6 ways to improve insulin sensitivity in PCOS

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What is insulin resistance?

Insulin resistance affects up to 70% of PCOS women and can make it very difficult to lose weight as well as increases androgens which trigger those unwanted symptoms that we all really don’t like such as acne, hirsutism, and hair loss. Insulin resistance can also be a cause of anovulation.

Insulin resistance (also known as prediabetes), basically means that your cells are not responding normally to insulin. Insulin is your storage hormone that gets secreted by your pancreas when you eat and when blood sugar goes up. Insulin’s job is to shuttle glucose from the bloodstream into the cell to be utilized as energy, or stored as fat for later if immediate use is not required.

With insulin resistance, our cells become desensitized to insulin and instead of using blood sugar as energy, it stores it as fat instead. Which, you guessed it, results in increased fat storage, but also an increase of insulin in the bloodstream in response to high blood sugar levels which can result in diabetes down the road.

Insulin resistance can develop over many years, even decades before diabetes develops, which is why glucose testing is not enough to determine insulin resistance and it’s so important to catch it early on!

Signs & symptoms of insulin resistance

There can be many obvious and some not so obvious signs of insulin resistance including excess stubborn belly fat, difficulty losing weight, ease gaining weight, skin tags, dark skin patches, fatigue, sugar and carb cravings, fatty liver…  and it’s important to note that you can also be insulin resistant and not be overweight!

How to test for insulin resistance

The most common tests include Fasting Glucose + Fasting Insulin. But other markers such as HBA1C, HOMA IR and Glucose tolerance test can also help determine if insulin resistance is present.

Other indicators include low serum HDL (our good cholesterol) levels and high blood triglycerides which are two other markers strongly associated with this condition.

When your lipid panel (total cholesterol, LDL, HDL, and triglycerides) is elevated, this often indicates a fatty liver (another risk with POCS) or an insulin resistant liver.

What are some causes of insulin resistance?

Though carbs are often demonized and recommended to avoid with PCOS and insulin resistance, not all carbs are bad. In fact, many will improve the condition. Refined sugars and flours, nutrient deficiencies, chronic stress, refined carbohydrates (1), artificial sweeteners (2), lack of exercise, trans fats, advanced glycation end products, smoking, lack of sleep, overeating, excess animal fat, excess fructose especially processed and modified like HFCS, medications, and the birth control pill are all factors that can increase insulin resistance and desensitize cell receptors.

So what can you do?

Eat insulin friendly foods

Turmeric, ginger, cinnamon, berries, spirulina, leafy greens, legumes, and omega 3 fats in particular all have been shown to improve insulin function through various mechanisms such as decreasing inflammation, sensitizing receptors, and slowing glucose absorption into the bloodstream.

Whole plant foods that are fiber-rich can help increase insulin sensitivity and also reduce the risk of chronic disease such as cardiovascular issues further down the line. And we can’t forget the role that fiber-rich carbohydrates have on our gut health!

As women with PCOS have been shown to have a lowered diversity of beneficial microbes and poor gut health, we really need to pay attention to getting prebiotics into our diet as well as probiotics.

Fiber, which is found only in plant foods is fermented by intestinal bacteria to produce short-chain fatty acids, which improve glucose response, insulin signalling, and insulin sensitivity. 

Resistant training & HIIT 

Building muscle supports insulin function because muscle tissue uses glucose for energy and improves glucose control. Strength training can increase insulin sensitivity in both healthy women and women who have polycystic ovarian syndrome while improving body composition.

HIIT workouts involve as little as four minutes of intense activity combined with rest for a total workout of only around 15-20 minutes, so don’t over do it!

Not only does HIIT beat conventional cardio as a more effective and efficient form of exercise, but it also provides health benefits such as a boost in human growth hormone (HGH), also known as "fitness hormone” and can increase metabolism and fat burning even days after your workout (3).

So as you can see, you really don’t need a whole lot of time to get a good workout in.

As a side note, workouts are great but I highly recommend balancing with lower impact and slower movement activities such as walking, pilates, yoga, or stretching. When we are continuously going hard we also trigger more cortisol and this is especially problematic for cycling females, resulting in compromised hormones, muscle wasting, and even fat storage. Our bodies don’t respond well to chronic stress and high-impact workouts chronically or during the second half of the female cycle when our metabolism increases, we are more sensitive to cortisol, and we require more rest and nourishment. My course helps you to understand the different cycle phases and how you can best support any phase you are in with the appropriate nutrition and exercises but also adjustments to your self-care, business, and social life for optimal results!

Walking is actually highly underrated but one of the best exercises for PCOS and hormone balancing!

Want to learn more about the best exercise for you and your PCOS? Tune into episode 62 on the Addicted to Healthy Podcast.

Vinegar before meals

Vinegar has been shown to reduce blood sugar effects of a high carb meal by lowering postprandial blood sugar and improving insulin function (4).

I like to add 1-2 tbsps of ACV to water before a meal. Always look for raw unpasteurized ACV with the “mother” as this will be fermented and keep the live enzymes intact. I love the brand BRAGGS!

Support your liver

The liver stores glucose and excess fat as triglycerides. Many women with PCOS have high TGS (4) which can contribute to insulin resistance and excess glucose storage.

We also need to remember that the liver has over 500 functions including processing toxins and excess hormones such as estrogen (hello PMS!), converting inactive to active hormones such as thyroid, creating bile which is crucial for fat absorption and toxin elimination, and burning excess fat.

In addition to avoiding inflammatory foods mentioned below, the liver loves loves loves bitter foods like leafy greens, artichoke, radish, cruciferous vegetables, and citrus fruits like lemons. So load up!

Check out my detox webinar on my website if you want to know more about how to support this organ. 

Avoid inflammatory foods

Processed, junk, refined foods, excess sugar, dairy, hydrogenated oils, alcohol, gluten are all inflammatory foods that can exacerbate insulin resistance and the PCOS pathophysiology by triggering spikes in blood sugar and insulin and by increasing inflammation.

Refined carbohydrates must be avoided however complex high fiber plant foods can improve insulin resistance. In addition, certain foods such as dairy and red meat actually trigger a significant insulin response so be careful with these foods especially in excess.

These foods are better avoided as they can worsen the PCOS condition and symptoms not to mention increase the risk of chronic disease.

Supplement accordingly

Supplementing is often necessary for insulin resistance but should only be regarded as a supplement to a balanced diet and lifestyle.

Commonly recommended supplements for insulin-resistant PCOS include inositol, chromium, magnesium, and berberine.  

Inositol is probably the most used supplement for PCOS and for good reason! Inositol has been shown to improve insulin signalling and glucose uptake in tissues, helping to improve the IR status of women with PCOS (5). It also has promising studies and efficacy to restore ovulation. I like using a powder form of myo-inositol with meals.

Need more support with your PCOS? If you’re ready to start taking control of your PCOS with the support & guidance of a holistic nutritionist who addresses the root causes of your PCOS, check out my PCOS services to start making progress with your health today.