Blood Glucose and the Menopause - Here's the Lowdown
Let's kick things off with a basic explanation of what blood glucose is, how it works in practice in our bodies, and why it's so important...
Glucose is a tiny, simple sugar that is used as a key source of energy for the brain, muscles, and a variety of other organs and tissues in the body.
When we eat carbohydrates in any form, they are broken down in the digestive tract and glucose is released into our bloodstream, as shown in the chart below.
But when we eat too many carbohydrates in one go or refined carbohydrates like bread, pasta, cakes, crisps, or sugar in its many forms, our blood glucose spikes too high and too quickly.
In a well-functioning body, the fat-storing hormone insulin will be released as this happens, to remove the glucose from the blood and take it into the cells, where it is either used for energy or stored as fat.
But too much glucose in the blood can cause a rush of insulin to be released, which removes too much glucose from the blood too quickly and sends our blood sugar too low.
You might notice this as feeling super hungry, craving caffeine or sweet things, feeling 'hangry' (hungry angry), or feeling sleepy during the day.
This is the body's natural survival mechanism to push us to eat something or do something to bring our blood sugar back up to a safe range.
Unfortunately, as we age, and especially as we reach peri/menopause due to loss of oestrogen and progesterone, this system starts to malfunction.
Where once we could eat what we wanted, and just 'exercise it off' or diet, this no longer works so well, if at all.
And actually, both of these approaches can make stubborn weight gain even worse!
We can become more prone to extreme hypoglycaemic episodes where we are much more sensitive to glucose and our blood sugar dips low more easily.
And we can become more, what is known as, 'insulin resistant,' where the cells no longer recognise the insulin knocking on the door. This can result in both high and low blood glucose and ultimately can lead to pre-diabetes and diabetes.
What is a normal blood glucose level?
Depending on how much glucose is in your body's system, blood sugar levels might be normal, high, or low.
The medical profession defines a normal blood glucose reading, after fasting, or before a meal as between 4 and 5.9 mmol/L. But, in reality, the optimum levels (i.e. where we really want the to be) are between 4 and 4.7 mmol/L.
And 90 minutes to 2 hours after eating, the guidance is that they should be no higher than 7.8 mmol/L (though I prefer most times for it to be closer to 6.7).
There is another measure that is used to help determine your average blood glucose levels over a 2 to 3-month period, known as the HbA1c test. The optimal for this test is below 42 mmol/mol.
But other than avoiding diabetes, why is blood glucose control so important?
Firstly, it is especially critical if we want to lose body fat in our perimenopause and menopause years. And especially if we want to lose weight around our trunk/middle/belly.
If this is where you are storing most of your fat, no amount of exercising or dieting is going to improve this.
But equally, it is incredibly important for our overall health and longevity:
- For good deep sleep.
- To avoid oxidative stress (a key driver of inflammation, heart disease, cognitive decline and general ageing!).
- To maintain good energy production, and avoid chronic fatigue
- To maintain a healthy immune system (so you can fight off the bugs you come into contact with)
- To avoid hot flashes and night sweats (see my email/post last week on this topic, if you missed it)
- To maintain or improve good memory and cognitive function (poor blood glucose control can contribute to brain fog)
- For healthy skin (yes, constantly spiking your blood glucose can lead to acne and premature ageing)
- To avoid more serious diseases and illnesses such as dementia, cancer, heart disease, depression, arthritis...
Ok, so that's the basics of what blood glucose is, how it works, and why it's so important.
Next up we are going to talk about the signs and symptoms of poor blood glucose control...
Blood glucose isn't as straightforward as some make out. There has been a recent surge in interest in it since the emergence of CGMs and the resulting companies jumping on the bandwagon.
Monitoring blood glucose gives us part of the picture... but not the whole picture. It is, after all, only measuring glucose.
It doesn't take into account what is happening with insulin, and whether you are insulin resistant (something that we become more prone to as women going into menopause).
But a good place to start to determine if you may have blood glucose issues are through symptoms. And there are quite a few to look out for!
1. Getting 'hangry' (hungry-angry) if you miss a meal or go too long without eating. Do you get tetchy if you are late eating? That's a clear sign that your blood glucose is not stable.
2. Getting sleepy when you shouldn't. Often this happens mid-afternoon. You may get a sudden onset of tiredness that makes you just want to close your eyes and snooze.
3. Waking up multiple times in the night, and finding it hard to get back to sleep.
[N.B. Sleep issues can be caused by numerous things, but blood glucose is such a common one! When my clients finally stabilise their blood sugar, they often find that they no longer wake, and have much deeper sleep.]
4. Bingeing or uncontrolled eating! If this happens to you, it might be time to consider your blood glucose control.
5. Craving coffee or sugar, especially in the afternoon. And craving sweet things in general.
6. Craving something sweet after meals, especially dinner
7. Fatigue or tiredness that is relieved by eating, especially carbs
8. Headaches if meals are delayed or missed
9. Feeling weak or shaky if meals are delayed or missed
10. Frequent urination
Now, let's discuss some of the common causes of poor blood glucose control (especially in women's peri/menopause years).
1. Eating too many refined carbohydrates
What we eat, of course, matters. Diets too high in refined carbs and sugars, and lacking in protein and healthy fats, will naturally lead to unstable blood glucose. This is where we always have to start, with what we are actually putting into our bodies.
2. The timing of our meals
When we eat actually makes a big difference to our blood glucose too! From extended overnight fasting (not advisable for most women over 40), to leaving big gaps between our meals, the timing of when we eat is as important as what we eat.
3. Imbalance of key minerals
You can be avoiding refined carbs and sweet stuff, and STILL struggle to control blood sugar, if certain minerals are out of balance. Namely the macro minerals Calcium, Magnesium and Potassium, plus other trace elements such as Chromium and Manganese. Yes, minerals strongly influence how well glucose is metabolised.
4. Insulin resistance
The problem is not insulin itself (which is an essential hormone that takes glucose out of the blood and into the cells) but rather chronically elevated levels of insulin, in part because the cells stop responding to it. Untreated, insulin resistance can lead to type 2 diabetes, and it can affect a LOT of women in the menopause years. Loss of oestrogen and a resulting testosterone-dominant effect during peri/menopause can make insulin resistance worse.
5. Chronic Stress
Stress, including life circumstances, illness, and lack of sleep, is also a contributing factor when it comes to blood sugar regulation. When the body is under stress, the adrenal glands trigger the release of glucose stored in various organs, which leads to elevated levels of glucose in the bloodstream (to prepare you to fight or flee). This is a survival mechanism and when used correctly, works perfectly. The problem arises with chronic stress on the body or mind, which leads to continuously raised glucose levels.
With my clients, I tend to see a combination of things contributing to imbalanced blood glucose; it's never just one thing. But for almost everyone, what they eat, when they eat, their mineral balance, and stress are part of the picture, which is why my approach addresses all of these areas.
Furthermore, I'm going to focus on Stubborn Weight & the dreaded Belly Fat!
This is probably the symptom that bothers women the most, yet the majority have no clue that irregular blood sugar is a BIG part of the problem!
So how does your blood glucose cause Belly Fat?
Whilst reducing calories is the standard recommendation for weight loss, it will do little for abdominal weight gain if it is not combined with a blood glucose balance strategy and an approach that reverses insulin resistance.
In fact, reducing calories too low will actually exacerbate the problem and slow the metabolism, preventing weight loss!
When glucose is high in the blood, insulin is released to remove it and store it elsewhere (as high glucose left in the blood causes oxidative stress and inflammation).
And where is it generally stored? Insulin has a few storage options:
1. The Liver which can store up to 100g, as glycogen
2. Our muscles which can store around 300g to 400g
The problem is, we tend to consume foods with much more glucose than that, so those storage options are filled up pretty quickly.
So the next storage unit is:
3. Our fat cells and there's no limit to how much can be stored there!
So once the liver and muscle storage facilities are full, the rest of the glucose is stored as fat in our fat cells.
Are you starting to see the issue here?
Add to that the fact that fructose (another form of sugar that is in many processed foods and drinks) can't be stored in the liver and muscles, and has to go somewhere... hello again fat storage!
To shift that body fat, we have to use up the glycogen stores in our liver and muscles first, and then the body will call on the fat reserves for energy.
Sounds simple right? Eat fewer high-glucose foods...right?
Not so fast...
The more glucose spikes we have in the blood, the more insulin is released.
And if insulin levels are chronically raised, we struggle to lose body fat.
We HAVE to get insulin stabilised if we want to lose fat, especially belly weight.
And there's one more element to this that very few talk about: the role of calcium, magnesium and potassium.
The release of insulin is calcium-dependent; in fact, calcium stimulates the release of insulin, whilst magnesium inhibits it.
When the ratio of calcium is elevated, especially in relation to magnesium, insulin levels are also likely high, making you 'sugar-sensitive' (and visa versa, when calcium is low, insulin levels are likely to be low).
Potassium, on the other hand, is required to transport glucose into our cells, so a lack of potassium (which I see ALL the time on HTMA tests, alongside too much calcium and not enough magnesium) adds to the problem!
This is why my approach to helping women over 40 to lose weight, is to not just focus on blood glucose control through diet and lifestyle, but also to correct these key mineral imbalances.
Hence why I am able to help women lose excess weight and belly fat, which they have struggled with for a long time prior...
Now you'd no doubt like to find out more about the root cause of YOUR symptoms, such as belly fat, stubborn weight, sleep issues, fatigue, anxiety and many more, PLUS the steps you need to take to resolve those issues.
What do you need to do to actually balance your blood sugar (and lose excess belly fat, have better energy, sleep better and so on)?!
The strategy I give to my clients is a whole-body strategy. Yes, a big part is focused on what they eat, of course, but there's more to blood sugar balance than just being careful with carbs.
So let's go through them, one by one.
1. Let's start with diet. Most of us need to focus on eating more protein. And you may be surprised to know that the majority of my clients are told not to go too low on carbs, but they are shown the right ratio for their metabolic speed, and the right types and quantities of carbs. And do not be afraid of fats, healthy fats are required to manufacture hormones... cut them out, and guess what happens to those hormones!
N.B. - I am not a fan of keto for women over 40. In fact, I'm not a fan of keto for anyone, in the long term.
2. Build muscle rather than excessive cardio. This also requires eating enough protein, but it means focusing on weight-bearing exercise rather than high-intensity or loads of cardio. Muscle helps to increase the metabolic rate (one of the reasons our metabolism slows during peri/menopause, as we lose muscle during this time. Yes, get your heart rate up, but don't run/cycle/spin like crazy (especially if you are doing t to try to lose weight!).
3. Reduce your stress. I touched on this topic earlier in the week - chronic stress = chronically raised cortisol = raised blood glucose + slowed metabolism = belly fat + stubborn weight. It is almost impossible to get rid of weight around the middle if you are constantly stressed. And it's not just emotional/mental stress either. It's ALL stress, including environmental, chemical and physical too (see previous comment about cardio!).
4. Get better sleep. If you are struggling to get a solid 7 hours+ of sleep a night, you will struggle to keep blood glucose stable during the day. And don't forget, unstable blood glucose also contributes to poor sleep! It's important to identify what is causing poor sleep and then resolve it (something I work with clients on as a priority). Start with sleep hygiene, the time you go to bed, blue screens at night and so on...
5. Balance your minerals. As previously discussed, earlier this week, there are key minerals that indicate and influence our metabolic speed, plus our ability to control blood sugar and our cellular thyroid function. This requires a hair mineral test and analysis by someone like me, who really understands how to interpret the test.
For those of you who have enjoyed and learned from this blog, you probably now want to understand MORE about YOUR symptoms, (such as belly fat, stubborn weight, sleep issues, fatigue, anxiety, joint pain, hot flashes, low mood and more)... and to understand more about how minerals impact on almost every symptom...
...you'll want to make sure you're at my next monthly MasterClass.
You can find out more about the MasterClass and register your place, by clicking HERE.
And in the meantime, for those of you who have weight/belly fat to lose as a priority, and haven't seen my mini-training called "What's With The Stubborn Weight in Peri/Menopause?" you can find the video training HERE In my Facebook Group.
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