inspired and excited about my life and health.”

Blood Code Panel March September
Total Cholesterol 226 208
Triglyceride 176 64
HDL 49 53
TG:HDL Ratio 3.6 1.2
Glucose 112 96
Insulin 13.4 7
HOMA-IR 3.7 1.7
Hgb A1C 5.9 5.6
Vitamin D. total 28 36
Total Bodyfat % 29% 22%
Triceps: skin fold (mm) 24 13
Biceps 12 7
Back 26 16
Hip 43 14

Choosing a low carbohydrate diet and finding an exercise plan that works does not require you to listen to another authority, or read another fad diet book. The book has been written—it’s inside you. Blood test results from your Blood Code panels provide actionable insight into your metabolic super powers.
Join in the conversation at Facebook.com/bloodcode or follow along twitter @drrichardmaurer.  Sign up at TheBloodCode.com to receive your wildly informative free 99-page PDF booklet on your blood test & body fat evaluation and interpretation.

Abstract Blood Cells picture licensed under the Creative Commons

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Dr. Richard Maurer

Dr. Richard Maurer, author of The Blood Code: Unlock the Secrets of Your Metabolism (Early 2014), has practiced integrative medicine in Maine since 1994.