• Dr. Saru Bala

3 Ways to Regulate Blood Sugar For Regular Periods


If you deal with PCOS, you know how important your blood sugar levels are.


And if you haven't had a diagnosis of PCOS, but you notice your periods have been irregular, you have consistent weight gain that you can't seem to tackle, and you've been losing hair on your head, and gaining it on your face- those might all be signs that point towards PCOS. Make sure you get worked up with your doctor if you're experiencing these.


The biggest piece to work on when dealing with PCOS or irregular periods is insulin resistance, AKA managing your blood sugar.


When insulin levels are high (with my patients, I like to shoot for 10 mIU/L or less, depending on your symptoms), this causes something called "sex hormone binding globulin" or SHBG to be low. And when SHBG is low, that causes androgens (like testosterone) to be higher, thus causing the symptoms you see of irregular periods, hair loss, and unwanted hair growth.


Think of SHBG as a bus. It's a protein carrier that binds up excess hormones within the blood. When there's enough of these busses, it goes around and picks up all the extra hormones (like testosterone) and binds it, so it's not active anymore.


But, when you run low on those busses (as is the case with insulin resistance), you get more of that testosterone left in the blood, and they cause issues with ovulation, your periods, and hair growth/loss.


SO WHAT CAN YOU DO?


Going all the way back upstream and keeping insulin in check will help regulate the rest of your hormones and get your period to come regularly.



1. NUTRITION

Of course, nutrition is the first place to start. In order to manage blood sugar, you want to make sure the food you're putting into your body isn't causing your sugar to spike and dip. When that happens often, that's when your body becomes resistant to insulin.

  • Make sure to eat 20-30g of protein WITH EACH MEAL. This means breakfast too! Protein will help to stabilize your blood sugar response and keep it from having large spikes. If you do eat sugar or a high carb meal, when you pair it with protein, it will help curb not only the sugar crash, but also keep you full longer and keep your blood sugar at a healthier level.


  • DO NOT skip breakfast. Studies show that eating about 30g of protein by 10 a.m. helps keep your insulin levels stable throughout the day. Other studies show that those who eat later in the day tend to have more metabolic issues than those who have an earlier eating schedule. So if you're going to skip a meal (aka you want to do intermittent fasting), make dinner the meal you skip, not breakfast.


  • Make sure to add about 20g of fiber with each meal. This part is super important as well. One study of about 6500 individuals found that adults with high fiber consumption have less insulin resistance than their counterparts. This will also help to keep you full longer and improve your gut microbiome while helping with your insulin levels.

"Adults with high fiber consumption have less insulin resistance than their counterparts."

2. SUPPLEMENTS

There are a lot of supplements that you may have heard that are supposedly helpful for insulin resistance or blood sugar maintenance. There are two that I use specifically for insulin resistance and managing irregular periods.

  • Berberine. "Compared with metformin, berberine exhibited an identical effect in the regulation of glucose metabolism, such as HbA1c, FBG, PBG, fasting insulin and postprandial insulin. In the regulation of lipid metabolism, berberine activity is better than metformin. By week 13, triglycerides and total cholesterol in the berberine group had decreased and were significantly lower than in the metformin group."

  • Use this supplement with caution. In excess amounts or for long term use, it can disrupt the gut microbiome as it's also a very potent antimicrobial herb. Make sure you consult with an integrative provider who is versed in herbal medicine.


  • Myo-Inositol. This is generally used in conjunction with D-chiro inositol and the two together are helpful for a lot of hormonal issues, mainly in women with PCOS. Studies have shown that it's helpful for lowering androgen levels as well as insulin levels, and there has been some evidence for the use of this in those with Hashimoto's as well. Dosing here is important. A high enough dose must be achieved in order to see benefit among insulin levels. Studies show that about 4g of myo-inositol per day has lowered androgen levels and insulin levels in women with PCOS.


3. EXERCISE

Of course you know exercise is good for you, don't we all? But exactly what should you be doing? It can feel overwhelming to hear so many different things.


Let's dispel some myths here. I know if you have PCOS you've probably heard from numerous sources, NOT to do HIIT (high intensity interval training) workouts. And let's stop right there. There is no one food, no one workout, no one supplement that will make or break any health issue. So let's not demonize HIIT workouts.


In fact, studies have shown that for women with PCOS, HIIT workouts are actually very beneficial at lowering insulin levels and androgen levels. But here's the thing I like to tell my patients: it depends on YOU.


HIIT workouts can be very draining to your adrenals if you're already under a lot of stress and your recovery is poor. If you feel like you're dragging yourself to a workout, and afterwards you feel even more tired, drained, and fatigued, then that's how you know that workout isn't working for you. Whether that's HIIT, cardio, Barre, Pilates, or whatever.


So a couple general rule of thumbs for insulin/blood sugar management when it comes to exercise:

  • 3 days/week of strength training. Strength training is low intensity activity, so it's good for even those who are feeling stressed. It helps with recovery if you're on the higher end of the stress scale. It's also beneficial for blood sugar as it helps you put on muscle, and the more muscle mass you have, the higher your metabolic rate.

  • One of my favorite resources (if you don't have a trainer, or access to one) is the app Nike Training Club. They have a free and paid version. You can customize your workout based on the equipment you have available. Anywhere from no equipment to a full gym.


  • 3 days/week of cardio or aerobic exercise. So many people ONLY do this, or ONLY do strength training. When combining both together you drastically improve your cardiovascular and metabolic health and you'll start seeing results faster. If you don't know where to start for cardio, start with walking. 20 minutes daily. Even better if you do it on an incline. If you want to take your cardio training to the next level check out how to do that here.


It can feel overwhelming to know how to regulate your blood sugar when you read several different conflicting "hacks" online. But remember, the best results are the ones that aren't a quick fix. Get back to the foundational pieces of WHY your hormones are off in the first place and you'll slowly start to see long term, sustainable results that don't leave you feeling tired, groggy, and frustrated.


If you need more help with regulating your cycles, schedule a visit and we can chat about how we can work together to get your periods back on track!


REFERENCES:

  • Lopez-Minguez J, Gómez-Abellán P, Garaulet M. Timing of Breakfast, Lunch, and Dinner. Effects on Obesity and Metabolic Risk. Nutrients. 2019;11(11):2624. Published 2019 Nov 1. doi:10.3390/nu11112624

  • Joo HJ, Kim GR, Park EC, Jang SI. Association between Frequency of Breakfast Consumption and Insulin Resistance Using Triglyceride-Glucose Index: A Cross-Sectional Study of the Korea National Health and Nutrition Examination Survey (2016-2018). Int J Environ Res Public Health. 2020;17(9):3322. Published 2020 May 10. doi:10.3390/ijerph17093322

  • Park YM, Heden TD, Liu Y, et al. A high-protein breakfast induces greater insulin and glucose-dependent insulinotropic peptide responses to a subsequent lunch meal in individuals with type 2 diabetes. J Nutr. 2015;145(3):452-458. doi:10.3945/jn.114.202549

  • Kahleova H, Belinova L, Malinska H, et al. Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study [published correction appears in Diabetologia. 2015 Jan;58(1):205]. Diabetologia. 2014;57(8):1552-1560. doi:10.1007/s00125-014-3253-5

  • Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008;57(5):712-717. doi:10.1016/j.metabol.2008.01.013

  • Wang H, Zhu C, Ying Y, Luo L, Huang D, Luo Z. Metformin and berberine, two versatile drugs in treatment of common metabolic diseases. Oncotarget. 2017;9(11):10135-10146. Published 2017 Sep 11. doi:10.18632/oncotarget.20807

  • Unfer V, Facchinetti F, Orrù B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocr Connect. 2017 Nov;6(8):647-658. doi: 10.1530/EC-17-0243. PMID: 29042448; PMCID: PMC5655679.












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