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What Is Insulin Resistance?

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If you think that worrying about insulin is only relevant to diabetics, think again! Maintaining normal insulin levels is crucial for everyone, regardless of whether they have diabetes or not. It’s not just about preventing insulin resistance; it’s the key to a healthy and fulfilling life, including managing conditions like PCOS.

Why is this important? Well, insulin resistance and high insulin levels have been linked to a wide range of health issues, including obesity, type 2 diabetes, heart disease, aging, Alzheimer’s disease, cancer, autism, mood disorders, and infertility. Surprisingly, studies show that 88% of US adults have insulin resistance. What’s even more concerning is that many people may not even realize they are insulin resistant or understand what it means. It’s alarming that insulin resistance, which lies at the core of numerous chronic diseases, isn’t yet a household term.

This is where Lilli Health comes in. Our mission is to educate people about insulin, insulin resistance, and overall health. Lilli, which stands for a low insulin lifestyle, forms the foundation of our company and educational efforts. We strive to inform individuals about the significance of lowering and maintaining normal insulin levels. By doing so, we can reverse insulin resistance, support weight loss, enhance fertility, improve skin complexion, and ultimately lead longer and healthier lives.

At Lilli Health, we believe that understanding insulin and its impact is crucial for everyone, regardless of their health status. Through education and awareness, we hope to empower individuals to make informed choices and embrace a low insulin lifestyle for their overall well-being.

Learn about Insulin Resistance

What Is Insulin?

What Is Insulin?

To understand the role of insulin, let’s dive into how our bodies use the energy from the food we eat, known as metabolism. Simply put, metabolism is how our bodies utilize the calories in our food to power all our bodily functions. From beating our heart to processing thoughts in our brains, from breathing with our lungs to walking with our legs, everything requires energy. And that energy comes from the calories in our food. Insulin plays a vital role in our metabolism and is essential for our survival because, without it, our bodies cannot use those calories efficiently.

When we eat a meal, our digestive system breaks down carbohydrates (sugars and starches) into glucose, proteins into amino acids, and fats into free fatty acids. Amino acids are usually used for building proteins in the body, but if needed, they can also be broken down into glucose. Glucose enters our bloodstream, signaling the pancreas to release insulin. With the help of insulin, cells throughout our body can absorb glucose from the blood and either use it for energy or store it as fat. We often refer to this process as “lowering blood sugar” – taking glucose from the blood and delivering it into our cells.

Think of insulin as the key that unlocks the cells. Without insulin, cells can’t access the glucose in the bloodstream. Conversely, having excessive insulin is like breaking a key inside the lock, making it difficult for cells to access glucose. Whether there’s too much or too little insulin, the end result is the same: glucose builds up in the blood, eventually leading to diabetes.

Insulin is known as an anabolic hormone, meaning it promotes growth by building and storing. When insulin is present, it acts as a messenger instructing your body to build and store. Unfortunately, higher levels of insulin are more likely to promote energy storage, converting the food you eat into fat. This is because elevated insulin levels encourage the body to prioritize energy storage rather than energy usage, leading to fat gain rather than fat loss.

Understanding how insulin influences metabolism and energy storage is key to making informed choices about our health. By managing our insulin levels effectively, we can optimize our energy usage, maintain a healthy weight, and support overall well-being.

What Is Insulin Resistance?

What Is Insulin Resistance?

Similar to other hormones, problems arise when insulin levels are too low and when they are too high. For example, the complete inability to make insulin is called type 1 diabetes and it’s why individuals with type 1 diabetes are required to administer frequent insulin injections. Individuals with type 2 diabetes, on the other hand, typically make too much insulin, also known as hyperinsulinemia, or too much insulin in the blood. This is because when insulin levels are always high, it prevents cells from responding to insulin the way they should, which forces the pancreas to secrete more insulin, and so on. This is called insulin resistance; cells are resistant to the insulin the pancreas secretes.

Think of insulin resistance as a middle ground between a healthy metabolism and type 2 diabetes. A person with insulin resistance usually has blood sugar levels that stay within the normal range, but it takes an excessive amount of insulin to keep blood sugars in the normal range. When insulin levels rise, it can become less effective at moving glucose from the blood and into the cells. Gradually, this results in blood sugars accumulating in the blood and eventually leads to a diagnosis of type 2 diabetes.

It’s like being in a traffic jam where all the exits are closed! So, while insulin resistance doesn’t necessarily mean the person is diabetic, they are heading in that direction. What’s even worse is that these individuals may have insulin levels that are too high for years, even decades, before their blood sugar ever rises outside the normal range.

Let’s look at 3 different scenarios that result in rising blood sugars and type 2 diabetes. I’ve named these the work-a-holic pancreas, the retired pancreas, and the lazy pancreas. In these graphs, the dotted line represents when blood sugars are high enough to receive a diagnosis of diabetes.

Work-A-Holic Pancreas

 

The work-a-holic pancreas represents the majority of the population, especially those with PCOS. Their pancreas just keeps on pumping out insulin, even though it doesn’t work appropriately, in an effort to keep blood sugars normal. Eventually all that excess insulin stops working and blood sugars rise, resulting in a diagnosis of type 2 diabetes.

Retired Pancreas

 

In some cases, when the pancreas retires, it means that it becomes overworked and can’t keep up with the demands of producing enough insulin to regulate blood sugar levels effectively. It’s like a hardworking employee who eventually needs a break. When this happens, the body may experience elevated blood sugar levels, which can lead to diabetes.

Lazy Pancreas

 

Some individuals, especially those of East and South Asian descent, may have a lazy pancreas that is less active and may struggle to produce enough insulin to meet the body’s needs. This can make them more prone to developing type 2 diabetes. Because high insulin levels can lead to weight gain, these individuals often have a lower body mass index (BMI).

These graphs clearly show that only testing your blood glucose or hemoglobin A1c is just one piece of the metabolic puzzle. To get the full picture of your body’s health, it’s equally, if not more important, to test your insulin levels. By measuring both blood glucose and insulin, you can gain valuable insights into how your body is managing sugar and how effectively insulin is working. This comprehensive approach empowers you to make informed decisions about your lifestyle, diet, and overall well-being.

Embracing a low insulin lifestyle and making mindful food choices that don’t cause sharp insulin spikes can have a positive impact on your body’s metabolic health. By adopting this approach, you can improve the efficiency of insulin in your body, leading to a healthier overall metabolism and healthier body.

Understanding the Risks

Understanding the Risks

When it comes to insulin resistance, there are many risks you should be aware of, especially in relation to weight gain. Again, insulin resistance occurs when your cells become less responsive to the effects of insulin, usually as a result of eating a diet that causes recurrent insulin spikes. Current estimates suggest that close to 9 out of 10 US adults have insulin resistance, meaning this is a major public health problem. This is especially important since many people have never heard of this condition.

Trying to lose weight when you are insulin resistant is like trying to go down the up escalator. When insulin levels rise in the body, it can hinder the breakdown of stored fat and promote fat storage. This can make it more challenging for the body to utilize fat as an energy source, which can contribute to weight gain over time. Additionally, when cells become resistant to insulin, it becomes more difficult for glucose to enter the cells and provide them with energy. As a result, the body may start breaking down muscle tissue to obtain energy from alternative sources. Remember, the body can convert protein to glucose!

increased-appetite

Moreover, insulin can influence appetite and cravings. When insulin levels are elevated, it can disrupt the normal regulation of hunger and fullness signals, leading to increased cravings for sugary and high-calorie foods. These cravings can contribute to overeating and even higher insulin levels. Lastly, high insulin levels can also contribute to increased fatigue. The constant fluctuations in blood sugar levels that occur with insulin resistance or poor insulin regulation can result in energy crashes and feelings of tiredness throughout the day.

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High insulin levels can cause the body to begin breaking down muscle mass to use as energy, which it doesn’t like to do (hello, muscle loss!).
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High insulin levels cause the body to slow down its metabolism in order to protect against excessive muscle loss (nap time!).
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High insulin levels can affect the signals that control your hunger and fullness, making you feel more hungry and less satisfied (more cravings!).

Hopefully it’s now clear telling someone with high insulin levels and insulin resistance to lose weight in order to reverse insulin resistance is an uphill battle. Instead of focusing solely on weight loss, a more effective approach would be to prioritize lowering insulin levels. By addressing the root cause of the problem, you can make significant progress toward weight loss and improving insulin sensitivity.

Lowering insulin levels through a low insulin lifestyle can reverse insulin resistance, which can make weight loss easier by reducing fat storage, curbing cravings, improving metabolism, and promoting overall health. In addition to weight management, a low insulin lifestyle can also help alleviate symptoms associated with PCOS. This includes reducing androgen levels, such as testosterone, which can alleviate symptoms like excessive hair growth (hirsutism), acne, hair loss, and irregular menstrual cycles.

Causes of Insulin Resistance

What Causes Insulin Resistance?

Experts have debated the relationship between hyperinsulinemia, insulin resistance, and obesity for decades. Determining which comes first has led to cause-and-effect questions and extensive debate. In the past, it was commonly believed that high insulin levels were a result of insulin resistance, which itself was caused by obesity. The prevailing theory suggested that once a person gained weight, their body became resistant to insulin, leading to elevated insulin levels. It was thought that these high insulin levels were merely a consequence of insulin resistance and obesity.

However, recent studies have turned this belief completely around. Experts now understand that eating in a way that triggers high insulin levels actually leads to insulin resistance, and both of these factors contribute to excess weight gain. This excess weight gain, in turn, worsens insulin resistance, increases insulin levels even further, and perpetuates the cycle of weight gain. This explains why some individuals find it so easy to gain weight but struggle to shed those extra pounds. It also sheds light on the challenges faced by healthcare providers who simply advise patients with insulin resistance or PCOS to lose weight as a solution. The truth is that high insulin levels make weight loss extremely difficult. Instead, women who are managing a PCOS diagnosis should be encouraged to adopt a low insulin lifestyle as a means to reverse the vicious cycle of insulin resistance and promote weight loss.


Understanding the vicious cycle of insulin resistance is crucial because it begins with the diet we choose, not necessarily with weight gain. It’s interesting to note that many adults today have elevated fasting insulin levels, even before the onset of obesity or type 2 diabetes. This highlights the importance of shifting our focus to insulin levels, not just blood glucose levels, in order to improve overall health, particularly when managing PCOS. Preventing diet-induced insulin spikes by following a low insulin lifestyle is the first step in lowering insulin levels, reversing insulin resistance, and managing PCOS.

Measuring Insulin Levels

Measuring Insulin Levels

Testing your insulin levels can provide valuable information about your metabolic health. There are a few different ways to measure insulin levels:

  • Fasting Insulin: The most common method is a fasting insulin blood test, which requires you to fast for several hours before the test. This test measures the amount of insulin in your blood when you haven’t eaten for a certain period of time, usually overnight.
  • OGTT: Another test is called the OGTT (oral glucose tolerance test). In this test, you drink a glucose solution, and then your blood is drawn at specific intervals to measure both glucose and insulin levels. This test helps assess how well your body responds to glucose and how effectively insulin is being released. This test is less common because most people are unable to wait for 2 hours to complete this test.
  • HOMA-IR: The formula used in HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) takes into account the relationship between fasting glucose and fasting insulin levels. Higher HOMA-IR values indicate greater insulin resistance, meaning your body is having difficulty using insulin effectively to regulate blood sugar.

Fasting Insulin: 3-8 mIU/ml

Fasting insulin greater than 8 mIU/ml suggests insulin resistance

HOMA-IR: ≤ 1.9

HOMA-IR score greater than 1.9 suggests insulin resistance

Ideally, a fasting insulin should be between 3-8 mIU/ml (50 pmol/L), but what is considered “normal” varies by lab. It may surprise you to know that some labs define a wide range of 3-30 mIU/ml as normal, which is quite concerning. Research studies have consistently shown that fasting insulin levels above 8 mIU/ml are associated with insulin resistance and an increased risk of developing chronic diseases.

Despite the significant impact of insulin on the development of chronic diseases, it’s unfortunate that measuring insulin levels is not a routine practice among healthcare providers. Usually, only blood glucose levels or hemoglobin A1c are measured, which solely provide information about elevated blood glucose levels. This is why I cringe when I hear the phrase “balance your blood sugar.” A “balanced” or “normal” blood sugar reading doesn’t provide insight into your insulin levels. Surprisingly, certain foods with no carbohydrates can still significantly impact insulin levels. That’s why it’s more accurate and beneficial to focus on “lowering your insulin levels” rather than solely aiming for blood sugar balance. By addressing insulin levels, we can not only resolve blood sugar problems but also address the underlying issues caused by elevated insulin levels. It’s a more comprehensive approach to improving overall health.

lower-your-insulin

Overall, it’s important to recognize that insulin plays a crucial role in overall health, especially when it comes to conditions like insulin resistance and PCOS. Therefore, it is valuable to advocate for more comprehensive testing that includes measuring insulin levels, as it provides a more complete picture of your metabolic health and helps guide appropriate interventions to manage insulin-related issues effectively.

Fortunately, we will soon offer the convenience of purchasing an insulin testing kit directly from our website! With this kit, you can easily measure your insulin levels and HOMA-IR in the comfort of your own home. It’s a simple and effective way to gain valuable insights into your insulin status and take control of your health. By understanding your insulin levels, you can make informed decisions and tailor your lifestyle choices to support optimal insulin function.

Lowering Insulin Levels

How Do I Lower My Insulin?

You’ve definitely come to the right place! At Lilli Health, our foundation is built on the concept of a low insulin lifestyle. We firmly believe in the tremendous impact of avoiding foods that trigger insulin spikes. This approach has undergone extensive research and has been specifically studied in patients with PCOS since 2011. Through these studies, we have gained valuable insights into the effects of our approach on managing PCOS symptoms and improving overall health. The results of these studies have been published in peer-reviewed journals and presented at conferences both in the US and internationally.

By understanding which foods can lead to insulin spikes, you can make informed choices about our diet and lifestyle. This knowledge can help empower you to take control of your health and effectively manage PCOS. We’re thrilled to share the wealth of scientific evidence supporting our approach, which highlights the positive outcomes achieved by individuals with PCOS who have embraced a low insulin lifestyle.

If you’re curious to learn more about the science behind a low insulin lifestyle, we recommend you explore our Science Behind a Low Insulin Lifestyle section. It provides an in-depth overview of the scientific evidence supporting this approach, along with a comprehensive review of the data. Additionally, you can delve into my personal journey with PCOS by reading my book, where I share valuable insights and experiences.

At Lilli Health, our goal is to provide you with the tools, resources, and support you need to make informed decisions about your diet and well-being. We’re excited to have you on board, and we’re here to support you every step of the way!

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References

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Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertil Steril. 2012;97(1):18-22. doi:10.1016/j.fertnstert.2011.11.036

Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord. 2019;17(1):46-52. doi:10.1089/met.2018.0105

Kolb H, Kempf K, Röhling M, Martin S. Insulin: too much of a good thing is bad. BMC Med. 2020;18(1):224. doi:10.1186/s12916-020-01688-6

Shanik MH, Xu Y, Skrha J, Dankner R, Zick Y, Roth J. Insulin resistance and hyperinsulinemia: is hyperinsulinemia the cart or the horse? Diabetes Care. 2008;31 Suppl 2. doi:10.2337/dc08-s264

Abdul-Ghani M, DeFronzo RA. Insulin Resistance and Hyperinsulinemia: The Egg and the Chicken. Journal of Clinical Endocrinology and Metabolism. 2021;106(4). doi:10.1210/clinem/dgaa364

Erion KA, Corkey BE. Hyperinsulinemia: a Cause of Obesity? Curr Obes Rep. 2017;6(2). doi:10.1007/s13679-017-0261-z

Thomas DD, Corkey BE, Istfan NW, Apovian CM. Hyperinsulinemia: An early indicator of metabolic dysfunction. J Endocr Soc. 2019;3(9):1727-1747. doi:10.1210/js.2019-00065

Templeman NM, Skovsø S, Page MM, Lim GE, Johnson JD. A causal role for hyperinsulinemia in obesity. Journal of Endocrinology. 2017;232(3):R173-R183. doi:10.1530/JOE-16-0449

Page MM, Johnson JD. Mild Suppression of Hyperinsulinemia to Treat Obesity and Insulin Resistance. Trends in Endocrinology and Metabolism. 2018;29(6). doi:10.1016/j.tem.2018.03.018

Johnson JL, Duick DS, Chui MA, Aldasouqi SA. Identifying Prediabetes Using Fasting Insulin Levels. Endocrine Practice. 2010;16(1):47-52. doi:10.4158/EP09031.OR

Dankner R, Chetrit A, Shanik MH, Raz I, Roth J. Basal-state hyperinsulinemia in healthy normoglycemic adults is predictive of type 2 diabetes over a 24-year follow-up: A preliminary report. Diabetes Care. 2009;32(8). doi:10.2337/dc09-0153

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