Fasting Insulin Levels
Fasting insulin levles are, in my opinion, one of the most important numbers
that you need to know and evaluate regularly. Fasting insulin isn't as
sexy as testosterone, but it can sure affect your sex life! (Actually, as we will discuss below, testosterone powerfully impacts insulin
levels and this is one of the primary reasons that low testosterone is
potentially so dangerous for hypogonadal men.) One study looked
at the relationship between erectile dysfunction and insulin resistance/levels
and found the following: 
a) Metabolic Syndrome, a.k.a prediabetes, was present in 43% of the participants
compared to 24% in a control group.
b) About three fourths of the erectile dysfunction patients had insulin
resistance compared to only a fourth in the general population.
c) Metabolic syndrome (P = 0.01), IR (P = 0.01), and fasting blood sugar (FBS)
>110 mg/dL (P = 0.01) correlated positively and moderately with increasing
severity of ED by SHIM score
So you don't just want to monitor testosterone for bedroom performance but
insulin as well. In fact,
I always say that you have two big enemies that create
90% of all health issues (and probably erectile dysfunction) for men in urban
societies: Insulin Resistance and Inflammation. These Two I's wreak havoc in virtually every tissue of your body from the
brain to the penis if allowed to go out of control. And guess what?
Fasting insulin is currently the measurement of choice used by physicians for
determining insulin resistance.
What exactly is insulin resistance? The condition occurs when insulin does not push glucose into your cells at the normal rate,
creating a toxic environment where both blood glucose and insulin levels rise.
Insulin resistance is the hallmark feature of
Metabolic Syndrome, or
prediabetes, and it is a HUGE risk factor many kill-you-slowly diseases such as
heart disease and erectile dysfunction. If you are a middle-aged or senior male
in a Western society, you very likely have the beginnings of insulin resistance,
whether you know it or not.
So what are safe fasting insulin levels and how can you bring them down?
Well, first of all, your lab results will probably have a huge range associated
with it. My physical a few months ago showed a range of 2-25 mIU/l (or
Physicians generally regard you to have an actual medical condition, insulin
resistance and/or hyperinsulemia, in the 10-12 range.
However, I recommend that you try to get your fasting insulin well below 12 or
even 10 mIU/l. (My doctor, for example, recommended getting it below 5,
which, interestingly enough, is the level that some health indigenous
populations have.) The reason is that researchers have found that blood glucose/insulin issues cause
major health issues:
a) Post-Meal Blood
Sugar Spikes. The refined carbohydrates in many of our meals spike glucose
levels which actually kills a few of our pancreatic beta cells. Over the decades
these cells dwindle in number and you have prediabetes and diabetes setting in.
(Your beta cells actually produce insulin, so as they die off, you're in
trouble.) Of course, I urge you to a) stay away from refined carbohydrates and sugars and b) buy an
inexpensive blood glucose monitoring kit.
This article by LEF covers
simple testing that you can do after a meal.
b) Small, Dense LDL Particles. As insulin resistance sets in, many
men begin to produce smaller LDL particles and these smaller particles
accelerate arterial/vascular damage and injury to your all-important
endothelium. As your endothelium as injured with the passing years, your
nitric oxide levels fall and erectile dysfunction sets in. Many studies have
verified that LDL particle size, fasting insulin and various inflammation
factors are tightly related to heart disease. 
c) Cognitive Decline and Dementia. Almost everyone knows about the
cardiovascular issues associated with insulin resistance. However, many men to
do not know that as the decades roll by insulin resistance injures the delicate tissues in the brain as well. 
So how you control your fasting insulin levels? It will probably not
surprise you to find that all the key things I push on this site as a natural
lifestyle greatly help control and reduce fasting insulin levels. Below we
have a list of some of thse key factors and the studies to go along with them:
Also, it should be noted that one study looked at men and women with lower or
medium cholesterol levels (less than about 210), yet with many signs of
Metabolic Syndrome. It found that insulin levels appeared to be independent risk
factor for heart disease even when things like non-smoking, blood pressure,
exercise levels and blood gluose were taken into account. In fact, it
conferred about twice the risk of heart disease.  So never ignore the signs
of insulin resistance and discuss with your doctor.
So how can you control fasting insulin
levels? Below are 15 Ways to
Control Your Insulin Levels based on the research.
CAUTION: If you are diabetic or on medications, be doubly sure to talk
with your doctor before making any changes as low or high blood sugar is
potentially very serious.
1. Weight. Get those high school abs back. Your woman will
love it and it will drop your insulin levels significantly.
Yes, those extra pounds around your gut have been found
to be very correlated to fasting insulin levels.  And many studies have
verified that losing weight helps you drop your fasting insulin levels
2. Exercise. When it comes to lower insulin levels and decreasing insulin
resistance, exercise is king. As we all know, physicians are reluctant to prescribe
natural lifestyle solutions generally speaking. However, very often now, physicians will
immediately tell type II diabetics to start an exercise program. The reason is simple:
moving the body just as surely moves the blood sugar. One interesting
study on children found that fitness levels were actually a better predictor of
fasting insulin levels than the degree of being overweight. 
Many studies have shown the power of exercise over insulin levels. But one
research summary pointed out that one of the surprising reasons that exercise is
so effective is that it converts fast twitch glycolytic IIb fibres to fast
twitch oxidative IIa fibres and increases the capillary density of muscle
tissue.  Yeah, muscle is much more important than just simple appearance:
it helps you inside and out.
Early research did not show improved insulin sensitivity with low intensity
workouts. However, more up-to-date research using the latest technology
did show virtually any type of exercise improved insulin sensitivity, which
makes sense considering that the vast majority of human history is based upon
simple walking. 
3. Testosterone. Low testosterone is associated with both diabetes and
Metabolic Sydrome.  And the reason is not well-know to many men.
However, in my book
Low Testosterone by the Numbers, I document how
testosterone has a very significant effect on
insulin levels and men with low testosterone will very likely see their
insulin levels and insulin resistance rise accordingly. This is one of
the many reasons that low testosterone is correlated with increased
cardiovascular mortality, arterial plaque, diabetes and Metabolic Syndrome.
For more information, see my link on
Testosterone and Insulin.
4. Coffee. Counterintuitvely, coffee can be a big help with
managing blood glucose and insulin levels due to a phytochemical that is
naturally occurring in the coffee bean (chlorogenic acid). Supplement
manufacturers have actually begun creating "green coffee bean extracts" for
this reason. You can read more about it in my link on
The Benefits of
Coffee Consumption, where I document how regular coffee consuption can
reduce your risk for cardiovacular disease and diabetes.
5. High Fat Diets. When researchers want to induce insulin
resistance in laboratory animals, how do they do it? Do they give them
some kind of special drug? No, it's much simpler than that: they
simply feed them a high fat diet.  And, yes, you too can drive yourself into
insulin resistance, just like a lab rat, if you eat enough fat in your meal. Whole food, plant-based, high fiber
diets, such as the
Low Fat Diets, are excellent choices to avoid
insulin resistance. NOTE: Fish oil can offer some protection against
the insulin promoting effects of high fat diets. 
6. Low Fat Diets: Triglycerides are very correlated with insulin resistance and some
studies have even suggested using triglycerides along with fasting insulin as an
excellent way to diagnose insulin resistance in the general populatiion.
It is a myth that a Low Fat Diet will push triglycerides and fasting insulin to
unsafe levels. For example, I eat a predominantly Low Fat Diet and my
triglycerides were 80 at my last checkup! This is about half of the
threshold usually given as a warning for patients. Furthermore, Dr. Barnard has
actually used a Low Fat Diet to reverse diabetes quite successfully in his
practice and you can read about it in
his book. Of course, the key is that a Low Fat Diet must be comprised of
whole foods. Cheating with sugars and refined carbohydrates ann calling
those Low Fat could get you into trouble. It may also be smart to avoid
wheat as you'll see in my link on
Review on Wheat Belly. But doing a
true Low Fat Diet has been shown to actually increase LDL particle size, which
is what you want. 
7. Mediterranean Diet. Several studies have shown that a Mediterranean
Diet can help with insulin resistance and other features of the
Syndrome. For more information, see this link on
The Many Benefits of a
8. Sleep. Yes, exercise is critical to control insulin
sensitivity, but NOT moving is just as critical. That's right - your
pillow time has a dramatic effect on your insulin levels. In fact, one
study on diabetics showed that those who slept 7-8 hours had almost half the
insulin levels of those who slept 5-6 hours!  That's an incredible
reduction. Many studies have looked the nasty effects of sleep apnea upon
insulin sensitivity as well. One study actually found that sleep apnea was an
independent risk factor for loss of insulin sensitivity.  (See my links on
Sleep and Testosterone,
Apnea and Erectile Dysfunction and
Testosterone for more information.)
NOTE: Does having hyperinsulinemia (clinically high insulin levels) or
elevated fasting insulin levels in young adulthood matter later in life? You
bet! According to a recent study, it did not matter what ethnicity or
gender you were: everyone was significantly more likely to develop
hypertension 20 years later.
9. Stress. Sleep is actually a stressor and lack of sleep usually
increase cortisol levels. And, in fact, any stressor will do the same. The
problem is that increasing cortisol increases Visceral Fat, which begins to
affect the liver. I discuss the Visceral Fat/cortisol/liver connection in my
link on Insulin Resistance and the Liver.
10. Fiber. A number of studies have verified that fiber has
a positive effect on insulin levels and insulin sensitivity.  Of course,
it's best to get this from vegetables, fruits and whole grains (excluding wheat
and soy in my opinion). And, as expected, fiber consumption is tied to a
lower risk of Type II diabetes as well. 
11. Alcohol. Some study work has shown that moderate alcohol
consumption leads to lower insulin levels.  This is likely one of the many
reasons that (moderate) alcohol consumption is associated with reduced
cardiovascular risks. However, there are defiites downsides to alcohol,
including slighly elevated estrogen and increased risk for GI cancers. See
my links on
Beer and Testosterone and
The Pros and Cons of Alcohol for some
12. Dark Chocolate. Chocoholics might say it is too good to be
true, but there is study out there showing that dark chocolate and dark cholocate
alone improved insulin sensitivity. 
13. ALA (Alpha Lipoic Acid). This supplement improves insulin
sensitivity in muscle tissue.  It works in diabetics as well  Of course,
discuss with your doctor as it can change medication requirements. Also, it
should be taken several time during the day since it has a relatively short half
life in the body.
14. Fructose. Actually, there is another way (besides high
fat diets) that researchers use to induce insulin resistance: high
fructose diets.  If you have enough fructose, greater than about 25-50
grams/ day, you can increase your insulin resistance and many other nasty things
that can affect your fasting insulin levels. For more information, see these
Fructose Summary Links.
15. Probiotics. Perhaps the most counterintuitve way to improve insulin
responsiveness is shoving good bacteria in your gut. Well, it's true, yet
another reason to take probiotics is for their insulin-improving
DIABETES CARE, VOLUME 24, NUMBER 3, MARCH 2001, "Diagnosing Insulin Resistance
in the General Population"
2) Int J Cardiol, 2002 Nov, 86(1):61-9, "Fasting insulin levels independently
associated with coronary heart disease in non-diabetic Turkish men and women"
3) The Journal of Pediatrics, April 2007, "Fitness is a Stronger Predictor of
Fasting Insulin Levels than Fatness in Overweight Male Middle-School Children"
4) Sports Medicine (Auckland, N.Z.), 1997, 24(5):321-336], "Role of exercise
training in the prevention and treatment of insulin resistance and
non-insulin-dependent diabetes mellitus"
5) Journal of Andrology, Jan/Feb 2009, 30(1), "The Dark Side of Testosterone
Deficiency: II. Type 2 Diabetes and Insulin Resistance"
6) The Journal of Sexual Medicine, Jan 2005, 2(1):96–103, "Incidence of Metabolic
Syndrome and Insulin Resistance in a Population with Organic Erectile
7) Diabetes, Nov 1991, 40(11):1397-1403, "Development of Muscle Insulin
Resistance After Liver Insulin Resistance in High-Fat–Fed Rats"
8) Science, 21 Aug 1987, 237(4817):885-888, "Fish oil prevents insulin resistance
induced by high-fat feeding in rats"
9) JAMA, 1998, 279(24):1955-1961, "Fasting Insulin and Apolipoprotein B Levels
and Low-Density Lipoprotein Particle Size as Risk Factors for Ischemic Heart
10) Arteriosclerosis, Thrombosis, and Vascular Biology, 1996, 16:201-207,
"Effects of Diet and Exercise on Qualitative and Quantitative Measures of LDL
and Its Susceptibility to Oxidation"
11) Diabetes Care, 2006, 29:2688–2693, "Hyperinsulinemia and Cognitive Decline in
a Middle-Aged Cohort"
12) Journal of Applied Physiology, Jan 1 2004,96(1)101-106, "Effect of the volume
and intensity of exercise training on insulin sensitivity"
13) DIABETOLOGIA, 2007, 50(11):2298-2304, "Association of sleep duration with
type 2 diabetes and impaired glucose tolerance"
14) Am J Respir Crit Care Med, Mar 1 2002, 165(5):670-676, "Obstructive Sleep
Apnea Is Independently Associated with Insulin Resistance"
15) Am J Clin Nutr, Mar 2005, 81(3):611-614, "Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons"
16) Am J Clin Nutr, July 2002, 76(1):274S-280S, "Glycemic index, glycemic load,
and risk of type 2 diabetes"
17) Diabetes Care, Jun 2005, 28(6):1397-1403, "Dietary Glycemic Index, Glycemic
Load, Fiber, Simple Sugars, and Insulin Resistance The Inter99 study"
18) Biochemical and Biophysical Research Communications, 8 Jul 2005,
332(3):885-891, "α-Lipoic acid increases insulinsensitivity by activating AMPK
in skeletal muscle"
19) HORMONES, 2006, 5(4):251-258, "Improvement of insulin sensitivity in patients
with type 2 diabetes mellitus after oral administration of alpha-lipoic acid"
20) Hypertension, 1987, 10:512-516"Fructose-induced insulin resistance and
hypertension in rats"
21) Journal of Hepatology, Nov 2008, 49(5):821-830, "Probiotics improve high fat
diet-induced hepatic steatosis and insulinresistance by increasing hepatic NKT