Do you ever get tired shortly after eating? Maybe you need elevenses (mid morning snack for the non British reader) or a pre tea time 3.30pm pick me up to get through the day?
Perhaps you have been diagnosed with PCOS, Insulin resistance, pre-diabetes or even type 2 diabetes (or suspect you have them). Maybe you have irregular cycles, don’t ovulate regularly, struggle to lose weight around the middle, have facial hair or thinning hair around your parting or the top of your scalp (so unfair, right)?
What makes it worse is when you end up beating yourself up for your lack of willpower but you crave the sweet stuff? I’ve been there too. When I see women with blood sugar level issues they often have the least predictable cycles. They can go for weeks without a bleed and then, crazy heavy bleeding that just doesn’t stop. As for ovulation, they may or may not happen, it’s anyone’s guess.
As someone with PCOS, balancing my blood sugar is crucial to me achieving hormonal balance and my period sweet spot. But this isn’t just something for women with period problems, it affects anyone with hormonal issues because you can’t isolate hormonal issues and blood sugar levels have a knock on effect with many of our hormonal systems.
Blood Sugar Levels & The Stress/Inflammation Cycle
Our bodies are primed to respond to threats thanks to our cavewomen ancestors. When we were threatened it started off a stress response, that reaction included releasing glucose reserves into our blood system to give us the energy to run from stress.
However, when our blood sugar rises, our insulin levels rise in response and once these raise over a certain amount it triggers a stress response in the amygdala, which raises, inflammation. Also, if our blood sugar levels drop because we haven’t eaten, have over-exercised or because we have had an insulin spike (so it lowered our blood sugar levels).
As you can see this is a bit of viscous cycle, get stressed, your blood sugar levels become imbalanced creating a rise in insulin. Get a spike or crash in blood sugar? You trigger a stress response and your body releases glucose into your blood stream.
But wait, it gets worse, if you are insulin resistant, when you blood sugar levels rise, you get the corresponding insulin spike, but your cells don’t respond to it as they should. So your pancreas has to product more insulin to get the same effect, but the cells register the higher insulin levels and desensitise themselves to insulin further, so your pancreas has to up the dose again. This keeps happening until the pancreas can no longer keep up with the demand and stops working, resulting in diabetes.
Pretty exhausting to think about, right?
How It Affects Periods & Hormones
Too much insulin can impair ovulation. Without ovulation, we have no progesterone, and no period. We also need progesterone for thyroid, breast, heart and bone health too. I see many women with PCOS who don’t ovulate for long periods of time who have high insulin.
A double whammy, if you have high levels of insulin, this stimulates your ovaries to produce testosterone, resulting in male hair patterns: facial hair, darker or thicker hair on limbs, that black line of hair from the belly downwards, pubic hair that spreads over the top of the legs and thinning hair on the top of the head or a receding hairline.
How Do I Know If My Blood Sugar Levels Are Unstable?
The ultimate way to know is to start measuring your blood sugar levels before and after each meal (at 30 minutes and 2 hours afterwards). If you think you have more serious blood sugar level issues, you can get a glucose tolerance test through your doctor (I highly recommend this if you think you have Insulin Resistance, pre-diabetes, PCOS or diabetes).
Signs and symptoms that you may have unstable blood sugar levels or insulin resistance include:
• Weight gain around the middle (waist circumference of over 80 cm) or an apple shape
• Sugar cravings
• Feeling tired after meals containing “white carbs” such as pasta or bread
• Lack of ovulation
• Heavy or painful periods
• Skin tags especially on face or neck
• Acanthosis nigricans: the thickening and darkening of skin especially on the armpits, neck, and any other joints
• Hursuitism: facial hair
• Androgenic alopecia: female pattern baldness, looks like male pattern baldness with a receding hairline and a thinning starting around the parting and thinning out the top of the head.
• Dizzy spells or fainting, (usually caused by hypoglycaemia, where the blood sugar level has dropped too far)
• Cravings around mid morning or mid-afternoon
• Brain fog and fatigue
What You Can Do About Your Blood Sugar
The good news is there is a lot that can be done to help low blood sugar levels:
1. Start measuring your blood sugar levels.
You can get a kit over the counter for around £30 which allows you to start measuring blood glucose (blood sugar levels) and will give you a chart to work on and normal ranges in the values used in your country. This is invaluable to see what is going on with your body and how any of the changes you may make listed below help.
2. Eat smaller more regular meals every 2-3 hours
This is including good quality protein, fat and fibre rich carbohydrates. If you are feeling hungry earlier, then try increasing the fat and protein content. Adequate amounts of fat and protein help to stabilise our blood sugar levels. Be careful on the protein though, too much can convert into sugar in the body. After a few weeks, you can go back to more standard meal timings and size, but you need to ensure that you are still eating adequate fat and protein.
3. Understand and learn about Glycaemic Index (GI)
Understanding and learning about Glycaemic Index (GI) and consume low to medium GI foods can be very helpful. High GI foods will stimulate higher insulin releases so it is important to stick to lower GI foods until you get an idea of what your body can tolerate. However, in the beginning, whilst you are balancing your blood sugar, stick to the lower end of the spectrum.
4. Cut out refined sugar and refined carbohydrates
If you are sticking to low and medium GI foods as above you will be doing this anyway. But just ensure you understand, eating anything sugary is going to cause a blood sugar and insulin spike (although the amounts that trigger this will vary from person to person). An easy way to identify this is to stop eating sugar. This means processed sugar, refined sugar, natural sugar crystals, honey, syrups, molasses, refined flour (cake, biscuits, bread, cookies, pasta), fruit or vegetable juices, and high GI fruits and vegetables. After a while you may be able to add small amounts back in and check your blood sugar levels afterwards, but to start with, cut these out completely.
5. Love the Fibre
When we consume fruit juice, you are giving your body a very fast, quickly absorbed hit of sugar which means the inevitable insulin spike. When you eat whole fruits and vegetables, you are consuming fibre, which coats the digestive tract and slows down the absorption rate of sugar into the system. But as above, stick with lower GI fruits and vegetables such as green vegetables, apples, pears etc.
6. Get Moving!
I recommend gentle nourishing exercises such as walking, slow or gentle yoga to start with so as not to tax your adrenals. I also recommend moving on to resistance or interval training exercise such as Tabata for women with insulin resistance.
7. Get Your Stress In Check
This is the most important thing for any hormonal imbalance as high cortisol, low cortisol or cortisol in the wrong amounts at the wrong time of day can cause just about any hormonal imbalance, although it often manifests differently in different women. Sometimes we have to learn to say “no”, cut down on things or add in nourishing activities to get our cortisol levels in check. You can find out more about cortisol and periods in this post.
8. Get More Sleep
There seem to be more and more studies and books coming out linking a lack of sleep with increased levels of insulin resistance. I try and get a good nighttime routine in so I am relaxing before I go to sleep and I am ready for bed around 10pm. I try and aim for 7-9 hours of sleep and recommend you do the same.
9. Consider Magnesium Supplementation
Magnesium can help with a number of hormonal issues but magnesium deficiency can impair insulin sensitivity. Magnesium is a pretty amazing mineral though as it can also help with cravings, sleep and reduce inflammation. You can get magnesium from green leafy vegetables, nuts and legumes but many people find they need to supplement as well.
10. Consider Inositol Supplementation
Supplements containing both d-chiro and myo-inositol can help improve insulin sensitivity and PCOS. Inositol was originally thought to be one of the B vitamin family but was downgraded when it was discovered some people can make it. However, women with PCOS or insulin resistance seem to need more than what they make in their bodies.
Wow, That’s A Lot of Information!
So now, you know what you can do to help with steadying your blood sugar, levels, pick one or two to start with and start measuring your blood sugar levels around meal times. This will help you to identify what will work for you.
And don’t forget, if you think you may have PCOS, diabetes or pre-diabetes, make an appointment with your primary care practitioner.