Insulin & Weightloss – the pivotal factor
Insulin is one of several hormones that are produced by the pancreas. Although insulin is often thought of as simply controlling blood sugar levels, it actually has far reaching effects on many other hormones and metabolic processes throughout your body. Insulin controls cellular intake of different substances including glucose in muscle and adipose tissue; it has a role in DNA replication and protein synthesis through its control of amino acid uptake; it modifies enzyme activity. It also has important roles in the function of blood vessels and thought processes.
Insulin resistance is a condition in which your insulin is not effectively controlling your blood sugar levels. The pancreas then produces more insulin in an attempt to maintain a normal blood sugar level. As an analogy, this is similar to patients that are on morphine-based pain killers who, with time, require progressively higher doses to achieve the same level of pain relief. Elevated levels of insulin are associated with obesity, polycystic ovarian syndrome (PCOS), high blood pressure, and elevated triglyceride levels. It increases the ratio of fat to muscle mass and decreases fat burning. It will also reduce your body’s ability to convert tryptophan into serotonin, the feel good hormone. Ultimately, the elevated insulin levels are unable to control the blood sugar level and diabetes ensues.
Some common symptoms of insulin resistance include:
•Weight gain / difficulty losing weight
•Constipation/diarrhoea / abdominal bloating
•Drowsiness especially after eating
•Elevated triglyceride levels
•Elevated blood pressure
•Increased risk of heart disease
•Ankle swelling / burning feet
•Irritability / poor memory/concentration
•Poly cystic ovarian syndrome / irregular menses
What is DHEA and how does it effect weight loss
DHEA (dehydroepiandrosterone) is the most abundant steroid hormone produced naturally in the body, mostly by the adrenal glands. It is often known as the ‘Mother hormone’ because so many other important hormones are made from it. Cholesterol is at the very start of the steroid hormone cascade and is initially converted to pregnenolone, which in turn is converted to DHEA and so on. So, some consider pregnenolone as the ‘Mother hormone’.
DHEA levels peak in the late 20’s / early 30’s (our lab has peak reference ranges 30-34 years for women and men). Following this the levels fall fairly rapidly, more so for women than men.
Some of the benefits of maintaining normal healthy young DHEA levels may include:
• Immune function support – inflammation is responsible for many disease processes and DHEA has been shown to improve immune function. In particular, systemic lupus erythmatosis (SLE), an autoimmune disease demonstrated clinical improvement and reduced flare ups with DHEA treatment.
•Maintaining cognitive function.
•Elevating mood and sense of well-being; i.e. some forms of depression can benefit from DHEA. Some forms of schizophrenia can also benefit.
•Help with abnormal sleep patterns.
•Peri- and postmenopausal support – through its own benefits and conversion to other steroid hormones down the cascade.
•Reducing fat mass and maintaining lean body mass – DHEA helps with metabolic syndrome by reducing insulin resistance. This also benefits patients with type 2 diabetes.
•Maintenance of bone health (prevent and treat osteoporosis for women).
•Maintenance of healthy lipid levels and cardiovascular health.
•Improvement of erectile dysfunction.
There is no clear cut evidence that DHEA causes cancer, but since some cancers may be hormone-mediated (in particular breast and prostate cancer), people with these conditions should not take DHEA. Also, regular breast and Pap checks for women, and PSA / rectal examinations for men, should be undertaken regularly when undertaking DHEA treatment.
Testosterone & Weightloss
Now you might think that testosterone is purely a male hormone, but you would be wrong! Women produce and need testosterone as well. For men a lack of testosterone is usually more obvious. When they hit ‘that time of life’, that is, male menopause or andropause, it’s their testosterone, as well as flagging levels of DHEA and thyroid hormones accompanied by rising oestrogen levels that can produce a host of symptoms. This can include weight gain, decreased sex drive, erectile dysfunction, reduced memory/concentration, poor job performance, low fitness, diminished bone density, and an increase in cholesterol, fatigue, depression, irritability, anxiety, backaches/stiffness.
So why should women be concerned about their testosterone levels? Testosterone is what puts the tiger in us! A decrease in testosterone levels can lead to a loss of muscle mass. As muscle burns more calories than fat, increasing testosterone levels can help reverse this muscle loss and put simply, this can help with weight loss. It is helped by the fact that testosterone improves insulin sensitivity which results in reduced insulin levels. Decreasing insulin levels promotes weight loss because elevated levels of insulin cause fat synthesis and inhibit the breakdown of fat.
Four things you can do to up regulate your testosterone production:
•Get more sleep – this promotes testosterone production.
•Increase your protein intake whilst making sure you are producing or supplementing with adequate digestive acid (Betaine hydrochloride) and enzymes (protease) to actually digest and absorb the protein. For vegetarians, a whole carob or pea protein shake (with no/little carbohydrate content) made on oat, almond or coconut milk is preferable.
•Make sure you are getting enough zinc (if you need to supplement – and a high percentage of the population are zinc deficient – use zinc citrate for its superior absorption and bioavailability). Zinc has a feedback effect with hydrochloric acid – if you don’t have enough acid in your stomach you won’t absorb zinc very well, and if you don’t have enough zinc you won’t produce enough stomach acid. A real “Catch 22” situation.
•Hit the weights at the gym – increasing muscle mass/tone can increase your production of testosterone.
Your testosterone levels can be easily measured by your specialist.
Many men are concerned that testosterone treatment will cause prostate cancer. However, research has shown that for men with values of testosterone AND oestradiol in the mid-range there is almost no risk and in fact may protect against prostate cancer. Low levels of testosterone, on the other hand, may increase the risk of developing prostate cancer. If you are undertaking testosterone treatment, then these levels should be checked regularly by your treating doctor.
Since testosterone works in concert with many other hormones, just replacing it by itself may not give all the desired results. Unfortunately, it is not just a case of taking testosterone for you could be unwittingly putting yourself in the firing line for more complications down the track as discussed above.
Oestrogen is balanced in our body with many other hormones but in regards to weight, what we want to look at is the relationship between oestrogen and thyroid hormones. If you are a normal weight these are likely to be in balance. If you are overweight you may have an excess of oestrogen which supresses the production of thyroid hormones. This causes your metabolism to slow down and it becomes very difficult to lose weight. A blood test will easily determine the relationship between your hormones.
Did you know there are three different types of oestrogen the body makes?
E1 (estrone), E2 (estradiol) & E3 (estriol).
Estrone is the main oestrogen made after menopause in the fat cells and is the one believed to be linked to breast and uterine cancers. Before menopause estrone is converted to estradiol in the ovaries. If you have no ovaries and/or carry a lot of fat your estrone:estradiol ratio will be high and you will be at increased risk. Estradiol is 12 times stronger than estrone and 80 times stronger than estriol and the form of oestrogen that is responsible for the 400 odd functions that oestrogen has in the body, including protecting your brain, heart and bones. Estriol protects against breast and uterine cancers. Replacing oestrogen should only be done trans dermally (through the skin). Taking oral oestrogen will increase your carbohydrate cravings – not helpful for weight loss! Orally it can also increase blood pressure, estrone (E1), triglycerides, liver enzymes, testosterone, serotonin and growth hormone.
By balancing your progesterone/oestrogen levels (oestrogen dominance) you may experience an improvement in your thyroid levels, and as a bonus you’ll find your mood and energy levels are improved too! You can get an indication of the balance between your oestrogen and progesterone levels by noting where you’re depositing your fat. Stacking it on to your hips and thighs in pre-menopause indicates your progesterone levels may be low. If you are male or post-menopausal it will usually be around the belly. Saliva testing can be done between day 12-14 of your cycle if you’re female and still menstruating. It may show low levels of progesterone if you have oestrogen dominance. If you’ve had tubal ligation or are taking the pill your progesterone is most likely to be low. Nutritionally supplementing with Vitamin A and magnesium can help if you have symptoms of pre-menstrual syndrome. Now, if you think it’s safe to dose yourself with progesterone think again. If the oestrogen:progesterone ratio is not just right and you end up with too much progesterone your fat storage will be increased as will your appetite, carbohydrate cravings, risk of insulin resistance, cortisol levels and it relaxes the small muscles of the bowel causing bloating and constipation, can cause incontinence, supresses the immune system, lower growth hormone and relaxes ligaments giving you backaches and leg and hip aches! Again the best and safest way to supplement is trans-dermally with bio-identical hormones and definitely not with synthetic progestins that are just plain dangerous.
An experienced Anti-ageing & Functional medicine doctor will be able to help you correctly balance your hormones – remember one hormone interacts with many, many other hormones and it is dangerous to adjust one without keeping an eye on all the others!
In men oestrogen is made from testosterone by an enzyme called aromatase. When too much is made your doctor may prescribe an aromatase inhibitor. Zinc citrate is an excellent aromatase inhibitor but please don’t self-diagnose and prescribe.
If you get too skinny you might actually suffer from oestrogen deficiency symptoms because you don’t have enough fat cells to oestrogen and particularly if you are female and have had your ovaries removed. Ladies you need to have a good 18% of body fat in order for your hormonal balance to be maintained. It’s unfortunate but men can get away with very little body fat, as low as 6% but women just can’t in the long run!
Here is a list of oestrogen deficiency symptoms:
•Difficulty falling asleep
•Lower libido (particularly if your testosterone levels are low – yes, women need testosterone too!)
•Dry Vagina (causes painful intercourse)
So that we can breakdown fat, which is what we all want to do when we exercise for weight loss, we want to have enough of one our neurotransmitter hormones called epinephrine. Epinephrine stimulates Hormone Sensitive Lipase (HSL) which is what blasts the fat cells apart. To make sure we have enough Epinephrine to begin with we need to have oestrogen to stimulate it! So you see it’s all a very delicate balance. You also need oestrogen to stimulate the production of Growth Hormone which stops carbohydrates (glucose) from being stored in your fat cells as fat. Growth Hormone lowers your levels of insulin which is good because insulin suppresses HSL that we need to blast those fat cells