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The Insulin Fat-Loss Connection | Supplementary Materials & Resources

www.fatisnotyourfault.com©2008, 2010, 2011 Dr. Bryan P. Walsh

The Insulin Fat-Loss ConnectionSupplementary Materials & Resources

Disclaimer: Information contained in this book is not intended to provide treatment for any disease, disability, ormedical condition, or to substitute for personal, individual medical care from a qualified physician. The reader isadvised to check with his or her own physician prior to following any recommendations given in this book or any ofits references. Every attempt has been made to provide accurate information. However, the reader is on notice thatthe information in this book has been compiled and written to address general principles. It is not intended asspecific advice for any individual. Thus, the personal application of any information provided herein is the soleresponsibility of the user and, if implemented, would be applied at his or her own risk.

Blood sugar and insulin issue are among the most prevalent and physiologically damagingconditions today. The negative impacts of chronically elevated insulin, including transientinsulin surges, cause damage to virtually every bodily system leading to everything fromcoronary and atherosclerotic damage, obesity and weight control issues, neurologicalsymptoms, hormonal dysregulation, hepatic (liver) dysfunction, fatigue and mitochondrialissues, inflammation, and immune system dysfunction, to name a few.

If optimal health and weight loss are desired, it is highly recommended that individuals seekto evaluate and correct any potential issues in this area.

SUMMARY

The spectrum of blood sugar and insulin imbalances are as follows:

Early Phase

The early phase is typically cased by elevations in blood sugar and therefore an excessiveinsulin response. This results on a blood chemistry as low blood sugar, and can result insymptoms of shakiness, lightheadness and agitation between meals, as well as afternoonsugar cravings, and feeling energized after meals.



In the very early phases of insulin resistance insulin is being produced in sufficientamounts and the insulin receptor sites are functioning well. Therefore glucose levels willtend to be low when measured due to the relative efficiency of the entire blood sugarmanagement system.Blood chemistry readings during the Early Phases may indicate:

- Glucose readings below 85mg/dL- LDH (lactodehydrogenase) below 140 IU/L- Elevated insulin and/or C‐Peptide

Glucose tolerance test may indicate:

- High‐normal glucose 20‐40 minutes after drinking the glucose solution, followedby excessively low glucose (i.e. 20‐30 points below the first baseline reading) oneto two hours after the glucose solution.

What To Do: Because insulin and insulin receptor are still functional during this phase, thekey to correcting the hypoglycemic tendencies is to better manage blood sugar levelsthrough proper dietary habits. Following healthy dietary strategies and a consistentexercise program is of the utmost importance during this phase. Nutritionalsupplementation may be helpful, but is generally unnecessary if proper diet, lifestyle andexercise prescriptions are followed.

Individuals in this phase must also consider evaluating adrenal and other relevanthormones. Reason being, there are four hormones designed to elevate blood sugar whenit is too low for optimal body function – cortisol, epinephrine, glucagon and growthhormone. Anyone experiencing periods of low blood sugar must consider deficiencies inany of these hormones, the most common deficiency being cortisol, and it is thereforerecommended to consider evaluating cortisol levels as well.

Intermediate Phase

The intermediate phase is often characterized by normal blood sugar values on a bloodchemistry lab, but it is in fact this is beginning of insulin resistance due to insulin receptormalfunction. In the previous phase, insulin level were so high, it started creating damageto the insulin receptors. When the insulin receptors become damaged, the same amountof insulin will no longer bring as much glucose into cells. Therefore, while elevations in



blood sugar still drives this phase, because the body lacks the sensitivity to insulin, lessglucose gets into the cells than in the prior phase and therefore may be normal on bloodsugar testing. Insulin will likely remain elevated, but will not be as efficient in gettingglucose into cells.

Blood chemistry values may indicate:

- Glucose between 85‐100mg/dL- Cholesterol/Triglyceride ratio less than 2:1- HDL less than 55mg/dL- Hemoglobin A1C above 5.6%- Elevated insulin and/or C‐Peptide

What To Do: Similar diet, exercise and lifestyle recommendations apply as theprevious phase. However, additional nutritional supplementation will likely be helpfulduring the Intermediate Phase. Also, consider exploration into food sensitivities, aswell as other sources of stress, as they can sometimes contribute to elevated bloodsugar levels.

Late Phase

The final phase of blood sugar and insulin dysregulation are typically characterized byelevations of glucose levels on a blood chemistry test. This phase will often have relativelysignificant insulin receptor dysfunction and therefore elevations in blood sugar due to theinability to get glucose into cells. More advanced stages of insulin resistance will likelyshow normal or even low insulin and C‐peptide levels due to the pancreas’ inability toproduce them adequately.

Blood chemistry values may indicate:- Glucose above 100mg/dL- Cholesterol/Triglyceride ratio close to 1:1- HDL less than 55mg/dL- Elevated LDL above the laboratory reference range- Hemoglobin A1C above 5.8%- Normal or low insulin and/or C‐Peptide- Elevated uric acid



What To Do: To prevent further dysfunction, individuals in this phase must employ arigorous diet and exercise program for a minimum of six months to help correct bloodsugar and insulin handling. Nutritional supplementation is recommended during thisphase, as is addressing food sensitivities, areas of stress, and gut dysfunction. Each ofthese areas may be contributing to the underlying blood sugar dysregulation.

TESTING

Testing is necessary to fully evaluate blood sugar and insulin dyregulation. The following aretests are recommended to most accurately evaluate possible blood sugar and insulinmishandling:

1. Blood chemistrya. Lipid panel (cholesterol, HDL, LDL, triglycerides)

i. The closer the cholesterol/triglyceride ratio is to a 1:1 ratio, the morelikely a blood sugar issue exists; ideally it will be a 2:1 ratio.Additionally, high LDL and low HDL may also indicate a trend towardsinsulin resistance.

b. Glucosei. Glucose is not an accurate marker by itself, but in conjunction with

other markers can be valuable. When fasting glucose is above100mg/dL, this can indicate a tendency towards insulin resistance.Along with an elevated Hemoglobin A1C and cholesterol/triglycerideratio close to 1:1, elevated fasting glucose further indicates thelikelihood of insulin resistance.

ii. Glucose below 85mg/dL, along with an LDH below 140 IU/L, mayindicate a tendency towards reactive hypoglycemia.

c. Hemoglobin A1Ci. Above 5.6% can indicate a general trend towards insulin resistance. The

higher the value, the more likely there is blood sugar and insulindysregulation.

d. Insulini. As mentioned in the video, this is not a valuable marker due to its short

half‐life. However, in conjunction with other markers, includingCpeptide, insulin levels can offer additional information.

ii. Elevated insulin often points to early signs of insulin resistance andpossibly a causative factor of reactive hypoglycemia. If insulin is low,



this may be an indication of poor pancreatic production and late stageinsulin resistance.

e. C‐peptidei. C‐Peptide is produced by the pancreas in a similar quantity as insulin

but has a longer half‐life than insulin and is therefore a more stable andreliable marker.

ii. If C‐Peptide is elevated, there is an increased chance of early insulinresistance and reactive hypoglycemia. If C‐Peptide is low, along withelevated glucose and/or Hemoglobin A1C, there is an increased chanceof late stage insulin resistance.

2. Glucose tolerance test*a. This is a valuable test that can further assist in the evaluation of blood sugar

and insulin issues. The test is performed as follows:i. On a day of low planned activity (i.e. the weekend) take your fasting

morning glucose upon arising.*ii. Shortly afterward, drink approximately 75g of high glycemic

carbohydrates. This can be accomplished by approximately 2 cups(16oz) of grape juice, or the glucose tolerance test drink found at manylocal drug stores or pharmacies.

iii. Twenty minutes after the glucose drink, perform another glucosereading using your glucometer and record the results.

iv. Forty minutes after the glucose drink, perform another glucose readingusing your glucometer and record the results.

v. Sixty minutes after the glucose drink, perform another glucose readingusing your glucometer and record the results.

vi. Ninety minutes after the glucose drink, perform another glucosereading using your glucometer and record the results.

vii. One hundred and twenty minutes after the glucose drink, take yourfinal glucose reading using your glucometer and record the results.

*It is critical that you perform absolutely no physical activities during this testand therefore merely sit to read a book or watch television for the duration ofthis test. You may only get up to use the restroom during the test.

Interpretation of the result is briefly discussed in the accompanying video. It can behelpful to view your results using a line graph for a visual representation of yourfindings. Ideal blood sugar and insulin handling will often demonstrate a small rise of



blood sugar above the initial reading (i.e. approximately 20‐40points above baseline),followed by a steady decrease back to normal by the end of the test two hours later.Excessively high glucose levels, a significant drop below the initial reading, or anyreading that has not returned to normal after two hours, can indicate a dysfunction inblood sugar handling.

*Please talk with your doctor before performing this test to see if it is appropriate foryou.

EVALUATION

Though there are diagnosable blood sugar related conditions, such as hypoglycemia ordiabetes, most blood sugar and insulin issue are somewhere along a spectrum of glucosedysreguation. As previously mentioned, early stages are characterized by physiologicalelevations of glucose but efficient insulin production and binding, and therefore low glucoseon blood chemistry tests. Later stages of blood sugar dysregulation are often characterized byelevated glucose readings on a blood chemistry test due to insulin’s inability to efficiently getglucose into cells.

The goal of this information is to help the reader learn where along that particular spectrumthey fall and, to offer options as to how to correct the underlying imbalance. Ultimately thereis no one ideal protocol to follow but rather directions to take based on your ownphysiological imbalances, and then retesting lab markers to determine if the protocol isworking or not.

HYPOGLYCEMIC TENDENCIES

Hypoglycemia is a term used to describe a variety of symptoms due to blood sugarfluctuations, including periods of low blood sugar. Conventionally hypoglycemia typicallyrefers to fasting blood sugar below 50mg/dL, but many people can experience symptoms oflow blood sugar well above this level (i.e. 70mg/dL for some individuals). The primary concernwith low blood sugar is inadequate brain function. The brain is the first organ to suffer whenglucose is unavailable and even permanent damage can take place when blood glucose is toolow for too long.

Reactive hypoglycemia, or functional hypoglycemia, is typically caused by one of two reasons:



1. Excess refined carbohydrate consumption leading to excessive insulin production.Symptoms will typically include excessive mood swings, erratic behavior before andafter eating, and a volatile personality.

2. Low cortisol levels leading to an inability to raise blood glucose between meals.Symptoms will often include sweating, shakiness, weakness and hunger betweenmeals. These symptoms are typically cause by epinephrine secretion to compensatefor the lack of cortisol.

A third and more rare form of hypoglycemia is caused by poor intestinal digestion andabsorption of nutrients. This would be evident on the glucose tolerance test by a relativelyflat glucose response less than +/‐ 15% from the fasting glucose level.

INSULIN RESISTANCE TENDENCIES

Once elevated blood glucose has become chronic, insulin will progressively become lessefficient at getting glucose into cells due to slowly deteriorating insulin receptor. The resultwill be elevated fasting serum glucose and triglyceride levels. Over time, the pancreas willlikely decrease its insulin production due to gradual damage and failure of beta cells. This willfurther elevate fasting serum glucose and triglyceride levels due to not only poor insulinreceptor function, but low levels of insulin as well.

CORRECTING IMBALANCES

The goal in correcting an underlying blood sugar or insulin imbalance is to:

1. Decrease the blood sugar response from food

This is accomplished by 1) consuming glycemically balanced meals, 2) increasing fiberintake during meals to slow down carbohydrate absorption and, 3) eliminating foodsthat may be causing sensitivities, i.e. following an elimination diet. Informationregarding the elimination diet can be found in the Gut Fat-Loss ConnectionSupplementary Materials.

2. Improve glucose entry into cells

This is accomplished by 1) improving insulin sensitivity of the insulin receptor sites, 2)improving pancreatic insulin production, and 3) utilizing exercise to enhance theexerciseinduced GLUT‐4 mechanism.



CORRECTING HYPOGLYCEMIC TENDENCIES

The symptoms associated with hypoglycemic tendencies have been described earlier inthis text. Hypoglycemic tendencies are characterized on blood work by low serum fastingglucose levels. Stable glucose is necessary for organ function, specifically proper brainfunction. Therefore it is critical to attempt to maintain healthy, stable blood sugar levelswhile the underlying cause is corrected.

DIETThe first and most critical step with hypoglycemic tendencies is to eat small,proteinbased, frequent meals throughout the day. This means never skipping a meal,including breakfast. Eating in this manner will help maintain stable blood sugar levelswhether the hypoglycemic tendencies are 1) due to elevated insulin levels or 2) due tolow cortisol.

Small, protein‐based meals will help maintain stable blood sugar levels preventing themuch dreaded glucose rebound effect due to elevated insulin levels after highglycemic meals.

If the cause of hypoglycemic tendencies is low cortisol, frequent meals will enable youto exogenously maintain stable blood sugar levels to compensate for the body’sinability to maintain stable glucose on its own.

SUPPLEMENTSNutritional supplementation can be helpful with hypoglycemic tendencies dependingon the underlying cause. If the hypoglycemic tendencies are being caused byexcessively elevated insulin levels, the focus should primarily be on maintaining ahealthy diet, performing adequate exercise, and possibly including some of the bloodsugar lowering compounds listed below. However, diet and exercise are typicallyenough to help correct this hypoglycemic tendencies due to insulin fluctuations.

On the other hand, if the hypoglycemic tendencies are being caused by hormonedeficiencies (i.e. low cortisol), they must first be corrected before glucose balance is tobe achieved. More on how to correct cortisol imbalances can be found in the CortisolFat-Loss Connection video and supplementary materials.



ADDITIONAL TESTINGEvaluating the underlying cause of hypoglycemic tendencies is critical. A salivaryadrenal test can help determine whether or not low cortisol is a contributing factor.Evaluating C‐peptide can be helpful in determining whether or not the hypoglycemictendencies are related to elevated insulin levels. If C‐peptide is high, this can indicatethat the hypoglycemic tendencies are related to elevated insulin levels and your goalwould be to maintain stable glucose levels using diet and exercise.

If hypoglycemic tendencies are present, the following tests should be considered:

1. Salivary adrenal hormone testing2. C‐peptide (serum)3. Insulin (serum)4. IGF‐1 (to determine growth hormone levels and liver function)

Depending on the result of these tests, consider retesting a minimum of every threemonths until the imbalance is corrected. Retesting the glucose tolerance test everythree months may also be helpful.

INSULIN RESISTANCE TENDENCIES

An individual with insulin resistance will typically see the following patterns: 1) elevatedfasting glucose, 2) glucose that is excessively elevated during the glucose tolerance test orfails to return to baseline after 2 hours, 3) elevated triglycerides (less than 2:1 with thecholesterol/triglyceride ratio, or greater than 1:1 with the triglyceride/HDL ratio), 4)depressed HDL, 5) Hemoglobin A1C above 5.6%, and 6) possibly elevated uric acid. The moreof these markers that are out of balance, or the more significant the elevations are, the moreadvanced the insulin resistance tendencies will be.

DIET

The goal the diet for insulin resistant tendencies is similar to that of hypoglycemictendencies – maintain stable blood sugar levels throughout the day. The reasons forthis however, are to reduce the need for insulin production, which will then allowinsulin receptor sites to resume normal function. Also, glucose is toxic to the body inexcess and will cause significant damage over time. Therefore managing glucose levelsis key in insulin resistance tendencies.



Small, protein based, low glycemic meals is the goal, with emphasis on high fiber, andlow starchy or refined carbohydrates. Many books have been written on this subjectand rather than go into further details here, some books and websites are listed in theResources section below.

EXERCISEResearch is clear that a combination of cardiovascular and resistance/strength trainingis invaluable in helping to correct blood sugar and insulin dysregulation. But again, thishas been written about extensively by a variety of experts in the field and thereforeneeds no further discussion here. The goal of the material here is to not rehash whathas already been covered elsewhere, or to create even more information to furtherconfuse consumers. Rather, the goal is to make other currently existing programswork even more effectively due to your new and improved physiology.

SUPPLEMENTATIONNutritional supplementation can be very helpful in correcting insulin resistancetendencies. The primary goal of nutritional supplementation is to improve insulinreceptor function. Note that the goal is not merely to lower blood sugar. Blood sugarcauses damage to the body but the reason it usually cannot get into cells is usually dueto dysfunction in insulin production and/or insulin receptors. Many pharmaceuticaldrugs, and even some natural compounds, lower blood sugar by increasing insulinproduction from the pancreas. Because elevated insulin levels likely caused theresistance issue in the first place, further elevating insulin levels will likely serve tocreate more dysfunction. Therefore, the goal is to improve insulin receptor functionand signaling, and not simply to lower blood sugar.

Many of the compounds listed below are chosen because they will not increase therisk of insulin resistance by increasing insulin levels, but rather serve to improve thebody’s ability to get glucose into the cell either by improving insulin receptor functionand/or intracellular mechanisms.

ADDITIONAL TESTINGWhen insulin resistant tendencies are found, one may want to look further intopossible contributors to elevated glucose levels. For example elevations in cortisol, ahormone that potently elevates blood glucose, can create high blood glucose despiteattempts at correcting it using diet and exercise.



Therefore if insulin resistant tendencies are present, the following tests should beconsidered:

1. Salivary adrenal hormone testing2. Intestinal permeability3. Insulin and C‐peptide (serum)4. Hemoglobin A1C

Depending on the result of these tests, consider retesting every one to three monthsuntil the imbalance is corrected. Retesting the glucose tolerance test every threemonths may also be helpful.

NUTRITIONAL SUPPORT

Most herbs and supplements have not been thoroughly tested for interactions with otherherbs, supplements, drugs, or foods. The interactions listed below are based on reports inscientific publications, laboratory experiments, or traditional use. You should always readproduct labels. If you have a medical condition, or are taking other drugs, herbs, orsupplements, you should speak with a qualified healthcare provider before starting a newtherapy.

If blood sugar and insulin imbalances exist, the primary goal of nutritional supplement shouldbe to improve insulin sensitivity of insulin receptor sites. This concept cannot be overstated.Many of the pharmaceutical medications for blood sugar dysregulation are aimed at loweringblood sugar levels. This may seem reasonable at first glance, but the mechanisms in whichsome medications achieve this are by increasing insulin levels. This is highly undesirable, as itwas elevated insulin that caused receptor insensitivity in the first place.

The goal of correcting blood sugar and insulin dysregulation issues should be to improveinsulin receptor site function and not to further elevate insulin. This point is being madebecause some of the nutritional compounds and herbs typically used to help lower bloodsugar act in a similar fashion as some pharmaceutical medications and therefore may makethe situation worse in the long run. Other herbs are simply not well enough understood tosee if they increase insulin resistance or not.

Below is a list of commonly used nutritional compounds used to help manage blood sugardysregulation. Where applicable, mention will be made as to the theorized mechanism of



action of each compound, as well as an appropriate dose. Consult with your doctor beforestarting any nutritional supplements.

COMPOUNDS TO CONSIDER FOR BLOOD SUGAR MANAGEMENT

Lipoic Acid (Alpha Lipoic Acid)

600‐1800mg in divided doses daily (taking with Biotin has been shown to improve theblood sugar and insulin lowering effect than either taken alone).

Lipoic acid is a sulfur‐containing compound that seems to improve insulin resistanceby increasing activation of glucose transporters (GLUT‐4 vesicles), which help sensitizetissues to insulin. Studies performed on Alpha Lipoic Acid have been shown to improveinsulin sensitivity. ALA also has potent antioxidant activities. Lipoic acid enhances theeffectiveness of other antioxidants, facilitates the production of energy in cells, andprovides support for detoxification processes of the liver. Lipoic acid is both water andlipid soluble, aiding to its multiple benefits, but has a short half‐life and thereforeeither sustained released capsules or frequent dosing is necessary.

Chromium

200‐1000mcg daily, in divided doses

Chromium is an essential trace mineral that plays an important role in carbohydratemetabolism and glucose tolerance. Chromium deficiencies are common in the UnitedStates, which are further depleted by a diet high in sugar and refined carbohydrates.Also known as “glucose tolerance factor”, studies demonstrate strong evidence thatchromium may optimize the impact of insulin on receptor sites and therefore improveglucose uptake and insulin sensitivity. Chromium may also positively impactpostprandial glucose and insulin levels, glycated hemoglobin, total cholesterol andLDLcholesterol. There is evidence that chromium taken with biotin may synergisticallyimprove glucose tolerance.



Carnitine

2,000mg daily, in divided doses

One question is whether mitochondrial dysfunction might be a factor in thedevelopment of type 2 diabetes, and whether insulin resistance is associated with adefect in muscle fatty acid oxidation. Intramyocellular lipid levels have become amarker for insulin resistance. Preliminary data suggest that supplementation with L‐carnitine can improve insulin sensitivity in individuals with type 2 diabetes, asevidenced in part by its ability to decrease intramyocellular lipid levels.

Banaba Leaf (Lagerstroemia speciosa)

50‐100mg, three times a day

Banaba leaves contain a number of active components, including corsolic acid, thathave demonstrated the ability to activate glucose transport and uptake across cellmembranes. Studies have demonstrated the ability for corsolic acid to aid in theregulation of blood sugar levels, serum insulin, and total cholesterol. The activeconstituents in banaba leaf have even shown to have a “memory effect” for bloodglucose control that lasted for several days after just one dose.

Cinnamon

250mg of standardized extract, three times a day; or 1‐6 grams of dry powder daily

Cinnamon contains a water‐soluble compound called MCHP (methylhydroxychalconepolymer) that has been shown to lower blood glucose levels via activation andimproved efficiency of insulin receptors. Studies have suggested that ¼ to 1 teaspoonof cinnamon daily might be helpful in type 2 diabetes.

A more active substance, called Cinnulin PF, is the only extract validated in studies bythe USDA to improve insulin response up to twenty‐fold and can be found in someblood sugar management nutritional formulas.

Of note, cinnamon contains coumarin and ingestion of large amounts should be firstdiscussed with your doctor. Liver toxicity in animal models has also been reported,



and reversible hepatotoxicity has been reported in humans at daily doses of 50‐7000mg.

Berberine

250‐500mg, three time a day

Numerous studies demonstrate the ability of berberine to improve blood sugar andinsulin management. Some of the proposed mechanisms for this benefit includes 1)mimicking insulin action, 2) activation of AMPK, 3) reducing insulin resistance byupregulating insulin receptor expression, 4) inducing glycolysis, 4) promotingglucagonlike peptide‐1 release, 5) inhibiting DPP‐4 and 6) inhibiting hepaticgluconeogenesis.

Myricetin (Myrica cerifera)

100‐300mg per day in divided doses

Myricetin is a relatively new ingredient gaining recognition for its fast‐acting effects.Recent research suggests it increases insulin sensitivity by enhancing the activity of 3proteins (IRS‐1, PI3‐kinase and GLUT 4), which are involved in post‐receptor insulinsignaling. Myricetin has also been shown to lower triglyceride levels and enhanceglycogen metabolism in the liver. In addition, in vitro studies have shown thatmyricetin mimics insulin in stimulating lipogenesis and glucose transport in ratadipocytes.

Gymnema Leaf Extract (Gymnema sylvestre)

200‐400mg daily in divided doses

Gymnema is a water‐soluble extract that may enhance the effects of insulin byreducing glucose absorption in the intestine, as well as stimulate the production of theinsulin producing cells of the pancreas called beta‐cells. When placed directly on thetongue, gymnema competes with sweet substances for receptor sites and candecrease the desire and taste for sweets. However, there is also evidence thatgymnema may also stimulate endogenous insulin production or, increase the body’sown production of insulin, which could potentially contribute to insulin resistance.



Given the multiple blood sugar regulating mechanisms of Gymnema, the benefit oftaking it may exceed the possible negative consequences of increased endogenousinsulin production. However, this mechanism must be taken into account.

Some studies have suggested that while Gymnema does increase insulin productionfrom the pancreas, it does not lead to insulin resistance. Therefore this compoundmay be helpful for some individuals.

Fish Oil : (Eicosapentaenoic Acid/Docosahexaenoic Acid, EPA/DHA)

1.8 grams of EPA, 1.2 grams of DHA per day

Daily intake of 1,500‐4,000mg of EPA and 1,000‐2,000mg of DHA have been shown toimprove insulin sensitivity in skeletal muscle, thus reducing fasting glucose. Krill Oil isanother option that may provide similar benefits.

Opuntia streptacantha (nopal, prickly cactus)

Recommended dose is 100 g of nopal stems grilled or 3 tablespoons of prickly pearfruit concentrate daily. (Historically nopal has been consumed by Mexican natives inthe whole form. Some studies have demonstrated that juice or capsule form of nopalhave no significant changes in serum glucose. This is not to suggest that it would notbe helpful, just that studies have not yet demonstrated this effect.)

Opuntia streptacantha has a high‐soluble fiber and pectin content, which may affectintestinal glucose uptake, partially accounting for its hypoglycemic actions. Animalmodels have reported decreases in postprandial glucose and Hemoglobin A1C withsynergistic effects with insulin. Studies in pancreatectomized animals report thathypoglycemic activity is not dependent on the presence of insulin. In other words, itseem that Opuntia works to decrease carbohydrate absorption in the gastrointestinaltract, thus lowering the glycemic effect of food, and the subsequent lowering of seruminsulin levels.

Side effects may include mild diarrhea, nausea, abdominal fullness and headache.



Salacia Oblong

500‐1000mg per day in divided doses

The herb, according to the study authors, seems to work similarly to oral diabetesdrugs known as alpha‐glucosidase inhibitors, which impede the body's absorption ofcarbohydrates. Salacia has demonstrated the ability to lower blood glucose and insulinlevels after a meal. May cause gas and/or cramping.

Green Tea (epigallocatechin gallate, EGCG)

275‐1300mg daily in divided doses

Numerous studies suggest that green tea and its active constituents can enhanceinsulin activity and protect pancreatic cells. EGCG (epigallocatechin gallate) is a majorpolyphenol or catechin in green tea that has been tested in may studies and is thoughtto be one of the most active ingredients. Green tea promotes healthy blood sugarmetabolism in humans and obese, diabetic mice without increasing insulin levels.Green tea rich in EGCG enhances insulin action instead of promoting insulin release. Ithas also been shown to reduce intestinal glucose absorption, downregulateglycogenolysis and upregulate glycogenesis. Furthermore, green tea and EGCG reducefat cell creation and growth, as well as blood levels of triglycerides and cholesterol. Asan added bonus, green tea protects against protein oxidation and glycation.

Bilberry

160 mg twice per day of an herbal extract containing 25% anthocyanosides

Bilberry extract has been shown to lower blood sugar while increasing insulinsensitivity.



American Ginseng (Panax quinquefolius)

200mg of herbal extract daily, containing approximately 5 to 7% ginsenosides with orfollowing meals

Studies have shown that American ginseng may improve insulin sensitivity. However,it must have a significant quantity of ginsenosides to have a blood lowering effect. In asmall preliminary trial, 3 grams of American ginseng was found to lower the rise inblood sugar following the consumption of a high‐glucose drink by people with type 2diabetes. The study found no difference in blood sugar–lowering effect if the herb wastaken either 40 minutes before the drink or at the same time. A follow‐up to this studyfound that increasing the amount of American ginseng to either 6 or 9 grams did notincrease the effect on blood sugar following the high‐glucose drink in people with type2 diabetes. This study also found that American ginseng was equally effective incontrolling the rise in blood sugar whether it was given together with the drink or upto two hours before.

Glucomannan

500 to 700 mg per 100 calories in the diet

Glucomannan is a water‐soluble dietary fiber derived from konjac root(Amorphophallus konjac) that delays stomach emptying, leading to a more gradualabsorption of dietary sugar. This effect can reduce the elevation of blood sugar levelsthat is typical after a meal. After‐meal blood sugar levels are lower in people withdiabetes given glucomannan in their food, and overall diabetic control is improvedwith glucomannanenriched diets, according to preliminary and controlled clinicaltrials. For controlling blood sugar, 500 to 700 mg of glucomannan per 100 calories inthe diet has been used successfully in controlled research.

Additional Nutrients

There are a number of additional nutrients that may prove helpful in managing bloodsugar and insulin. Such nutrients such as mixed tocoperols (vitamin E), magnesium,zinc, biotin and vitamin K have been shown to improve insulin sensitivity, increaseglucose tolerance and decrease insulin resistance.



Biotin: 10,000mcg daily, in divided doses. When taking large doses of any B vitamin, itis recommended to take other B vitamins with it. Biotin has been shown to improvethe function of lipoic acid.

Vitamin K: 500mcg daily, in divided doses. Low vitamin K has been shown to induce anearly insulin response, and late hyperinsulinemia. One study on vitamin K2 found thatintake had a statistically significant inverse relationship to the risk of developing type 2diabetes.

Zinc: 25mg daily, in divided doses. Zinc has been shown to help improve insulinsensitivity, insulin metabolism and is important in the management of blood sugardisorders. It is questionable as to the benefits of zinc in non‐zinc deficient individuals,but given the prevalence of zinc deficiency today, adding zinc to a blood sugarmanagement protocol will likely prove helpful.

Mixed Tocopherols (vitamin E): 400‐800IU daily, in divided doses. Vitamin E has beenshown to improve insulin sensitivity and may help improve blood lipids.

Magnesium: 400‐800mg per day, in divided doses. Magnesium may help improvemultiple mechanisms of insulin, including insulin receptor function, glucose transportand intracellular processes. As with many minerals (i.e. zinc, chromium), individualswith blood sugar disorders are typically deficient in one or more of them.

QUESTIONABLE COMPOUNDS

Bitter Melon (Momordica charantia, Momordica elegans)

Many nutritional blood sugar formulations contain Bitter Melon, due to its potentability to rapidly lower glucose. However, one of the proposed mechanisms for thiseffect is that Bitter Melon contains insulin‐like polypeptides, which are structurallysimilar to insulin and thus may contribute to insulin resistance. In other words, ifelevated insulin levels are what contributed to insulin resistance in the first place, itstands to reason that something was structurally similar to insulin would lowerglucose, but also may cause more insulin resistance. The benefits of a nutritionalformula that contains Bitter Melon may outweigh the risks, but it would be wise to becautious with this compound when trying to improve glucose levels long‐term.



Vanadyl sulfate

Vanadyl sulfate a biologically active form of vanadium, a trace mineral that mimics theaction of the hormone insulin. Vanadyl Sulfate may reduce hepatic gluconeogenesisand “mimic” insulin’s effect. It appears to have insulin‐like impact on receptor sitesand improves the transport of glucose transporter to the cell membrane to allow cellsto intake serum glucose. This physiologic impact is of great importance because mostdefects in insulin resistance involve intercellular transduction reactions that vanadiumappears to enhance.

Holy Basil (Ocimum sanctum)

White the mechanism for holy basil’s glucose lowering effect is still not clear, it ispostulated that it does so by increasing insulin secretion. Again, this could feasiblyworsen one’s progression towards insulin resistance by increasing insulin levels.

Taurine

Several studies have demonstrated improved insulin sensitivity and insulin action inanimal models. One study suggests that it may be beneficial to take Taurine with NAC.Taurine is likely a safe amino acid to take, but the research on it in managing bloodsugar and insulin is scant, and there are numerous other compounds with muchstronger evidence.

COMPOUNDS TO AVOID

Fenugreek

Fenugreek is known to stimulate insulin production from the pancreas, which willlikely further the development or progression of insulin resistance. This compound isfound in many blood sugar formulas, but if excess insulin is the cause behind insulinresistance, there are very few people who would benefit from increased insulinproduction.



SPECIFIC FORMULAS

Some products and formulas will work better for some people than they will for others.Therefore the best method in nutritionally supporting blood sugar and insulin dysregulation isto try certain products for 30 days and retest laboratory markers to determine if a positivebenefit was achieved. If so, continuing on a certain protocol will likely be beneficial incorrecting blood sugar imbalances.

On the other hand, if negative symptoms exist using a specific formula or compound or, iflaboratory markers do not improve, either adjusting the dose or trying a different protocol isnecessary. If after 90 days laboratory markers and/or symptoms do not improve, it is likelythat the particular mechanism driving the physiological imbalance has not been adequatelyaddressed.

No protocols are listed here simply because there generalized protocols to fix physiologicalimbalances simply do not exist. Finding an effective protocol requires evaluating yourparticular physiological imbalances and then experimenting with different products,followed by retesting, to determine the most effective products and dosages for you.

Here are some specific professional formulas that may be beneficial in helping to correctblood sugar and insulin imbalances:

Xymogen: CinnDrome‐X

Apex Energetics: Glysen, Protoglysen

Vital Nutrients: Berberine 200mg, Green Tea Extract 80%

Designs for Health: Metabolic Synergy, Carnitine Synergy, Carnosine Supreme,Carnitine Tartrate Powder

Integrative Therapeutics: Glycemic Manager

Pharmax: Multiple varieties of fish oil



RESOURCES

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