Insulin Resistance Symptoms, PCOS & Blood Sugar: What You Need to Know
When we talk about hormones, most people think of estrogen, progesterone, or testosterone.
But there’s another hormone, arguably one of the most influential in the body, that often goes overlooked in everyday health conversations:
Insulin.
And yet, insulin plays a central role in metabolic health, hormones, and long-term disease risk.
An interview featuring Dr. Ben Bikman, whose work focuses on insulin and metabolic health, offers important context for understanding insulin’s broader role in the body.
One key takeaway is that insulin does not only regulate blood sugar - it also influences our hormones.
Elevated insulin levels can interfere with the body’s ability to convert testosterone into estrogen by affecting aromatase activity, which may contribute to higher testosterone levels and downstream hormonal effects.
The discussion also reinforces a consistent theme in metabolic health: common dietary patterns can contribute to chronically elevated insulin.
Over time, this can occur quietly, often developing for years before changes appear on standard lab markers, while still influencing overall metabolic and endocrine function.
Why Insulin Matters More Than You Think
While insulin is often discussed primarily in the context of diabetes, its role in the body is much broader than blood sugar alone.
Insulin functions as a key regulatory hormone that helps coordinate how the body uses and stores energy. Its primary role is to move glucose (sugar) from the bloodstream into cells, where it can be used for energy or stored for later use. In a well-functioning system, insulin rises after a meal and then gradually returns to baseline.
Over time, however, consistently elevated insulin levels can make the body’s cells less responsive to its signal. This process, known as insulin resistance, doesn’t usually happen overnight. Instead, it tends to develop gradually, often long before any abnormalities appear on routine blood work.
One reason this can go unnoticed is that the body initially compensates by producing more insulin in order to keep blood sugar within a normal range.
As a result, glucose levels may still appear “normal,” even while the body is working harder behind the scenes to maintain balance.
Because of this compensation, early metabolic changes are often subtle.
People may notice fatigue after meals, stronger cravings for carbohydrates, difficulty maintaining steady energy throughout the day, challenges with weight regulation.
These signals can reflect the body beginning to struggle with blood sugar regulation, even when standard lab markers have not yet changed. In many people, insulin can remain elevated for extended periods, often Silently and for YEARS. This is why a “normal” fasting glucose does not necessarily mean your metabolic health is fully optimized.
The Overlooked Link Between Insulin and Hormones
Insulin doesn’t just regulate our blood sugar, it also influences other hormones in meaningful ways.
One key example: Elevated insulin can interfere with the body’s ability to convert testosterone into estrogen.
This matters because:
In women with PCOS (Polycystic Ovary Syndrome), higher testosterone levels are often part of the clinical picture
Disruptions in this hormones can contribute to irregular cycles, acne, fertility challenges, and other symptoms
Men can also experience downstream effects from hormones tied to metabolic dysfunction
In other words, insulin is not just a metabolic hormone - it is deeply connected to endocrine health.
The Quiet Progression of Elevated Insulin
One of the challenges with insulin dysfunction is that it develops gradually. It’s entirely possible for insulin levels to remain elevated for years before changes appear in your fasting glucose, hemoglobin A1c, or standard metabolic panels. This is why early assessment matters. Even if your thinking, “nah, my fasting blood glucose is 92, I’m fine”, I’m here to warn you that maybe you are not…
Fair warning: fasting insulin is rarely included in standard panels, so you'll likely need to request it. Some practitioners may push back. Go in prepared to advocate for yourself — it's worth it!
How Diet Patterns Drive Blood Sugar Instability
Many modern eating patterns unintentionally create a cycle of blood sugar spikes and crashes.
A common example: High-carbohydrate breakfasts (cereal, pastries, toast, bagels), and minimal protein or fat to stabilize the response.
This type of meal can lead to rapid increases in blood sugar, a strong insulin response, and a subsequent drop in energy, often followed by cravings. Over time, this pattern can reinforce insulin resistance.
Foods and Patterns That Disrupt Insulin Balance
Rather than focusing on trends or extremes, it’s more useful to look at consistent patterns.
Some of the biggest contributors to chronically elevated insulin include:
Highly processed carbohydrates (refined grains, packaged snack foods)
Added sugars in beverages and packaged foods
Meals that combine high amounts of both fat and processed carbohydrates
These combinations tend to be particularly dysregulating for blood sugar.
What Elevated Insulin Is Associated With
Persistently high insulin levels are linked to a wide range of health concerns, including:
Metabolic syndrome
Weight gain and difficulty losing weight
High blood pressure
Fertility challenges
Menstrual irregularities and PCOS
Acne and skin changes
Cognitive decline over time
Poor wound healing
This is not meant to be alarmist - but rather to highlight how foundational insulin regulation is to overall health.
The best way to Approach to Supporting Insulin Health?
Improving insulin sensitivity does not require extreme or restrictive strategies. In most cases, it comes down to consistent, foundational habits.
1. Adjust Meal Composition
Focus on meals that include: Protein, Healthy fats, and Fiber-rich carbohydrates. This combination helps slow glucose absorption and reduces large insulin spikes.
2. Be Strategic With Carbohydrates
Carbohydrates are not inherently problematic - but the type and context matter.
Prioritize:
Whole, minimally processed sources
Pairing carbs with protein and fat
Reducing reliance on refined, fast-digesting options
3. Build and Maintain Muscle
Skeletal muscle acts as a glucose reservoir, helping pull sugar out of the bloodstream. Resistance training and regular movement improve insulin sensitivity over time.
4. Support Sleep and Recovery
Sleep plays a direct role in metabolic regulation. Even short-term sleep disruption can impair insulin sensitivity. I recommend at least 8 hours of sleep per night, sometimes more can be helpful.
5. Consider More Personalized Data
For some individuals, tools like continuous glucose monitors (CGMs) can offer insight into how specific foods affect their body. Responses to food are not universal - and personalized feedback can be valuable.
The Bigger Picture
Insulin is not a niche topic - it’s a foundational one.
If you are navigating:
PCOS symptoms
Weight fluctuations
Fatigue or energy instability
Hormonal functions
…it’s worth looking beyond surface-level markers and considering how insulin may be influencing the bigger picture.
Frequently Asked Questions
What are common symptoms of insulin resistance?
Common signs include fatigue after meals, sugar cravings, weight gain (especially around the abdomen), and difficulty maintaining stable energy levels throughout the day.
Can insulin resistance affect hormones in women?
Yes - elevated insulin can contribute to higher testosterone levels and is a key driver in conditions like PCOS, impacting cycles, skin, and fertility.
Is fasting glucose enough to assess metabolic health?
Not always - fasting glucose can appear normal even when insulin is elevated, which is why a fasting insulin test can provide more insight.
How does diet impact insulin levels?
Frequent intake of processed carbohydrates and sugars can lead to repeated blood sugar spikes, increasing insulin demand and contributing to resistance over time.
What is the best breakfast for stable blood sugar?
A balanced meal with protein, healthy fats, and fiber - such as eggs with vegetables or yogurt with nuts - can help prevent blood sugar spikes and crashes.
Can insulin resistance be reversed?
In many cases, insulin sensitivity can improve with consistent lifestyle changes such as nutrition, strength training, sleep, and stress management.
How does muscle mass affect blood sugar?
Muscle acts as a storage site for glucose, helping lower blood sugar levels and improving overall insulin sensitivity.
Is PCOS always related to insulin resistance?
While not every case is the same, many individuals with PCOS have underlying insulin resistance that contributes to their symptoms.
Should I use a continuous glucose monitor (CGM)?
For some people, CGMs can provide useful, personalized insight into how specific foods impact blood sugar, though they are not necessary for everyone.
How long does it take to improve insulin sensitivity?
Improvements can begin within weeks of consistent changes, though meaningful, lasting shifts typically develop over months.
Weight loss medications have changed the landscape of health and weight management. GLP-1 medications are helping people lose weight, reduce inflammation, and, in many cases, decrease reliance on other medications. For many, they feel like a long-awaited solution.
But for many, this solution isn’t the full story. New research shows that 50-80% of people report gaining back between 25 and 60% of the lost weight within two years of stopping medication. What does that tell us? For many, supportive lifestyle pieces were likely missing.
Lasting success requires a plan. Many people are never taught the lifestyle strategies needed to preserve muscle, support metabolism, and nourish their body while appetite is suppressed. Muscle loss during weight loss is one of the biggest predictors of regain—and it can be prevented.
The GLP-1 Companion is about setting you up for long-term success. Together, we’ll focus on how to eat and move in a way that supports fat loss while protecting muscle, energy, and overall health. No gimmicks, no fads—just science-based guidance, common sense, and consistent support.
I’ll be with you every step of the way. We’ll tailor our calls to your goals, your body, and your lifestyle, so you leave this program confident in how to care for yourself both on and beyond your GLP-1 medication.
Program Details
Length
5 weeks
Meetings & Ongoing Support
Coaching Calls:
Five 60-minute one-on-one calls
Total Calls: 5 (5 total hours)
Email Support:
Weekly email support for questions and guidance throughout the program
Additional Support:
Additional consultation hours available at $175/hour
Areas of Focus
We’ll focus on the foundational habits that support sustainable weight loss and long-term metabolic health, including:
How weight loss occurs in the body
Fat loss vs. muscle loss—and why it matters
The role of movement and exercise while on GLP-1 medications
Protein, carbohydrates, and fats: how to balance them with reduced appetite
Practical strategies for managing decreased hunger cues while meeting nutritional needs
Investment
$1,075
We plan ahead to optimize outcomes—weddings, vacations, and job interviews. Why wouldn’t we plan to optimize our health before pregnancy? Don’t wait until you’re nauseous and exhausted to realize you need a strategy to eat better, sleep more, and stress less. Pregnancy can be an immense drain on the body, especially one that begins the journey stressed, undernourished, underslept, and exposed to a high level of environmental toxins.
Fertility Foundations is about controlling what we can control. Together, we’ll reduce lifestyle factors that may hold you back from feeling your best and do the work in advance so your body is prepared, resilient, and supported when pregnancy occurs.
This program is ideal for anyone on a fertility journey and is most effective if we have at least 3–6 months before you’d like conception to occur—but it’s also a powerful starting point if you’re earlier in the planning phase. Every change we make together supports your health, the health of your partner, and the health of your future child (and any children already in your home).
I’ll be with you every step of the way. We’ll identify the supports you need, tailor our calls to your priorities and unique situation, and adjust as life or plans shift. Entering pregnancy with a nourished, rested, and less inflamed body can make a meaningful difference in how you feel during pregnancy itself.
This program is not testing-dependent, though functional medicine testing can be added at standard rates if we decide it would be helpful. Testing is not included in the baseline program cost.
Program Details
Length
3.5 months
Meetings & Ongoing Support
Initial Setup Call:
One 60-minute onboarding sessionOngoing Calls:
Two calls per month for the first three months (45–60 minutes each)
One final call in month four (45–60 minutes)
Total Calls: 8
Email Support:
Weekly email support, as needed, for questions and ongoing guidance
Areas of Focus
We’ll focus on preparing your body—and your home—for pregnancy by improving nutrition and lifestyle factors that support fertility and a healthy conception or implantation. Topics may include:
Nutrition, optimized for fertility
Exercise
Stress management
Sleep
Environmental toxins
Supplements
Cycle regulation, if needed
Investment
$1,7000
Some of us may have a new friend in our lives. She’s… unpredictable. A bit chaotic. It doesn’t seem like she’s leaving anytime soon, and we need to figure out how to deal with her.
Meet Peri.
All jokes aside, perimenopause is often described as a time of hormonal chaos—and for many women, that’s exactly what it feels like. In today’s world of full-time jobs, aging parents, kids, school schedules, activities, and running a household, feeling “off” can sneak up on you. Perimenopause can begin 10 or more years before menopause, which is wildly inconvenient, considering these are often the years when women have the least amount of time to stop and figure out what the h*ll is going on.
Let me help.
Spend a little time with me each month, and together we’ll make sense of what’s happening in your body, reduce the overwhelm, and create a plan that actually fits your life.
If you’re in your 30s and suspect you’re just entering perimenopause, we’ll troubleshoot current symptoms, make sure the foundational lifestyle pieces are in place, and prepare you for what’s coming. If you’re in your 40s or 50s and right in the thick of it, we’ll evaluate what’s going on now, troubleshoot symptoms, refer out when appropriate, and focus on the strategies you need right now to feel better.
Areas of Focus
Our work together may include:
Understanding your current symptoms
Understanding the hormonal shifts occurring
Knowing what’s happening now and how things may change over time
Optimizing nutrition
Appropriate and effective exercise for this stage of life
Sleep hygiene
Hormone Replacement Therapy (HRT) education and discussion
Stress management strategies
How to minimize toxins
How to optimize supplements
This program is not testing-dependent. Functional Medicine testing can be added at standard rates if we decide it would be helpful. Testing is not included in the baseline program cost.
Program Details
Duration
3 months
Meetings & Support
Introductory Call:
One 60-minute onboarding sessionOngoing Calls:
Two calls per month for three months (45–60 minutes each)
Total Calls: 7
Email Support:
Weekly email support, as needed, for questions and ongoing guidance
Investment
$1,525
Would you rather do this with a friend? Check out the Add a Friend program instead!
This is the same Very Peri program—just designed for two people instead of one.
Do you have a friend who’s at the same stage of life? Move through the Very Peri coaching experience together and share the journey. You’ll receive the same education, guidance, and support as the one-person program, with the added benefit of a built-in accountability partner who truly gets it.
The topics, framework, and core content are exactly the same as the individual Very Peri program. The difference is that this option is structured to support two participants at once, with individual onboarding and expanded communication support for both people.
You’ll move through the same discussions, education, and practical guidance—together—while still receiving individualized support within the shared sessions.
How the Two-Person Program Works
Both participants attend all coaching calls together
You must be available at the same time (you may join from separate locations)
Coaching is tailored to each individual within the shared sessions
You’ll gain insight into your own perimenopause experience and learn through your friend’s perspective
What We’ll Cover
(Same as the One-Person Very Peri Program)
Understanding current symptoms
Understanding the hormonal process occurring
What’s happening now—and how things may change going forward
Optimizing nutrition
Appropriate and effective exercise for this stage of life
Sleep hygiene
Hormone Replacement Therapy (HRT) education and discussion
Stress management strategies
How to minimize toxins
How to optimize supplements
This program is not testing-dependent. Functional Medicine testing can be added at standard rates if we decide it would be helpful. Testing is not included in the base program cost.
Program Details
Duration
3 months
Meetings & Support
Introductory Calls:
Two 60-minute onboarding sessions (one per participant)Ongoing Calls:
Two shared calls per month for three months (45–60 minutes each)
Total Calls: 8
Email Support:
Up to two emails per week, as needed, for questions and ongoing support
(Emails may be submitted jointly or individually)
Investment
$2,000 total
($1,000 per person)