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Which functional lab tests correlate with insulin resistance?

Here are some lab tests that are commonly used to assess insulin resistance:

  1. Fasting Blood Glucose (FBG): A simple test that measures your blood sugar levels after an overnight fast. Elevated fasting blood glucose levels (typically above 100 mg/dL) can indicate insulin resistance.
  2. Hemoglobin A1c (HbA1c): This test provides an average of your blood sugar levels over the past 2-3 months. Elevated HbA1c levels, usually above 5.7%, can be an indicator of insulin resistance and diabetes.
  3. Oral Glucose Tolerance Test (OGTT): This involves drinking a sugary solution and then measuring blood sugar levels at specific intervals. Insulin resistance can be indicated by higher-than-normal blood sugar levels during the test.
  4. Fasting Insulin Levels: Measuring fasting insulin levels alongside fasting blood glucose can help evaluate insulin resistance. Elevated fasting insulin levels can indicate reduced insulin sensitivity.
  5. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR): This is a formula that calculates insulin resistance based on fasting glucose and fasting insulin levels. Higher HOMA-IR values suggest greater insulin resistance.
  6. C-peptide Levels: C-peptide is a marker of insulin production by the pancreas. High levels of C-peptide, especially in the presence of elevated blood sugar, can suggest insulin resistance.
  7. Triglyceride Levels: Elevated triglyceride levels often accompany insulin resistance and are part of the metabolic syndrome. A triglyceride-to-HDL ratio is sometimes used as an indicator.
  8. High-Density Lipoprotein (HDL) Cholesterol Levels: Low HDL cholesterol levels can be associated with insulin resistance.
  9. Fasting Serum Leptin Levels: Leptin is a hormone that regulates appetite and metabolism. Elevated leptin levels are often seen in individuals with insulin resistance.
  10. Adiponectin Levels: Adiponectin is a hormone that plays a role in insulin sensitivity. Lower levels of adiponectin are associated with insulin resistance.
  11. Liver Function Tests: Elevated liver enzymes and markers of non-alcoholic fatty liver disease (NAFLD) can be indicative of insulin resistance.
  12. Inflammatory Markers: Elevated levels of inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6) are often associated with insulin resistance and metabolic dysfunction.

It’s important to note that these tests provide a snapshot of your metabolic health, and a comprehensive evaluation should be conducted by a healthcare professional. Additionally, insulin resistance is often part of a larger picture of metabolic syndrome and can be influenced by genetics, lifestyle, and other factors.

How to reverse insulin resistance in functional medicine


Reversing insulin resistance through functional medicine involves addressing the underlying factors that contribute to the condition. Functional medicine takes a holistic approach, focusing on individualized care and treating the root causes of health issues.

Here’s a general outline of how insulin resistance can be addressed using functional medicine principles:

  1. Dietary Changes:
    • Focus on a whole foods, nutrient-dense diet rich in vegetables, fruits, lean proteins, healthy fats, and complex carbohydrates with a low glycemic index.
    • Reduce or eliminate processed foods, sugary snacks, sugary beverages, and refined carbohydrates.
    • Consider incorporating anti-inflammatory foods like turmeric, ginger, omega-3 fatty acids, and green tea.
  2. Balancing Blood Sugar:
    • Eat regular meals and snacks to maintain stable blood sugar levels.
    • Avoid large meals that can lead to spikes in blood sugar.
    • Include protein and healthy fats with meals to slow down the absorption of carbohydrates.
  3. Exercise and Physical Activity:
    • Engage in regular physical activity, including both aerobic exercise and strength training.
    • Exercise helps improve insulin sensitivity and can lower blood sugar levels.
  4. Stress Management:
    • Chronic stress can contribute to insulin resistance. Practice stress-reduction techniques such as mindfulness, meditation, yoga, and deep breathing.
  5. Sleep Optimization:
    • Aim for 7-9 hours of quality sleep each night. Poor sleep can disrupt insulin sensitivity.
  6. Supplements and Nutritional Support:
    • Some supplements may help improve insulin sensitivity, such as chromium, magnesium, alpha-lipoic acid, and berberine. Consult a healthcare provider before adding supplements.
  7. Gut Health and Inflammation:
    • Address gut health issues as imbalances in gut bacteria can impact metabolism and inflammation.
    • Consider probiotics and a diet that supports a healthy gut.
  8. Detoxification Support:
    • Support the body’s natural detoxification processes by staying hydrated, consuming fiber-rich foods, and supporting liver health.
  9. Individualized Approach:
    • Functional medicine focuses on personalized care. Work with a healthcare provider experienced in functional medicine to create a tailored plan based on your unique health history and needs.
  10. Monitoring and Adjustments:
    • Regularly monitor your progress through lab tests, glucose monitoring, and other relevant assessments.
    • Adjust your approach based on your results and how your body responds.

Remember that reversing insulin resistance takes time and commitment. It’s advisable to work with a qualified healthcare provider, such as a functional medicine practitioner or a registered dietitian, to guide you through the process and ensure you’re making safe and effective choices. Functional medicine aims to treat the whole person, so lifestyle, nutrition, and other factors will be considered as part of your treatment plan.

What does Dr. Ben Bikman say to reverse insulin resistance

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  1. Low-Carbohydrate Diet: Dr. Bikman has highlighted the benefits of a low-carbohydrate diet for improving insulin sensitivity. He suggests reducing the consumption of refined carbohydrates and sugars, which can lead to chronically elevated insulin levels.
  2. Healthy Fat Intake: He supports the consumption of healthy fats, such as those found in avocados, nuts, olive oil, and fatty fish. These fats can provide sustained energy and may help improve insulin sensitivity.
  3. Intermittent Fasting: Dr. Bikman has discussed how intermittent fasting and time-restricted eating can help regulate insulin levels and improve insulin sensitivity. These eating patterns can give the body more time to clear excess glucose from the bloodstream.
  4. Exercise: He emphasizes the importance of regular physical activity, both aerobic exercise and strength training, for improving insulin sensitivity and metabolic health.
  5. Avoiding Overeating: Dr. Bikman advocates for avoiding overeating, as excess calorie intake can contribute to insulin resistance and obesity.
  6. Reducing Inflammation: Addressing chronic inflammation through dietary choices and lifestyle changes is important for improving insulin sensitivity. Consuming anti-inflammatory foods and managing stress can play a role in this.
  7. Personalized Approach: Dr. Bikman often emphasizes that individuals may have different responses to dietary and lifestyle interventions. He encourages people to monitor their own responses to different foods and habits to find what works best for them.
  8. Metabolic Flexibility: He discusses the concept of “metabolic flexibility,” which is the body’s ability to switch between using glucose and fats for energy. Improving metabolic flexibility can be beneficial for insulin sensitivity.

It’s important to note that while Dr. Ben Bikman’s insights can provide valuable guidance, every individual’s situation is unique. If you’re interested in following his recommendations to reverse insulin resistance, consider consulting with a healthcare professional who can tailor a plan to your specific needs and medical history. Additionally, staying updated with his latest research and presentations will provide the most current information on his views and recommendations.

What is METABOLIC Flexibility as per Dr. Ben Bikman?


Here’s a more detailed explanation of metabolic flexibility:

  1. Glucose Utilization: When glucose is available, such as after consuming carbohydrates, a metabolically flexible individual can effectively take up and use glucose for energy. This is important to maintain stable blood sugar levels and provide energy to cells, especially those that rely on glucose as their primary fuel source, like certain parts of the brain.
  2. Fat Utilization: On the other hand, when glucose availability is low, such as during fasting or low-carbohydrate intake, a metabolically flexible individual can switch to using stored fat as a source of energy. This involves breaking down stored fats into fatty acids, which can then be utilized by various tissues and organs.
  3. Insulin Sensitivity: Metabolic flexibility is closely linked to insulin sensitivity. Insulin sensitivity refers to how responsive cells are to the effects of insulin, a hormone that regulates glucose uptake by cells. When cells are insulin sensitive, they are better able to take up glucose from the bloodstream, reducing the risk of high blood sugar levels.
  4. Benefits of Metabolic Flexibility: Metabolic flexibility is associated with improved metabolic health. It allows the body to adapt to different situations, such as variations in food availability and energy demands. It may also play a role in preventing insulin resistance, obesity, and type 2 diabetes. People with good metabolic flexibility are often better equipped to maintain stable energy levels and body weight.
  5. Factors Affecting Metabolic Flexibility: Various factors can influence metabolic flexibility, including diet, physical activity, genetics, and overall metabolic health. Regular exercise, a balanced diet that includes both carbohydrates and healthy fats, and maintaining a healthy body composition can contribute to better metabolic flexibility.

Dr. Ben Bikman, in his research and presentations, emphasizes the importance of metabolic flexibility as a marker of overall metabolic health. He often discusses how promoting metabolic flexibility through dietary strategies like reducing carbohydrate consumption and improving insulin sensitivity can have positive effects on various health markers, including insulin resistance.

As with any scientific concept, the understanding of metabolic flexibility is continually evolving, so it’s a good idea to refer to Dr. Bikman’s latest work or other reputable sources for the most current insights and research findings on this topic.


What is insulin resistance and how does it cause fat weight gain?

  1. Elevated Blood Sugar Levels: With insulin resistance, cells are less efficient at taking up glucose from the bloodstream. As a result, blood sugar levels remain elevated. To control high blood sugar, the body produces more insulin. Elevated insulin levels can promote the storage of excess glucose as fat in adipose tissue.
  2. Increased Fat Storage: Insulin plays a role in fat metabolism. When insulin resistance is present, the body’s ability to break down stored fat and use it for energy can be impaired. Instead, the body favors fat storage, especially in the abdominal area.
  3. Disrupted Appetite Regulation: Insulin resistance can disrupt the signals that regulate appetite and satiety. This can lead to overeating and a higher intake of calories, contributing to weight gain.
  4. Promotion of Lipogenesis: Insulin resistance can lead to an increased conversion of glucose into fatty acids in the liver, a process known as lipogenesis. These fatty acids are then transported and stored as fat in various tissues.
  5. Inflammation and Hormonal Imbalances: Insulin resistance is associated with chronic low-grade inflammation and hormonal imbalances. These factors can contribute to metabolic dysfunction, including the promotion of fat storage.
  6. Impaired Lipolysis: Lipolysis is the process by which fat is broken down to release fatty acids for energy. Insulin resistance can hinder this process, making it more difficult for the body to use stored fat as an energy source.
  7. Effect on Fat Cells: Insulin resistance can affect adipocytes (fat cells) directly, causing them to become larger and promoting the release of inflammatory substances. Larger fat cells can lead to increased fat storage.
  8. Metabolic Syndrome: Insulin resistance is often a component of metabolic syndrome, a cluster of conditions that include high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol levels. Metabolic syndrome can further contribute to weight gain and other health issues.

It’s important to note that while insulin resistance can contribute to weight gain and obesity, it’s not the sole factor. Genetics, diet, physical activity, and other lifestyle factors also play a significant role. Addressing insulin resistance through lifestyle changes, such as improving diet, increasing physical activity, and managing stress, can help mitigate its effects on weight gain and overall health. If you suspect you have insulin resistance, it’s advisable to consult a healthcare professional for proper diagnosis and guidance.

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What is Insulin sensitivity and what impacts insulin to become insensitive?


On the other hand, insulin insensitivity (or insulin resistance) occurs when cells become less responsive to insulin’s signals. This means that even when insulin is present, cells don’t efficiently take up glucose, leading to elevated blood sugar levels. Insulin resistance can eventually lead to type 2 diabetes if not properly managed.

Several factors can impact insulin sensitivity and contribute to the development of insulin resistance:

  1. Obesity: Excess fat tissue, especially around the abdominal area, can promote inflammation and affect insulin signaling, leading to insulin resistance.
  2. Physical Inactivity: Lack of regular physical activity can reduce insulin sensitivity. Exercise helps improve glucose uptake by cells and can lower insulin resistance.
  3. Dietary Factors:
    • High Sugar and Refined Carbohydrate Intake: Consuming large amounts of sugary foods and beverages can lead to chronically elevated blood sugar levels, contributing to insulin resistance.
    • Low Fiber Intake: A diet low in fiber can lead to rapid spikes in blood sugar after meals, which can impact insulin sensitivity.
    • Unhealthy Fats: Diets high in unhealthy saturated and trans fats can contribute to inflammation and insulin resistance.
  4. Genetics: Genetic factors can play a role in determining an individual’s susceptibility to insulin resistance.
  5. Age: Insulin sensitivity tends to decrease with age, making older individuals more prone to developing insulin resistance.
  6. Sleep Disturbances: Poor sleep quality and insufficient sleep can negatively affect insulin sensitivity and glucose metabolism.
  7. Stress: Chronic stress can lead to hormonal imbalances and inflammation that affect insulin sensitivity.
  8. Inactivity: Prolonged periods of sitting and a sedentary lifestyle can contribute to insulin resistance.
  9. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) and hormonal disorders can impact insulin sensitivity.
  10. Inflammation: Chronic low-grade inflammation in the body can disrupt insulin signaling and promote insulin resistance.
  11. Medications: Some medications, such as certain antipsychotics and corticosteroids, can contribute to insulin resistance.
  12. Gut Health: Emerging research suggests that imbalances in gut bacteria (the microbiome) might influence insulin sensitivity.

It’s important to note that insulin sensitivity is a dynamic condition that can change based on lifestyle choices and health status. Lifestyle modifications, including a balanced diet, regular physical activity, stress management, and adequate sleep, can improve insulin sensitivity and help prevent or manage insulin resistance. If you suspect you have insulin resistance, consulting a healthcare professional for proper evaluation and guidance is recommended

Does low estrogen impact insulin sensitivity?


Here’s how low estrogen levels can affect insulin sensitivity:

  1. Insulin Sensitivity and Menstrual Cycle: Throughout the menstrual cycle, estrogen levels fluctuate. Some research suggests that insulin sensitivity tends to be higher during the follicular phase (when estrogen levels are rising) compared to the luteal phase (after ovulation, when estrogen levels decrease). This could indicate that higher estrogen levels are associated with improved insulin sensitivity.
  2. Postmenopausal Women: In postmenopausal women, estrogen levels decline significantly. This decline in estrogen can contribute to changes in body composition, including an increase in visceral fat (fat stored around internal organs). Visceral fat is linked to insulin resistance and metabolic disturbances.
  3. Estrogen Replacement Therapy: Estrogen replacement therapy (ERT) or hormone replacement therapy (HRT) is sometimes prescribed to postmenopausal women to alleviate symptoms of menopause. Some studies suggest that ERT might have a positive effect on insulin sensitivity.
  4. PCOS: Polycystic ovary syndrome (PCOS) is a hormonal disorder that often involves insulin resistance. Women with PCOS typically have higher levels of androgens (male hormones) and lower levels of estrogen, which could contribute to insulin resistance.
  5. Pregnancy: During pregnancy, estrogen levels increase significantly. This hormonal shift can influence insulin sensitivity to accommodate the changes in glucose metabolism needed to support the growing fetus.

It’s important to note that estrogen’s impact on insulin sensitivity is complex and can be influenced by various factors, including the specific context (e.g., menstrual cycle, pregnancy, menopause), genetics, overall hormonal balance, and lifestyle factors. Estrogen is just one piece of the puzzle when it comes to insulin sensitivity, and individual responses can vary.

If you have concerns about insulin sensitivity, hormonal balance, or any related health issues, it’s recommended to consult with a healthcare provider who can evaluate your specific situation and provide appropriate guidance and recommendations.

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insulin resistance

Dr. Jockers on The Causes of Insulin Resistance

The exact causes of insulin resistance are not yet fully understood, however, there are some well-known factors that can lead to developing insulin resistance.

Insulin resistance develops if you have:

  • High levels of insulin circulating in your blood
  • High level of inflammation in your body
  • Excessive fat stored in your pancreas and liver

Factors that may increase the risk of insulin resistance include (6):

  • Being overweight or obese
  • A high-sugar, high-carbohydrate, or high-calorie diet
  • Sedentary lifestyle
  • Chronic stress
  • Smoking
  • High blood pressure
  • Sleep issues
  • Using high doses of steroids for an extended period
  • Polycystic ovary disease or Cushing’s disease

How does exercise make us more insulin sensitive?  What about Nutrition?



  1. Enhances Muscle Glucose Uptake: Physical activity, especially aerobic exercise and resistance training, increases the demand for energy by muscles. This stimulates glucose uptake by muscle cells, even in the absence of high insulin levels. This process improves insulin sensitivity over time.
  2. Reduces Body Fat: Regular exercise helps reduce body fat, especially visceral fat (fat stored around organs), which is strongly associated with insulin resistance. Lowering body fat levels can help improve insulin sensitivity.
  3. Muscle Adaptations: Exercise induces changes in muscle cells that improve their ability to take up glucose. It enhances the function of glucose transporters on cell membranes, allowing more efficient glucose uptake.
  4. Increases Insulin Receptor Sensitivity: Exercise helps sensitize insulin receptors on cells, making them more responsive to insulin’s signals and improving glucose uptake.
  5. Affects Hormone Regulation: Exercise can positively influence hormones related to metabolism, such as reducing cortisol (stress hormone) levels and increasing adiponectin (a hormone associated with improved insulin sensitivity).
  6. Enhances Overall Metabolic Health: Exercise improves overall cardiovascular health, lipid profiles, and inflammatory markers, which are all connected to insulin sensitivity.

Nutritional Therapy:

  1. Balanced Diet: A diet rich in whole, unprocessed foods provides essential nutrients for proper metabolic function. Avoiding excessive consumption of refined sugars and carbohydrates helps prevent blood sugar spikes that can lead to insulin resistance.
  2. Controlled Carbohydrate Intake: Managing the intake of carbohydrates, especially those with a high glycemic index, can help regulate blood sugar levels and reduce the demand for insulin secretion.
  3. Healthy Fats: Including healthy fats, such as omega-3 fatty acids from sources like fatty fish, and monounsaturated fats from sources like avocados and nuts, can support insulin sensitivity.
  4. Fiber-Rich Foods: Foods high in fiber, such as whole grains, legumes, vegetables, and fruits, help slow down the absorption of glucose and improve insulin sensitivity.
  5. Protein: Adequate protein intake supports muscle maintenance and growth, which in turn can enhance glucose uptake and utilization.
  6. Balanced Meals: Combining carbohydrates with protein and healthy fats in meals can help stabilize blood sugar levels and prevent rapid spikes.
  7. Hydration: Staying hydrated supports overall metabolic processes, including insulin sensitivity.
  8. Anti-Inflammatory Foods: Incorporating foods with anti-inflammatory properties, like turmeric, ginger, and green tea, can help manage inflammation and improve insulin sensitivity.

Exercise and nutritional therapy are complementary approaches. Combining regular physical activity with a balanced diet that supports metabolic health is an effective strategy to enhance insulin sensitivity. Consulting with a healthcare professional, such as a registered dietitian or a fitness expert, can help you create a personalized plan that takes into account your health goals, preferences, and any underlying conditions.

Exercise and fasting can both contribute to improving insulin sensitivity, but they work through different mechanisms.

While both approaches offer metabolic benefits, they have distinct effects on the body’s response to insulin and glucose regulation.

Exercise and Insulin Sensitivity:

  • Exercise increases glucose uptake by muscle cells even without the need for a large amount of insulin. This effect is partly due to the increased expression of glucose transporters on muscle cell membranes.
  • Physical activity stimulates the activation of certain cellular pathways that enhance insulin receptor sensitivity. This means that cells become more responsive to insulin’s signals, leading to improved glucose uptake and utilization.
  • Regular exercise helps lower body fat levels, especially visceral fat, which is linked to insulin resistance. Reduced body fat contributes to better insulin sensitivity.

Fasting and Insulin Sensitivity:

  • Fasting involves periods of not consuming calories, allowing insulin levels to decrease. When insulin levels are low, cells become more sensitive to insulin’s effects.
  • Fasting helps deplete glycogen stores (the stored form of glucose) in the liver and muscles. This makes room for the uptake of glucose during periods of refeeding, improving insulin sensitivity in response to carbohydrate consumption.
  • Fasting can promote metabolic adaptations that improve glucose utilization and insulin sensitivity.

Synergistic Effects: There is evidence to suggest that combining exercise with fasting might have synergistic effects on insulin sensitivity and metabolic health. For example, exercising in a fasted state can enhance the body’s ability to use fat for energy, preserve muscle mass, and further improve insulin sensitivity.

It’s important to note that individual responses to exercise and fasting can vary. Some people may find certain strategies more effective or sustainable than others. The key is to find an approach that works for you, supports your health goals, and aligns with your lifestyle.

Before making significant changes to your exercise routine or dietary habits, especially if you have underlying health conditions, it’s advisable to consult with a healthcare professional. They can provide personalized guidance based on your individual needs and circumstances.


Dr. Jockers suggestions:

Best Foods to Improve Insulin Resistance

To lower inflammation in your body and stabilize your blood sugar, you need to remove toxic foods, such as sugar, artificial sweeteners, alcohol, caffeine, GMOs, trans and hydrogenated fats, artificial ingredients, high fructose corn syrup, and processed foods. Instead, you should fuel your body with nutrient-dense foods using the principles of an anti-inflammatory ketogenic diet.

The most important part of an anti-inflammatory keto diet is healthy fats, including avocados, coconut oil, olive oil, coconut butter, coconut milk, pasture raised eggs, and grass-fed butter. You can get plenty of antioxidants to protect your health from free radical damage through herbs, non-starchy vegetables, and low-glycemic fruits, such as berries, lemons, and limes.

Another important part of your diet on keto is high-quality protein, such as grass-fed beef, wild-caught fish, pasture-raised poultry, and wild game. Adding some nuts and seeds to your diet can add additional fiber and Omega-3s to reduce inflammation. Fermented foods, such as sauerkraut, kimchi and pickles can protect your gut health. Natural sweeteners, such as monk fruits and stevia can add sweetness to your life when needed in a recipe.  If you want to learn more about the keto diet, you can read this article.

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