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Unexplained Weight Gain?

Have you had a 10, 20, 30 lb weight gain in the last 1-2 years and wonder where it came from? Maybe your diet has remained about the same. Activity level not changed much, and yet - here come the pounds. So easy to put on, so difficult to get off!


Often times the thought is - "maybe my thyroid is off"? That is absolutely possible, and the thyroid should be evaluated. But one hormone that seems to get ignored is fasting insulin. Maybe you've had a glucose level drawn, or a HgA1c looking at blood sugar control over the past 3 months, but just because those labs come back in normal range, does not address the possibility of higher insulin release going on behind the scene in order to keep blood sugars in normal range.


Have you heard the term "insulin resistance"? This refers to cell receptors of the body becoming less sensitive to insulin's binding, which facilitates sugar out of the bloodstream and into the cell. Higher levels of insulin are released from the pancreas in an effort to keep blood sugars stable. As insulin levels increase, hormonal imbalances are now under way. Elevated insulin hormone can affect adrenal function and cortisol hormone levels. The thyroid may be impacted by elevated insulin and then there are the sex hormones that insulin can cause imbalances with. (Polycystic Ovarian Syndrome/PCOS, elevated Testosterone levels and Estrogen dominance to name a few).


Weight gain is not the only symptom of insulin resistance. Other possible symptoms may be headaches, brain fog, joint pain, fatigue, elevated blood pressure, ED or other sexual dysfunction, menstrual cycle changes, acne, irritability, and generalized inflammation.


Applying the Functional Medicine approach to resolve these symptoms, we want to reverse the insulin resistance, improve insulin sensitivity of the cells and bring fasting insulin levels down to optimal range, which is around 3-5 uIU/mL. (There is a difference between "normal" and optimal. My patients know this is important to me when we review labs).


A few of my favorite recommendations for reversing insulin resistance:


1. Increase fiber intake - aim for above 35 g/day (I can't wait to write about this goldmine of a nutrient. Stay tuned!)

2. Consistent exercise - aim for at least 5 days a week for 45 min/day

3. Intermittent fasting - aim for 12 hours nightly (okay, another big topic here - more details to come!)

4. Sometimes a little support from supplements such as NAC, Alpha-lipoic acid or Resveratrol can be helpful as well.


Generally, I like to retest fasting insulin about 3 months later to see how the progress is coming.