Nicolette: 0:01

Welcome to the Health Pulse, your go-to source for quick, actionable insights on health, wellness and diagnostics. Whether you're looking to optimize your well-being or stay informed about the latest in medical testing, we've got you covered. Join us as we break down key health topics in just minutes. Let's dive in.

Mark: 0:23

Hey everyone and welcome back to the Deep Dive. You know we're always on the lookout for those health insights that could make a really big difference, and today we're diving deep into one that might just change how you think about your metabolic health.

Rachel: 0:37

Yeah, we're going beyond the usual suspects, beyond just looking at your blood sugar.

Mark: 0:40

Right, we all know about glucose. It gets a lot of the spotlight.

Rachel: 0:42

Yeah, it's always glucose, glucose, glucose.

Mark: 0:45

But today we're talking about fasting insulin. It's a hormone that can actually give us a much earlier heads up if things are starting to hit in the wrong direction metabolically.

Rachel: 0:55

Absolutely, and you know there's that saying you can't manage what you don't measure.

Mark: 0:59

Right.

Rachel: 1:00

And when it comes to metabolic health, most people are just measuring their fasting glucose and that's the standard blood work, right, right. But what's often missed is fasting insulin. It's a powerful early warning sign for insulin resistance.

Mark: 1:12

And that's where things get kind of interesting and maybe even a little bit concerning, because by the time your blood sugar levels even hit that pre-diabetic range, your fasting insulin could have already been elevated for years.

Rachel: 1:23

Exactly, and we call that hyperinsulinemia.

Mark: 1:26

Years we're talking years of missed signals.

Rachel: 1:29

Yes, it's like we're missing out on that crucial window to make changes and turn things around.

Mark: 1:34

So that's what we're doing in this deep dive today Uncovering what fasting insulin really tells us about our health, why it can reveal way more than just glucose or even your A1c, and how it can help us spot potential problems before we're dealing with a diagnosis like diabetes or obesity, or even heart disease.

Rachel: 1:52

Right on.

Mark: 1:53

So let's start with the basics. What exactly is fasting insulin?

Rachel: 1:57

Well, at its core, insulin is a hormone that's made by your pancreas, and its main job is to allow your cells to take in glucose from your blood and use it for energy or storage. So think of insulin as like a key. It unlocks the door to your cells so glucose can get in. When you eat carbohydrates, your pancreas releases insulin to lower your blood sugar, and it does that by moving the glucose into your muscle, fat and liver cells.

Mark: 2:21

Got it. So then, what information does the fasting insulin test actually give us?

Rachel: 2:26

So the fasting insulin test. It measures how much insulin is in your blood after you haven't eaten anything for eight to 12 hours.

Mark: 2:32

Okay.

Rachel: 2:33

So it's a direct way to see how much your pancreas is working to keep your blood sugar stable, even when your glucose numbers look normal.

Mark: 2:40

Ah, I see so, even when those glucose numbers look normal. That's an important point. How does this differ, then, from the fasting glucose and the A1C test that we hear so much about?

Rachel: 2:50

Great question Fasting glucose it's a snapshot of your blood sugar at a single point in time. Okay, and A1C gives you an average of your blood sugar levels over the past two to three months. But fasting insulin? That shows us your body's baseline demand for insulin and, like we said before, this demand can actually start increasing years before your glucose levels actually get high.

Mark: 3:10

And when that demand increases, that's when we start talking about insulin resistance, right.

Rachel: 3:14

Exactly.

Mark: 3:15

Can you explain what's going on there?

Rachel: 3:16

Sure. So insulin resistance it's basically a condition where your body's cells, they become less responsive to insulin signal. Okay, so remember that key analogy we talked about. Well, imagine your cells start to become a little bit resistant to that key. To make up for this, your pancreas has to work harder. It starts producing more insulin to try and get that same effect, to get glucose into your cells, and this leads to higher levels of insulin in your blood, chronically high levels. And it's often missed in routine blood work because doctors don't usually test insulin unless your blood sugar is already high.

Mark: 3:51

That makes sense. So what are we talking about? Nih? A typical range that's often cited is 2 to 20 microinternational units per milliliter.

Rachel: 4:10

But a lot of practitioners, particularly in integrative and preventive medicine, they aim for a tighter range, more like 5 to 7. And anything above 10 could be a sign of some early metabolic dysfunction, even if glucose levels are still in that normal range. So that's something to really pay attention to.

Mark: 4:27

That is something to pay attention to Now. Insulin resistance this isn't something that just kind of happens overnight, right?

Rachel: 4:33

No.

Mark: 4:33

It's a gradual process.

Rachel: 4:34

Yeah, it's a slow burn. It develops gradually and silently, often over many months or even years, and often this is happening when blood sugar levels still look perfectly normal. So that's why fasting insulin is so valuable. It has the potential to detect this dysfunction early, before glucose levels even become a problem.

Mark: 4:51

So let's walk through what happens normally. We eat carbs. Glucose enters our bloodstream. What's different when someone is developing insulin resistance?

Rachel: 4:59

So you eat carbs, they get broken down into glucose which enters your bloodstream. Your pancreas responds by releasing insulin to move that glucose into your cells for energy or to be stored. So far, so good, right. In a healthy person, this process works smoothly and efficiently. But certain things like a diet high in processed foods and sugar, chronic stress, not enough sleep, lack of physical activity these can all make your cells less responsive to insulin over time, and that's what we call insulin resistance.

Mark: 5:29

And the body tries to compensate for this.

Rachel: 5:35

It does. Yeah, your pancreas senses that glucose isn't getting into cells as easily as it should, so it starts pumping out more insulin to try and overcome that resistance.

Mark: 5:39

OK.

Rachel: 5:40

So your glucose levels might still be normal because of all this extra insulin, but your insulin levels are climbing.

Mark: 5:45

Are there any early signs, any clues that might tip someone off that this is happening, even if their blood sugar is still normal?

Rachel: 5:52

There can be, yeah, things like difficulty losing weight, especially around your belly.

Mark: 5:57

Right.

Rachel: 5:57

Frequent energy dips, maybe intense cravings for sugary foods, brain fog, fatigue after meals these can all be early signs that your body's working harder to manage your blood sugar. But without actually measuring insulin, it's easy to miss these or just chalk it up to something else.

Mark: 6:12

Yeah, so it seems like we're really missing a piece of the puzzle if we're only relying on these glucose tests.

Rachel: 6:19

I think so. Yes, if this resistance keeps going, eventually the pancreas can't keep up with the demand for more and more insulin, and that's when glucose levels start to rise and you get a diagnosis of prediabetes or type 2 diabetes. And research has shown that this resistance it can be present for at least a decade before diabetes is actually diagnosed. This was in a study published in the Journal of Clinical Investigation, and it's not just diabetes Insulin resistance is linked to obesity, high blood pressure, pcos, non-alcoholic fatty liver disease. So waiting for your glucose to be high means we're missing a big opportunity to intervene early and make changes that could make a real difference.

Mark: 6:59

Okay, so let's talk about fasting glucose and A1C a little bit more. They're obviously useful tests, but it sounds like they're not the whole picture when it comes to metabolic health.

Rachel: 7:08

Yeah, they're helpful but they have limitations for sure. The big comes to metabolic health. Yeah, they're helpful, but they have limitations, for sure. The big thing to remember is that you can have normal glucose levels and still have insulin resistance.

Mark: 7:18

And how is that possible? Because if my blood sugar is normal, wouldn't that mean that everything's okay?

Rachel: 7:25

Not necessarily. This is because of that compensation mechanism we talked about earlier.

Mark: 7:28

Right.

Rachel: 7:29

So in the early stages of insulin resistance, your body's producing more insulin to keep that glucose normal. So the glucose tests might look good and your A1C, which is the average over time, might also look normal. But under the surface there's this problem brewing your cells aren't responding to insulin well and your pancreas is overworking to keep up. And this dysfunction isn't always picked up by glucose tests alone. It's like your body is putting out fires, but you don't see the smoke until it's too late. Plus A1C, while it gives you a good overview, can miss early insulin resistance and it can be thrown off by other things that affect red blood cells.

Mark: 8:07

So it's like ignoring that check engine light until the car breaks down.

Rachel: 8:10

Pretty much so, relying only on glucose and A1C. You're waiting for the problem to become really obvious. Right Fasting insulin gives you a chance to catch it much earlier, and that's why a lot of functional and integrative medicine doctors consider fasting insulin to be such an important test, especially for people who have a family history of diabetes, PCOS obesity or heart disease.

Mark: 8:31

So let's say, someone gets their results back and their fasting insulin is high. What does that actually tell us about their health? What are we looking at there?

Rachel: 8:38

It's an early sign that your metabolism is struggling, even if your blood sugar looks good, your weight seems fine, your A1C is normal. High fasting insulin means your body's having to work extra hard to maintain those stable blood sugar levels, and that usually means you have insulin resistance. The cells aren't responding well to insulin, so the pancreas has to pump out more of it to get the job done. And the worse that resistance gets, the higher the insulin levels climb, and even before it causes obvious symptoms or changes in your glucose. This imbalance can start to contribute to a lot of chronic health problems. It's not just about blood sugar. It can affect fat storage and increase your risk of heart disease.

Mark: 9:17

So what are some of those specific health problems that we see linked to high fasting insulin?

Rachel: 9:22

Well, the big ones are prediabetes and type 2 diabetes. We talked about how high insulin comes before high glucose, sometimes by years, and research from the NIH shows that it's a strong predictor of diabetes risk, even before those standard lab markers are abnormal. And then there's obesity and weight gain. Insulin is what we call a fat storing hormone. When it's high, it tells your body to store more fat, and that can lead to weight gain, especially around the belly Makes sense body to store more fat and that can lead to weight gain, especially around the belly, Makes sense.

Rachel: 9:56

Non-alcoholic fatty liver disease, NAFLD, is another one. High insulin can cause fat to build up in the liver even if you don't drink a lot of alcohol, and that makes AFLD one of the most common liver problems that we see. Then there's high blood pressure, or hypertension. Insulin can mess with how your body handles sodium and how your blood vessels work, and that can lead to high blood pressure and stiffer blood vessels. And for women specifically, high insulin is a major factor in PCOS, polycystic ovary syndrome. It can affect periods, cause acne and make it hard to lose weight. Fasting insulin is often used to diagnose and manage PCOS.

Mark: 10:29

Wow, insulin resistance can really have a far-reaching impact.

Rachel: 10:32

Yeah, it can, and even cognitive decline and Alzheimer's disease are linked to it. Some experts even call Alzheimer's type 3 diabetes because of that strong connection, and the Alzheimer's Association has highlighted this connection as well. So it's not just about diabetes, it's really about your overall health.

Mark: 10:48

So it sounds like knowing your fasting insulin level could be a really powerful tool.

Rachel: 10:52

I think so.

Mark: 10:53

For being proactive about your health. Now, who should be thinking about getting this test? It sounds like it's not just for people who have already been diagnosed with something.

Rachel: 11:01

That's right. It can be really valuable for people whose regular lab tests still look normal, but they have some signs that something might be off metabolically. So what are some signs people should be looking out for? So ask yourself are you having trouble losing weight? So what are some signs people should be looking out for? What about things like slightly high triglycerides, low HDL cholesterol or blood pressure that's creeping up? Even some hormonal symptoms like irregular periods or low libido could be related to insulin. In all these cases, even if your other labs are normal, getting your fasting insulin check and calculating your HOMAS IR score could be really helpful.

Mark: 11:51

Now. Earlier we talked about waist circumference as a simple way to assess metabolic risk.

Nicolette: 11:55

Right.

Mark: 11:56

How does that fit in with fasting insulin?

Rachel: 11:58

It's a great way to gauge metabolic risk. It's actually more useful than BMI because it tells you how much fat you have around your organs and that visceral fat. That's the type that's linked to insulin resistance and all the problems that come with it. And the NIH says that a waist circumference of 40 inches or more for men and 35 inches or more for women, that's a red flag for metabolic syndrome and insulin resistance. So if your waist is getting bigger, even if your weight's the same, pay attention to that, especially if you're having energy dips, cravings or your blood pressure starting to rise. Getting your waist circumference and your fasting insulin checked together can really help you find hidden metabolic risk that you might not see otherwise.

Mark: 12:38

So for someone who's listening and thinking OK, this sounds like something I should get checked out. What's the process like? How do they actually get tested?

Rachel: 12:45

Fasting insulin isn't usually part of a standard blood test. You'll have to ask your doctor for it specifically, but the good news is that it's a pretty simple blood test and most doctors can order it, or you can even go through some online lab testing companies.

Mark: 12:57

What do they need to do to get ready for the test?

Rachel: 12:59

So you'll need to fast for 8 to 12 hours beforehand, which means no food or drinks except water, and it's usually easiest to get your blood drawn in the morning. You'll get a fasting insulin test, and it's a good idea to get a fasting glucose test at the same time. Having both of those numbers lets you calculate your HOMA-IR score, which is a measure of how resistant your cells are to insulin. You can think of it like a resistance score. The higher it is, the harder your body is working to keep your blood sugar in check, and a HOMA-IR of over two could mean you have some insulin resistance, even if your glucose and A1c are normal.

Mark: 13:36

So where can people go to get this testing done?

Rachel: 13:39

Well, you can start by asking your regular doctor to order the tests. Some doctors might not routinely test for fasting insulin unless they see signs of blood sugar problems already, so you may have to be a little bit persistent. Another good option is to see a functional or integrative medicine doctor. Have to be a little bit persistent. Another good option is to see a functional or integrative medicine doctor. They often use HOMA-IR and fasting insulin as part of their standard metabolic health assessments, and they're also companies that offer at-home blood testing. A lot of people find that seeing their insulin and glucose results side by side really helps them understand why they're having problems like stubborn weight gain or fatigue, even if their other lab tests looked normal.

Mark: 14:14

What if someone gets their results and their fasting insulin or HOMA-IR is high? What should they do?

Rachel: 14:20

The first thing is don't panic. High fasting insulin or HOMA-IR it's not a diagnosis. It's a chance to be proactive and potentially prevent things like type 2 diabetes or heart disease. And the good news is that insulin resistance can be improved, especially if you catch it early, before your blood sugar gets really high.

Mark: 14:38

So what are some evidence-based things people can do to address high insulin levels?

Rachel: 14:42

The most important thing is making lifestyle changes that you can stick with. The first big one is eating in a way that supports healthy blood sugar. That means cutting way back on processed foods and refined carbs and choosing low-glycemic, fiber-rich carbs like leafy greens, beans, berries, quinoa. Prioritizing protein and healthy fats at meals also helps keep your blood sugar steady and makes you feel full. Timing your carbs can be helpful too. Maybe save the higher glycemic ones for earlier in the day or around when you're more active and if you have more severe insulin resistance, cutting back on carbs overall might be a good idea. There was a review in the journal Nutrients in 2020 that found that eating whole foods and lowering glycemic load can actually improve insulin sensitivity, even without losing a lot of weight.

Mark: 15:26

That's really helpful. What about exercise? How does that fit in?

Rachel: 15:29

Exercise is super important for lowering insulin and making your cells more sensitive to it, and you don't even have to lose weight to see benefits. Try to get at least 150 to 180 minutes of moderate exercise each week. Something as simple as a brisk walk after meals can really help with blood sugar and insulin control, and strength training is important for building muscle, which helps with insulin sensitivity in the long run.

Mark: 15:50

And we always hear about sleep and stress.

Rachel: 15:52

Yeah, those are huge.

Mark: 15:53

How do they play into all of this?

Rachel: 15:55

When you don't sleep enough, your body doesn't use insulin as well, and it can make your cortisol levels go up, and that can lead to cravings, weight gain and more stress on your metabolism. So aim for seven to nine hours of good quality sleep each night. Keep a regular sleep schedule and avoid screens and food before bed. Managing stress is really important too. When you're stressed out all the time, your body pumps out cortisol and that can lead to insulin resistance. Things like mindfulness, breathing exercises, spending time in nature, gentle movement like yoga or tai chi, and watching your caffeine intake if you're feeling wired but tired, those can all help with stress management.

Mark: 16:32

Are there any supplements that could help with managing insulin levels?

Rachel: 16:36

There are some that might help, but it's super important to remember that they're not a substitute for those lifestyle changes we talked about. They're just extra support. Some examples are berberine, which acts kind of like the medication metformin in improving glucose and insulin. Myoinositol can be helpful for women with PCOS, Magnesium helps your body use glucose and alpha lipoic acid is an antioxidant that might improve insulin resistance. But talk to your doctor before you start any new supplements, especially if you're on any medications, just to make sure they're safe for you. So remember getting a high fasting insulin result isn't a life sentence. It's a wake-up call and you can often reverse insulin resistance and improve your metabolic health by changing your diet, exercise habits, sleep and how you handle stress.

Mark: 17:23

This has been such an eye-opening deep dive. To wrap things up, what's the most important thing you want our listeners to remember about fasting insulin?

Rachel: 17:30

I think the biggest takeaway is this Fasting insulin. It gives you a crucial early glimpse into your metabolic health, often before your blood sugar even hints that there's a problem. High insulin is one of the earliest signs and luckily one of the most reversible signs that your metabolism is under stress. By getting it checked, you get this valuable information that you can use to make positive changes.

Mark: 17:51

And stepping back a bit. Why is it so important to have this early insight?

Rachel: 17:56

Well, it's not just about individual health anymore. Healthcare costs are going up, a lot of people are struggling with insurance and chronic diseases are putting a huge strain on everyone Conditions like type 2 diabetes, high blood pressure, fatty liver disease. They cause emotional and physical stress and they're also really expensive to manage. That's why prevention is so important. It's not just something your doctor tells you to do. It's about protecting your quality of life Absolutely, and by catching these metabolic issues early. With tests like fasting, insulin and Shlomo Sayar, you can take action before you need medication, before you develop serious complications and before the financial burden becomes too much.

Mark: 18:35

And, on that note, think about how powerful it would be to have this deeper understanding of how your body works. Imagine how much better your health could be if you make changes now, while you have time and knowledge on your side.

Rachel: 18:49

It's empowering.

Mark: 18:50

It really is. Thanks for joining us for this deep dive into fasting insulin. We hope this information helps you take control of your metabolic health and we'll see you next time.

Rachel: 18:58

See you then.

Nicolette: 19:03

Thanks for tuning into the Health Pulse. If you found this episode helpful, don't forget to subscribe and share it with someone who might benefit. For more health insights and diagnostics, visit us online at wwwquicklabmobilecom. Stay informed, stay healthy. No-transcript.