Introduction, after lurking for a long time, and insulin mystery

[RebeccaJ]

Hello all!

I got my DNA tested through Self Decode after finding out both of my parents are APOe 3/4, so it was no surprise to find out that I am a 3/4 also. So grateful that it wasn't 4/4! I was already doing a lot of the lifestyle interventions discussed here. I'm struggling with finding the right diet for me, as my doctor doesn't want to order tests for me every time a make a change.

Since finding out about my 3/4 status I've been trying to make sense of the various blood work results. I've discovered that my blood glucose is always low no matter what my diet looks like, but all my blood lipids are VERY sensitive to diet. So I've been trying to find the best diet to keep them in the range I want, but it's been hit or miss.

Over the past year, my ALT has been slowly creeping up and is now several points above the normal range. I've also gained about 15 pounds during that time. My doctor said that I'm developing fatty liver, which is "caused" by my high cholesterol and weight gain. I knew this didn't make sense, that it was likely the reverse. I suspected that I had developed insulin resistance. Since I'm not actually diabetic, she would not order any further testing. I ordered a fasting insulin and diabetes panel from Life Extension to see for myself, and the results were surprising. This was after a 10 hour fast.

Hemoglobin A1C= 5.1%
Glucose- 61 mg/dl
Insulin- 0.5 uIU/ml

My symptoms point to insulin resistance, but the insulin result is so low that would seem to not be the case. Is low insulin is something to worry about if my glucose is also low? Has anyone ever seen a fasting insulin this low? Maybe a lab error? Any insight or suggestions would be much appreciated!

[Tincup]

My symptoms point to insulin resistance, but the insulin result is so low that would seem to not be the case. Is low insulin is something to worry about if my glucose is also low? Has anyone ever seen a fasting insulin this low? Maybe a lab error? Any insight or suggestions would be much appreciated!

Welcome Rebecca!

My insulin has likely been close. One thought is to "stress test" your insulin. Eat your carbiest meal of the day and go in and get glucose & insulin tested 2 hours after. It might be good to go into the lab before you do this and see how to set it up with them. My experience is that New Century Labs (in this list) is usually the cheapest, they resell Quest Lab tests.

Dr. Catherine Crofts analyzed Dr. Joseph Krafts 5 hour insulin/glucose tolerance test data & found that looking at it at 2 hours was a good proxy. She told me once that fasting insulin is very pulsatile, so bounces around a lot. Here is a general search on her work. Here is one on both her and Kraft for posts by me.

[abalboa]

Hello all!

I got my DNA tested through Self Decode after finding out both of my parents are APOe 3/4, so it was no surprise to find out that I am a 3/4 also. So grateful that it wasn't 4/4! I was already doing a lot of the lifestyle interventions discussed here. I'm struggling with finding the right diet for me, as my doctor doesn't want to order tests for me every time a make a change.

Since finding out about my 3/4 status I've been trying to make sense of the various blood work results. I've discovered that my blood glucose is always low no matter what my diet looks like, but all my blood lipids are VERY sensitive to diet. So I've been trying to find the best diet to keep them in the range I want, but it's been hit or miss.

Over the past year, my ALT has been slowly creeping up and is now several points above the normal range. I've also gained about 15 pounds during that time. My doctor said that I'm developing fatty liver, which is "caused" by my high cholesterol and weight gain. I knew this didn't make sense, that it was likely the reverse. I suspected that I had developed insulin resistance. Since I'm not actually diabetic, she would not order any further testing. I ordered a fasting insulin and diabetes panel from Life Extension to see for myself, and the results were surprising. This was after a 10 hour fast.

Hemoglobin A1C= 5.1%
Glucose- 61 mg/dl
Insulin- 0.5 uIU/ml

My symptoms point to insulin resistance, but the insulin result is so low that would seem to not be the case. Is low insulin is something to worry about if my glucose is also low? Has anyone ever seen a fasting insulin this low? Maybe a lab error? Any insight or suggestions would be much appreciated!

Welcome RebeccaJ,
Thank you for joining our site and posting in the forum! While you've already received some great information from other members- I would love to share several tools & resources as a support team intern to help you get the most out of your experience if you would like to explore the site in more detail. The Primer is a detailed and informative resource written by a practicing M.D. with ApoE4/4. It includes information about the biochemistry of the ApoE4 gene and offers a variety of research-based prevention strategies.

Some helpful tips to navigate the site include the How-To Guide. It includes topics such as navigating the forum, private messaging, and searching. One great tip is using the quote (") button when replying to a post. Using the button will automatically alert the member of your response.

If you are interested in learning more about other members check out Our Stories.

Again, I am so glad you joined our forum. I look forward to hearing from you in the future. Please feel free to reach out anytime.

Warmly,
Angie

[RebeccaJ]

One thought is to "stress test" your insulin. Eat your carbiest meal of the day and go in and get glucose & insulin tested 2 hours after.

Thank you for the information! I thought fasting insulin would be the more important marker. I'll have to read up on Dr Croft's work, and try this as soon as I can get it organized.

For now I'm acting as if I do have insulin resistance and making lifestyle changes accordingly. I don't think it can hurt anyway. I get my liver numbers checked again in a few months to see if they are moving in the right direction.

[gena]

One thought is to "stress test" your insulin. Eat your carbiest meal of the day and go in and get glucose & insulin tested 2 hours after.

Thank you for the information! I thought fasting insulin would be the more important marker. I'll have to read up on Dr Croft's work, and try this as soon as I can get it organized.

For now I'm acting as if I do have insulin resistance and making lifestyle changes accordingly. I don't think it can hurt anyway. I get my liver numbers checked again in a few months to see if they are moving in the right direction.

Hi Rebecca- Not sure if this helps but sharing just in case. My ALT became elevated a couple of years ago and the culprit turned out to be niacin. I didn’t realize it was in my b complex as niacinamide. When I stopped taking it, my ALT returned to normal over a few months. Any chance you are taking it?

[mike]

[Thank you for the information! I thought fasting insulin would be the more important marker.

Rebecca, if you had insulin resistance, then your fasting insulin would likely be high... Your BG was quite low and you would not want to have insulin in your blood trying to lower your BG even further. Your A1c is excellent.

2 hours after eating, your BG will should be back to about where you started pre-meal. If it is still high, then you likely have some insulin resistance. If your insulin has to go up to high levels to bring your BG down, then that is also indicative. Taking your BG at 1 hour will show you about how high your BG will be, and is a useful way to test different foods to see what you best tolerate.

[RebeccaJ]

[Thank you for the information! I thought fasting insulin would be the more important marker.

2 hours after eating, your BG will should be back to about where you started pre-meal. If it is still high, then you likely have some insulin resistance. If your insulin has to go up to high levels to bring your BG down, then that is also indicative.

I tested again, 2 hours after a high carb meal.. Blood glucose: 135, Insulin: 59.5. Definitely not good; at least now I know. I've been doing alternate day fasting for the past month. I've lost 5 pounds, so I'll stick with that. I'll also lower my carbs some more and restest in a few months.

[mike]

I tested again, 2 hours after a high carb meal.. Blood glucose: 135, Insulin: 59.5. Definitely not good; at least now I know. I've been doing alternate day fasting for the past month. I've lost 5 pounds, so I'll stick with that. I'll also lower my carbs some more and restest in a few months.

Hi Rebecca,
How are you measuring insulin?
What was your BG before the meal? Without that, the BG=135 doesn't mean as much... If you started at 80 and ended up at 135, that would be different than starting at 115 and ending up at 135 (latter is better). Insulin level is not out of whack for that BG. If you are up for sticking yourself a few times, it would be interesting to see BG at 0, 30, 60, 120 and 240 minutes to get a better idea of the shape of the curve.