The Connection Between Insulin Resistance and Hormonal Imbalances_Final_Updated HHC July18 version

>> Hi there. It's great to see you again. In this lecture, we're going to talk about blood sugar control and its connection to different hormonal imbalances. As you may already know, there's a lot more to blood sugar than just diabetes. Blood sugar plays a big role in a lot of conditions such as polycystic ovarian syndrome, or PCOS for short, Alzheimer's, insulin resistance, thyroid disease, and cortisol dysregulation. So while a client may not have full on diabetes, they may have issues that are the early signs of it. As their Health Coach, you'll want to be aware of these signs and know what to do to help your clients keep their blood sugar levels in check. Let's start with a quick review of how normal blood sugar management works. Blood sugar control in the body is run like a tight ship. The hormones are brilliantly designed to work together and balance each other out. As food enters the digestive tract, the pancreas hears about it and sends its trusty general insulin to start getting the cells ready to receive all that sugar as it gets digested and processed. The pancreas is getting information the whole time from the scouts around the body. And once it hears that the sugar levels are starting to go down, it sends out another trusted general, glucagon, to tell the cells to stop taking in the sugar so the levels don't get too low. When the system stops working properly, the cells don't receive the sugar, and it stays in the bloodstream. Insulin resistance is what happens when the signal is going out, but the cells are just ignoring it. Think of it like a traffic jam and the ambulance can't get through. What's going on here is that there's so much inflammation blocking the cells that the important stuff can't get in. There's plenty of insulin, but nothing happens when it gets released, which leads to lots of insulin and sugar in the bloodstream. When insulin resistance first starts, the traffic isn't too bad, and eventually, the cells begin to take up the glucose. This is why it often goes unnoticed in the early stages, but as it gets worse, it's harder and harder for insulin to do its job. The cells in the body that respond to insulin include the muscles, liver, and fat tissue. They're affected when this happens because they are the major players in energy storage and usage. The brain is affected by insulin resistance too. There are certain cells in the brain that are insulin sensitive. These cells are very dependent on blood sugar to keep going. When the brain cells become insulin resistant, food intake, bodyweight, reproduction, learning, and memory are all affected. Early symptoms your clients might complain of include feeling foggy, unfocused, and scatterbrained. Many times, clients will feel like no amount of caffeine in the morning can get them going or they have massive sugar cravings in the mid-afternoon or after dinner and feel they must satisfy those cravings with their favorite sweet treats. Insulin resistance is only the beginning of blood sugar issues. It's followed by type 2 diabetes and then metabolic syndrome if not addressed early. And metabolic syndrome is serious business. It causes stroke and heart disease and is one of the leading causes of death. Metabolic syndrome is also closely tied to PCOS, and now it's even considered a factor in endometrial, breast, and colon cancer. For most people, their fasting blood sugar isn't high when insulin resistance begins. Quite often, your clients don't even know they have an issue, but the disease is silently taking its toll on their bodies. This is a shining example of why preventative healthcare is so crucial and how badly Health Coaches are needed in this system. Symptoms of insulin resistance include fatigue, brain fog, belly fat, sleepiness after meals, and sugar cravings, especially right after a meal. Insulin resistance officially becomes type 2 diabetes when the fasting blood sugar is over 120 and a lab test called the hemoglobin-A1C is more than 6.5. This is often when people first learn they have blood sugar problems because the symptoms are more obvious. Symptoms of type 2 diabetes include increased thirst, frequent urination, poor healing of cuts or wounds, increased hunger, and unexplained weight loss. Metabolic syndrome refers to a cluster of medical conditions. When any three of the following are present, a person may be diagnosed with metabolic syndrome. High triglyceride levels, abdominal obesity, high blood pressure, high fasting blood sugar, and low HDL cholesterol levels. Please remember, it's not your role to diagnose your clients. If you have a client who appears to be a candidate for metabolic syndrome, refer them to their primary doctor for assessment. There are four other conditions that are directly correlated to insulin resistance. These are polycystic ovarian syndrome or PCOS, premenstrual syndrome or PMS, thyroid hormone imbalance, and gestational diabetes. Let's start with polycystic ovarian syndrome. It's important to understand that PCOS is actually a form of metabolic syndrome. Although this condition was originally identified based on cysts found on the ovaries, you may be surprised to learn that the cysts probably don't contribute much to the syndrome. It's the metabolic changes that are the real issue, and in fact, it's no longer even necessary to have ovarian cysts and be diagnosed with PCOS. The common signs of PCOS are increased facial and body hair, acne, excess androgens or male hormones, male-pattern baldness on the head, abdominal obesity, and ovulation abnormalities. However, it's possible to be at a regular weight with no excess hair growth and still have PCOS if you have a predisposition to insulin dysregulation. Even lean women with PCOS have increased insulin production. PCOS seems to be one way that the body shows metabolic syndrome. It probably starts with high insulin levels due to the consumption of too much sugar and refined carbohydrates. The ovaries have insulin receptors. Excess insulin causes them to make androgens rather than their usual pro-fertility hormones, estrogen and progesterone. Too much testosterone, one of the androgens produced by the ovaries, can decrease or even completely stop ovulation. Testosterone, when not balanced out by DHEA, also causes increased abdominal obesity, a problem normally seen more commonly in men than in women. It does this both directly and by ramping up production of cortisol, which is known to increase visceral fat. Next, we have premenstrual syndrome or PMS, which is directly affected by insulin resistance. Insulin can also cause estrogen dominance, not through acting on the ovaries like you might expect but instead through the peripheral muscle. While the ovaries are the main source of estrogen in the body, it's also made in peripheral muscle by converting testosterone to estrogen. So what's happening here is that too much insulin causes the muscles to grow which would then convert more testosterone to estrogen. As a reminder, estrogen dominance occurs when estrogen becomes dominant over progesterone in the body. It is linked to PMS, painful heavy and long periods, breakthrough bleeding, long cycles, PCOS, endometriosis, and fibroids. Excess weight increases insulin resistance and it also raises estrogen, that is why women who are overweight are more prone to conditions related to estrogen dominance, so weight loss can improve both the insulin resistance and the estrogen dominance. This excess estrogen can suppress follicle stimulating hormone or FSH production. When FSH is suppressed, this causes luteinizing hormone or LH to dominate over FSH. Remember, FSH is responsible for maturing your follicles. When LH dominates over FSH, ovulation generally begins to sputter and may stop occurring completely. This is because FSH isn't able to complete its job. This leads to lower progesterone. Without enough progesterone, the body can't fully support normal menstrual cycles or pregnancy. Next, let's talk about thyroid hormone imbalance. Poorly controlled blood sugar has an impact on the thyroid hormones and vice versa. Over time, high insulin levels can cause the thyroid to malfunction. When this happens, the thyroid becomes enlarged and produces nodules. However, it can also work the other way around, both hypothyroidism and hyperthyroidism can worsen insulin resistance. Thyroid dysfunction has a negative impact on the beta cells of the pancreas, and it can also affect the insulin receptors in the muscle. The main takeaway point here is that optimally managing thyroid disease helps to make blood sugar more balanced and managing blood sugar helps to improve thyroid disease. Finally, gestational diabetes is an early sign of insulin resistance in later life. Gestational diabetes is on the rise just like all the other blood sugar disorders. With treatment, the complications can be managed during pregnancy, but women who have gestational diabetes are still at risk later in life for type 2 diabetes. It is important to enquire if your clients have a history of gestational diabetes so you can help them decrease their risk of developing type 2 diabetes after they've given birth. The risk can be reduced substantially through diet, exercise, and weight loss. Okay, that concludes our introduction to blood sugar and its impact on other hormones in the body. To summarize, we discussed how normal blood sugar management works in the body, how insulin resistance begins, and the symptoms of this condition as well as its impact on other important hormones like estrogen, progesterone, testosterone, and thyroid hormone. We also discussed how insulin resistance can develop into serious conditions like type 2 diabetes, metabolic syndrome, polycystic ovarian syndrome, thyroid disease, and gestational diabetes. We'd love for you to join the conversation in Facebook and share what you learned in this lecture about blood sugar and insulin along with any of your own experiences that you're comfortable disclosing. Prior to this lecture, were you aware of insulin's profound impact on other endocrine glands like the ovaries and thyroid? Let us know in the Facebook group. Thanks so much for watching, and we look forward to seeing you in the next lecture.