Insulin sensitivity supplements and applying functional medicine

Pick the low-hanging fruit to get started with functional medicine and insulin sensitivity supplements to impact patient success

The best way to start a functional medicine practice is to start a functional medicine practice. When you learn a musical instrument, you usually learn one song at a time. You can learn functional medicine the same way, one “song” at a time, and make an impact “prescribing” insulin sensitivity supplements and protocols to help patients.

Think of insulin insensitivity as the “Chopsticks” of functional medicine. There are several reasons that make insulin insensitivity (also called insulin resistance or prediabetes) a good place to start:

• It affects a lot of patients
• It is at the root of many of your patients’ complaints
• It is easy to get good results

Too much sugar = too much insulin

The average American consumes more than 200 pounds of sugar each year (compared to about 10 pounds in the 18^th century). About half of the calories the average American consumes consist of refined carbohydrates, which the body treats the same way it treats sugar. As a result, we are producing too much insulin. Eventually, we become insensitive to insulin, and that has serious health consequences. Insulin insensitivity can become diabetes if not treated with proper diet and insulin sensitivity supplements.

A patient can have insulin resistance but still have normal lab results. Insulin resistance can lead to high triglycerides, although that test is not used to diagnose diabetes. A more reliable test is the Hemoglobin A1C test (sometimes just called the A1C test), which indicates blood sugar levels over time. An A1C level of 6.5% or higher on two separate tests indicates that diabetes is present. An A1C between 5.7-6.4% indicates prediabetes (insulin resistance), while below 5.7 is considered normal.

Impacting 1/3 of the population

It affects a lot of patients: There are 100 million patients in the U.S. alone, nearly 1/3 of the population. There are 34 million Americans with Type 2 diabetes (which is just insulin insensitivity that has gotten out of hand). Nearly 25% (7.2 million) of those with diabetes do not know they have the condition. Only 11.6% of those with insulin insensitivity know they have it.

It is at the root of many of your patients’ complaints. Symptoms of insulin sensitivity include fatigue, weight gain, brain fog, carbohydrate craving, and periods of hypoglycemia after a high-carbohydrate meal (often needing a nap after eating). Many of your patients will just plain feel better when you treat this.

Many more serious health problems can be addressed by treating insulin insensitivity as well. These include:

• Polycystic ovary disease
• Low testosterone in men
• Insomnia: It is common for someone with insulin insensitivity to wake up in the middle of the night and have trouble falling back to sleep.
• Hypertension: About half of your patients with hypertension have high blood pressure because of insulin insensitivity.
• Metabolic syndrome: High cholesterol, low “good” cholesterol (HDL), high “bad” cholesterol (LDL) and high triglycerides. Medicine does not seem to know what to do about high triglycerides, and often places these patients on statins. Treating insulin insensitivity can lower cholesterol in many patients as well as lowering triglycerides.
• Obesity: One of the best strategies for losing weight is to treat insulin insensitivity.
• Biliary stasis, gallstones: Bile tends to thicken, creating “biliary stasis.” Early signs of this include dry skin and itching. It can progress to gallstones.
• Fatty liver
• Type 2 diabetes: If left untreated, insulin insensitivity can lead to Type 2 diabetes.

Insulin sensitivity supplements and treatments

1. Diet: Have the patient pay attention to the glycemic load (not the glycemic index) of the food he or she eats. They are not to eat a food with a glycemic load greater than 10. Charts are available online.

Intermittent fasting is a well-researched way to get insulin insensitivity under control and to lose weight. You have an eight-hour window to eat. There needs to be 16 hours between dinner and breakfast the next morning. If you eat dinner at 5 p.m., breakfast is at 9 a.m. the next morning. It works because when you fast you produce glucagon, which is a hormone that helps to break down fat.^1,2 This is also why people with insulin insensitivity should be discouraged from snacking between meals.

2. Exercise: This should be obvious. For one thing, exercise helps prevent diabetes. The authors of one study stated, “Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a six-year period among those with IGT [glucose insensitivity].”³ There are literally hundreds of scientific studies showing the benefits of exercise for diabetics. There are too many to list here. They consistently show a lowering of A1C scores for diabetics who begin an exercise regimen. Light exercise is best, and it should be done daily.
3. Magnesium Orotate (if there are cardiac issues) or Magnesium Taurinate (if there is high blood pressure). Have the patient take it on an empty stomach (magnesium binds to fats in the diet). Have them take it before bedtime to bowel tolerance. Increase by one tablet each night until stools become soft, then back off. Magnesium and its role in blood sugar control have been extensively studied. Insulin insensitivity and the overproduction of insulin found in Type 2 diabetes may actually interfere with magnesium absorption.⁴ An insulin sensitivity supplement such as magnesium has even been shown to improve the cholesterol and triglyceride levels of people with Type 2 diabetes.⁵ Magnesium intake can help prevent the transition from prediabetes (glucose resistance) to diabetes.⁶ Poor magnesium status may even increase the risk for neuropathy in diabetics. Research found that diabetic patients with polyneuropathy tended to have low levels of magnesium when tested in the red blood cells.⁷
4. Multiple vitamins designed for blood sugar balance: Many insulin sensitivity supplements and nutrients, like B vitamins, vitamin D, magnesium and other nutrients have been shown to improve glucose tolerance. Many of the supplement companies have combined these ingredients to address insulin insensitivity. Give your patient such a product and have them take it according to manufacturer’s recommendations.
5. Berberine: Give 500 mg 3x/day. Berberine has been well-researched and shown to reduce blood sugar and A1C. Studies have shown that berberine can help and that berberine performs similarly to metformin. Subjects have had significant decreases in A1C, fasting blood glucose, postprandial blood glucose, and plasma triglycerides.^8,9,11,12,16 It has even been shown to lower cholesterol,^10,12,13 reduce BMI,¹⁷ and it may also help with fatty liver disease.¹⁵

Lessen the need for medication

If the patient already has Type 2 diabetes, this same regimen will help. Just make sure they are monitoring blood sugar levels if they are on medication. The program will change their medication need. One supplement that may be helpful to patients who have diabetes is lipoic acid.

Lipoic acid: There are several studies that show lipoic acid to help prevent and reduce suffering from diabetic neuropathy.^{18,19,20,21,22,23,24} All these studies not only find that lipoic acid is beneficial to diabetics, but it is also safe. Supplementation should be considered for improving the lipid profile and for protecting against neuropathy in diabetics. The dose is usually 200 mg 3x/day.

Fatty liver and biliary stasis: Insulin insensitivity is linked to fatty liver and biliary stasis. Fatty liver can progress to cirrhosis of the liver. Many studies have found that eating sugar and developing insulin insensitivity causes problems with the liver and gallbladder.^25,26,27,28 If the problem has progressed to biliary stasis, several companies make supplements that are designed to thin bile and address the problem. These products have either an artichoke base or a beet base. Artichoke is preferable because beets have oxalates, which are a problem for many patients (especially those with leaky gut). If your patient has the following symptoms, consider adding such a product to the regimen.

• Nausea or digestive distress triggered by greasy food
• Dry skin
• Itchy skin
• Clay-colored stools
• Fat or grease in the stool
• Gastric reflux that does not respond to other treatment
• Constipation that does not respond to other treatment
• Bitter or metallic taste in the mouth
• Deficiency in essential fatty acids
• Deficiencies in vitamins A, D, E and K
• Pain under the right rib cage
• Biliary stasis is a possibility in pregnant women with itchy skin

Looking for and treating insulin insensitivity in your patient base will not only get you started with functional medicine, but will also help a lot of your patients.

PAUL VARNAS, DC, DACBN, is a graduate of the National College of Chiropractic and has had a functional medicine practice for 34 years. He is the author of several books and has taught nutrition at the National University of Health Sciences. For a free PDF of “Instantly Have a Functional Medicine Practice,” email him at paulgvarnas@gmail.com or visit drvarnas.com.