In this post I am going to tell you about the links between blood sugar, insulin, stress and cancer. More importantly, I will focus on key tests you need to know about and request from your doctors. Your “normal” lab results may actually be fueling cancer growth, which is why you need this information. These critical tests will help you really know where you stand so you can start to address any issues if necessary.
There is a significant link between elevated blood sugar, elevated insulin levels, stress, metabolic syndrome and uterine cancer. Doctors don’t often run the necessary tests to know if you have these problems. Simply testing a fasting blood glucose or a hemoglobin A1C here and there is not enough.
In the United States, 77% of people are now overweight or obese and 1 in 3 has metabolic syndrome, sometimes called “diabesity”. Even children are being affected. When they determine standard lab ranges, they are testing these people, not healthy subjects and athletes. So when you look at standard lab ranges and think you are fine, you may not be. Naturopathic doctors know this and have ideal ranges for these blood tests and this is what you should strive for.
So many women are in the dark when it comes to their metabolic health, so I want to help you figure it out by explaining the labs you need and what they mean. Stay to the end where I will give you ways to improve your labs and your metabolic health before it’s too late.
METABOLIC SYNDROME
Metabolic syndrome (MetS) has become an epidemic in the United States and many other countries. What defines this syndrome is a myriad of pathologies including obesity, insulin resistance, dyslipidemia and hypertension. The main driver of metabolic syndrome is our diet.
Studies have shown for decades that the increase in the use of seed oils (corn, soybean, canola, sunflower and safflower) and sweeteners, mainly high fructose corn syrup, are the main factors causing this epidemic, yet nothing is being done about it. MetS is a significant risk factor for cardiovascular disease, diabetes, neurodegenerative diseases like Alzheimers and cancer. The problem is that many women don’t even know they may be developing MetS or already have it and doctors are not routinely testing for it.
FASTING GLUCOSE
Ideal range: 55-85 mg/dL
Standard lab range: 70-100 mg/dL
HYPERGLYCEMIA
Hyperglycemia (elevated blood glucose) increases the risk of diabetes, cardiovascular disease, peripheral neuropathy, insulin resistance and metabolic syndrome.
Not only that, but elevated glucose feeds cancer cells. All cells in the body need glucose for energy, but rapidly dividing cancer cells have a higher demand for glucose.
Normal cells have a very efficient power plant (mitochondria) that fully burns sugar with oxygen to get lots of energy. Cancer cells have a faulty power plant (dysfunctional mitochondria). Even with lots of oxygen, they prefer to quickly burn sugar in the main room (cytoplasm) through a less efficient process called aerobic glycolysis, which produces a byproduct called lactate. This fast, but inefficient process gives them not just quick energy, but also the building blocks for making more cells. It helps create a favorable (acidic) environment for their rapid growth and spread. Glucose is necessary for cancer cell survival, because it’s their go-to fuel for this quick energy and essential building blocks.
Studies have shown that endometrial cancer cells in particular rely heavily on aerobic glycolysis for growth.
Cancer cells have higher levels of glucose transporters (GLUTs) on their surface compared to normal cells. This means they can take up glucose from the bloodstream more rapidly.
Not only does elevated glucose feed cancer cells, but it creates other problems.
Hyperglycemia promotes the formation of advanced glycation end products (AGEs). These AGEs react with DNA causing damage and increase the production of reactive oxygen species. This can lead to mutations in the DNA that can activate oncogenes and deactivate tumor suppressor genes.
Hyperglycemia contributes to cancer cell resistance to apoptosis and chemotherapy and promotes the development of tumors.
Hyperglycemia, a Neglected Factor during Cancer Progression Read More
During aerobic glycolysis, reactive oxygen species are created, which increase the expression of vascular endothelial growth factor (VEGF). This promotes new blood vessel formation (angiogenesis) in tumors and tumor growth.
The PI3K/AKT/mTOR signaling pathway, when activated, can lead to uncontrolled tumor growth and metastasis. This signaling pathway is very sensitive to glucose and insulin.
Hyperglycemia is a big risk factor for developing peripheral neuropathy.
The Role of Hyperglycemia in Endometrial Cancer Pathogenesis Read More
FASTING INSULIN
Ideal range: 0.5-3.0 uIU/mL
Standard lab range: 2.6-24.9 uIU/mL for women
HYPERINSULINEMIA
Hyperinsulinemia (elevated insulin) is an indicator of insulin resistance. Insulin resistance is a pre-cursor to diabetes. It is when the cells in your body and organs are not responding well to the insulin hormone your pancreas is producing. Insulin is what lets glucose from the foods you eat into your cells.
When the cells aren’t letting the glucose in, it builds up in the blood stream causing hyperglycemia. This signals the pancreas to make even more insulin, eventually leading to hyperinsulinemia, which is a risk factor for endometrial cancer. If this goes on long enough, type 2 diabetes can result.
Insulin itself can act as a growth factor, directly stimulating the proliferation of endometrial cancer cells and promoting tumor growth.
High insulin levels create low-grade inflammation throughout the body, which can also contribute to cancer growth and spread.
Hyperinsulinemia increases the production of androgens (male hormones) and decreases the production of sex-hormone binding globulin (SHBG). This can lead to higher levels of estrogen particularly in post-menopausal women. Elevated estrogen levels increase endometrial cancer proliferation and metastasis.
Insulin can bind to specific receptors on cells triggering signaling pathways (PI3K/AKT/mTOR) that promote cancer cell proliferation, survival and angiogenesis. With elevated insulin, these pathways may be overstimulated fostering uncontrolled cancer progression.
Unfortunately, most doctors don’t run this test unless you are already diabetic. This test is essential though and can tell you a lot more about your metabolic health than a fasting glucose or even the hemoglobin A1C test.
Association of abnormal glucose metabolism and insulin resistance in patients with atypical and typical endometrial cancer Read More
HOMA-IR
Only testing fasting blood glucose without testing fasting insulin tells you very little. Two people can have the exact same fasting glucose levels, but have very different circulating insulin levels. In fact, your blood glucose may be in the normal range, but it may be taking increasing amounts of insulin to keep it there, leading to insulin resistance. This is why you need both fasting glucose and fasting insulin tests.
HOMA-IR stands for Homeostatic Model Assessment of Insulin Resistance. It’s all about the relationship between glucose and insulin and how they work together. The body is trying to keep its essential systems in balance, called homeostasis. This calculation will give you a better understanding of your level of insulin resistance.
Here is how to calculate your HOMA-IR:
fasting glucose (mg/dL) x fasting insulin ➗ 405
- < 1.0 indicates optimal insulin sensitivity
- 1.0-2.9 indicates moderate insulin resistance
- > or = to 3.0 indicates significant insulin resistance
HEMOGLOBIN A1C
Ideal range: 4.0-5.0%
Standard lab range:
- Anything below 5.7% is considered normal
- 5.7-6.4% is considered pre-diabetic
- 6.5% and higher is diabetic
This test measures your average blood glucose over the past 2-3 months. Elevated levels indicate poor glycemic control, meaning your glucose levels are consistently out of the normal range. Again, doctors do not routinely run this test unless you are at risk for diabetes.
According to Dr. Nasha Winters, founder of the Metabolic Terrain Institute of Health, anything above 5.6% is considered diabetic. There is no pre-diabetes.
Studies have shown that women with endometrial cancer have higher levels of Hgb A1C than healthy subjects.
Evaluation of hemoglobin A1c levels in endometrial cancer patients: a retrospective study in Turkey Read More
INSULIN-LIKE GROWTH FACTOR 1
Ideal range: 85-100 ng/mL
Standard lab range: 44-300 ng/mL
Insulin-like growth factor 1 (IGF-1) is an anabolic hormone, similar to insulin. It is primarily produced in the liver in response to signals from growth hormone. IGF-1 then circulates through the blood and binds to IGF-1 receptors on various cells in the body promoting growth and proliferation and inhibiting apoptosis (programmed cell death). It has beneficial effects for healing, such as in muscle growth and repair, but it can be a problem for cancer patients.
Elevated IGF-1 is detrimental. Like insulin, IGF-1 can bind to specific receptors on cancer cells telling them to grow, divide and survive. It inhibits apoptosis of cancer cells, stimulates angiogenesis and can even promote metastasis. Elevated IGF-1 has been implicated in the progression of various cancers.
IGF-1 that is too low can indicate muscle wasting.
C-PEPTIDE
Ideal range: 0.5-2.0 ng/mL or 0.2-0.8 nmol/L if fasting
When the pancreas produces insulin it starts off as a larger molecule called proinsulin. Before the insulin can be released into the bloodstream, the proinsulin is broken down into insulin and a protein byproduct called C-peptide. C-peptide and insulin are secreted in equal amounts. Insulin has a shorter lifespan of 5-10 minutes before it is taken up by the liver. C-peptide stays around longer in the bloodstream (30-35 minutes) and is mainly cleared by the kidneys.
Measuring C-peptide is a way to see how well your pancreas is functioning and is a more direct measure of insulin activity.
LOW
This means the pancreas is not working to produce sufficient insulin. This is commonly seen in Type 1 diabetes and long-standing Type 2 diabetes. Low c-peptide is also seen in people using injectable insulin for diabetes treatment.
NORMAL
This indicates that the pancreas is functioning well and insulin production is normal. This is expected in people without insulin resistance.
HIGH
A high c-peptide indicates increased insulin production and is often associated with insulin resistance and early stage diabetes. Rare causes of this are a pancreatic insulinoma (tumor) and kidney disease.
CORTISOL (AM)
Ideal range: 15-17 µg/dL
Standard lab range: 10-20 µg/dL
HYPERCORTISOLEMIA
Cortisol is a hormone released by the adrenal glands in response to stress. It follows a natural diurnal rhythm, typically peaking in the morning and gradually decreasing throughout the day. This test should be done in the morning.
An elevated morning cortisol above 17 indicates that your body has too much stress response and this can contribute to cancer growth in several ways.
Hypercortisolemia can suppress the immune system and reduce the activity of natural killer cells and other immune responses that are necessary for identifying and destroying cancer cells.
Chronic elevation of cortisol can lead to increased inflammation, which is a known factor in cancer development, progression and metastasis.
Elevated cortisol can contribute to hyperglycemia, hyperinsulinemia, insulin resistance and elevated IGF-1 which, as I discussed above, are all detrimental when it comes to cancer.
High cortisol levels can also disrupt normal circadian rhythms, affecting sleep and other bodily functions, increasing risk of cancer progression.
WAYS TO IMPROVE YOUR LABS AND YOUR HEALTH
Now that you know about the different tests to check your metabolic health and what they mean, what do you do if you have elevations in these labs?
DIET
First and foremost, most of these problems are diet related. Unfortunately, doctors simply want to give medications to treat symptoms, not address the underlying cause of the problems. A naturopathic doctor once said, “you can’t throw drugs at a dietary disease and expect to make it better.”
- Remove all processed and ultra-processed foods from your home. These foods are loaded with seed oils, high fructose corn syrup, chemicals, additives, dyes and toxic substances.
- Switch to a low-carbohydrate, high fat, moderate protein diet of real, whole foods. These foods include healthy meats, fish, eggs, low-carb vegetables and leafy greens. Nuts and seeds and dairy may be allowed and tolerated by some people, but not all so see what works for you.
- Avoid grains, high sugar, starchy vegetables and fruits, beans, pasta, bread and anything that causes spikes in blood sugar, which all of these do.
- Although people think fruit is healthy, it may not be. If you are already metabolically unhealthy, fruit is not a good idea. It is high in fructose, which has been directly linked to hyperglycemia, hyperinsulinemia and metabolic syndrome. Fructose, insulin resistance, and metabolic dyslipidemia Read More
- Dairy, especially cow’s milk can stimulate insulin and IGF-1 release. If you have elevated insulin and or IGF-1 or are hyperglycemic, you should remove dairy from your diet. Whey protein, commonly found in many protein powders, can also increase insulin levels, so you may want to avoid this.
The goal is to maintain low, steady blood glucose levels throughout the day, even after meals.
Get a glucose monitor or, even better, a continuous glucose monitor to test your blood sugar throughout the day. You may be surprised by how high it is or how much it spikes after a meal. This is how you can test to know how certain foods are affecting you.
BERBERINE
Berberine is an herbal supplement that helps lower blood sugar and improves insulin sensitivity. It has been shown in studies to be as effective as the drug metformin to reduce glucose levels. It is commonly used for the treatment of metabolic syndrome, obesity and cancer. Recommended dose is 500mg 2-3 times per day. Berberine can impact the CYP450 enzymes in the liver so pulsed use is better. For example, 8 weeks on followed by 2-4 weeks off. It has many other excellent benefits against cancer.
CURCUMIN
Curcumin is another herbal supplement that can improve pancreatic function, lower blood glucose and combat insulin resistance. It also has many other tremendous benefits against cancer. Recommended dose is 600mg 2-3 times per day.
GOOD SLEEP is essential to reduce cortisol and glucose. Really work on improving your sleep to get 7-9 hours a night.
REGULAR EXERCISE can regulate blood sugar and stress and improve metabolic health. We have to incorporate this into our lives every day. Walking, cycling, weight lifting, stretching, yoga, pilates and more. Pick what you enjoy the most and get moving as much as possible!
STRESS MANAGEMENT techniques are very important. These include breathing exercises, mindfulness, meditation, getting outside in nature and grounding.
STAY HYDRATED! Make sure to drink plain water. Avoid sugary drinks like Gatorade, soda and flavored water. Once again, these contain preservatives, dyes and other toxic substances as well as high fructose corn syrup. Caffeine can elevate both glucose and cortisol and cause sleep disruptions so you may want to limit this.
LOSE WEIGHT if you are overweight or obese. This is critical. Obesity is a direct risk factor for endometrial cancer. Oncologists who tell you to eat whatever you want so you don’t lose weight are doing you a disservice. A ketogenic diet will make this much easier for you as well as getting off all processed foods. Weight loss “shots” are not your friend. As I said, most of these problems are completely diet related and throwing a drug at it for a quick fix is not treating the underlying cause, it is merely treating the symptom.
FASTING is a great option to lower glucose, insulin and IGF-1. Here is my post about the different ways to do this and all the benefits.
MONITOR YOUR LABS REGULARLY
You won’t know if you are improving if you don’t test. I’m guilty of this one and not getting tested enough. Ideally you want to be checking these labs every 3-6 months or more frequently if you have problems. If you can’t get these tests regularly through your doctor or have it paid for by your insurance, you can order your own labs and pay out of pocket at discount prices. Here is a list of online labs you can order from.
Own Your Labs
Ulta Lab Tests
Evexia Diagnostics
Quest Diagnostics
When you order labs, you will need to make an appointment at your local LabCorp or other blood draw facility with the paperwork to have the tests run. You can do all of this without a doctor.
As Dr. Nasha Winters has said over and over again, “test, assess and address, don’t guess.” We really need to know about our metabolic health in order to heal from cancer.
Whoever gives heed to instruction prospers, and blessed is he who trusts in the Lord.
~Proverbs 16:20