April 10, 2025 • 19 mins
In this episode of The Health Pulse Podcast, we uncover the importance of fasting insulin testing—a powerful yet often overlooked marker that can reveal signs of metabolic dysfunction years before blood sugar levels show a problem.
Learn how insulin resistance develops, why hyperinsulinemia can go undetected for so long, and how this early warning signal is connected to chronic conditions like diabetes, obesity, PCOS, fatty liver disease, and even cognitive decline. We also explain what your fasting insulin and HOMA-IR scores mean and how to interpret them.
Discover practical ways to improve insulin sensitivity through nutrition, movement, quality sleep, and stress management—even without major weight loss.
🎧 Tune in to learn why asking for a fasting insulin test could be the most important thing you do for your long-term health.
📞 Need lab work done from the comfort of home? QLM offers fast, reliable mobile phlebotomy services—no clinic visit required.
📅 Book your appointment or learn more at:
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📧 Contact us: info@quicklabmobile.com
💬 Enjoyed the episode? Leave us a review and let us know what topics you'd like us to cover next! Your feedback helps us bring you the content that matters most.
Disclaimer: The information provided in this podcast is for informational purposes only and should not be considered medical advice. The content discussed is based on research, expert insights, and reputable sources, but it does not replace professional medical consultation, diagnosis, or treatment. We strive to present accurate and up-to-date information, medical research is constantly evolving. Listeners should always verify details with trusted health organizations, before making any health-related decisions. If you are experiencing a medical emergency, such as severe pain, difficulty breathing, or other urgent symptoms, call your local emergency services immediately. By listening to this podcast, you acknowledge that The Health Pulse and its creators are not responsible for any actions taken based on the content of this episode. Your health and well-being should always be guided by the advice of qualified medical professionals.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Nicolette (00:01):
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Mark (00:23):
Hey everyone and welcome back to the Deep Dive.
You know we're always on thelookout for those health
insights that could make areally big difference, and today
we're diving deep into one thatmight just change how you think
about your metabolic health.
Rachel (00:37):
Yeah, we're going beyond the usual suspects, beyond just
looking at your blood sugar.
Mark (00:40):
Right, we all know about glucose.
It gets a lot of the spotlight.
Rachel (00:42):
Yeah, it's always glucose, glucose, glucose.
Mark (00:45):
But today we're talking about fasting insulin.
It's a hormone that canactually give us a much earlier
heads up if things are startingto hit in the wrong direction
metabolically.
Rachel (00:55):
Absolutely, and you know there's that saying you can't
manage what you don't measure.
Mark (00:59):
Right.
Rachel (01:00):
And when it comes to metabolic health, most people
are just measuring their fastingglucose and that's the standard
blood work, right, right.
But what's often missed isfasting insulin.
It's a powerful early warningsign for insulin resistance.
Mark (01:12):
And that's where things get kind of interesting and
maybe even a little bitconcerning, because by the time
your blood sugar levels even hitthat pre-diabetic range, your
fasting insulin could havealready been elevated for years.
Rachel (01:23):
Exactly, and we call that hyperinsulinemia.
Mark (01:26):
Years we're talking years of missed signals.
Rachel (01:29):
Yes, it's like we're missing out on that crucial
window to make changes and turnthings around.
Mark (01:34):
So that's what we're doing in this deep dive today
Uncovering what fasting insulinreally tells us about our health
, why it can reveal way morethan just glucose or even your
A1c, and how it can help us spotpotential problems before we're
dealing with a diagnosis likediabetes or obesity, or even
heart disease.
Rachel (01:52):
Right on.
Mark (01:53):
So let's start with the basics.
What exactly is fasting insulin?
Rachel (01:57):
Well, at its core, insulin is a hormone that's made
by your pancreas, and its mainjob is to allow your cells to
take in glucose from your bloodand use it for energy or storage
.
So think of insulin as like akey.
It unlocks the door to yourcells so glucose can get in.
When you eat carbohydrates,your pancreas releases insulin
to lower your blood sugar, andit does that by moving the
(02:18):
glucose into your muscle, fatand liver cells.
Mark (02:21):
Got it.
So then, what information doesthe fasting insulin test
actually give us?
Rachel (02:26):
So the fasting insulin test.
It measures how much insulin isin your blood after you haven't
eaten anything for eight to 12hours.
Mark (02:32):
Okay.
Rachel (02:33):
So it's a direct way to see how much your pancreas is
working to keep your blood sugarstable, even when your glucose
numbers look normal.
Mark (02:40):
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 muchabout?
Rachel (02:50):
Great question Fasting glucose it's a snapshot of your
blood sugar at a single point intime.
Okay, and A1C gives you anaverage of your blood sugar
levels over the past two tothree months.
But fasting insulin?
That shows us your body'sbaseline demand for insulin and,
like we said before, thisdemand can actually start
increasing years before yourglucose levels actually get high
.
Mark (03:10):
And when that demand increases, that's when we start
talking about insulin resistance, right.
Rachel (03:14):
Exactly.
Mark (03:15):
Can you explain what's going on there?
Rachel (03:16):
Sure.
So insulin resistance it'sbasically a condition where your
body's cells, they become lessresponsive to insulin signal.
Okay, so remember that keyanalogy we talked about.
Well, imagine your cells startto become a little bit resistant
to that key.
To make up for this, yourpancreas has to work harder.
It starts producing moreinsulin to try and get that same
(03:38):
effect, to get glucose intoyour cells, and this leads to
higher levels of insulin in yourblood, chronically high levels.
And it's often missed inroutine blood work because
doctors don't usually testinsulin unless your blood sugar
is already high.
Mark (03:51):
That makes sense.
So what are we talking about?
Nih?
A typical range that's oftencited is 2 to 20
microinternational units permilliliter.
Rachel (04:10):
But a lot of practitioners, particularly in
integrative and preventivemedicine, they aim for a tighter
range, more like 5 to 7.
And anything above 10 could bea sign of some early metabolic
dysfunction, even if glucoselevels are still in that normal
range.
So that's something to reallypay attention to.
Mark (04:27):
That is something to pay attention to Now.
Insulin resistance this isn'tsomething that just kind of
happens overnight, right?
Rachel (04:33):
No.
Mark (04:33):
It's a gradual process.
Rachel (04:34):
Yeah, it's a slow burn.
It develops gradually andsilently, often over many months
or even years, and often thisis happening when blood sugar
levels still look perfectlynormal.
So that's why fasting insulinis so valuable.
It has the potential to detectthis dysfunction early, before
glucose levels even become aproblem.
Mark (04:51):
So let's walk through what happens normally.
We eat carbs.
Glucose enters our bloodstream.
What's different when someoneis developing insulin resistance
?
Rachel (04:59):
So you eat carbs, they get broken down into glucose
which enters your bloodstream.
Your pancreas responds byreleasing insulin to move that
glucose into your cells forenergy or to be stored.
So far, so good, right.
In a healthy person, thisprocess works smoothly and
efficiently.
But certain things like a diethigh in processed foods and
(05:19):
sugar, chronic stress, notenough sleep, lack of physical
activity these can all make yourcells less responsive to
insulin over time, and that'swhat we call insulin resistance.
Mark (05:29):
And the body tries to compensate for this.
Rachel (05:35):
It does.
Yeah, your pancreas senses thatglucose isn't getting into
cells as easily as it should, soit starts pumping out more
insulin to try and overcome thatresistance.
Mark (05:39):
OK.
Rachel (05:40):
So your glucose levels might still be normal because of
all this extra insulin, butyour insulin levels are climbing
.
Mark (05:45):
Are there any early signs, any clues that might tip
someone off that this ishappening, even if their blood
sugar is still normal?
Rachel (05:52):
There can be, yeah, things like difficulty losing
weight, especially around yourbelly.
Mark (05:57):
Right.
Rachel (05:57):
Frequent energy dips, maybe intense cravings for
sugary foods, brain fog, fatigueafter meals these can all be
early signs that your body'sworking harder to manage your
blood sugar.
But without actually measuringinsulin, it's easy to miss these
or just chalk it up tosomething else.
Mark (06:12):
Yeah, so it seems like we're really missing a piece of
the puzzle if we're only relyingon these glucose tests.
Rachel (06:19):
I think so.
Yes, if this resistance keepsgoing, eventually the pancreas
can't keep up with the demandfor more and more insulin, and
that's when glucose levels startto rise and you get a diagnosis
of prediabetes or type 2diabetes.
And research has shown thatthis resistance it can be
present for at least a decadebefore diabetes is actually
(06:39):
diagnosed.
This was in a study publishedin the Journal of Clinical
Investigation, and it's not justdiabetes Insulin resistance is
linked to obesity, high bloodpressure, pcos, non-alcoholic
fatty liver disease.
So waiting for your glucose tobe high means we're missing a
big opportunity to interveneearly and make changes that
could make a real difference.
Mark (06:59):
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 comesto metabolic health.
Rachel (07:08):
Yeah, they're helpful but they have limitations for
sure.
The big comes to metabolichealth.
Yeah, they're helpful, but theyhave limitations, for sure.
The big thing to remember isthat you can have normal glucose
levels and still have insulinresistance.
Mark (07:18):
And how is that possible?
Because if my blood sugar isnormal, wouldn't that mean that
everything's okay?
Rachel (07:25):
Not necessarily.
This is because of thatcompensation mechanism we talked
about earlier.
Mark (07:28):
Right.
Rachel (07:29):
So in the early stages of insulin resistance, your
body's producing more insulin tokeep that glucose normal.
So the glucose tests might lookgood and your A1C, which is the
average over time, might alsolook normal.
But under the surface there'sthis problem brewing your cells
aren't responding to insulinwell and your pancreas is
overworking to keep up.
(07:50):
And this dysfunction isn'talways picked up by glucose
tests alone.
It's like your body is puttingout fires, but you don't see the
smoke until it's too late.
Plus A1C, while it gives you agood overview, can miss early
insulin resistance and it can bethrown off by other things that
affect red blood cells.
Mark (08:07):
So it's like ignoring that check engine light until the
car breaks down.
Rachel (08:10):
Pretty much so, relying only on glucose and A1C.
You're waiting for the problemto become really obvious.
Right Fasting insulin gives youa chance to catch it much
earlier, and that's why a lot offunctional and integrative
medicine doctors considerfasting insulin to be such an
important test, especially forpeople who have a family history
of diabetes, PCOS obesity orheart disease.
Mark (08:31):
So let's say, someone gets their results back and their
fasting insulin is high.
What does that actually tell usabout their health?
What are we looking at there?
Rachel (08:38):
It's an early sign that your metabolism is struggling,
even if your blood sugar looksgood, your weight seems fine,
your A1C is normal.
High fasting insulin means yourbody's having to work extra
hard to maintain those stableblood sugar levels, and that
usually means you have insulinresistance.
The cells aren't respondingwell to insulin, so the pancreas
has to pump out more of it toget the job done.
(08:59):
And the worse that resistancegets, the higher the insulin
levels climb, and even before itcauses obvious symptoms or
changes in your glucose.
This imbalance can start tocontribute to a lot of chronic
health problems.
It's not just about blood sugar.
It can affect fat storage andincrease your risk of heart
disease.
Mark (09:17):
So what are some of those specific health problems that we
see linked to high fastinginsulin?
Rachel (09:22):
Well, the big ones are prediabetes and type 2 diabetes.
We talked about how highinsulin comes before high
glucose, sometimes by years, andresearch from the NIH shows
that it's a strong predictor ofdiabetes risk, even before those
standard lab markers areabnormal.
And then there's obesity andweight gain.
Insulin is what we call a fatstoring hormone.
(09:43):
When it's high, it tells yourbody to store more fat, and that
can lead to weight gain,especially around the belly
Makes sense body to store morefat and that can lead to weight
gain, especially around thebelly, Makes sense.
Non-alcoholic fatty liverdisease, NAFLD, is another one.
High insulin can cause fat tobuild 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 thatwe see.
Then there's high bloodpressure, or hypertension.
(10:06):
Insulin can mess with how yourbody handles sodium and how your
blood vessels work, and thatcan lead to high blood pressure
and stiffer blood vessels.
And for women specifically,high insulin is a major factor
in PCOS, polycystic ovarysyndrome.
It can affect periods, causeacne and make it hard to lose
weight.
Fasting insulin is often usedto 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 linkedto it.
Some experts even callAlzheimer's type 3 diabetes
because of that strongconnection, and the Alzheimer's
Association has highlighted thisconnection 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 thinkingabout getting this test?
It sounds like it's not justfor people who have already been
diagnosed with something.
Rachel (11:01):
That's right.
It can be really valuable forpeople whose regular lab tests
still look normal, but they havesome signs that something might
be off metabolically.
So what are some signs peopleshould be looking out for?
(11:23):
So ask yourself are you havingtrouble losing weight?
So what are some signs peopleshould be looking out for?
What about things like slightlyhigh triglycerides, low HDL
cholesterol or blood pressurethat's creeping up?
Even some hormonal symptomslike irregular periods or low
libido could be related toinsulin.
In all these cases, even ifyour other labs are normal,
(11:45):
getting your fasting insulincheck and calculating your HOMAS
IR score could be reallyhelpful.
Mark (11:51):
Now.
Earlier we talked about waistcircumference 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 thanBMI because it tells you how
much fat you have around yourorgans and that visceral fat.
That's the type that's linkedto insulin resistance and all
the problems that come with it.
And the NIH says that a waistcircumference of 40 inches or
more for men and 35 inches ormore for women, that's a red
flag for metabolic syndrome andinsulin resistance.
(12:19):
So if your waist is gettingbigger, even if your weight's
the same, pay attention to that,especially if you're having
energy dips, cravings or yourblood pressure starting to rise.
Getting your waistcircumference and your fasting
insulin checked together canreally help you find hidden
metabolic risk that you mightnot see otherwise.
Mark (12:38):
So for someone who's listening and thinking OK, this
sounds like something I shouldget 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 doctorfor it specifically, but the
good news is that it's a prettysimple blood test and most
doctors can order it, or you caneven 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 drinksexcept water, and it's usually
easiest to get your blood drawnin the morning.
You'll get a fasting insulintest, and it's a good idea to
get a fasting glucose test atthe same time.
Having both of those numberslets you calculate your HOMA-IR
score, which is a measure of howresistant your cells are to
(13:22):
insulin.
You can think of it like aresistance score.
The higher it is, the harderyour body is working to keep
your blood sugar in check, and aHOMA-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 notroutinely test for fasting
insulin unless they see signs ofblood sugar problems already,
so you may have to be a littlebit persistent.
Another good option is to see afunctional or integrative
medicine doctor.
Have to be a little bitpersistent.
Another good option is to see afunctional or integrative
medicine doctor.
They often use HOMA-IR andfasting insulin as part of their
standard metabolic healthassessments, and they're also
(14:00):
companies that offer at-homeblood testing.
A lot of people find thatseeing their insulin and glucose
results side by side reallyhelps them understand why
they're having problems likestubborn weight gain or fatigue,
even if their other lab testslooked 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-IRit's not a diagnosis.
It's a chance to be proactiveand potentially prevent things
like type 2 diabetes or heartdisease.
And the good news is thatinsulin resistance can be
improved, especially if youcatch 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 insulinlevels?
Rachel (14:42):
The most important thing is making lifestyle changes
that you can stick with.
The first big one is eating ina way that supports healthy
blood sugar.
That means cutting way back onprocessed foods and refined
carbs and choosing low-glycemic,fiber-rich carbs like leafy
greens, beans, berries, quinoa.
Prioritizing protein andhealthy fats at meals also helps
keep your blood sugar steadyand makes you feel full.
(15:03):
Timing your carbs can behelpful too.
Maybe save the higher glycemicones for earlier in the day or
around when you're more activeand if you have more severe
insulin resistance, cutting backon carbs overall might be a
good idea.
There was a review in thejournal Nutrients in 2020 that
found that eating whole foodsand lowering glycemic load can
actually improve insulinsensitivity, even without losing
(15:25):
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 moresensitive to it, and you don't
even have to lose weight to seebenefits.
Try to get at least 150 to 180minutes of moderate exercise
each week.
Something as simple as a briskwalk after meals can really help
with blood sugar and insulincontrol, 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 makeyour cortisol levels go up, and
that can lead to cravings,weight gain and more stress on
your metabolism.
So aim for seven to nine hoursof good quality sleep each night
.
Keep a regular sleep scheduleand avoid screens and food
before bed.
Managing stress is reallyimportant too.
When you're stressed out allthe time, your body pumps out
(16:18):
cortisol and that can lead toinsulin resistance.
Things like mindfulness,breathing exercises, spending
time in nature, gentle movementlike yoga or tai chi, and
watching your caffeine intake ifyou're feeling wired but tired,
those can all help with stressmanagement.
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 thatthey're not a substitute for
those lifestyle changes wetalked about.
They're just extra support.
Some examples are berberine,which acts kind of like the
medication metformin inimproving glucose and insulin.
Myoinositol can be helpful forwomen with PCOS, Magnesium helps
your body use glucose and alphalipoic acid is an antioxidant
(16:59):
that might improve insulinresistance.
But talk to your doctor beforeyou start any new supplements,
especially if you're on anymedications, just to make sure
they're safe for you.
So remember getting a highfasting insulin result isn't a
life sentence.
It's a wake-up call and you canoften reverse insulin
resistance and improve yourmetabolic health by changing
(17:19):
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 themost important thing you want
our listeners to remember aboutfasting insulin?
Rachel (17:30):
I think the biggest takeaway is this Fasting insulin
.
It gives you a crucial earlyglimpse into your metabolic
health, often before your bloodsugar even hints that there's a
problem.
High insulin is one of theearliest signs and luckily one
of the most reversible signsthat your metabolism is under
stress.
By getting it checked, you getthis valuable information that
you can use to make positivechanges.
Mark (17:51):
And stepping back a bit.
Why is it so important to havethis 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 chronicdiseases are putting a huge
strain on everyone Conditionslike type 2 diabetes, high blood
pressure, fatty liver disease.
They cause emotional andphysical stress and they're also
really expensive to manage.
That's why prevention is soimportant.
(18:17):
It's not just something yourdoctor tells you to do.
It's about protecting yourquality of life Absolutely, and
by catching these metabolicissues early.
With tests like fasting,insulin and Shlomo Sayar, you
can take action before you needmedication, before you develop
serious complications and beforethe financial burden becomes
too much.
Mark (18:35):
And, on that note, think about how powerful it would be
to have this deeperunderstanding of how your body
works.
Imagine how much better yourhealth could be if you make
changes now, while you have timeand knowledge on your side.
Rachel (18:49):
It's empowering.
Mark (18:50):
It really is.
Thanks for joining us for thisdeep dive into fasting insulin.
We hope this information helpsyou take control of your
metabolic health and we'll seeyou next time.
Rachel (18:58):
See you then.
Nicolette (19:03):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy.
No-transcript.
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Mark (00:23):
Hey everyone and welcome back to the Deep Dive.
You know we're always on thelookout for those health
insights that could make areally big difference, and today
we're diving deep into one thatmight just change how you think
about your metabolic health.
Rachel (00:37):
Yeah, we're going beyond the usual suspects, beyond just
looking at your blood sugar.
Mark (00:40):
Right, we all know about glucose.
It gets a lot of the spotlight.
Rachel (00:42):
Yeah, it's always glucose, glucose, glucose.
Mark (00:45):
But today we're talking about fasting insulin.
It's a hormone that canactually give us a much earlier
heads up if things are startingto hit in the wrong direction
metabolically.
Rachel (00:55):
Absolutely, and you know there's that saying you can't
manage what you don't measure.
Mark (00:59):
Right.
Rachel (01:00):
And when it comes to metabolic health, most people
are just measuring their fastingglucose and that's the standard
blood work, right, right.
But what's often missed isfasting insulin.
It's a powerful early warningsign for insulin resistance.
Mark (01:12):
And that's where things get kind of interesting and
maybe even a little bitconcerning, because by the time
your blood sugar levels even hitthat pre-diabetic range, your
fasting insulin could havealready been elevated for years.
Rachel (01:23):
Exactly, and we call that hyperinsulinemia.
Mark (01:26):
Years we're talking years of missed signals.
Rachel (01:29):
Yes, it's like we're missing out on that crucial
window to make changes and turnthings around.
Mark (01:34):
So that's what we're doing in this deep dive today
Uncovering what fasting insulinreally tells us about our health
, why it can reveal way morethan just glucose or even your
A1c, and how it can help us spotpotential problems before we're
dealing with a diagnosis likediabetes or obesity, or even
heart disease.
Rachel (01:52):
Right on.
Mark (01:53):
So let's start with the basics.
What exactly is fasting insulin?
Rachel (01:57):
Well, at its core, insulin is a hormone that's made
by your pancreas, and its mainjob is to allow your cells to
take in glucose from your bloodand use it for energy or storage
.
So think of insulin as like akey.
It unlocks the door to yourcells so glucose can get in.
When you eat carbohydrates,your pancreas releases insulin
to lower your blood sugar, andit does that by moving the
(02:18):
glucose into your muscle, fatand liver cells.
Mark (02:21):
Got it.
So then, what information doesthe fasting insulin test
actually give us?
Rachel (02:26):
So the fasting insulin test.
It measures how much insulin isin your blood after you haven't
eaten anything for eight to 12hours.
Mark (02:32):
Okay.
Rachel (02:33):
So it's a direct way to see how much your pancreas is
working to keep your blood sugarstable, even when your glucose
numbers look normal.
Mark (02:40):
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 muchabout?
Rachel (02:50):
Great question Fasting glucose it's a snapshot of your
blood sugar at a single point intime.
Okay, and A1C gives you anaverage of your blood sugar
levels over the past two tothree months.
But fasting insulin?
That shows us your body'sbaseline demand for insulin and,
like we said before, thisdemand can actually start
increasing years before yourglucose levels actually get high
.
Mark (03:10):
And when that demand increases, that's when we start
talking about insulin resistance, right.
Rachel (03:14):
Exactly.
Mark (03:15):
Can you explain what's going on there?
Rachel (03:16):
Sure.
So insulin resistance it'sbasically a condition where your
body's cells, they become lessresponsive to insulin signal.
Okay, so remember that keyanalogy we talked about.
Well, imagine your cells startto become a little bit resistant
to that key.
To make up for this, yourpancreas has to work harder.
It starts producing moreinsulin to try and get that same
(03:38):
effect, to get glucose intoyour cells, and this leads to
higher levels of insulin in yourblood, chronically high levels.
And it's often missed inroutine blood work because
doctors don't usually testinsulin unless your blood sugar
is already high.
Mark (03:51):
That makes sense.
So what are we talking about?
Nih?
A typical range that's oftencited is 2 to 20
microinternational units permilliliter.
Rachel (04:10):
But a lot of practitioners, particularly in
integrative and preventivemedicine, they aim for a tighter
range, more like 5 to 7.
And anything above 10 could bea sign of some early metabolic
dysfunction, even if glucoselevels are still in that normal
range.
So that's something to reallypay attention to.
Mark (04:27):
That is something to pay attention to Now.
Insulin resistance this isn'tsomething that just kind of
happens overnight, right?
Rachel (04:33):
No.
Mark (04:33):
It's a gradual process.
Rachel (04:34):
Yeah, it's a slow burn.
It develops gradually andsilently, often over many months
or even years, and often thisis happening when blood sugar
levels still look perfectlynormal.
So that's why fasting insulinis so valuable.
It has the potential to detectthis dysfunction early, before
glucose levels even become aproblem.
Mark (04:51):
So let's walk through what happens normally.
We eat carbs.
Glucose enters our bloodstream.
What's different when someoneis developing insulin resistance
?
Rachel (04:59):
So you eat carbs, they get broken down into glucose
which enters your bloodstream.
Your pancreas responds byreleasing insulin to move that
glucose into your cells forenergy or to be stored.
So far, so good, right.
In a healthy person, thisprocess works smoothly and
efficiently.
But certain things like a diethigh in processed foods and
(05:19):
sugar, chronic stress, notenough sleep, lack of physical
activity these can all make yourcells less responsive to
insulin over time, and that'swhat we call insulin resistance.
Mark (05:29):
And the body tries to compensate for this.
Rachel (05:35):
It does.
Yeah, your pancreas senses thatglucose isn't getting into
cells as easily as it should, soit starts pumping out more
insulin to try and overcome thatresistance.
Mark (05:39):
OK.
Rachel (05:40):
So your glucose levels might still be normal because of
all this extra insulin, butyour insulin levels are climbing
.
Mark (05:45):
Are there any early signs, any clues that might tip
someone off that this ishappening, even if their blood
sugar is still normal?
Rachel (05:52):
There can be, yeah, things like difficulty losing
weight, especially around yourbelly.
Mark (05:57):
Right.
Rachel (05:57):
Frequent energy dips, maybe intense cravings for
sugary foods, brain fog, fatigueafter meals these can all be
early signs that your body'sworking harder to manage your
blood sugar.
But without actually measuringinsulin, it's easy to miss these
or just chalk it up tosomething else.
Mark (06:12):
Yeah, so it seems like we're really missing a piece of
the puzzle if we're only relyingon these glucose tests.
Rachel (06:19):
I think so.
Yes, if this resistance keepsgoing, eventually the pancreas
can't keep up with the demandfor more and more insulin, and
that's when glucose levels startto rise and you get a diagnosis
of prediabetes or type 2diabetes.
And research has shown thatthis resistance it can be
present for at least a decadebefore diabetes is actually
(06:39):
diagnosed.
This was in a study publishedin the Journal of Clinical
Investigation, and it's not justdiabetes Insulin resistance is
linked to obesity, high bloodpressure, pcos, non-alcoholic
fatty liver disease.
So waiting for your glucose tobe high means we're missing a
big opportunity to interveneearly and make changes that
could make a real difference.
Mark (06:59):
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 comesto metabolic health.
Rachel (07:08):
Yeah, they're helpful but they have limitations for
sure.
The big comes to metabolichealth.
Yeah, they're helpful, but theyhave limitations, for sure.
The big thing to remember isthat you can have normal glucose
levels and still have insulinresistance.
Mark (07:18):
And how is that possible?
Because if my blood sugar isnormal, wouldn't that mean that
everything's okay?
Rachel (07:25):
Not necessarily.
This is because of thatcompensation mechanism we talked
about earlier.
Mark (07:28):
Right.
Rachel (07:29):
So in the early stages of insulin resistance, your
body's producing more insulin tokeep that glucose normal.
So the glucose tests might lookgood and your A1C, which is the
average over time, might alsolook normal.
But under the surface there'sthis problem brewing your cells
aren't responding to insulinwell and your pancreas is
overworking to keep up.
(07:50):
And this dysfunction isn'talways picked up by glucose
tests alone.
It's like your body is puttingout fires, but you don't see the
smoke until it's too late.
Plus A1C, while it gives you agood overview, can miss early
insulin resistance and it can bethrown off by other things that
affect red blood cells.
Mark (08:07):
So it's like ignoring that check engine light until the
car breaks down.
Rachel (08:10):
Pretty much so, relying only on glucose and A1C.
You're waiting for the problemto become really obvious.
Right Fasting insulin gives youa chance to catch it much
earlier, and that's why a lot offunctional and integrative
medicine doctors considerfasting insulin to be such an
important test, especially forpeople who have a family history
of diabetes, PCOS obesity orheart disease.
Mark (08:31):
So let's say, someone gets their results back and their
fasting insulin is high.
What does that actually tell usabout their health?
What are we looking at there?
Rachel (08:38):
It's an early sign that your metabolism is struggling,
even if your blood sugar looksgood, your weight seems fine,
your A1C is normal.
High fasting insulin means yourbody's having to work extra
hard to maintain those stableblood sugar levels, and that
usually means you have insulinresistance.
The cells aren't respondingwell to insulin, so the pancreas
has to pump out more of it toget the job done.
(08:59):
And the worse that resistancegets, the higher the insulin
levels climb, and even before itcauses obvious symptoms or
changes in your glucose.
This imbalance can start tocontribute to a lot of chronic
health problems.
It's not just about blood sugar.
It can affect fat storage andincrease your risk of heart
disease.
Mark (09:17):
So what are some of those specific health problems that we
see linked to high fastinginsulin?
Rachel (09:22):
Well, the big ones are prediabetes and type 2 diabetes.
We talked about how highinsulin comes before high
glucose, sometimes by years, andresearch from the NIH shows
that it's a strong predictor ofdiabetes risk, even before those
standard lab markers areabnormal.
And then there's obesity andweight gain.
Insulin is what we call a fatstoring hormone.
(09:43):
When it's high, it tells yourbody to store more fat, and that
can lead to weight gain,especially around the belly
Makes sense body to store morefat and that can lead to weight
gain, especially around thebelly, Makes sense.
Non-alcoholic fatty liverdisease, NAFLD, is another one.
High insulin can cause fat tobuild 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 thatwe see.
Then there's high bloodpressure, or hypertension.
(10:06):
Insulin can mess with how yourbody handles sodium and how your
blood vessels work, and thatcan lead to high blood pressure
and stiffer blood vessels.
And for women specifically,high insulin is a major factor
in PCOS, polycystic ovarysyndrome.
It can affect periods, causeacne and make it hard to lose
weight.
Fasting insulin is often usedto 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 linkedto it.
Some experts even callAlzheimer's type 3 diabetes
because of that strongconnection, and the Alzheimer's
Association has highlighted thisconnection 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 thinkingabout getting this test?
It sounds like it's not justfor people who have already been
diagnosed with something.
Rachel (11:01):
That's right.
It can be really valuable forpeople whose regular lab tests
still look normal, but they havesome signs that something might
be off metabolically.
So what are some signs peopleshould be looking out for?
(11:23):
So ask yourself are you havingtrouble losing weight?
So what are some signs peopleshould be looking out for?
What about things like slightlyhigh triglycerides, low HDL
cholesterol or blood pressurethat's creeping up?
Even some hormonal symptomslike irregular periods or low
libido could be related toinsulin.
In all these cases, even ifyour other labs are normal,
(11:45):
getting your fasting insulincheck and calculating your HOMAS
IR score could be reallyhelpful.
Mark (11:51):
Now.
Earlier we talked about waistcircumference 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 thanBMI because it tells you how
much fat you have around yourorgans and that visceral fat.
That's the type that's linkedto insulin resistance and all
the problems that come with it.
And the NIH says that a waistcircumference of 40 inches or
more for men and 35 inches ormore for women, that's a red
flag for metabolic syndrome andinsulin resistance.
(12:19):
So if your waist is gettingbigger, even if your weight's
the same, pay attention to that,especially if you're having
energy dips, cravings or yourblood pressure starting to rise.
Getting your waistcircumference and your fasting
insulin checked together canreally help you find hidden
metabolic risk that you mightnot see otherwise.
Mark (12:38):
So for someone who's listening and thinking OK, this
sounds like something I shouldget 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 doctorfor it specifically, but the
good news is that it's a prettysimple blood test and most
doctors can order it, or you caneven 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 drinksexcept water, and it's usually
easiest to get your blood drawnin the morning.
You'll get a fasting insulintest, and it's a good idea to
get a fasting glucose test atthe same time.
Having both of those numberslets you calculate your HOMA-IR
score, which is a measure of howresistant your cells are to
(13:22):
insulin.
You can think of it like aresistance score.
The higher it is, the harderyour body is working to keep
your blood sugar in check, and aHOMA-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 notroutinely test for fasting
insulin unless they see signs ofblood sugar problems already,
so you may have to be a littlebit persistent.
Another good option is to see afunctional or integrative
medicine doctor.
Have to be a little bitpersistent.
Another good option is to see afunctional or integrative
medicine doctor.
They often use HOMA-IR andfasting insulin as part of their
standard metabolic healthassessments, and they're also
(14:00):
companies that offer at-homeblood testing.
A lot of people find thatseeing their insulin and glucose
results side by side reallyhelps them understand why
they're having problems likestubborn weight gain or fatigue,
even if their other lab testslooked 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-IRit's not a diagnosis.
It's a chance to be proactiveand potentially prevent things
like type 2 diabetes or heartdisease.
And the good news is thatinsulin resistance can be
improved, especially if youcatch 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 insulinlevels?
Rachel (14:42):
The most important thing is making lifestyle changes
that you can stick with.
The first big one is eating ina way that supports healthy
blood sugar.
That means cutting way back onprocessed foods and refined
carbs and choosing low-glycemic,fiber-rich carbs like leafy
greens, beans, berries, quinoa.
Prioritizing protein andhealthy fats at meals also helps
keep your blood sugar steadyand makes you feel full.
(15:03):
Timing your carbs can behelpful too.
Maybe save the higher glycemicones for earlier in the day or
around when you're more activeand if you have more severe
insulin resistance, cutting backon carbs overall might be a
good idea.
There was a review in thejournal Nutrients in 2020 that
found that eating whole foodsand lowering glycemic load can
actually improve insulinsensitivity, even without losing
(15:25):
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 moresensitive to it, and you don't
even have to lose weight to seebenefits.
Try to get at least 150 to 180minutes of moderate exercise
each week.
Something as simple as a briskwalk after meals can really help
with blood sugar and insulincontrol, 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 makeyour cortisol levels go up, and
that can lead to cravings,weight gain and more stress on
your metabolism.
So aim for seven to nine hoursof good quality sleep each night
.
Keep a regular sleep scheduleand avoid screens and food
before bed.
Managing stress is reallyimportant too.
When you're stressed out allthe time, your body pumps out
(16:18):
cortisol and that can lead toinsulin resistance.
Things like mindfulness,breathing exercises, spending
time in nature, gentle movementlike yoga or tai chi, and
watching your caffeine intake ifyou're feeling wired but tired,
those can all help with stressmanagement.
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 thatthey're not a substitute for
those lifestyle changes wetalked about.
They're just extra support.
Some examples are berberine,which acts kind of like the
medication metformin inimproving glucose and insulin.
Myoinositol can be helpful forwomen with PCOS, Magnesium helps
your body use glucose and alphalipoic acid is an antioxidant
(16:59):
that might improve insulinresistance.
But talk to your doctor beforeyou start any new supplements,
especially if you're on anymedications, just to make sure
they're safe for you.
So remember getting a highfasting insulin result isn't a
life sentence.
It's a wake-up call and you canoften reverse insulin
resistance and improve yourmetabolic health by changing
(17:19):
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 themost important thing you want
our listeners to remember aboutfasting insulin?
Rachel (17:30):
I think the biggest takeaway is this Fasting insulin
.
It gives you a crucial earlyglimpse into your metabolic
health, often before your bloodsugar even hints that there's a
problem.
High insulin is one of theearliest signs and luckily one
of the most reversible signsthat your metabolism is under
stress.
By getting it checked, you getthis valuable information that
you can use to make positivechanges.
Mark (17:51):
And stepping back a bit.
Why is it so important to havethis 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 chronicdiseases are putting a huge
strain on everyone Conditionslike type 2 diabetes, high blood
pressure, fatty liver disease.
They cause emotional andphysical stress and they're also
really expensive to manage.
That's why prevention is soimportant.
(18:17):
It's not just something yourdoctor tells you to do.
It's about protecting yourquality of life Absolutely, and
by catching these metabolicissues early.
With tests like fasting,insulin and Shlomo Sayar, you
can take action before you needmedication, before you develop
serious complications and beforethe financial burden becomes
too much.
Mark (18:35):
And, on that note, think about how powerful it would be
to have this deeperunderstanding of how your body
works.
Imagine how much better yourhealth could be if you make
changes now, while you have timeand knowledge on your side.
Rachel (18:49):
It's empowering.
Mark (18:50):
It really is.
Thanks for joining us for thisdeep dive into fasting insulin.
We hope this information helpsyou take control of your
metabolic health and we'll seeyou next time.
Rachel (18:58):
See you then.
Nicolette (19:03):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy.
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