Who Needs to Know?
I have insulin resistance tied in with PCOS, and extreme IBS (irritable bowel syndrome), which has manifested itself through a constellation of symptoms over the years. Over the past two, chronic heartburn and bloating has become extreme and unmanageable. Despite the seemingly complete lack of help from the medical industry over months of doctor's visits, there is a lot I have figured out, and I'm finally on the mend. There are so many insulin-resistant people out there, and especially women, who don't have the proper information at hand to be able to treat, or even reverse the symptoms (which can indeed be done), who end up doctor shopping and putting themselves through countless unnecessary tests and procedures. The purpose of this piece is to inform others of the information I have come across, which has proven helpful in improving my quality of life and even reversing some of my conditions. In a sea of medical confusion and chaos that can be quite daunting, I wanted to share what I have learned.
Most people struggling with insulin resistance have corresponding gut issues on top of it. I’m specifically referring to IBS and GERD, both of which seem to be medical labels given to a patient with heartburn, indigestion, chronic bloating, diarrhea, constipation, and other punishing reactions that body gives. These two problems are diagnosed separately, but perhaps they shouldn’t be, as there is a clear connection between insulin resistance and IBS.
When patients who have these conditions go to the doctor, many, many of them are put into positions similar to the one I was in. They find themselves in chair seated across from a man or woman wearing a white coat asking them a series of questions. After about a minute this person usually booms, “you have IBS. We don’t really know what that means but cutting down on your carb intake and sugars may help to alleviate it. Oh, and here’s some omeprazole. Take it twice a day for the diarrhea” (well okay, maybe they don’t put it quite like that, but that's basically what they're saying!). They might be given a pamphlet on the Low FODMAP diet (a diet which cuts down on the saccharides or sugars in certain foods not easily digested) and sent away with a list of foods to eat and not eat. And note for a dietician.
If you’ve been frustrated and cheated out of a solution to chronic IBS by the medical community, and you have insulin resistance, stay tuned.
Defining Insulin Resistance
Insulin resistance is when the body doesn’t have the ability to regulate its own insulin. We usually see it go hand in hand with women who have PCOS (see below, insulin resistance and PCOS). The reason that keto and paleo diets have become a common go-to for those who want to better their insulin and reverse the syndrome, is that no-carb diets force the body to start tapping into fat, rather than carbs, for energy. Since the body can’t regulate insulin when it’s running off of carbs it needs another source of fuel to tap into. It can be really hard to go keto cold-turkey (impossible, really, in my opinion) and I do have some great resources on how to make gradual changes in the diet, so that you can graduate into a low-carb lifestyle more naturally and still eat delicious foods, which I will talk about in a future piece.
A quick note here on keto: I don’t recommend that anyone cut all carbs at once because your body will go into shock and start to experience the infamous keto flu symptoms. Do what you can, at first, and remind yourself that any low-carb modifications you make are better than nothing. Any change you are able to make will get you into a better place than you were before, so be kind to yourself (I've hyperlinked one of my favorite Diet Doctor podcasts here. It features my friend and nutritionist Amy Berger, who is great with the gradual-change approach).
Insulin Resistance and the Keto Diet
And Then It Hit
Over the past year, I’ve done lots of tests and switched out my stomach medications for new ones. The meds are vastly ineffective, and scheduling, fasting, and going through constant tests proved to be frustrating and unyielding. To the credit of the nurse practitioner I was seeing (who was much a much better communicator and doctor, in my opinion, than the actual GI at this particular place) she did do a test for a condition called SIBO (small intestinal bacteria overgrowth) that was positive, so kudos to her for that. It gave me the first lead into my research. SIBO is a methane gas which causes excessive gas and bloating, and I mean bloating, beyond your usual run of the mill IBS symptoms. During some of my worst episodes, you could have rolled me right over the hill we live on, and I would have bumbled down it, like an overblown beach ball.
Although I was happy to have some kind, any kind of diagnosis, after treating myself with two rounds of Xifaxan but not seeing any real change, I began to wonder what else it could be. When I went to see my family doctor the other day a realization suddenly hit me during our conversation. He mentioned that I probably should not get off the metformin I was on just yet because the endocrinologist thought I had something called insulin resistance (of course, I already knew that!). As I walked to my car after the visit my mind started to work a couple of extra circles. They talk about insulin resistance as a condition itself, I thought. . . could it be a condition that was somehow causing these other issues? Could it be causing my IBS?
What I Discovered
Despite all of the tests I had done and talks I’d had with doctors by that time, none of them had mentioned insulin resistance itself as a root cause. I researched it, and my findings showed that I was correct, and that there is a very strong correlation between them. As I was doing my reading, my heart did a double beat. Insulin problems cause weight gain, and weight gained around the abdomen causes the muscles in the stomach to be pushed up, which in turn can create a situation in which you have chronic heartburn. Another thing it causes, though, is something called dysbiosis. Dysbiosis is the medical term for an imbalance of healthy bacteria in the gut. Exactly what I was looking for!
When I started reading over the symptoms and probable causes, everything finally started to click. I already knew SIBO to be an overgrowth of bacteria and knew I had been diagnosed with it, so it was more than possible that gut bacteria itself was actually at the root of my IBS. Here are some of the causes. I’ve also linked the article where I got the information at the end of this article1
- PPIs (proton pump inhibitors): long term use of stomach medications and antacids. The classic how-one-solution-often-leads-to-making-the-problem-worse, example. Omeprazole, pantoprazole and anything in this category which might seem apparently harmless.
- NSAIDS- chronic use of pills like Advil and aspirin
- Birth and hormone control pills
As soon as I read the over the first few items, things started making sense. I’ve been taking NSAIDS abundantly for years having been prone most of my life to chronic migraines. I was also put on omeprazole four years ago and have taken some form of pill in this category ever since. They actually increased my medications recently, so I was up to taking pantoprazole twice a day. I had family members who experience similar GI problems, who I also know to be on birth control and daily acid reducers, so putting everything together, I soon had my conclusion.
Where I Am Now
Since making these revelations, I have begun the process of weaning off the frequent Advil and stomach meds. The first few days I drastically reduced my intake of Advil I came down with a constant dull headache that would not subside. When taken chronically, stripping these medications away suddenly and attempting to replace them with alternatives, can often cause a rebound reaction. Rebound headaches usually die off within about twenty days at the most, though, and weaning off, rather cutting the previous meds cold turkey can make the process a bit easier. I would still take the rebound headaches any day now over the basketball stomach, however!
Gradually, I am healing my GI tract, and today am well on the mend. I am digesting food again, and let me tell you, one thing I've learned through all this is that we definitely take the small things in life for granted! If you have ever had chronic heartburn and bloat for a period of months or more, you'll know what I mean about the joys of digestion! It is so wonderful to be able to eat without all those punishing and embarrassing reactions. I've started taking digestive enzymes, which have also made an impactful and noticeable difference. As I am writing this piece, I am much more hopeful, happy, and energetic. I see a bright, healthy future ahead of me once more, and my view of things has changed.
I still have some ways to go, but it's a hundred and eighty from where I was a few months ago. I wanted to share a few useful pieces of advice along my journey for anyone out there who might benefit.
Amy Berger (keto and insulin resistance on Diet Doctor podcast. I've met her in person and she's awesome!): Keto without the crazy with Amy Berger — Diet Doctor Podcast - YouTube
Insulin and bloating: How Gut Dysbiosis is Making You Sick - Dr. Stephanie Davis (drstephaniedavis.com)
Insulin and Digestion
Side effects from antacids
Insulin Resistance and PCOS
Insulin Resistance and Acid Reflux
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2022 Emerald Fox