Carbohydrate Intolerance / Insulin Resistance
Carbohydrate intolerance/insulin resistance are terms often used interchangeably because they usually go hand-in-hand. Carbohydrate intolerance is when a person doesn’t tolerate carbohydrates very well, usually gluten containing products or simple sugars. They typically crave sugar but it may give them a headache, feeling of weakness, or make them irritable, edgy, unfocused, or angry. Insulin resistance is a term used to signify that the body’s cells have become resistant to the insulin produced by the pancreas resulting in a rise in blood sugar. In a normal person, about 40% of consumed carbohydrates are converted to fat. In a person with CI, that number increases to 50-60%. The excess insulin can cause blood sugar to drop too quickly, and then the adrenal glands must kick in to get the blood sugar back up. Not only will this cause more stress on the adrenal glands, but usually too much glucose is released, further causing the pancreas to produce more insulin. Around and around it goes. Eventually, the body must produce more insulin to metabolize the same amount of glucose. CI is caused by a number of factors; some of the more common reasons include increased stress hormones, a diet containing hydrogenated fats, a food allergy (milk is the most common as it has been shown to attack the beta cells of the pancreas – this is why children under 1 year old are advised not to consume dairy), a high carbohydrate diet, and caffeine. Insulin resistance can cause the following:
- BLOCK MAJOR HORMONES INCLUDING DHEA AND THE CONVERSION OF T4 TO T3 (THYROID HORMONES) AS WELL AS LOWERED GROWTH HORMONE
- ELEVATE BLOOD PRESSURE
- ELEVATE TRIGLYCERIDES AND LDL, THE “BAD” CHOLESTEROL
- AN INCREASED TENDENCY TO GAIN FAT IN THE UPPER BODY
- PMS AND POLYCYSTIC OVARIES IN WOMEN
- DECREASE ENERGY OUTPUT, ESPECIALLY AFTER EATING
- GIVE A CRAVING FOR SUGAR – A “SWEET TOOTH”
- HANDS GO NUMB AND “FALL ASLEEP” AT NIGHT, OR INDUCE A “PINS & NEEDLES” FEELING DOWN THE HANDS, ESPECIALLY DURING EXERCISE
- IRRITABILITY & UNSTABLE MOODS
STEPS TO IMPROVE CARBOHYDRATE METABOLISM and INSULIN SENSITIVITY:
- FOLLOW THE “TWO-WEEK TEST” TO SEE YOUR CARBOHYDRATE TOLERANCE LEVEL
- CHECK OUT THE PALEO DIET
- CONSUME ADEQUATE HEALTHY FATS (EGGS, AVOCADO, COCONUT, BUTTER, RED MEAT, NUTS & SEEDS) TO SUSTAIN YOUR ENERGY FOR SEVERAL HOURS
- EVALUATE NEED FOR NUTRIENTS: CHROMIUM, VANADIUM, ZINC, AND SESAME SEED OIL.
- EXERCISE AEROBICALLY UNTIL YOU HAVE A SUFFICIENT AEROBIC BASE; THEN CONSIDER ANAEROBIC ENDURANCE TRAINING
- WEIGHT LIFTING/STRENGTH TRAINING CAN HELP OR HINDER AT FIRST; IT DEPENDS ON YOUR SITUATION AND TYPE OF TRAINING
Hi,
I have started the two week test and I was wondering is it ok to have Mozarella cheese as I know this is quite milky cheese?
I see you told someone they could have decaf coffee is it ok to have decaf tea?
Thank you
Suzanne
The cheese should be fine, though I wouldn’t go crazy on it.
Either coffee or tea, decaf or regular, is fine.
Hi,
Thanks for the information. Are there any type of cheese which should be avoided apart from the processed cheese?
Also I have been having problems eating tomatoes. I seem to be ok on fresh tomatoes but having a problem with tinned tomatoes. Could there be something in the tinned tomatoes giving me problems? As soon as I eat tinned tomatoes I am in agony pain and bloated instantly.
Thank you.
No on the cheese. Could be so many problems with the canned food from the BPA, preservatives, concentration, pesticides, etc.
I get hyper, anxious, when I consume any type of carbs and i can feel it instantly. I lack focus and it always seems foggy. I’m super sensitive to any types of carbs and I’ve been like this for as long as I can remember, although its gotten worse I think in the past 5 yrs I think. Iare there any other explanation for this? Is my only option to cut carbs?
It’s never your only option – as the post discusses hormones have a lot to do with it. Gut issues (dysbiosis) can cause sugar handling problems too. Cutting carbs is rarely a bad idea though.
It’s never your only option – as the post discusses hormones have a lot to do with it. Gut issues (dysbiosis) can cause sugar handling problems too. Cutting carbs is rarely a bad idea though.
I was diagnosed with PCOS when I was 15 -31 years ago. I never understood what it all entailed. I struggled with my weight but played sports and ran to keep it under control. when I was 30 I was in a motorcycle accident and am now a t-4 paraplegic. I have had the worst time keeping the weight off! I then when to see a nutritionist and he told me it was from IR. put me on metformin, I wrote everything down I ate eating 50% protien, 30 fat and 20 carbs and exercised (water jogged int he pool) this helped me lose the weight. I became sensitive to the metformin and couldnt take it any longer. I started wondering why I have such a hard time keeping weight off and why all medicines bother me. and pretty much have had to unravel the puzzle myself. I had a revelation the other day that I am allergic to carbs. I googled just that phrase and well, now I know. the whole list of symptoms is spot on. my questions are is there a natural alternative to metformin? could my carb intolerance be a symptom of my adrenal glands or lacking something in my diet? what causes carb intolerance? Thank you for your wisdom! I wish I would have found this site eons ago. by the way my fasting insulin level was 58 a month ago. she put me on junivia and it is at 34 now. still way too high! help; and my daughter has the same issues.
Hi Mona, thanks for the comment. The “natural alternative” to CI is diet and lifestyle. The only food “supplement” I recommend to a non-patient since there’s no harm in taking it is UNrefined sesame seed oil. You can get this at pretty much any health food store. Make sure it is unrefined. It’s great to use on salads – do NOT cook with it. Using around 1TB a day can help with inflammation caused by insulin resistance.
I put my patients on the Paleo-Type diet, http://www.drgangemi.com/2011/07/paleo_diet/ and for those with gut problems then the FODMAPs Diet – which is very similar. http://www.drgangemi.com/2011/08/fodmaps/.
Fasting insulin should be <15 – ideally <10.
Thank you for the response! I have already started the TWT. What is your view for the TWT on turkey bacon and burger? I was reading the ingredients last night and noticed the hidden MSG. Should I continue the metformin while doing this trial (I just started the stuff anyway)?
I would love, love, love to have a consult. sigh, only if insurance would cover it. Thank you again for your wisdom!
Turkey stuff is fine as long as there are no hidden sugars or additives, including MSG. I can’t advise you to take or not to take a medication; sorry!
Hi. I have reactive hypoglycemia and find that when I eat a diet with carbs (even healthy carbs) in it then I need to eat a lot of fat and I have hypoglycemia symptoms. When I go to a high protein diet, then my carb tolerance falls to zero and I feel the effects of the carbs immediately (as well as getting hypoglycemia symptoms). The immediate symptoms I have when I eat a carb (even vegetables) are that I feel weak in the middle of my body, have difficulty breathing, and need to eat fat to stabilize myself. Then depending on how much I ate or other factors, I may be our of commission for the next several hours. Right now my diet consists of meat, fish, eggs, nuts, butter and olive oil. Have you ever heard of this? Thank you very much!
Yes and you may have something else driving your carb intolerance. Too much stress, past (or current) injuries, food allergies – just some of the things that can cause this problem. Also, it depends what you consider “a lot”. I’d say most people do best on a diet well over 50% fat.
Thank you for replying. Do you have any ideas of what I can do to help it? I’ve cleared my food allergies multiple times with elimination diets, TBM and NAET. As for stress I’ve not worked now for over a year and have no real obligations – so I don’t know how to reduce it any more! I’m interested that you have heard of others with the reaction I have since I haven’t been able to find anything else on it yet on the internet. Is there anything written anywhere that describes my particular reaction that you can recommend to help me understand it better? I’m about to start breathing exercises and I’m hoping that will help. Do other people have the exact same reaction or just something similar? When you say injuries do you mean physical or emotional? Thank you again.
You’re welcome but really hard to say too much more since it’s so individualized and that’s impossible for me to say w/o seeing you. You might try the FODMAPS Diet I discuss on this site as the dysglycemia could be from a gut issue.
By injuries in this case I was referring to physical.
Is there an explanation for why my body can handle oatmeal, beans, and honey and not handle refined sugars? Does this mean I am not carbohydrate intolerant, but maybe more sensitive to insulin responses?
Well it just means you’re more sensitive to higher fructose or sucrose foods and not those that are more complex carbs. Honey is kinda the exception but generally well tolerated because its natural & unprocessed (hopefully!).
Hi – I am curious about CI, and I am thinking that I probably have a pretty severe reaction to carbs. For the last 4 years doctors have been trying to figure out what is causing my fatigue, inability to lose weight (I exercise 5-6 days a weeks ranging from yoga, running, HIIT and weights, etc) I thought I ate pretty well, I don’t eat processed foods/fast food or sugary foods. I recently did a challenge where all these people were losing weight, and I lost nothing…maybe a couple inches. I didn’t eat any wheat/bread products but I did consume a ton of fruit. Would that mean I am really CI? I would love to lose the last 10 pounds, but no matter what I do nothng works. I tried doing a TWT a while ago, but maybe my re-introductions wasn’t correct? However, for me, I strongly believe that I can’t have any forms of wheat/rice/potatoes/fruits/etc….I just don’t know how to get enough carbs in my diet then? Thanks for reading!
If you’re burning fat efficiently then you shouldn’t need a whole lot of carbs in your diet. Veges for the most part, with fruit and some starches only scattered in when you exercise hard. And of course maybe you’re exercising too hard. I’m not a subscriber of HIIT workouts, for most. http://sock-doc.com/2012/01/sock-doc-training-principles/
Just finishing up my TWT- first off I feel fabulous! I went to get weighed today and have lost 4 lbs in the 2 weeks. I know it isn’t much but I am paralyzed t-7 so have no large muscle mass to help burn the calories. I swim (more like a modified water jog). I am starting to introduce carbs today, I am going to try some fresh fruit and see how it goes. I also had my blood drawn this morning to see what impact it has had on my fasting insulin- started at 50ish, went to 32 a month ago and now hopefully even lower! Thank you for all your wisdom on this!!!!!!
Hey nice work Mona. Would love to hear what that insulin level is. <15 would be great; <10 superb.
thought I would update you: received my fasting insulin results today from the test last thursday. WOOHOO it is going down baby! not perfect but getting there. 20.6. why oh why must my body be so rebellious! but at least all of the hard work is paying off.
Thanks again! ( I was serious about the alaska halibut offer)
Thank you! I do feel better when I am sticking to a lower impact routine such as yoga and light running, but I love the thrill of the intensity. How can I maintain muscle if I back off from anaerobic training? Will eliminating most carbs, other than veggies allow me to keep my muscle mass as my protein levels will be higher? I know I have a lot of the ‘over training’ symptoms…thanks again for reading!
Aerobic exercise doesn’t deplete muscle, that’s a myth.
I agree, I know it doesn’t deplete muscle…but I haven’t noticed in the past that when I don’t keep up with strength training I quickly lose any definition I have? Other question, if you’re not eating carbs wouldn’t your body burn fat no matter what exercise you are doing? Thanks again for reading!
No – your body will quickly break down protein (from your muscles) into amino acids and use that to make glucose to fuel the body. So you burn muscle and hang onto fat.
Thank you again for replying, Dr. Gangemi, and for all the other answers on your site – really very much appreciated. So I guess I’m already doing FODMAPS since I mainly only eat meat, eggs, fish, nuts, butter and oils – but I could could try to reduce the nuts and I will cut out the almonds and hazelnuts. I started the sesame oil today. But since I can’t eat any carbs (every now and then I can eat a vegetable) I just read on your site that I won’t switch to fat burning and I’m concerned about that :( Also if I goof anything up during the day (miss a snack, don’t eat enough at a meal – or the other day I ate organic pork that somehow didn’t register to my body as having eaten anything) then I can’t sleep at night and I need to get up eating and it’s hard to get enough to eat (I’m still awake at 4:30 am too hungry to sleep after two chicken legs, 2 eggs, 3 tsp sesame oil, 2 tsp olive oil and a bunch of almonds) … Also my brain fog hasn’t improved at all since I cut out the carbs – maybe because I haven’t switched to a fat metabolism? Maybe I could eat more fat. Thank you for any more advice you can give!
Make sure your protein and fats are plentiful in your diet; you shouldn’t need to eat every few hours if they are. Hopefully that helps you; sometimes there’s more to it than diet – hormonal balancing, lifestyle factors, food allergies…
Thank you very much! I must be eating too much protein/not enough fat. So I’m going to switch to 50g or so of protein daily and an equal (or more) amount of fat like you say. Only problem is the nausea from eating fat so I guess I have to start to increase the fats slowly. Do you have any other ideas for the fat-induced-nausea problem? Thank you again, as I think this is going to help a lot. Then I will need to figure out the food allergy, hormones, lifestyle, stress, etc. factors too.
Nausea from fat can be due to a gallbladder problem. I often recommend 1g of protein per kilogram of weight (so a 125 lb person would be eating around 55g protein). But typically 1.5g per kg is better and 2g or more for athletes.
Well…that won’t work since it’s no where near enough calories. I had read though that around 50g of protein is what is good, but that would mean I’d have to eat around 150g or more of fat which doesn’t seem right. Unless I’m calculating it wrong…
Ok. I will try 1-1.5g per kg of protein and 2.5-3.0 g per kg of fat (that’s more than 50% of fat, but I don’t know how else to do it to get enough calories – is that ok?) and see if that helps. And see what I can do for my gall bladder in the mean time. Thank you!
I eat around 60-70% fat most days.
Ok, then I will aim for that too. Thank you again. Do you have any suggestions for heartburn at night, though? I need to eat right before bed and frequently need to get up once or more at night to eat (or I can’t sleep, get RLS, etc.) and eating fat at night can cause me to get heartburn (and I don’t think that protein alone will get me through the night). Sorry to be so much trouble! Thank you.
Also the reason I want to restrict my proteins as much as possible (45-55g per day) is to make sure I go into ketosis (I thought that would get me through the night better and relieve my brain fog) and so I don’t want to be turning excess protein into glucose. If I do the 1-1.5 g of protein per kg body weight would that interfere with ketosis? (I already do zero carbs.) Again, thank you. I hope these questions help someone else too.
There is no reason to always be in “ketosis” as in it showing up in your urine.
That is not necessarily healthy over time. If the fat causes the heartburn then that’s a gallbladder problem.
Oh. I thought that if I switched to ketosis – fat as my main fuel for my brain and other organs – then I would be more steady. Now if I go a little too long in between meals (I have 6 small ones a day) then my blood sugar drops and I can’t sleep at night and as I said need to eat several times at night in order to fall asleep. I would like to not have that problem anymore! I thought I was eating too much protein and so I was still prone to hypoglycemia even though I had cut out the carbs.
For gallbladder I’m thinking that the solution is to do a gallbladder/liver cleanse. Is that what you would do? (something with epson salts, olive oil and lemon juice…)
You can try the flush, sometimes they work sometimes not.
If you have to eat 6 meals a day you’ll never correct your CI. All you’re doing is supporting habitually high blood sugar levels. If you eat enough protein and fat 3-4 meals a day then it’s close to impossible to be able to eat 6X a day. You won’t be hungry and you won’t have sugar-swings.
What else can you do for the gallbladder if a cleanse doesn’t work?
Ok. I will try the 3-4 meals with enough protein and fat. If you have the 4th meal is that a meal or snack? And is it between lunch and dinner or after dinner or whatever you are hungry for? How long can you go between meals? (Sorry to be so scientific – but I don’t always get hungry, and then the only way I know I’m hungry is that I get RLS during the day, and then by that time I’ve gone too long without eating and that causes me to not be able to sleep unless I get up to eat several times at night.)
I’m confused though because all the hypoglycemia diets call for 6 small meals. I suppose hypoglycemia and CI are not necessarily the same thing, just related. Any clarification would be helpful.
What do you consider a “high blood sugar level”?
Thank you, again – very much.
Sorry, I can’t spend so much time giving you such detailed advice. That’s not the idea behind the website. Thanks for understanding. A lot of the questions you’re asking can be found on this site – you can always use the search tool. I can go 6-7 hours easily w/o feeling hungry and even longer w/o symptoms.
What are your thoughts on the blood type diet? According to that, it says that I should be a vegetarian….I have been trying to find what works with me, yet there is so much out there and everyone has their own opinions which makes everything all the more confusing as to what truly is factual based science. Thanks in advance for your time!
I think people get better from the blood type diets because they preach general principles of health – no trans fats, no HFCS, no artificial sweeteners, etc.
Thanks! I was just curious because I have been doing really well with the ‘paleo’ type diet, lost 6 pounds in 10 days, which is good as I only wanted to lose 10. However, I have a friend whose I bodybuilder and suggested the blood type diet. I looked into it, and figured it had been two weeks, I could add in some carbs. I had cherries and some GF oatmeal, and literally gained my weight back over the course of 3 days! I think one of the reasons why I played into it was because it said type A’s benefit from yoga, which I believe is true for me. I just wish there was a clear cut path as to what is good for me, it’s all so frustrating!
Thanks again!
If the cherries and oatmeal put the weight on then you might look into the FODMAPS diet since those are FODMAPS foods. The weight you probably put on was most likely water from a gut issue, not actually fat.
http://www.drgangemi.com/2011/08/fodmaps/
This actually makes sense, thank you!
Quick question, how do you know if you should start with the FODMAPS diet, or if you should start with the SIBO diet? What symptoms call for taking it one step further and starting with the SIBO first?
After reading about both, I strongly agree that this is what has been troubling me over the past 4-5 years. I had a c-section almost 5 years ago and shoulder surgery last year, both of which caused some severe bowel changes, among various other symptoms, it all makes sense now.
Thank you for all that you do, it’s a breathe of fresh air knowing there is an end in site…it’s just getting there now!
Just go with FODMAPS – I think it’s better – more comprehensive – than SIBO diet.
I was facinated that you list hands and fingers falling asleep at night and when exercising. Why does it do that with CI and when can I expect it to stop. it is very annoying. I have always thought it was because of my injury line T-7 intersting it probably doesn’t have anything to do with my SCI.
It is because of the relationship of the biceps and triceps with blood sugar handling issues and how those muscle can impinge some of the nerves off brachial plexus.
Are alpha and bean sprouts okay on the TWT
I am beginning to think I’m intolerant of dairy. I never used to be, or at least not that I’ve noticed.
After losing lots of weight, I started to add dairy and carbs back in to my diet. I’ve gained 15 lbs recently (I needed to though. I was too thin) and I was blaming on the carbs (I do only healthy cards mostly) in spite of the fact that I run 42 miles a week and lift weights twice a week.
Every morning, I have a Greek yogurt with berries and two eggs. After breakfast, I get extremely tired and feel weak and get palpitations.
Lately, I’ve been getting a lot of water retention. My feet and ankles swell. I thought it was because I quit smoking, and it very well could be, but it’s been a month since I quit smoking. This morning, my feet and ankles got puffy after breakfast.
For lunch I had an eggplant parm that I made. The ricotta cheese I put in it didn’t affect me like breakfast did.
Do you think it’s the eggs or the yogurt? I’m not sure which to cut out first. Thoughts?
Thanks!
Fatigue after eating is a common sign of a food sensitivity or carbohydrate intolerance. I’d cut the dairy out first since that’s more common (as an allergy) and it also has sugar (lactose) whereas the egg doesn’t.
I’m eliminating all dairy, effective immediately. Thanks for your advice.
Assuming I am sensitive to the dairy sugars/carbs…does this make me pre-diabetic?
Anyone who is insulin resistance is in essence “pre-diabetic.” You can check your Hemoglobin A1C level to get a good reflection of your average blood sugar levels over the past 3-4 months measured in a percentage in which they have affected your red cells.
Hi,
I had a hair test done and it showed carb intorance. I have been sugar and carb free for 2.5 weeks. I have only lost 3 #s and I am very tired and thirsty. I have had issues with being tired for years, now I feel exhausted. I do drink a lot of water normally but noticed that I am very thirsty for that past 4 days. I emailed my doctor (acupunture and natural medicine) and he sent me an article regarding candida die off. I am confused bc I am not doing that diet. I have spent alot of money at different physicians offices as well as doing the acupunture and natural healing. I was hoping that this would take care of the issues but I feel Im still at square one. I cannot work out as my heart rate goes very high with very low impact. Any suggestions?
Also, I have been taking my blood sugar for the past 3 days and it stays between 71-99. My friend said I should test that to make sure ketoacidtosis was not an issue.
High HR when exercising and carb intolerance are both closely related to hormonal imbalance – specifically adrenal gland problems. Lots of info on both site (use the SEARCH tabs). If you are carb intolerant that doesn’t mean you get rid of all carbs/sugars to fix the problem; actually it can make it worse because you stress your adrenals out more.
Should I avoid onions when cutting down on carbs?
Dr.Gangemi,I’m extremely thankfull to you,I live in INDIA and nobody could diagonose my problem,after reading your article I have brought changes in my diet and lifestyle.I feel better now.I will try the two week test and keep you posted.Thanks again.
I have fibromyalgia and take metformin for insulin resistance…however, I have never had high blood sugars…on the contrary I have often been hypoglycaemic and have fainted in the OR when scrubbed up before only an hour after eating and my BM was 2mmols.
I understand fibro people can have a reactive hypoglycaemia …can you tell me if this needs treating differently than insulin resistance..I must add I have most of the symptoms including a change in where body fat is stored. I changed within months of beginning tricyclics for pain.
I have been a type 2 diabetic for years. I take Metformin, Amaryl and Levemir long acting insulin. However, for the past several months, no matter what I do, if I consumer ANY kind of carbs, my blood sugar goes through the roof. It doesn’t matter if it’s milk, fruit, or whole grains. I just can’t seem to get my numbers under control. Could I have such a severe case of carbohydrate intolerance??
Yes you sure could but there’s a lot more to regulating sugar than just insulin.
So are there any tests that can be done to determine if I am that severely carbohydrate intolerant? Do you have any advice on learning how to eat with that kind of intolerance and still get enough proper nutrition? or advice in general about this?