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The Surprising Reason Most Practitioners Quit – And What You Must Know about Insulin Resistance

 

I hope this is helpful to you!  This is one of the top three root causes of dis-ease, imbalance, and dysfunction I see in my own clients.  And I bet you’ll see them in yours too!  Get savvy.  Because wildly satisfied clients build wildly successful practices!

Please feel free to post any follow-up questions or comments below.  I am happy to provide more detailed guidance on any of the pearls I shared.  I want to hear from you!

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  • If you want more fundamental info on insulin resistance, please check here.   And yes, there are many practitioners who did not have heavy science backgrounds who are now powerfully and confidently comfortable with all of this detail.  If you are passionate and committed, you can absolutely learn the pearls of functional medicine know-how.
  • In general, sustained, elevated blood sugar is toxic to nearly all tissues in the body.  This is why there are so many debilitating secondary effects to insulin resistance.  The kidneys and the eyes (as well as various types of neuropathy) are of the tissues which are most often affected first.
  • Yes, fasting glucose tolerance test (which also measures insulin) is definitely the “gold standard” of blood sugar dynamics.  However, this is a cumbersome, multi-hour test and not very practical for gauging ongoing progress in addressing the root cause of insulin resistance.  Thus, fasting insulin (or c-peptide, less often available but even more accurate given the longer half-life in the body) is perhaps the best practical lab gauge of progress.
    • Both fructosamine and HbA1c are markers of blood sugar levels over a longer period of time, but both have pitfalls.  In the moderate stages of insulin resistance progression, patients can actually struggle more with low blood sugar – and hypoglycemic episodes – vs. high blood sugar – for the very fact that insulin is so high.
  • Typical fasting insulin lab reference ranges are 0-25 mIU/L.  However, as we know, a reference range is not an optimal target, or even a healthy range, for that matter.  Sources and studies disagree somewhat on the exact level of optimal fasting insulin, and consensus appears to be around 5.  The point is that it’s certainly not 12!  The mid-point of the range!  Studies have shown that levels of ~9 or more accurately indicate existing pre-diabetes .
  • Yes, there are certainly other, more options such as adiponectin as a  marker of insulin resistance (but alas, less readily available than fasting insulin).
  • Sure, happy to share some of the clinical studies (here and here) showing that aggressive lowering of average blood sugar via medication did not decrease the risk of cardiovascular disease in high-risk patients.  Similarly, aggressive lowering of blood pressure and serum cholesterol in Type 2 diabetic patients did not reduce the risk of cardiovascular events or death.  Again, we have to get to the root cause of the insulin resistance itself for the body to heal itself.
  • Yes, there are many, many sources of oxidative stress and inflammation.  Beyond what I mentioned in the video, I definitely agree that both food sensitivities and gut microbial imbalances can be major contributors.
  • Yes, there is labwork that can measure oxidative stress/damage, in particular a marker called 8-OHdG (that is, 8-Hydroxy-2-deoxyguanosine).   Dozens of clinical studies validate its utility, and this organic acid can be measured in blood or urine.  Another more readily available marker is GGT (that is, gamma glutamyltransferase), the enzyme that allows the body to recycle glutathione to handle more oxidative stress and/or detoxification (especially of heavy metals).
  • As an interesting aside, subclinical elevations in GGT are more common in those diagnosed with Type 2 diabetes than any other lab marker (including things we might assume would be highly correlated such as BMI or blood sugar levels).   If you wish a deep dive in this topic, you might appreciate this study.
  • Yes, elevated cortisol (stress hormone) can also contribute to elevated blood sugar.  However, cortisol tends to suppress insulin secretion (from the pancreas) in an effort to keep blood sugar high for immediate (presumably emergency) use.  Ongoing elevated cortisol can definitely create insulin resistance as well.  This can be caused by mental/emotional stress (e.g. workaholic mentality) but also by physiological stress (e.g. heavy metal toxicity, pervasive food sensitivities).  Overall, indeed, the work we do to support our clients with sustainable stress relief is critically important.
  • The form of magnesium I most commonly recommend for clients with insulin resistance (with or without secondary hypertension) is magnesium glycinate.   If clients also need help with constipation, I recommend mag citrate.  I’ve written before about magnesium in detail.

The next two videos mentioned in this series can be found here: Part 2 and Part 3

 

P.S.  If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about our training program here.

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Carolyn Kilgore
Carolyn Kilgore

I’m sure you probably stated, but I am having trouble finding it, is it ok to begin the Berberine while they are still on the metformin?

SAFM Team

Switching from Metformin to berberine and the potential overlap treatment should be supervised by a physician. Technically, there could be an overlap in the use of Metformin and berberine but one needs to be careful about the blood sugar potentially dropping too low. Please explore this post:
https://schoolafm.com/ws_clinical_know/blood-sugar-busting-berberine/
and and also this article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/

Dana J Camera

Thank you for this information!

I do have a question about “hypoglycemia”. How do I approach hypoglycemia? My client is struggling with this most of her adult life. She is super fatigued. Her fasting glucose was elevated and her diet is relatively ok, there needs to be some tweaking. I used one of your templates to ask her Dr. to run additional blood tests (full thyroid panel, A1C, fasting insulin, RBC magnesium and a cardio IQ). I remember you saying that low blood sugar is also a flag for insulin resistance, but I can’t remember where 😮 Her TSH was elevated. She is 59, 5’4″, 110 pounds.
I started her on magnesium, B-complex and a few other things… Blood Values that were flagged in my eye related to this concern:
Total Protein: 7.5
Albumin: 4.4
Globulin: 3.1
Glucose: 102
TSH: 4.570, T4: 7.8, Total T3: 128

SAFM Team
Reply to  Dana J Camera

Hypoglycemia is typically caused in the early stages of high blood sugar and insulin resistance and happens due to an ‘overshooting’ of insulin by the pancreas and lowering the blood glucose too much. Keep in mind that insulin resistance is often a result and a cause of low thyroid function. Everything that supports the reversal of the insulin resistance will help this condition as well. In hypoglycemia specifically, it may be helpful to ensure more frequent meals that include primarily protein and healthy fats as well as complex carbohydrates to keep the blood sugar more stable and prevent the ‘dips’ that are the hallmarks of the hypoglycemia. In the case of your client, the “relatively ok diet” and struggling with having good energy may mean food sensitivities that she’s not honoring. Eating the foods that constantly trigger the immune system can lead to the feelings of poor energy and exhaustion. In addition, the hypothyroid state will exacerbate the insulin resistance and low energy. Think also what are other sources of inflammation and oxidative stress for her. You’ve mentioned the estrogen dominance that is likely still at play, stress, and migraines. You certainly can help this woman by honing in on… Read more »

Celeste

I have been plugging along slowly for years, hoping to take it to the next step. This info always boost my confidence. THanks so much, Celeste BTW I am looking for a video you sent recently on allergies. Can you share how I can find it again, thanks

Celeste
Reply to  SAFM Team

Ah, Yes, thanks so much! I was able to explain it to my client simply and she it really resonated with her. Woo HOO!!

Samantha
Samantha
Reply to  Celeste

Tracy,

I have a client who has type 2 Diabetes and has made some amazing progress over the past year. He has lost over 30 pounds, and is back down to his High School Football weight. He feels better than he ever has. He eats more organically, and low glycemic. He is on a few supplements as well one being Curamed by Terry Naturals and he shortly regained feeling in his feet for the first time in several decades. He wants to get off Metformin and I am familiar with Berberine, but it is my understanding that it can be hard on the liver? Is that the case, or can it be taken long term? IF so, how should he wean off Metformin while introducing Berberine? I know to start slow of course. Please advise.

Heather Green

Tracy thanks so much for this! What about NAC for insulin resistance?

Amanda Buse
Amanda Buse
Reply to  SAFM Team

Hi Tracy,

I have a client with insulin resistance and PCOS. I think NAC would be very beneficial for her but she is still taking Metformin. Will that create a problem for her to take both? Thanks!

Amanda Buse
Amanda Buse
Reply to  SAFM Team

Thanks for the clarifications Tracy! I should also add that my client with PCOS who is on Metformin also had her gallbladder removed quite some time ago. She is willing to do the berberine, B12, mg, and also will need vitamin D. Any thoughts as to how the lack of gallbladder might be a problem?

Kathleen Mitchell
Kathleen Mitchell

So happy to be joining in with your Tracy and in this community. Wooo Whooo! I loved listening to this recording. It was so informative and empowering! I have also heard that Chromium is helpful to opening the doors and getting the glucose into the cells as well as the magnesium, and I have heard that turmeric could be as helpful as metforim as well as the berberine. It is such an exciting time in medicine and the difference is all about understanding how the body works and supporting it on a deeper level.
Thank you Tracy for being the person who I have been praying for:)

Shanti Pappas

Tracy, this is so empowering! Not only for our clients who come to us, but also for us as coaches. With the “pearls” I’ve learned from this course, I’ve been able to help 100s of clients (yes, I said 100s) not only get to the weight they want, but get rid of the symptoms that keep them from fully enjoying their life. My job has become more rewarding as my confidence as a health coach has increased dramatically with the education and expertise you’ve given me. I hope other health coaches out there, reading this, can do what I did, and get out of their own way and start learning the very important clinical aspects to health.

Kasia

Yeah, the burn out feeling is very familiar to me – and I agree with all three reasons that you enumerate. I’m looking forward to remedying that very soon. Thank you for touching on this topic as the burn out can feel shameful – nonone wants to be ‘a quitter’. Love and truly appreciate your support on all levels 🙂

Andrea Moss

WOW. You are SO right on, Tracy!! In the beginning of my practice, I truly think (if I am being honest with myself) that the number one cause of my burn out was not feeling “good enough” in helping my clients. I would put so much time and effort into our sessions, yet success on their end would be “good” but usually not mind-blowing, raving-fan kind of good. And let me tell you, that gets tiring and frustrating quickly. Now it can feel like the opposite with a complex client: Because I can help them on a much deeper level than I used to, I find we both leave the sessions feeling hopeful and energized and enthused. LOVE THAT! THANK YOU, THANK YOU for helping me help my clients on such a deep level. It truly has made all the difference in my practice, and I am forever grateful!!!

Dainna Pearlman

Here, Tracy’s given you the exact information you need to support clients with insulin resistance in order to prevent Type 2 Diabetes from developing and/or reverse it.
Several years ago, the first 2 people I helped with this issue (both 70+ y/o women) were eternally grateful for the education and support I provided. Now that you know this, YOU can too. Get out there and do it!