Hello and welcome to Part 2 of my blog on biochemical ‘Fat Traps’ and hormones
If you prefer to listen to the blog post then here it is
Insulin and Insulin Resistance
Certain hormones, especially insulin and thyroid hormone decide what the body does with the energy that it has. Energy is the food we eat or the energy stores we have, fat and muscle.Research is starting to show that when people suffer from weight issues, there appears to be some sort of hormone imbalance involved and human obesity is more than just calories in and calories out. For more see Fat Traps, Cortisol and Insulin Part 1
Insulin is a small protein and hormone, that is secreted by the beta cells in the pancreas. Its main jobs is to clear glucose from the blood and usher it into cells, particularly muscle and fat cells, as blood sugar levels need to be tightly regulated. Insulin tells the body to store energy, while glucagon (another hormone) opposes insulin and mobilises energy and helps release fat from cells (lipolysis) so it can be used as energy in a process called B-oxidation. There are other hormones which oppose insulin. Insulin is also a potent growth factor which is both a good and bad thing.
So to sum up insulin is a storage hormone and a growth factor. It is only a problem when there is too much or too little insulin. Insulin is supposed to be released in pulse when we eat and then go back down to a normal level. We don’t want insulin to be high all the time as it will cause stored fat and proteins to be locked away, making them unavailable to cells that need them, making the body think carbohydrate is the only fuel it can use. Chronically high insulin is also inflammatory which causes a host of health issues from acne, pain and fertility issues.
Every cell in the body has insulin receptors (insulin binds to the receptors), each with different responses to insulin. This means insulin affects nerves, blood cells, bones or any other cell in the body. The common effect is that insulin promotes cell growth and this can be a problem when insulin levels become too high or some cells become insulin resistant. Problems with insulin and other hormones can be due to the receptor as there can be plenty of hormone, but if the receptor or cell membrane where the receptor resides is faulty then the cells will ignore the hormone.
Factors which can increase insulin levels and insulin resistance include;
- Excess carbohydrates (particularly sugar) eaten too frequently.
- Low salt / sodium
- Chronically high cortisol
- Abdominal fat
- Low thyroid
- Low lean muscle mass
- A bad night’s sleep
- Some genes
- Certain medications and supplements eg Growth Hormone and Olanzapine
- Too much oxalic acid
Because all cells are affected, we get numerous conditions associated with diabetes, it is important to emphasise that these conditions are not consequences of glucose alone. They begin to appear before glucose levels change, as insulin is driving the pathologies too, not glucose alone.
You can have normal sugar levels and still have abnormal insulin levels.
This is why type 2 diabetes can develop silently over decades as we are chasing the wrong maker and giving type 2 diabetics more insulin, when they already have too much, thus increasing the risk of cancer, cardiovascular disease and other complications. Patients should be encouraged to have their insulin levels tested rather than just blood glucose.
Some ‘do it at home steps’ to manage insulin
As doctors are not taught to measure insulin levels the tests can be hard to obtain. However you can measure your ketone levels, because ketone levels are inversely proportional to insulin. If ketones are high, insulin must be low (unless you are drinking exogenous ketones, like MCT oil or BHB).
For insulin levels to be low, you do not have to be in nutritional ketosis which is 0.3-0.5 mm/L. A reading of (>0,1 mmol/L) is fine for insulin control. Remember insulin is released in response to raised blood glucose / sugar levels.
Dr Benjamin Bikman, who has a PhD in Bioenergetics 3–step diet tips for managing insulin are;
- Control the Carbs
- Prioritise Proteins
- Fill with Fat (healthy fats)
I personally would also include no sugar too particularly if low carb is new to you or you are insulin resistant already. There are no nutrients in sugar, the types of food it is added to are mainly junk foods, it is addictive and it can deplete your body of certain minerals. You might feel crap for a few days while your metabolism adjusts, but it will be worth it in the end.
With respect to a keto or low carb diet some people take it to the extreme and try to limit protein too much. This is because under some circumstances protein can spike insulin, but in people who are ‘fat adapted’ studies found that protein cause a much lower insulin spike than in ‘carb burners’.
Fasting and intermittent fasting, if done properly are also a great way to manage insulin levels as it pushes the body out of energy storage mode and into energy usage mode, which means insulin will be low (insulin is a storage hormone).
Exercise is key too as it increases insulin sensitivity, expends energy and maintains or develops muscle mass, which glucose is stored in as glycogen.
Exercise 1st – refuel 2nd if you are trying to manage your insulin levels or lose fat – ‘Earn your carbs – Charles Poliquin’
The Importance of salt
Under normal circumstances you need 3-6g of salt per day. When you restrict salt, your body’s biochemistry begins to panic, and one way to rescue this situation is to raise insulin levels.
When insulin levels are high salt is retained in the body, so when you lower insulin levels by either cutting carbs or fasting more salt is excreted by the kidneys. If you drop too low in salt then your body releases stress hormones to retain salt which also raises insulin, which will drop blood sugar and potentially cause sugar or refined carb cravings. To add to this low salt triggers the dopamine centers in the brain which is the reward center, which means cravings for sugar and other pleasurable substances increase.
You need 1-2g extra grams of salt a day if you are following a low carb / keto diet. You also need more salt if you drink a lot of coffee /energy drinks, exercise heavily or use a sauna often. Saunas are great by the way and have many health benefits!
Restricting salt to less than 3g/day causes artery stiffening hormones such as renin, angiotensin II, and aldosterone to sky-rocket (ironically these are the targets for blood pressure lowering drugs) and also activates stress hormones noradrenaline and adrenaline. This means restricting salt intake actually raises blood pressure and over works the adrenal glands which can lead to adrenal fatigue/insufficiency.
Luckily, we have a built-in system, a “salt regulating gauge’. Our salt regulating gauge signals the brain to seek more salt when we need more to function, as well as when to stop when we have enough to function efficiently.
Good quality salt (Pink Himalayan or pure sea salt) is essential and it contains iodine which is key for thyroid function, we have been mis-informed about salt and this white crystal is not the enemy ! Read more about this in The Salt Fix – By Dr. James DiNicolantonio or listen to an interview with James to learn about the dangers of low salt diets.
There are some supplements and nutrients which can help with insulin sensitivity such as chromium or magnesium, but this usually only helps if the person was deficient in that nutrient to start with. Magnesium and other mineral deficiency is very common nowadays due to the poor quality soil that plants are grown in.
I hope this has been helpful. When trying things for yourself remember that it is an n=1 experiment and what works for one person may not work for you and vice versa.
There are many layers and intricacies to biochemical pathways and I haven’t covered everything in this blog but the take home message is salt is not bad and if you are struggling with weight loss or cravings consider checking your salt intake.
Thanks for reading
DiNicolantonio, James. The Salt Fix: Why the Experts Got it All Wrong and How Eating More Might Save Your Life (Kindle Locations 2074-2078). Little, Brown Book Group.