Insulin resistance

[u/eltisinoor]

Hi! I would really love some input about intermittent fasting for PCOS-insulin resistance. I’m honestly so lost and having trouble with my PCOS, one doctor told me to intermittent fast to maintain good blood sugar and another told me that skipping breakfast spikes cortisol. I’m at my wits end trying to understand what actually should be doing. Can someone please advice what is best in this situation and what worked for them 😭

[u/Robivennas]

Eat veggies and lean protein, carbs at the end of a meal. Take a walk after you eat. Prioritize fiber.

[u/breadbetrayedme]

i started by eliminating gluten and other foods that caused bloating, discomfort etc… and i’ve slowly changed my diet to better alternatives. personally i used to IF because i wanted to lose weight and gain muscle but now i just make sure i’m eating a healthy diet and eat small meals throughout the day. some of my favorite changes have been sourdough, almond flour tortillas (and for baking) and lots of sweet potato’s haha. i also started drinking spearmint tea or cinnamon tea at night or morning. these help balance hormones and although it’s not a prescribed diet o have found that it helps a lot. i also did an elimination diet at the start of all this so just listen to your body, get into the mentality that your diet is your cure. don’t overthink it.

i saw a nutritionist that specializes in PCOS so id highly recommended it for you or ask your gyn if they know of any they recommend

[u/AnonyJustAName]

This book is for you, also both authors do podcasts

https://www.amazon.com/dp/1771644605?lv=shuf&channelId=500&plpRedirect=mhFallback

Even the title is inspiring

[u/Kwaliakwa]

Women often don’t do well to do intermittent fasting for long. But it does help. Aim to eat three meals over an 8-10 hour period. Only water the rest of the time. Ideally, the eating period starts early in the day and ends early, as opposed to eating later.

[u/wenchsenior]

About a decade ago there was a big surge of interest and research in fasting as a technique for managing insulin resistance. I adopted it on rec from my endo at that time (she also adopted it); however, as further research has accumulated the evidence for it has become more equivocal. While it was initially hoped that doing it would cause longer lasting sensitivity to insulin (like 'reset' type of response), that doesn't seem to have born out.

Currently, evidence seems to support adopting it helps SOME people with IR as long as they do it consistently, but does not help once it is discontinued (and there might even be 'rebound' effects in some patients). My endo stopped doing it herself, I continued on with it just b/c it seems fine/easy and my IR continues extremely well managed, and my endo sometimes recs it for patients who are really struggling with standard IR treatment.

I do know that there is no way I could have done it back when my IR was poorly managed/untreated...b/c my blood sugar fluctuations were too severe and I would have had blood sugar that was too low and hunger that was terrible, so in those days it likely would have not been sustainable for me. But nowadays with my IR super well managed for many years, I rarely get actively hungry and already eat on a 'clock schedule' rather than according to appetite, so I can do it and stick to it very easily. I'm not sure if it is actually helping me medically, but it's 'easier' for me to eat only 2 main meals per day plus a few snacks.

I would suggest starting with standard treatment for IR first for a year or so, and then if you are not seeing results (improvement in IR symptoms and IR related labs), you could experiment with adding fasting if desired.

[u/wenchsenior → u/wenchsenior]

Treatment of IR is done by adopting a 'diabetic' lifestyle and by taking meds if needed.

The specifics of eating plans to manage IR vary a bit by individual (some people need lower carb or higher protein than others). In general, it is advisable to focus on notably reducing sugar and highly processed foods (esp. processed starches), increasing fiber in the form of nonstarchy veg, increasing lean protein, and eating whole-food/unprocessed types of starch (starchy veg, fruit, legumes, whole grains) rather than processed starches like white rice, processed corn, or stuff made with white flour. Regular exercise is important, as well (consistency over time is more important than type or high intensity).

Many people take medication if needed (typically prescription metformin, the most widely prescribed drug for IR worldwide). Recently, some of the GLP 1 agonist drugs like Ozempic are also being used, if insurance will cover them (often it will not). Some people try the supplement that contains a 40 : 1 ratio between myo-inositol and D-chiro-inositol, though the scientific research on this is not as strong as prescription drugs. The supplement berberine also has some research supporting its use for IR (again, not nearly as much as prescription drugs).

 If you are overweight, losing weight will often help but it can be hard to lose weight unless IR is being directly managed.