Practical Practitioner

By: Pamela Egan, FNP-C CDE

Fatigue and weight gain linked to Insulin Resistance

Experts estimate that 25 percent of all Americans suffer from Insulin Resistance. The percentage is much higher among pre-menopausal women.

The health effects of insulin resistance- also called Metabolic Syndrome and Syndrome X- are striking. Besides leading directly to diabetes, it’s been associated in heart disease, obesity, breast cancer, Alzheimer’s, polycystic ovarian syndrome (PCOS) and many more diseases. It also often is associated with hormonal imbalances.

Because insulin is one of the “major” hormones, it’s also impossible for your body to balance its “minor” hormones (estrogen, progesterone and testosterone among them) until your insulin metabolism is balanced first. For instance, if you have hot flashes and you are insulin resistant, it’s going to be nearly impossible to cure the hot flashes without first reversing the insulin resistance.

Over 80 million Americans suffer from insulin resistance, and it appears to sit at the center of related health problems. Women who are insulin resistant are at much greater risk of obesity, diabetes, high blood pressure, heart disease, high cholesterol, breast cancer and polycystic ovarian syndrome (PCOS). There is some evidence that insulin resistance may contribute to endometrial cancer. It’s also been implicated in Alzheimer’s disease.

Insulin resistance often accompanies the most common complaints fatigue and weight gain. As women approach menopause, they become increasingly intolerant of carbohydrates and find it easier to gain weight especially around their waists. Afternoon blahs, sugar crashes and carbohydrate cravings may all be early symptoms of insulin resistance.

Our metabolism developed ages ago, when our diet included fewer and more complex carbohydrates. Today, most calories in an average diet come in the form of carbohydrates, and most of those are simple carbohydrates- sugars that quickly enter the bloodstream. The body has to release high levels of insulin to keep the level of glucose in the bloodstream from spiraling out of control. Eventually, the cells quit responding to this signal. At this point the body is “insulin resistant”.

The body wasn’t designed for prolonged high levels of insulin, which disrupt cellular metabolism and spread inflammation. Diabetes occurs when the body fails to keep blood glucose under control. There are many negative health outcomes before full blown diabetes.

Of special concern to women is how insulin resistance disrupts fat metabolism. When the cells won’t absorb the extra glucose, the liver has to convert it into fat. Fat cells are loaded with glucose receptors, so this is a vicious cycle. While the insulin-resistant woman is gaining weight, her cells are actually “starved” for glucose, so she feels exhausted and tends to eat carbohydrate-heavy foods in search of energy.

These extra fat cells produce extra estrogen. That contributes to the estrogen dominance that causes so many symptoms during the early stages of pre-menopause. (Treatment of insulin resistance to be continued next week).

This article was originally published February 7, 2005 in The St. Tammany News.

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