An inability to maintain healthy blood sugar has been rightly identified as the crux of most recent modern health problems, underlying metabolic syndrome, type II diabetes, and it is thought possibly even dementia and heart disease. In alternative medicine, there are a number of well-known approaches to support a healthy blood sugar level, such as supplementing the trace mineral chromium, using herbs like Gymnema, Cinnamon, and Bitter Melon, and encouraging weight loss with fasting or low-carb ketogenic diets. But as our understanding continues to increase, new facets of the issue are being uncovered and with them, new approaches which may prove more effective at addressing this issue. These include a focus away from carbohydrates towards reducing polyunsaturated fat intake, addressing high cortisol levels, and supplementing vitamins B6 and K2, whose role in glucose metabolism has recently become better understood.
Achieving Weight Loss
An underappreciated nuance when approaching weight loss efforts to control blood sugar is the fact that sugar is not the only article of the diet that can contribute to weight gain. While sugar can promote weight gain by increasing insulin, it should not be assumed that sugar is the only culprit, even in someone with blood sugar issues. Unhealthy levels of polyunsaturated fat (PUFA) intake are now suspected to play as large or even a greater role in the obesity epidemic than excess sugar intake. PUFA-rich seed oils including corn, soy, canola, safflower, and cottonseed are industrial food products that have been known for years to directly promote fat gain, first in livestock (specifically why they’re fed to livestock) but also in humans as well. The excessive quantities of omega-6 fatty acids provided by modern diets rich in these cheap oils can program the body for weight gain by mechanisms independent of blood sugar and insulin. And because fat cells become progressively less sensitive to insulin as they store more fat, this type of weight gain may be causing the elevated blood sugar, as opposed to blood sugar causing the weight gain.
There is a lot of misinformation available on the best diet to control blood sugar, which has created a confusing debate on whether diabetics should avoid saturated fat for weight loss and eat plenty of carbohydrates to maintain energy levels, or avoid carbohydrates to help lower blood sugar and eat something approaching a ketogenic diet for weight loss. The best practical advice, however, is to avoid neither fats nor carbohydrates; instead, one should avoid bad fats (PUFA-rich oils in processed and fast foods) and refined sugar, while eating a nourishing diet comprised mainly of whole foods. Healthy eating is necessary to lose weight, but the best diet for blood sugar control is essentially the diet best suited for health in general, rich in nutrients and low in high-calorie processed ingredients. Some patients do thrive on ketogenic diets, but for others this approach to eating is not necessary and may even become a counterproductive source of added stress.
Controlling Cortisol Levels
Although insulin is directly tied to blood sugar, it is not the only hormone that needs to be addressed. High cortisol can be an equally significant issue, because the functions of insulin and cortisol in the body are directly linked. When cortisol is elevated, sensitivity to insulin decreases, meaning that in a high cortisol state, more insulin is required to stabilize blood sugar. The reason why cortisol makes the body less sensitive to insulin pertains to cortisol’s role in providing the body’s energy for daily activity. Every morning, a large surge of cortisol promotes the breakdown of both fat and muscle to liberate nutrients to fuel daily activity. The resulting burst of energy promotes wakefulness in the morning, and insulin sensitivity is decreased so that these nutrients can remain in the bloodstream. When cortisol follows a healthy rhythm, its decrease later in the evening makes the body sensitive to insulin again, so that nutrients entering the bloodstream can be stored for growth, repair, and replenishing of tissue stores. Because the action of insulin is to store calories and nutrients away rather than convert them to energy, cortisol is specifically designed to reduce the action of insulin during the day, creating a perfect metabolic balance of catabolism and anabolism, breakdown and regrowth.
If cortisol becomes excessive, however, it completely wrecks this natural balance by reducing insulin sensitivity too much for too long. Stress-related weight gain occurs when a normal diet is consumed under conditions of high cortisol and reduced insulin sensitivity, as this metabolic state programs the body to store more food as fat and turn less of it into energy. The result is fatigue, elevated blood sugar, and increased body fat. In such cases, if elevated cortisol is not identified and addressed, the common approach is to subject the stressed individual to a reduced caloric intake compounded by exercise in an effort to promote weight loss, which can backfire by increasing stress and cortisol further. Almost anything we perceive as physically or emotionally stressful, as well as things we may enjoy but our bodies perceive as stressful (like staying up late or exercising intensely), can dysregulate blood sugar by elevating cortisol levels. As such, encouraging a low-stress lifestyle avoiding extremes of both healthy and unhealthy behavior, and using approaches to balance cortisol while supporting adrenal health can be an important part of helping patients achieve blood sugar control.
Targeting Nutrient Intake
Maintaining healthy blood sugar levels has been a widespread and growing concern for quite some time now, and the good news is that the scientific community has been responding to this issue, with an enormous amount of research having lately come forth relating different micronutrient levels to blood sugar control. It is almost more difficult at this point to name nutrients that have not been linked to healthy blood sugar than it is to list the vitamins and minerals which are. It has been known for some time that the trace mineral chromium is essential to pancreatic islet cell function, and that chromium intake can promote a healthy insulin response. One thing that can deplete chromium in the body is prolonged elevations of cortisol, providing another holistic link to the cycle of stress and weight gain. Importantly, chromium can be depleted both by excesses of the body’s natural cortisol and artificial elevations induced by corticosteroid medications. It is not an uncommon phenomenon to witness blood sugar elevations and prednisone-related weight gain stubbornly persist even after the medication is stopped, likely due to a chromium deficiency induced by the course of steroids.
While the importance of chromium is well known, emerging research has identified several other vitamins playing unexpectedly significant roles in the regulation of blood sugar. Of these, two of the most important standouts are vitamins K2 and B6. Vitamin K2 or menaquinone, which is not the same as the vitamin K1 obtained from leafy green vegetables, is a nutrient commonly deficient in modern diets and acts in synergy with vitamin D to maintain adequate calcium levels. The link between vitamin K2 and blood sugar is provided by osteocalcin, a hormone once thought simply to regulate calcium levels in the blood, but which has since been discovered to play many additional roles inside the body. Beyond regulating bone mineralization, osteocalcin has been shown to stimulate the growth of insulin-secreting beta cells inside the pancreas, as well as increase both insulin production and insulin sensitivity. Osteocalcin is therefore extremely important to maintain healthy blood sugar, and its activation depends upon vitamin K2.
The other vitamin to emerge for the promotion of healthy blood sugar is vitamin B6, which plays numerous roles in the body and is one of the vitamins frequently depleted by stress. Especially in combination with magnesium, B6 supplements have long been used to reduce the effects of stress and promote healthy mood and sleep, as it seems many of the negative effects of stress involve strain on the body’s B6 reserves. Other factors that tend to deplete B6 include medication, alcohol, and hormonal fluctuations, as B6 is involved in metabolizing and clearing cycling hormones from the body. This, in part, explains the link between stress and hormones, but it also furthers the link between stress and blood sugar. B6 has been shown to lower blood glucose after a sugary meal in healthy people1, and is currently being explored as a potential treatment for diabetes. Why is B6 so crucial to blood sugar? The ability of insulin to lower blood sugar is largely dependent on how sensitive to insulin the tissues are, primarily the liver and muscles, which are the body’s main storage sites for glucose. In these tissues, glucose is stored as glycogen for future use, and it is only when glycogen can be effectively utilized for energy that these tissues become sensitive to insulin, to replenish their glycogen stores. Converting glycogen back into glucose for usable energy requires the active form of vitamin B6, hence not getting enough of this vitamin through diet, or its depletion by stress, medications, hormone fluctuations, etc., will compromise the body’s ability to use sugar as a fuel and cause it to accumulate in tissues. The end result is eventually that these tissues simply can’t take up any more glucose, and it remains in the blood as elevated blood glucose. Especially when stress is a factor, adequate vitamin B6 is crucial to maintaining healthy blood sugar levels.
- Kim HH, Kang YR, Choi HY, Lee JY, Oh JB, Kim JS, Kim YC, Lee KW, Kwon YI. Postprandial anti-hyperglycemic effect of vitamin B6 (pyridoxine) administration in healthy individuals. Food Sci Biotechnol. 2019 Jan 4;28(3):907-911. doi: 10.1007/s10068-018-0534-7. PMID: 31093449; PMCID: PMC6484044. ↩︎