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Insulin Resistance
Insulin resistance often begins a decade before blood sugar rises. We measure fasting insulin, read the full pattern, and address the gut, muscle, sleep, stress, and inflammation behind it.
What you may be noticing
You crash in the afternoon and crave sweets or carbohydrates. You feel tired or foggy after a carbohydrate-rich meal, or shaky and irritable when meals are late. Weight gathers at your waist even though you eat reasonably. Skin tags, dark patches on the neck, and stubborn fatigue may appear. Your fasting glucose looks normal, so no one has looked further.
Why it is rarely one thing
Insulin resistance is not just eating too much sugar. It is cells that have stopped responding well to the signal of insulin, so the pancreas produces more to compensate. For years, glucose can stay normal while insulin climbs. Standard screening that checks only glucose misses this early stage.
Elevated insulin is not silent. It promotes fat storage, inflammation, high blood pressure, fatty liver, and hormonal imbalance, and it affects the brain, which depends on insulin signaling for memory and energy. Some researchers describe Alzheimer disease as a form of insulin resistance in the brain, a working hypothesis that makes early metabolic care brain care as well.
Not every high glucose is insulin resistance. When glucose is high but insulin is low, the pancreas may be under-signaling, which calls for a different workup. Reading insulin and glucose together, rather than glucose alone, is how I tell these patterns apart.
The question is why the cells stopped listening. The answer usually involves the gut, muscle, sleep, stress, inflammation, and the environment as much as food.
Patterns we look for
- Fasting insulin, which rises long before glucose, and HOMA-IR, calculated from fasting glucose and insulin.
- HbA1c and glucose patterns, including continuous glucose monitoring where helpful.
- Triglyceride to HDL ratio, an accessible marker of insulin resistance.
- Liver enzymes such as ALT, read with functional ranges for early fatty liver.
- Muscle mass, the largest site of glucose disposal in the body.
- Sleep deprivation and circadian disruption, which reduce insulin sensitivity quickly.
- Cortisol and the stress axis, including high morning glucose.
- Gut health, inflammation, and the microbiome.
- Thyroid function, magnesium, and vitamin D.
- Endocrine-disrupting chemicals that interfere with metabolic signaling.
- Brain effects: insulin resistance in the brain is linked with cognitive decline.
How I evaluate it
A comprehensive functional neurological exam shows how blood sugar instability affects your brain: cognitive stamina, eye movement fatigue, and autonomic responses.
Functional labs may include fasting insulin and glucose with HOMA-IR, HbA1c, a lipid panel with advanced markers, liver enzymes, uric acid, inflammatory markers, a thyroid panel, vitamin D, and magnesium. When glucose is high and insulin is low, C-peptide and related markers clarify pancreatic output. A two-week continuous glucose monitor can reveal how your body responds to real meals.
How we address it
- Calm inflammation and support the gut early, since digestion and absorption shape metabolic signaling.
- Structure meals around clean protein, fiber, vegetables, and healthy fats, with low-glycemic choices and fewer refined carbohydrates.
- Build muscle through strength training, and add movement after meals.
- Restore sleep and circadian rhythm, and calm the stress axis.
- Fill nutrient gaps with categories of metabolic support matched to your labs.
- Reduce exposure to endocrine disruptors.
- Coordinate any medication with your physician, and track progress with fasting insulin, glucose patterns, and how you feel.
Your cells can listen again. Energy steadies, cravings quiet, and the brain is better fueled.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.