Whether you’re aware that your energy slumps, cravings for sweets or breads, bouts of irritability, or poor concentration relate to patterns of poor eating; or you need to pull out of a stall in the weight loss program you started earlier in the year; or you just want to improve your eating habits for greater health and vitality, better blood sugar balance is essential. We now know that there are serious consequences for long-term uncontrolled blood sugar and its evil sister, hyperinsulinemia (high blood levels of the hormone insulin): increased risk for stroke and cardiovascular disease; high serum cholesterol/ triglycerides; Type 2 diabetes mellitus; inflammation; dementia, and many more members of the dysfunctional family of chronic degenerative diseases. So achieving and maintaining blood sugar stability may be one of the most important and simplest strategies for health promotion in the short term and disease prevention for the long run.
While blood sugar balance involves complex interactions between the food we eat, many hormones, and multiple organs and body systems, when it comes down to it there are two essential elements around which the whole process revolves: the pancreas, which secretes the blood sugar-regulating hormone insulin, and the membrane of each cell, where glucose leaves the blood to be put to use inside the cells.
Blood Glucose and Insulin
Glucose is an end-product of the digestion of carbohydrate-containing foods from our diets: healthy, complex carbs are found in fruits; grains; vegetables, particularly the starchy ones such as potatoes; nuts; seeds; and beans. Whether you have the garden-variety form of blood sugar imbalance called hypoglycemia (low levels of blood glucose); or the opposite problem of high blood glucose (hyperglycemia, which when advanced and chronic becomes diabetes mellitus), the net effect is the same: not enough glucose inside the cell, where it can be put to use making energy and helping cells work properly. Glucose enters the cell by crossing the cell membrane, and it does this through “doorways” in the membrane called glucose channels. These doorways have “locks” on them called insulin receptors, which will only open if the “key” to the insulin receptor – the hormone insulin – turns smoothly in the lock. When that happens – abracadabra! – the glucose channels open, glucose streams into the cell, and the cell makes energy with it. The whole cell is happier, healthier, and more productive when this lock and key system works well; when it doesn’t, your cells can’t function well and neither can you.
Re-sensitize your insulin receptors
At the cellular level, balanced blood sugar depends on healthy, sensitive insulin receptors – so if your blood sugar is out of whack, it’s smart to ask, What will make my insulin receptors work better?
Just as an insensitive person may have poor listening skills, insensitive insulin receptors don’t “hear” insulin knocking at the door, so they don’t respond as they are supposed to, letting glucose into the cell. While there are many nutrients that can help your insulin receptors to hear better, to keep it simple I’ll mention just a few of the most important: the trace mineral chromium (the “trivalent” nutritional form, not the toxic, shiny metallic form); the antioxidant alpha-lipoic acid; the omega-three class of essential fatty acids; a high-potency B-complex vitamin.
Chromium picolinate or polynicotinate (yeast-free): these two versions of chromium have shown better absorption than others; named “Glucose Tolerance Factor” when first discovered, trivalent chromium has been shown to improve glucose balance in numerous studies. It is estimated to be present in low amounts in 90% of diets. Though I may use higher dosages clinically, daily intake of between 200 and 600 mcg. is reasonable and has been demonstrated to be safe and beneficial in human studies.
Alpha-Lipoic Acid: this super antioxidant has been shown in studies to positively affect glucose balance and insulin sensitivity by means of several mechanisms. While opinions differ as to which version is most effective (the R-form or a mixture of the two biochemical forms, the R and S forms), I have come down on the side of the R-form, and routinely prescribe a stabilized R-Alpha- Lipoic Acid, in doses ranging from 100-200 mg. twice to three times daily.
Omega-3 Fatty Acids (EPA and DHA): these healthy fats (EFAs, or essential fatty acids) are found in certain fatty fish, calamari, and krill, and have been found to improve glucose and insulin balance in Type 2 diabetics. They keep cell membranes supple, enabling the receptors and channels seated in the membrane to work better, and their anti-inflammatory effects improve insulin receptor sensitivity for better glucose balance. I may prescribe between 2000 and 6000 mg. daily of total omega-3’s when addressing glucose/ insulin intolerance. Fish oil quality varies widely, and I am careful to choose those from manufacturers which adhere to pharmaceutical-level production practices and are sustainably sourced, are third-party assayed for contaminants (mercury, arsenic, cadmium, dioxins, PCBs), and are stabilized with natural antioxidants (such as tocopherol [vitamin E], ascorbyl palmitate [a form of vitamin C], or rosemary) to reduce the rate of deterioration in the bottle.
B-Complex vitamins: because of their role in turning glucose into energy, increasing chromium bioavailablilty, and promoting healthy essential fatty acid metabolism, no program for better blood sugar balance is complete without attention to B-vitamin status. In my practice, I often prescribe 50-100 mg. daily of many of the B-vitamin family members; I also provide counsel regarding potential for and symptoms of toxicity for Pyridoxine (vitamin B-6).
Preserve your pancreas!
The pancreas, remember, is another major player in blood sugar regulation. One of its primary functions is to secrete insulin from special cells called beta-cells. In someone with insulin-dependent diabetes mellitus, the beta cells don’t make enough insulin, so the person must take it daily to keep blood sugar in balance. When insulin receptors have become “hard of hearing” as described above, the pancreas tries to fix the situation by flooding the bloodstream with insulin, hoping to overcome the insulin insensitivity and push glucose into the cell. This condition of hyperinsulinemia is bad enough, because it is associated with a host of serious, undesirable health issues, some of which have been described. But even worse is the unfortunate reality that over time, the pancreas just can’t continue to secrete so much insulin; it becomes fatigued, so to speak, and can’t put out enough to manage blood sugar. Of course, the best way to protect your pancreas from overwork and exhaustion is to minimize refined carbohydrates (foods which contain processed sugars and flours – so-called “white foods”), eat a whole foods, low-glycemic burden, Mediterranean diet, balancing complex carbohydrate and protein in five or six smaller meals and snacks spread through the day; to exercise; and to balance your stress response.
Gymnema sylvestre and Beta-cell regeneration
But what if your pancreas is close to burn-out, what can you do? A number of botanicals have been found to positively affect glucose/ insulin balance, among them Momordica charantia (bitter melon), Vaccinnium myrtillus (bilberry) and Cinnamonium cassia (cinnamon). A standout among botanicals for blood sugar control, however, is the herb Gymnema sylvestre (known in Hindi as gurmar, or sugar destroyer, because it reduces the taste of sweetness for a couple of hours after chewing on its leaves). This mellifluously named herb has been used in India for 2,000 years to treat diabetes, and over the past decades extracts of Gymnema have become a focus of scientific research for their ability to increase pancreatic beta-cell insulin production and normalize blood glucose. In naturopathic medicine, Gymnema is an important tool for improving insulin secretion in people with “pancreatic fatigue” and declining or low insulin output; in my practice I prescribe a formula which contains 100 mg. of Gymnema extract, standardized to contain 25% of the gymnemic acids which are thought to be the active components of the herb. I usually prescribe Gymnema in two divided daily doses of 100-200 mg. each.
Take it slow and steady
Because they are very effective, if you have severe blood sugar imbalance and in particular if you take pharmaceutical medication for blood sugar/insulin regulation, you must start with lower amounts of these natural agents and you must monitor blood glucose carefully as you increase them. If you take too much, too soon, it can cause an excessive drop in blood sugar: the goal is balance, so it’s best to take a gradual approach. If you’re on medication, adding these natural assists for healthier blood sugar may well enable you to reduce it over time, with the help of the physician who prescribed it (who knows, s/he might want to know how you did it!).