Insulin Resistance Test (Best Test for IR & Stubborn Weight Loss) Homa-IR

what is the best test for insulin resistance insulin resistance is linked

to the majority of modern disease obesity diabetes cardiovascular disease

all have a component of insulin resistance so people want to know how to

measure it for a lot of people it's enough just to

measure your basic glucose and maybe an a1c but for some it's not enough that's

not going to tell them the whole picture so today we're going to talk about Homa

IR what it can measure and when it's a good idea to ask your doctor for a test

coming right up

Homa IR stands for homeostatic model assessment of insulin resistance glucose

is one indicator of insulin resistance but glucose varies it fluctuates a whole

lot through the day so depending on when we catch it we may or may not get a

representative value a1c is a blood glucose average it measures how much

glucose sticks to a red blood cell and the red blood cell lives about three to

four months so by measuring how much is stuck to a red blood cell we can get a

three to four month average of the glucose so that's a better measurement

but it still doesn't tell us the whole picture because you could still be

insulin resistant and have a normal blood sugar so let's talk about that and

Homa IR measures insulin and glucose and the homeostatic means how good is the

body's ability to return to balance these two factors out to return to

homeostasis so we multiply the blood glucose by the insulin and we divide by

a constant to come up with a score so there's two factors that drive the score

it's both blood glucose and insulin so either one could drive up the score and

that where it gives us the value so if you have a normal blood glucose but a

high insulin you still insulin-resistant and if both are

high then obviously you are also insulin resistant so let's look at a few

examples here every time you eat your body raises blood sugar the food gets

into the bloodstream blood sugar goes up if you eat carbs it goes up a lot

if you eat protein it goes up a little bit and if you eat fat it hardly rises

at all then that blood glucose the purpose is not to be in the blood the

blood is just a transportation system to get the fuel to the cells because the

cells are going to do some work with that fuel and insulin is what allows the

glucose to get out of the blood and into the cell so it's like a lock key into a

lock to open up the door to let the cell use that fuel so we eat something our

glucose goes up insulin goes up it delivers it to the cell when the cell

has the food then insulin is no longer lead that needed and insulin goes back

down so that's kind of the normal sequence of things and the system is set

up beautifully because it's self managing as long as we live a natural

life and eat whole healthy foods if we have a moderate or low amount of blood

glucose it doesn't take much insulin to control that and we have a balanced a

homeostatic situation and our Homa IR score would be 1 or less so let's look

at a few examples there the first example is a person who goes get their

blood work their fasting glucose is 90 we measure their insulin levels their

fasting insulin levels which come out to 4.5 we plug it into the formula we

multiply glucose by insulin divided by the constant and we have 1.0 so this is

a person with good insulin sensitivity meaning it doesn't take a lot of insulin

the body doesn't have to work very hard to deliver that food to the cell the

cell is receptive it's sensitive because it wants that food so this is a

good situation there a 1 C measures 5.5 so their average glucose is about 110

and so they start the day off at 90 and then they eat but they eat reasonably

well so the blood sugar goes up it goes a little bit outside of the zone maybe

if they eat some rice and potatoes and things but it doesn't climb excessively

because they eat whole food and it comes back down in the range and the body

doesn't have to work very hard the next example though that person comes in get

their blood work their fasting glucose is 85 so if that was all we measured for

that person we go hey congratulations you're in tip-top shape don't worry

about a thing just keep doing what you're doing and the person goes off and

he's heading into trouble because if we had also measured insulin we'd see that

it was 10 and this person that insulin is more than twice that one even though

they're fasting glucose is lower so when we calculate the home IR we get a two

point one meaning the body can maintain the blood sugar especially after a while

when you've been fasting but it has to work really hard at doing so then we

measure the a1c and we see this person has a 6.3 indicating an average glucose

of 134 and there's a big big difference between the fasting the fasting they

look good but their average is pretty high so this person is pre-diabetic and

even though if we had sent him off with the congratulations based on the fasting

glucose and he keeps doing what he's doing he is heading for diabetes so what

is he doing well he starts off the day low but then he eats his milk and cereal

and toast with a jam and orange juice and then he has a hamburger and a coke

and every time he eats his blood sugar goes very very high it goes way

outside that ideal range which is an emergency and the body has to make a ton

of insulin but the body can still keep up so the insulin is sufficient to bring

it back down to a normal level especially if you let it work overnight

which is when we take that fasting glucose so here's an example of where

you're developing insulin resistance you are eating a lot of carbs a lot of

processed food the blood sugar goes high a lot of insulin is pushing all that

fuel into the cell and the cell is happy in the beginning and then after a while

it says hey this is too much I can't use all this fuel so the sugar gets

converted into fat and the fat starts filling up the cells of the body

especially the liver which is usually the first place to develop insulin

resistance the cell has had enough the cell says I don't want any more so it

starts resisting insulin the longer you go without food the more the cell can

start burning off those stores and then it welcomes insulin you become more

insulin sensitive so this person would do well to start changing some habits

before it's too late the earlier you can catch something the quicker and easier

it is to turn it around it's never too late

but this quickly you get at it the easier it is this is a full-blown type-2

diabetes patients fasting glucose is 200 their insulin is at 20 a 1 C is a 10

average glucose 240 we calculate their score and it's a nine point nine so

here's a very insulin resistant person and of course we had no doubt because

every marker indicates that there's something out of whack here there if we

charted their blood glucose they are never in the normal range they never

ever get down there because they push their body too far they start off high

every meal they eat which is probably frequent they increase it they make mass

of amounts of insulin but the cells are so resistant that the massive amount of

insulin is not can't make a dent in it it fluctuates a little bit up and down

but it stays at a very high level even so the moment this person stops eating

carbohydrate the blood sugar will start to go down so there is hope even in this

case but what I really wanted to focus on with the Houma IR is this special

case and this is the person who has tried everything they might have lost

some weight maybe they plateaued maybe nothing

happened maybe it's a person who managed to lose a good bit of weight but all the

remaining weight sits on the midsection and this could be someone who has eaten

really really well for a long time maybe for years

so we checked them their fasting glucose is a hundred so it's a little bit on the

high end but not alarming we check their insulin and it's a whopping twenty it's

it's as high with half the blood sugar it's as high as this one so their score

calculates 26.2 so they're very very insulin resistant but they've eaten well

for quite some time so their blood sugar never goes crazy and we check their a1c

it's a 5.4 their average glucose is about 108 so there's hardly any

difference between the fasting and the a1c and in some cases they could be the

same this person's blood sugar never really budges and yet they can't lose

weight so if we think about this and and these are these are I have seen people

like this and every person with this might be different so don't think that

I'm just talking about you but it could be a large range of cases if this

doesn't look exactly like you then just look at the the principal's so this

person might have been on keto they might be fully fat

adapted the body burns fat for fuel perfectly they don't get hungry much

they have no cravings but they're so insulin resistant that the cells won't

release the fuel okay they have all this fuel stored on the body but it takes

extreme measures to release any of it the body there's so much insulin there

that the body that that packs the fuel into the cell that locks the cell down

that the body prefers to eat fat to as opposed to burning it so this person if

they're on keto they probably feel a strong urge to maintain their calories

their intake they get hungry when they don't get food because even though their

fat adapted and they have all this fat they still can't get to it because of

all that insulin so in this case you probably have to get a little bit more

drastic so a lot of these people have already tried the the keto they've tried

the calorie restrictions they've done all those things so Kido may not be the

thing that's going to do it for them they it might low-carb is absolutely

necessary because if you start loading up the carbs then their system is going

to get even more insulin crazy but keto may not be enough so they need to stay

keto and/or low-carb but they need to start doing some other things as well

exercise would be one thing and they want to do low intensity exercise

something that gets their heart rate to a hundred hundred and twenty not higher

because then you start burning a lot of cortisol which drives more insulin they

might want to play around with fasting so even if they've done intermittent

fasting 16 hour fast 18 hour fast they probably want to go more toward ohm add

one meal a day or even longer fasts like 36 48 72 hours and they might be a

little uncomfortable because the body is so

resistant to releasing that energy that fat for fuel but if they can get over

the hump then they'll probably see some results and then of course then there

are also cases where even that may not be enough because there can be other

factors that are underlying the problem so things like hypothyroid if you're

toxic with metals chemicals immune toxins or if you have nutritional

deficiencies then your body is just not in a strong enough place to to bounce

back all of the things we talked about are still appropriate but they may not

be enough where you may get very slow results so this is what we specialize at

in our office we analyzed the body and find out what are the hidden root causes

so if you've tried everything then try this and then maybe look if there's

someone locally that can help you as well we do nutrition response testing

which is the best method I've ever found of identifying those things so let me

know if this answers your questions on insulin resistance or if there's

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