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Hypothyroidism and Insulin Resistance

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Certified Nutrition Specialist® Evelyn DeDominicis shares how insulin resistance (when cells in your muscles, fat, and liver can't easily take up glucose) associates with your thyroid and metabolism.

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[00:00:00] Evelyn DeDominicis: Hi, there. I am Evelyn DeDominicis from evelynd.com. And I am here to share with you information about insulin resistance, your thyroid and metabolism, and how everything works together. And can pose some problems if we are not working on our nutrition and lifestyle. So let's begin first a little bit about me, just the highlights.

So I am a Board Certified, Certified Nutrition Specialist. I have a Master's degree in functional medicine nutrition. I'm also a life coach, a yoga teacher, and intuitive healer. I was diagnosed with Hashimoto's, which is autoimmune thyroid disease in 2002 after I gave birth to my third daughter, who is now 18.

My dad [00:01:00] has type two diabetes, and he manages it with diet and lifestyle and some supplements and he is on Metformin, but he's doing really well. He's 78.  I went through menopause when I was 47, so I am 52 now, and  that was in 2015. My period stopped. So I am menopausal just something that I'm going to touch on later.

Kind of connecting those dots. I have decades of yo-yo dieting, intense exercise, you name it, restriction, all kinds of things to try to manage my weight in the past. I also have history of gut issues. Adrenal exhaustion, hormonal imbalances, even had heavy metals with high mercury and lead.

So now today I am diet free. No yo-yo dieting. It's not part of my lexicon or anything that I do. I have balanced weight and hormones, peace and ease around food, my Hashi's is in [00:02:00] remission, and I enjoy wine and other indulgences weekly. So I specialize in helping women in midlife optimize their nutrition and their lifestyle in a way that's empowering, that gives them balance with their weight, their hormones, their gut, whatever.

And I get into kind of that root cause, the whole mindset piece that is so important when it comes to how we actually behave our food choices, et cetera.

All right. So today we are talking about insulin resistance and how it connects with your thyroid and your metabolism. So what is insulin resistance? The analogy that I love and I always use is think of it as the boy who cried wolf. So he kept crying wolf and nobody would let him in because he kept, basically, lying.

And so with insulin resistance in the body, this is a physiological state where your blood sugar is elevated [00:03:00] either through carbohydrate intake that is too high for your current capacity, as well as stress can be another thing that can raise your blood glucose, your blood sugar.

And when that happens, your pancreas will secrete insulin to bring the body into homeostasis, or balance, because it's very dangerous to have elevated blood sugar. You could die, or, have really severe reactions. So the pancreas secretes the insulin to package that blood sugar and bring it to your muscle tissues, your liver and if those two areas are at capacity, it will store the excess insulin with the blood sugar package in that cells.

This is how we gain weight if we are insulin resistance. What happens though is when those cells are like, getting this barrage of signaling of "blood glucose is high," either through  too much carbohydrate intake and/or too much stress ,  the cells start to say, [00:04:00] treat the package of insulin with the glucose as "mmhmm, I'm not going to let you into the cell." So the pancreas is like, "then I'm just going to keep producing insulin." And so there's excess insulin. And when that happens, that can increase Inflammation, it can increase weight.

It can cause all kinds of symptoms. And one of the most dangerous is it can lead to diabetes. And then as diabetes can lead to, all a host of other symptoms and disease states as well. So insulin sensitivity is something that we want. Insulin resistance is what we don't want, right? We want to be sensitive to insulin and not resistant to insulin so that the body is running optimally.

Another example here, another graphic in terms of we eat food, the pancreas makes insulin, the cells resist. They learn how to resist the insulin. And [00:05:00] then the sugar gets stored as fat. We feel terrible. Like we're tired, we're hungry all the time. And so we keep perpetuating the cycle and from a hormonal perspective, the hypothalamus and the brain, along with the pituitary communicates to our endocrine system. So the thyroid, the pancreas, the adrenals, and our sex hormones—everything is always communicating with one another, which is what can explain the connection between low thyroid function or even high thyroid function like hyper active thyroid or hypo underactive, thyroid, and insulin resistance.

There is always a connection. Here's some snippets from a study, that shows this. It's a study in 2015  and basically just emphasizing the connection between insulin resistance and thyroid hormone.

A couple of things I wanted to point out here in the highlights is one: plasma glucose level were [00:06:00] not significantly different among groups. So in this specific study, they took people that were had thyroid issues and didn't, and with the insulin resistance, their blood glucose wasn't much different. So that this is something I'm going to talk about a little bit. Just because your blood glucose is normal, doesn't necessarily mean you are efficiently managing your insulin.

And then another point here is: the serum thyroid hormone, but not TSH were considered to be. associated. So a lot of doctors, conventional labs will only look at TSH (thyroid stimulating hormone) to assess how your thyroid is doing, but they need to actually look at the actual thyroid hormones, T4 T3, so that they can assess.

[00:07:00] So the the gold standard, when it comes to these studies is something you might've picked up on the that panel, but you probably might have to ask for insulin—in my insurance it's covered so I'm always asking because I want to see how my body is doing. And just even if you wanted to do a quick and dirty with  understanding your insulin optimization, your fasting insulin should be under three.

Anything between two and five is considered optimal from a functional medicine [00:08:00] perspective. So looking at that fasting insulin is something that you can start to talk about with your doctor. Here other signs cause of insulin resistance. One: obesity, right? So losing weight alone can help reverse insulin resistance. A waistline—specifically a waist to hip ratio of 0.8 for men or 0.7 for women— anything above that would be considered a risk factor for insulin resistance, which is again, that kind of precursor to diabetes. High blood pressure, high fasting, triglycerides, anything over 150. Ideally you even want that to be under 100. And then any kind of low HDL is also, so it's really that triglyceride HDL ratio that is indicative of insulin resistance.

Other signs are skin tags, dark skin patches,  and you want your fasting glucose to be under [00:09:00] 95—ideally anything between 85 and 100. And there is a lot of bioindividuality in this regard and stress also plays a big role in terms of how you're managing your blood sugar. And you want you HBA1C to be less than 6% —4.6 to 5.4 is ideal.

So those are other things you can look at. What are some re some other risk factors besides obesity and all the things that I mentioned before? One is your genetics. I mentioned in the intro slide that my dad has type two diabetes. So I know that my fasting insulin and my fasting glucose tends to run high when I'm not doing the right things.

However, this does not mean that you are destined for insulin resistance or diabetes. All it means is that you might have to be a little bit more diligent and intentional with your diet and lifestyle, to manage it well, to be in that optimal state. Unfortunately age is something [00:10:00] that increases your risk factor for developing insulin resistance.

So over the age of 45, we find more cases of insulin resistance, especially if you are a woman in midlife with all the hormones that I walked through. There is a shift that happens in the perimenopause-menopause stage, and we tend to be more insulin resistant, which means less tolerant to stress and less tolerant to carbohydrates.

It doesn't mean carbohydrates are bad. It just means that we need to find that right tolerance level for you as an individual and then your nutrition and lifestyle. An inflammatory diet of processed foods, toxins—whether that's what you put on your body, what you inhale in your home or what you're exposed to, whether in your work or in outside, pollution—those kinds of things.

Those can increase your risk of developing insulin resistance, just having an unhealthy lifestyle in general. So not getting enough sleep, being [00:11:00] too stressed out, being negative about life,  all of these can significantly decrease your insulin sensitivity and decrease your metabolism, your thyroid function, and increase your disease risk.

How do you turn this around? If you already know you're struggling? what are some of the things that you can do? One, I already hinted to this is clean up your diet. So eat real nutrient dense food in the right balance. So what does that mean? There's macronutrients. A all of our food is divided into macronutrients: protein, fat, and carbohydrates.

You want a base. And then you want your non starchy vegetables to be the foundation for each meal. And then you want to have a balance of fat and starchy carbohydrates or fruit in the real food family, so that could be grains or beans, if [00:12:00] tolerated as well as your starchy vegetables and your fruit, those might need to be adjusted.

And in balance with your intake of fat. Another strategy that's very successful, tons of research on this, is to eat less often. I was raised to wake up and eat within a half hour and eat every three hours to stoke your metabolism. That is false, right? So you want to experiment perhaps with intermittent fasting.

This could be and eating later and definitely the research shows, closing your eating window earlier, so not eating at night,  probably not eating after dark most days would be actually a great strategy to improve your insulin sensitivity. And another thing you could do if you're not into intermittent fasting is just avoid or minimize snacking.

And if you do snack, make sure you're not snacking on only carbohydrates. Maybe instead of the [00:13:00] chips or the cookies or the donuts or the bagels have a snack, something that's higher in protein, maybe a little bit of fat as well. That could be nuts or that could be, a hard boiled egg or something like that.

Look for things that are more based in protein, maybe non starchy veggies, like some, celery with hummus, those kinds of things might be a better choice if you do have to snack. And then healthy lifestyle, right? So optimizing your sleep, even having one bad nights of sleep can lower your insulin sensitivity by up to 33%.

So making sure you're prioritizing your sleep and you're getting good restorative sleep. You want to move every day. So whether that be a walk or just moving around, you don't want to be sitting so much .  It doesn't have to be excessive, so it doesn't need to be necessarily like a high intensity interval training where you're at the gym for two hours or [00:14:00] running miles and miles on a treadmill or a Peloton or that kind of thing, you need to find the right dose of movement that feels good in your body. And that keeps you balanced. Making sure you're moving every day, for however much you can handle it, and that's going to be unique to the individual as well.

Being in nature is a great way to lower cortisol, improve insulin sensitivity. Building muscle— so,  in addition to walking or hiking or even running, if you can do that, doing some strength training is something that you can just be bodyweight types of things, or you can lift weights. If you love doing that. Anything to help build muscle. Increased muscle mass improves your insulin sensitivity. So that is very clear and it's also good for our bone health and those kinds of things.

I've already talked about sitting, managing stress. This is a big one, so you could have your diet completely perfect, but if you're always stressed out, [00:15:00] you might still have insulin resistance and or diabetes, leading into pre-diabetes or diabetes. Making sure that you are managing your stress and that can just be with mindset work. That's a big focus of my work as well with my clients and in my programs. I'm working on mindset, making sure you're not emotionally eating those kinds of things or unintentionally, mindlessly eating those kinds of things.

You also want to minimize your toxic exposure as much as you can, for the things that you're actually buying. See if there is a cleaner alternative, a greener alternative, that's less toxic. If you smoke, make sure you quit. There's definitely research that shows that insulin resistance is higher in people that smoke cigarettes. And alcohol in moderation. So that's something that if you enjoy imbibing in alcohol, a glass of wine here and there, just make sure it's in the right balance for your body. And then you should be good to go.

All right, [00:16:00] that's it for me on this topic. If you would like to learn more and just stay connected with me, you can get lots of resources at evelynd.com. I have a free download. I have a quiz you can take about for my ladies in midlife. If you would like to partake in a free 20 minute discovery session, you can do that here evelynd.com/workwithme and follow me on Facebook and Instagram at Evelyn D Nutritionist.

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