Possible insulin resistance?

[eli]

High IGF1, Low HDL, Low SHBG, but normal Blood glucose and A1C. Fit and not overweight at all. Thyroids are all good, no fatty liver

Would you say there's a possibility that I suffer from mild insulin resistance? What other tests are out there to confirm this?

It's been years and I'm still trying to figure out why SHBG is low. I recently found blood work from 11 years ago before I started abusing steroids for a long time, and SHBG was 26 before touching any hormones. Now it's at 13. So I don't think mine is genetic related.

 

[Vince Carter]

Whether its genetic or not nothing I've ever seen from real guys says SHBG is anything other than benign with certain segments that can't make TRT work turn it in to a doom and gloom medical condition.

There's not one guy that fixed "X" , or "Y" and his SHBG went up any appreciable amount and now it's all fine.

Note, too, that insulin resistance, metabolic syndrome and a few others that get tied to low SHBG are not recognized medical conditions and honestly those generally fall in to...lazy people "diseases".

 

[eli]

Whether its genetic or not nothing I've ever seen from real guys says SHBG is anything other than benign with certain segments that can't make TRT work turn it in to a doom and gloom medical condition.

There's not one guy that fixed "X" , or "Y" and his SHBG went up any appreciable amount and now it's all fine.

Note, too, that insulin resistance, metabolic syndrome and a few others that get tied to low SHBG are not recognized medical conditions and honestly those generally fall in to...lazy people "diseases".

I'm being OCD here, need to know 100% there's nothing wrong with me lol... I gave up last year, but I'm back at it again. How am I supposed to know if I'm insulin resistant tho? Any particular bloodwork ?

 

[Dansk]

Check a fasting insulin level and Hemoglobin A1C.

“Prediabetes” is one result of insulin resistance. Insulinresistance causes high cholesterol, high glucose, and high blood pressure. A high level of fasting insulinindicates insulin resistance and can encourage a person to make changes to lower it.

 

[[email protected]]

High IGF-1 is correlated with insulin resistance.
The Association Between IGF-I and Insulin Resistance: A general population study in Danish adults

 

[[email protected]]

Steroids, especially high testosterone, will often reduce SHBG. If used over an extended period of time, the body will adapt to the higher levels. I’m assuming this is possibly why your SHBG levels have stayed low.

 

[fesh0401]

I'm being OCD here, need to know 100% there's nothing wrong with me lol... I gave up last year, but I'm back at it again. How am I supposed to know if I'm insulin resistant tho? Any particular bloodwork ?

Easiest thing to do is go buy a $20 glucometer at Wal-Mart and check what your fasting blood glucose is (fasting being 8+ hours of no food so check first thing in the morning) clinical if your under 100 then you're not insulin resistant but I think it should be more less than 90.

 

[dnfuss]

Easiest thing to do is go buy a $20 glucometer at Wal-Mart and check what your fasting blood glucose is (fasting being 8+ hours of no food so check first thing in the morning) clinical if your under 100 then you're not insulin resistant but I think it should be more less than 90.

I'm being OCD here, need to know 100% there's nothing wrong with me lol... I gave up last year, but I'm back at it again. How am I supposed to know if I'm insulin resistant tho? Any particular bloodwork ?

Don't look to secondary/corollary markers for a diagnosis. Either do self-testing or have the right clinical bloodwork done. For home testing, I would recommend the Freestyle Freedom Lite meter and Freestyle Lite meter (slightly smaller), both from Abbott Laboratories, are highly accurate and recommended by noted diabetologist Dr. Richard Bernstein (they're the only ones he's found to be tolerably accurate at near-normal blood sugar levels). You will need to buy the test strips made for your meter.

Test your blood sugar immediately upon arising. Then test it both one hour and two hours after each meal eating what you typically do (if you are on a low-carb diet, this advice will need a slight modification). Do this for a few days. Although the ADA and others disagree (perhaps for reasons other than the well-being of patients), I would consider truly normal non-diabetic blood sugars generally to be 70s to mid-80s mg/dl upon arising (certainly under 90 mg/dl), under 100 mg/dl one hour post-prandial (on occasion, with a super-high sugar meal, slightly higher, but not often), and near to fasting blood sugars by two hours. Again, others will espouse different views, but these are the blood sugars exhibited by the completely gluco-normal patient. You should also on your next blood panel have fasting insulin run (it's easy and cheap to run, and insurance will usually cover it no questions asked). The lower the better, 5iu or under is great. Anything much over 12iu or so would concern me.

Having said all this, there is a clinical test to run that is also pretty definitive: an Oral Glucose Tolerance Test with Insulin. But most doctors don't want to run it unless you present with diabetic fasting blood sugars (over 125 mg/dl) or HgbA1c (over 6.5%) because it's a big PITA for them to administer (you have to hang around their office for hours and have blood drawn several times) and without those other indicia of diabetes insurance likely won't pay for it and most patients balk at paying out-of-pocket.

Good luck.

 

[[email protected]]

I’m in keto, and my blood sugar when I wake up is 115, and down to 85 in the evening.

 

[dnfuss]

I’m in keto, and my blood sugar when I wake up is 115, and down to 85 in the evening.

Given a low-carb diet (which it sounds like you're on) a fasting blood sugar on arising of 115 mg/dl is strongly indicative of pre-diabetes, if not diabetes.

 

[[email protected]]

I’ve read it’s different for keto, primarily because insulin levels are low and glucose intake very low. With low glucose intake, glucose in the blood is driven on demand instead of supply and insulin doesn’t spike to remove excess glucose (demand driven meaning no excess). The term is called physiological insulin resistance, or glucose sparing, since some organs require glucose to function (thyroid), and other cells are insulin resistant because they are preferring ketones.

 

[[email protected]]

Now if my elevated glucose levels were due to too much sugar in the diet over time, rather than a preference for ketones, than that would not be benign, but dangerous.

 

[Dansk]

Given a low-carb diet (which it sounds like you're on) a fasting blood sugar on arising of 115 mg/dl is strongly indicative of pre-diabetes, if not diabetes.

This is very common in the keto community, it has to do with the liver and Gluconeogenesis. see the link.

Gluconeogenesis: What It Is and Why You Shouldn’t Fear It On Keto - Perfect Keto

 

[[email protected]]

This is very common in the keto community, it has to do with the liver and Gluconeogenesis. see the link.

Gluconeogenesis: What It Is and Why You Shouldn’t Fear It On Keto - Perfect Keto

Yes, this is one of the sites I read. A good read.

 

[BradWI]

Easiest thing to do is go buy a $20 glucometer at Wal-Mart and check what your fasting blood glucose is (fasting being 8+ hours of no food so check first thing in the morning) clinical if your under 100 then you're not insulin resistant but I think it should be more less than 90.

Disagree. I've had an A1C of 5.1 or less for the past few years but still have severe insulin resistance.

OP, you need to do a fasting insulin test ($12 add on through Defy when I got it in August 2018) and also test your blood glucose around the same time.

HOMA-IR = (Fasting Insulin * FBG) / 405.

My last test was 13.0 * 99 = 1287 / 405 = 3.17

Unfortunately for me....

Healthy Range: 1.0 (0.5–1.4)
Less than 1.0 means you are insulin-sensitive which is optimal.
Above 1.9 indicates early insulin resistance.
Above 2.9 indicates significant insulin resistance.

After that test I had my Defy doctor put me on Metformin - there's plenty of data supporting it's role in reducing Insulin Resistance - a few good threads on this forum about it's benefits and a wonderful video by Nelson. I'm now shedding weight like no other and still eating as much as I want. I've done multiple things to improve my Insulin Resistance so it's hard to pinpoint exactly what is lowering it. Metformin, carnivore, weight lifting, some IF but for the most part if I'm hungry I eat and it naturally falls into somewhere around 16/8 window.

Also my average ketones level has been getting deeper since I started Metformin. Ketones and Insulin levels are inverse.
Insulin vs. Ketones | Insulin IQ

 

[dnfuss]

Yes, this is one of the sites I read. A good read.

Gluconeogenesis occurs in everyone, in those eating the Standard American Diet and those on a ketogenic diet. It occurs in diabetics and in those with completely normal blood sugars. It is neither an explanation nor a justification for why those on ketogenic diets would exhibit abnormal serum glucose levels. A patient presenting with consistent fasting serum glucose of 115 mg/dl (not just temporarily due to a systemic infection, for example) does not have normal blood sugars. Those with completely and naturally normal non-diabetic blood sugars have them persistently, no matter what their diet. Their pancreas does not "forget" how to produce insulin nor lose its stores thereof nor lose the ability to respond to rising sugar levels just because they adopt a very-low-carbohydrate diet. Switch back to eating the Standard American Diet for a few days and see if your blood sugars normalize (fasting and post-prandial). It is highly likely they will not.

 

[Dansk]

Gluconeogenesis occurs in everyone, in those eating the Standard American Diet and those on a ketogenic diet. It occurs in diabetics and in those with completely normal blood sugars. It is neither an explanation nor a justification for why those on ketogenic diets would exhibit abnormal serum glucose levels. A patient presenting with consistent fasting serum glucose of 115 mg/dl (not just temporarily due to a systemic infection, for example) does not have normal blood sugars. Those with completely and naturally normal non-diabetic blood sugars have them persistently, no matter what their diet. Their pancreas does not "forget" how to produce insulin nor lose its stores thereof nor lose the ability to respond to rising sugar levels just because they adopt a very-low-carbohydrate diet. Switch back to eating the Standard American Diet for a few days and see if your blood sugars normalize (fasting and post-prandial). It is highly likely they will not.

when the body makes it own glucose, (gluconeogenesis) insulin release is much lower than if you eat something. thus elevated fasting, especially in the AM. This is not a bad thing its actually good, and shows insulin sensitivity. Read the link below for more details.
Bottom line for the OP is to have your fasting insulin levels checked.

Why High Fasting Blood Glucose on Low Carb or Keto? – Diet Doctor

 

[dnfuss]

when the body makes it own glucose, (gluconeogenesis) insulin release is much lower than if you eat something. thus elevated fasting, especially in the AM. This is not a bad thing its actually good, and shows insulin sensitivity. Read the link below for more details.
Bottom line for the OP is to have your fasting insulin levels checked.

Why High Fasting Blood Glucose on Low Carb or Keto? – Diet Doctor

What is described simply isn't reflective of our understanding of robust blood glucose control in the euglycemic. The so-called experts on the referenced site (Jason Fung, et al.) are the same ones who say that diabetics have been "cured" by intensive fasting despite maintaining HgbA1c of 6.5%, etc. Regularly elevated blood sugars, in and of themselves, cause physiological damage to the tissues and organs of the body. That is the fundamental pathology of diabetes. It's not somehow acceptable because you're in ketosis. So even if the explanation of the cellular process were correct, it still wouldn't justify tolerating sustained damaging blood glucose levels.

 

[rafapark]

High IGF1, Low HDL, Low SHBG, but normal Blood glucose and A1C. Fit and not overweight at all. Thyroids are all good, no fatty liver

Would you say there's a possibility that I suffer from mild insulin resistance? What other tests are out there to confirm this?

It's been years and I'm still trying to figure out why SHBG is low. I recently found blood work from 11 years ago before I started abusing steroids for a long time, and SHBG was 26 before touching any hormones. Now it's at 13. So I don't think mine is genetic related.

Are you taking any peptides? The same thing happended to me when taking sermorelin/GHRP-2. I took a comprehensive blood panel and it showed a mild insulin resistance but normal blood glucose and A1C. My Doctor suggested I cycle off the peptides because of this.

 

[rafapark]

Are you taking any peptides? The same thing happended to me when taking sermorelin/GHRP-2. I took a comprehensive blood panel and it showed a mild insulin resistance but normal blood glucose and A1C. My Doctor suggested I cycle off the peptides because of this.

Also these were the tests that I took related to Insulin Resistance specifically:
Leptin (ng/mL) - normal
Adiponectin (μg/mL) - low
Free Fatty Acid (mmol/L) - normal
Ferritin (ng/mL) - normal
α-hydroxybutyrate (μg/mL)- high
Oleic Acid (μg/mL) - normal
Linoleoyl-GPC (μg/mL) -normal
HOMA-IR (calculated)