S2 E10: supporting blood sugar balance with Jillian Greaves, RD

In this episode, we are diving deeper into blood sugar balance and insulin resistance with PCOS expert and functional dietitian, Jillian Greaves. Jillian provides comprehensive nutrition and lifestyle counseling to women, with a special emphasis on PCOS, hormone balance, and digestive health. Jillian helps clients identify and address the root causes of their hormone and digestive symptoms naturally using advanced lab testing, personalized nutrition and supportive lifestyle therapies as the first line of intervention. Jillian runs a virtual private practice and is the creator of the Empowered PCOS Program. It’s her mission to empower women to take back control of their health, reclaim their confidence, and experience life at its fullest potential.

The goal with this episode is to help you better understand how our blood sugar gets out of balance and how to support your body maintaining healthy blood sugars long term. 

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Amanda Montalvo 0:00
Hey, this is Amanda Women’s Health dietitian. And I’m Emily nutritional therapy practitioner and this is the RU menstrual podcast where we help you navigate the confusing world of women’s hormones in teach you how to have healthy periods. Each week we will be diving into a different topic on women’s health and sharing our perspective using nutrition, female physiology and metabolic health. Our goal is to help you wade through conflicting health information and empower you on your healing journey. We hope you enjoy it.

In this episode, we’re diving deeper into blood sugar balance and insulin resistance with PCOS expert and functional dietitian Julian grieves Julian provides comprehensive nutrition and lifestyle counseling to women with a special emphasis on PCOS hormone balance in digestive health. Julian helps clients identify and address the root causes of their hormone and digestive symptoms naturally, using advanced lab testing personalized nutrition and supportive lifestyle therapies as the first line of intervention, Jillian runs a virtual private practice and is the creator of the Empowered PCOS program. It’s her mission to empower women to take back control of their health, reclaim their competence and experience life at its fullest potential. Thank you so much for being here. Jillian, thank you for having me. I’m so excited. It’s gonna be a good episode, I get a lot of questions around blood sugar, insulin resistance. Usually it relates to PCOS not always, or someone that maybe thinks that they have it. But really the goal of this episode is to help you better understand how our blood sugar gets out of balance, and then how to support your body maintaining healthy blood sugar’s long term. So why don’t we start off with a little bit of your background? Obviously, you’re a functional dietitian. But what made you want to focus on women’s health? Yeah, so I love that question. And really, some of my personal experiences. And my own personal health journey is sort of what led me to become super passionate about women’s health and to, you know, seek out advanced training and functional medicine. So my personal kind of health journey started probably almost like a decade ago, which is crazy. And at the time, I was going through a super busy phase of life where I was, you know, working full time, going to grad school at the same time, and generally kind of had a life full of stressors that was very busy. And alongside that I was eating predominantly a plant based diet. I was doing tons of hit training, running half marathons. And I was also on hormonal birth control, which I had been on for 10 or 11 years old at the time really crazy phase of life. And I started to experience a lot of symptoms, anxiety, I was having trouble sleeping, I was breaking out in skin rashes, my hair was thinning. I was bloated all the time, I really thought that I was doing all these great, you know, sort of wonderful, healthy things for myself, I started kind of looking into the research on female hormones and physiology, and really starting to question how I was supporting myself with nutrition and lifestyle, and the potential impacts of you know, the prolonged hormonal birth control use. And I sought out some support from my primary care physician who basically like laughed in my face and told me that I was completely fine. Everything was normal. I was the picture of health despite, you know, all of the symptoms I was experiencing. And she basically told me, you know, you can use a topical for the skin rashes, you know, you can look into anxiety medication, but you’re totally fine. I was not willing to accept that as an answer for everything that was going on, I really started to dig into everything and support my own body. And I took myself off birth control, I really immersed myself in functional medicine and women’s health and worked for a couple of years really to support and heal my own body, and essentially unlearn a lot of what I had been taught in terms of conventional nutrition. So with all of those experiences, I really wanted to be able to support other women who were going through similar things.

Jillian Greaves 4:17
And really to provide them with the support that I wish that I had had when I was you know, struggling and dealing with all of these things. So yeah, I feel like everyone has the like own background of like, okay, I went through all these things, and I’m gonna help people with something similar. And as dieticians it’s like we get a little bit we get a little bit with endocrinology and a little bit with women’s health, but it’s so small, and honestly, it depends on the program that you go through. It was so brief in mind, and it’s so then all of a sudden you’re like realizing, okay, I’m doing all these things that I feel like are supposed to be really healthy, but it’s not working for my body, and then it just kind of clicks in your head like Okay, so we have a lot more bio individuality than we’re being

Amanda Montalvo 5:00
tight. And it’s just something that you have to research and look deeper into. And unfortunately, a lot of that’s going to fall on you because we’re not, we’re just not being taught that stuff in school.

Speaker 2 5:11
Exactly. And I think a lot of what we are taught in school is sort of these guidelines, right, that are based off of super outdated research. And when you really start to delve into things and realize, realize how much things have evolved, and how much more there is to the story and starting to really, you know, learn about the bio individuality that that you mentioned, it’s pretty incredible the world that’s out there, outside of the small bits that were taught in, you know, some of the conventional training,

Amanda Montalvo 5:39
I just feel like women are different. And there’s not enough of an emphasis on that, because when you look at nutrition research, it doesn’t distinguish one, they’re not going to be they’re not going to include menstruating women, it’s usually women on the pill or postmenopausal women that are going to be included in the studies. Because there’s less variables women are harder to study because we aren’t we have those cyclical changes in our bodies. But yeah, it’s it’s frustrating. And I feel like so many people can relate to your story. It’s, I just can’t even imagine how hard it is for women that don’t have that background, or don’t necessarily know how to advocate for themselves. I did a whole episode with Michelle on like, advocating in our health care system and that kind of stuff. And she has that free guide. And if you guys don’t go back to that anxiety episode with Michelle, we talked about like, what to bring your doctor’s visits, like how to get the things you need. And Michelle is also a close friend of both Julian and I. Yeah, but

Speaker 2 6:31
But to your point, like I was in, you know, I had a an undergraduate degree in nutrition, I was almost finished with a master’s degree in nutrition, I worked in clinical nutrition research. And I was I was struggling, right. And I had the skill set to be able to do the deeper digging and evaluate research and all of those things. But I can’t imagine what it would be like for, you know, just someone trying to figure out what the heck is going on with their body that has, you know, no health, nutrition, you know, kind of training or background.

Amanda Montalvo 7:00
Yeah. And that’s why you know, that’s why this podcast exists. That’s why both of us share helpful information on social media and our blogs, because there’s just no other way to get it out to like a massive amount of people, especially those that struggle with things like blood sugar imbalances, and throat resistance, PCOS. I know that’s a huge part of your client population. And one of the biggest issues especially seeing you like you go to the doctor who have PCOS, or you suspect insulin resistance, or maybe they bring it up to you. And they talk about like balancing your blood sugar, right? Usually, they’re telling you to eliminate carbs. But we’re going to talk about why we don’t recommend that. It’s just this idea of like, yeah, you want to keep your blood sugar balanced. But what does that really mean? Can you go through the process of like, what’s happening inside her body so that everyone can better understand, like, what the heck we’re even talking about when we say that?

Speaker 2 7:50
Yeah, absolutely. I feel like that verb balancing blood sugar is just thrown around all over the place. So in terms of what that actually means, let’s sort of break down what blood sugar is, and what’s kind of happening in terms of, you know, blood sugar fluctuations in the body. So basically, when we eat foods, specifically carbohydrates, these carbohydrates are broken down into glucose or sugar. And the sugars then enter the bloodstream and cause blood sugar to rise, and to take a step back, too. So glucose is basically the primary and preferred source of energy used by our brains to power our central nervous system, our muscles, our organs. So super important. So when the body basically senses a rise in blood sugar after eating, the pancreas releases a hormone called insulin. And it’s insulins job to basically manage blood sugar levels by bringing or transporting blood sugar out of the bloodstream, and into the cells where it goes to be used for energy or it’s stored for later use. So essentially, that process helps to keep blood sugar from you know, getting too high. So when we’re talking about Balanced blood sugar, specifically, really the goal is to have a sort of a slow, gradual rise in blood sugar after eating a meal and a slow decline. So throughout the day, balanced blood sugar would basically kind of resemble, like slow rolling hills, if we’re talking about imbalanced blood sugar that would basically involve like sharp rapid spikes in blood sugar, big crashes or dips in blood sugar, so things would look you know, really erratic. So balanced blood sugar, basically, you know, those slow rolling hills and the gradual increases in decline declines after eating meals.

Amanda Montalvo 9:38
And I think one of the things that people tend to focus on and we were chatting about this before we started recording, what is that? It’s always the high blood sugar, which I get because eventually having chronically high blood sugar can lead to things like insulin resistance, different tissue damage and issues within the body. But what about low blood sugar like what is the

Jillian Greaves 10:00
importance of having both, you know, avoiding highs and lows in order to keep those nice slow rolling hills throughout the day. Yeah, so that’s such an amazing question that’s really not talked about enough. But But yeah, so basically, we do want to avoid these big, you know, rapid spikes in blood sugar and insulin that can be super inflammatory.

But blood sugar crashes that can come from

a blood sugar high. So it’s sort of that idea that what goes up must come down, right, so the bigger the rise, sometimes the bigger the crash. Or if low blood sugar is happening from under eating carbohydrates, or going too long without eating, this puts a significant amount of stress on the body. And when blood sugar crashes, it crashes, this sort of sends off the alarms in the body, and the body starts to produce more stress hormones, specifically, one of the the primary hormones that the body produces When blood sugar is too low is cortisol. Cortisol is a glucocorticoid. And one of its primary jobs is to keep blood sugar stable, so blood sugar’s low, we pump out more stress hormones, and basically, you know, cortisol will tap into glucose stores and dump, you know, glucose into the bloodstream to normalize blood sugar levels. Alongside that, cortisol will also tell your cells to become more resistant to insulin. So it actually makes insulin resistance worse if that if it’s happening on a persistent basis in terms of lots of low blood sugar and big blood sugar crashes. So, you know, the, the idea that high blood sugar is only the problem is like, silly in a sense, because you’re just sort of missing an entire piece of the puzzle, high blood sugar and low blood sugar often, you know, coexist in terms of issues. So we really want to make sure that we’re kind of avoiding both, we’re minimizing both the big highs and the big lows. Yeah, and I think, you know, people don’t realize that. That’s why having your blood sugar be out of balance, it is a stressor. Like I always, some people get mad when I say this, but I say like nutrition is the number one way to reduce stress, because it reduces it on so many levels, getting the vitamins and minerals that your body needs, but also getting those macronutrients that you need an eating enough, that’s a huge stress relief on your body. Because if your blood sugar stable, for the majority of the day, think about how many cortisol dumps that you are just like defending your body against and it really, it really can like that’s with like anxiety and things like that. And, you know, poor appetite, like all that stuff is coming from those cortisol dumps, and the highs and lows and blood sugar and the just the response that elicits from our body. And it’s really, it doesn’t sound great, but it’s like that cortisol is your body trying to protect you right from the low blood sugar. Because if our blood sugar drops too low, then we will no longer be living eventually. And so it has to keep that stable. That’s why we release it. I also see a lot of people waking at nighttime, because they don’t have the ability to balance that blood sugar throughout the night. Usually, it’s because maybe they’re not eating enough or not eating enough carbs, of bouncing the meals to store that glucose in their liver. And so what is their body do blood sugar drops too low releases that cortisol and that does still create a stress response and wake you up. But I’m sure you see that as well, all the time, a huge thing that I see especially what you’re describing with the waking, like in the early hours of the morning where people are getting the cortisol, the adrenaline spikes, but yeah, absolutely. When you know, when things are erratic with food, it is just or nutrition, it is just such a significant stressor on the body. And it’s hard to really do anything else in terms of supporting your health if blood sugar isn’t balanced on a really basic level. Yeah, that’s kind of the point of this podcast episode. And I promise we’re gonna cover insulin resistance in a second because I know people were like, can you explain that? What can throw your blood sugar off balance or make it difficult? Obviously, we just talked about nutrition a little bit and you can definitely dive deeper into that. I think a lot of people are going to relate, but even like other aspects of our health, yeah. So to build sort of quickly off the nutrition pieces, some of the fundamental things with nutrition that disturbed blood sugar imbalances in terms of macronutrients, which I think you just mentioned. So if things are, you know, for lacking certain core Mac, macronutrients at meals, or the proportions are really off that can contribute to wonky blood sugar as well as just erratic meal timing or, you know, issues with meal frequency where we’re going like super long periods of time without eating.

And then also micronutrients. So deficiencies in micronutrients, like you know, magnesium, potassium, zinc, all sorts of stuff.

One things that can contribute to dis, dis regulating blood sugar. So that’s where kind of the diet quality piece comes into play. So nutrition super important. And then other things that can really disturb blood sugar would be things like stress, we talked about stress, in terms of, you know, blood sugar crashes, right, that’s a physical stressor on the body that produces a stress response. And then also things like emotional stressors and just stressors of day to day life in our modern society can really, really impact blood sugar stability. So even if we’re not getting low blood sugar, or blood sugar crashes, levels of stress are really high. And our stress response system is sort of firing, it increases blood sugar levels, and it, you know, contributes to that insulin resistance. So stress is a big one. And also things like sleep disruption. So we even have research that has found that one night of disturbed sleep can contribute to elevated blood sugar and you know, blood sugar issues. So that’s a huge one, if we’re not getting good quality sleep, we’re not getting enough sleep, that can really contribute to can contribute to disturbances in blood sugar. Also things like over exercising under exercising. So again, it’s always about finding that nice delicate balance that’s actually supporting your body and not, you know, creating more dysregulation. So those are some big ones that that come to mind in terms of, you know, nutrition and lifestyle pieces. I do think insulin resistance is the result of a lot of those things, right. So can you talk about, like, what is insulin resistance? And we can definitely cover like PCOS as well. But just at like that basic level, what is insulin resistance and how like what typically comes up when someone’s dealing with that? Yeah, so basically, insulin resistance is kind of exactly how it sounds, the cells in insulin resistant, your cells are not responding properly to insulin after eating, or they are resistant to insulin. And what happens is when the cells are resistant to insulin, insulin cannot Usher glucose or sugar into the cells as efficiently as it should. So blood sugar levels will remain elevated. And when the pancreas or the body senses that blood sugar levels are remaining high, the pancreas will continue to pump out more and more insulin in response to the elevated blood sugar. So that’s kind of what insulin resistance is in a nutshell. So

you know, the, the cells are resistant to insulin. And then we’re in this situation where we’re, you know, we have high blood sugar, high insulin levels, but we’re also not getting fuel or energy, you know, in in an appropriate way. So we can experience all these sort of big, big dips, and spikes that aren’t going to feel so great for the body.

Some common kind of signs and symptoms that I might look for, to you know, figure out if insulin resistance is an issue would be things like really intense sugar or carbohydrate cravings. Again, that’s sort of your body having a difficult time actually actually accessing the energy from the food that you’re eating and the way that it should

differ difficulty feeling full can be another one. And maybe just always feeling hungry chronically.

Feeling shaky, irritable, Dizzy, noticing some really significant symptoms, after not eating for prolonged periods of time, that can be another symptom of insulin resistance, feeling really tired and fatigued after meals, that would be another big one to look for.

And then there’s definitely some some other symptoms too, that would, you know, can can happen really across the board with insulin resistance, but are really common in insulin resistant PCOS. So things like

you know, skin tag, the dark, velvety patches of skin that women will experience in the folds of their skin, irregular cycles, and things like that. I see that a lot in like armpits, people will say like, the darkness in my armpits has gone away. And I’m like, Yeah, that’s like a great sign for insulin resistance. Yeah, I don’t know why I always see it there. It’s so strange. I see it there. And then the back of the neck is another one. Yeah. Yeah, that’s another really common one. I feel like sometimes people don’t even notice it on the back of their neck. Yeah, yeah. There’s probably much more people that have that that have no idea.

Amanda Montalvo 19:38
I was gonna say I don’t think I would notice that if I sit there. Okay. So that’s helpful for exactly what insulin resistance is. So basically, it’s you’re releasing more and more insulin because your cells just aren’t picking up on it. Right. They’re not as sensitive to it. And so I think the big piece that a lot of people miss with this is that you aren’t getting the energy right? Your cells literally aren’t getting that energy.

Jillian Greaves 20:00
So that’s why it leads to a lot of the symptoms of like, constantly feeling hunger, feeling fatigue, like really big energy dips and stuff throughout the day. Really intense cravings because your body’s like, what the heck? Like I haven’t gotten nourishment yet. So it’s, it’s so it’s difficult, but it’s like that’s your body communicating with you. It’s not always a bad thing. It’s like, hey, there’s something deeper going on. Is there like a spectrum? I always talk about like, PCOS and insulin resistance is like a spectrum, because I think sometimes people want they want the black and white, like, do I fall in there or not? Do you think that there’s a spectrum to insulin resistance? And then is PCOS always present? When insulin resistance is present? Yeah, so there is absolutely a spectrum when it comes to insulin resistance. So the severity, you know, is, you know, can be low, moderate, super severe, that can also shift, right, because we have a lot of influence over that. So the severity of insulin can can shift based off a variety of factors, but I definitely see a spectrum. And there are individuals that will be super, super insulin resistant. And you know, their lab work is like screaming insulin resistance and blood sugar issues. And then there’s other women who, you know, their lab work maybe looks normal, in terms of conventional standards, or maybe they don’t even have, you know, lab work. Kind of a full assessment there. And, you know, so they haven’t been told that they have any type of insulin resistance. So you know, they don’t think that they have it, but when we take a look at their symptoms, we can definitely start to identify that there is some degree even if it isn’t, to the extent that you know, maybe other women are experiencing where, you know, things are really screaming and outward. So definitely a spectrum there. And then your other question, what was your other question? I forget, just like, is PCOS always present? Because I think that’s something people kind of wonder like, maybe they haven’t actually gotten the official diagnosis. But they they maybe they have skin tags, they noticed the velvety patches, like they’re taking off like all the symptoms of insulin resistance, they know that they have energy dip issues like it. Do you think that PCOS is always present? Since insulin resistance can kind of like drive that? Or do you see them separate as well? I definitely see them separate. And I’m, I’m curious what your thoughts are on this too. But I definitely see them separate. And it’s talked to a lot you know, about a lot with PCOS. Because you know, it’s really prevalent. But it can completely happen. And it does happen often when PCOS is not a piece of the puzzle. So insulin resistance can occur for for a variety of reasons, it can be driven by so many different factors definitely doesn’t have to be in the presence of PCOS. Yeah, I see it a lot when people are like on that healing journey to, you know, like coming from like, similar background that you had thinking they’re doing all these really healthy things for themselves, maybe they’ve gone low carb, I don’t know, people just think it’s healthy in there. And I get it like we we want to do, it’s coming from such a good place. Like they want to do something really good for themselves and their future health. So they’ll do something like even if it’s, you know, and it doesn’t have to do with weight loss, and then they’re just like, I’m going to lower my carb intake, because that is, you know, touted as one of the healthiest things you can do like avoid sugar, it’s the devil, all that kind of stuff. And then they kind of go through this phase where they’re like, Okay, I’m kind of getting a lot of symptoms, they’re not like hair loss, like, maybe their cycles are getting a little bit longer, or they’re noticing that they didn’t ovulate, they’re getting a lot of hormonal symptoms, that sort of thing, sleep difficulties, and then they’re like, I gotta make some changes. And they maybe they start adding in more carbs working on eating more, more frequently. And they start to notice a lot of those insulin resistant symptoms, because they’re coming from this place of like high stress where that cortisol is driving up that insulin resistance, and then their cells aren’t as used to use utilizing that sugar that glucose as the main energy source. And so it can be, I think, just confusing for people. Because they’re like, Well, I don’t have PCOS. And maybe they’re even ovulating, and they have totally normal cycles. So they just kind of assume that it’s not an insulin resistance or blood sugar thing, but it can still be there, whether PCOS is present or not 1,000% And something to mention there too, that I see a lot, which I think is really frustrating is that oftentimes, insulin resistance is only being looked at when women are in a bigger body, right? So there’s that kind of weight bias in our healthcare system. And you know, you can be at any any body weight and experience issues with blood sugar and insulin. And I think that’s important to mention. Because it you know, it doesn’t always have a certain you know, sort of presentation there. And, you know, it’s just sort of important to look at these things for for really everyone across the board since blood sugar is so important. Yeah, I know. My interest is Emily. She shared her story and like just like tidbits and

Amanda Montalvo 25:00
For an episodes that we’ve done, she’s a very petite woman, and she has PCOS. And she like She definitely had insulin resistance. When she first came to see me, I was like, oh my goodness, like it was just so much with the blood sugar instability, like she could not regulate it. And she was so symptomatic. Her doctors were like no way, you know, like no way that this is an issue for you, just because she’s not overweight. And same thing with people that you can be overweight and have body fat, and still not be insulin resistant. So it’s like, we gotta take the weight kind of out of the equation there and look more at like, your daily habits, what you’re eating your symptoms. And I’ll dig a little bit deeper before just like assuming that someone has does or does not have that.

Yeah, absolutely. I couldn’t agree more.

Hey, Amanda, here, just giving you a quick break, hopefully a break for your brain in the middle of this podcast episode, to remind you that if you haven’t gone through our free training, optimizing hormone health or mineral balance, we really do recommend starting there. And the main reason for that is because you’re going to hear us say things like mineral foundation, having a solid foundation, are you putting the foundations in place, especially what was we get deeper and deeper into different hormonal topics and specific imbalances in the body, though, the mineral foundation is always going to be so essential. So if you haven’t watched the free training, you can find it in our show notes. Or you can go to hormone healing rd.com. And it’s going to be right on that front page there. But we really recommend starting there. So you can understand how is your current mineral status? How do you assess this, and how to get started with all that just so you can get as much as you possibly can out of the rest of the podcast episodes. But that’s it, I hope you enjoy the rest of this episode.

The women that are listening this podcast, I feel hopefully they have a good understanding at this point of like what blood sugar balance means, you know, those slow rolling hills not having too many highs or lows. When it’s out of balance, it creates more stress, more cortisol for the body. And that can really drive up that insulin resistance that makes it hard for your cells to get the nutrients it needs. And the micronutrients too, which is really important, I think to mention that like if we can’t get glucose inside the cell, we’re not going to get those really important vitamins and minerals in there either. Which I think that’s another big driver of like cravings and stuff like that with insulin resistance. But what can they start doing to work on keeping their blood sugar balanced and reducing insulin resistance, or at least like avoiding it in the future?

Jillian Greaves 27:38
Yeah, so I think there’s a few things that anyone can do or look at right off the bat that can be really impactful. And these aren’t always like the most sexy or exciting things to chat about. But they’re, they’re fundamental. And they’re often you know, really game changers in terms of blood sugar balance. So I would say, you know, first and foremost, focus on the basics with your nutrition in terms of meal timing, and meal composition.

Sort of a great starting point or a guideline might be to think about, you know, kind of aligning your pattern of eating with your circadian rhythm. So ideally, having something to eat within, you know, the first hour or two of waking and eating consistently throughout the day. After that, you know, ideally, around every three to four hours is generally my recommendation. But certainly that could could vary based off the individual, but eating really consistently and starting there. In terms of, you know, macronutrients, I would say a really good starting point for a lot of people, particularly women, because I find that so many women I work with just do not get enough of this macronutrient is protein. Think about optimizing protein intake at every single meal. So aim to have a really great quote, quality protein source protein is incredible for, you know, balancing blood sugar, and it basically slows down the absorption of glucose into the bloodstream. So it helps to minimize the big spikes and crashes.

So those are some good starting points with

with nutrition. A couple other things that you know, people could consider related to nutrition would be including a consistent carb source at meals, which might sound scary for some women so totally okay, if you need to start slow and experiment and sort of monitor how your body responds, but really making sure you have that consistent glucose source throughout the day. Super important. And then also with nutrition, maybe thinking about you know, once you’ve you’ve sort of built a foundation with consistent eating and having you know, carbs and protein consistently at meals, thinking about optimizing your micronutrient intake in terms of the quality of foods that you’re bringing in. would be another issue.

For one,

from a lifestyle standpoint, some things that anyone could get started with would be maybe incorporating more movement in the form of things like walking. So things that are really gentle, that a lot of us, you know, often don’t get enough of, especially with, you know, work from work from home life. But, you know, sometimes we think that, you know, in order to impact our health, we have to do all these like crazy intense workouts, which, like I mentioned, can sometimes do more more harm than good for blood sugar. So thinking about maybe incorporating some daily walking or short walks after meals, which can help to improve and promote insulin sensitivity.

Some other kind of lifestyle, things to think about could be, you know, carving out outlets during your day for stress reduction. You know, maybe it means carving out brakes for you know, doing some breath work, or, you know, just stepping away from work and, you know, listening to a podcast or you know, something fun like that, and things that just feel really genuine to you in terms of, you know, calming that nervous system periodically throughout the day.

And then, you know, actually to in terms of going back to movements, something I always like to mention that, I think, sometimes can feel a little bit scary for some women, too, is incorporating strength training. So strength training is incredible for promoting, you know, insulin sensitivity, kind of incorporating that into your, you know, a well rounded workout routine, or movement routine can be really helpful as well. And I think even with a walking piece, it’s like walking is nice, because it kills two birds with one stone, like, it can help lower cortisol. So if you’re, if you’re more stressed, and you’re trying to find a way to reduce that during the day, or at the end of the day, going for an gentle walk is helpful for that. But it’s also great for that blood sugar, it will literally lower your blood sugar. So I mean, I love that I think it’s probably one of the most under utilized underrated things to do for health, obviously, protein is so important. And those animal proteins, right, and so I’m sure people are kind of nodding their head, realizing they’re like, Okay, like, I could definitely work on getting a little bit more protein, that’s usually one of the first things I have women do, if they’re not eating enough, and even just that in and of itself, like if you can balance protein and carbs better, and just kind of get a better understanding of what your body is going to tolerate the best, it’s going to just ease that transition to including the carbs, because one of the biggest mistakes I see people make is adding carbs in without enough protein. Like they’re like excited, they’re like, Yes, I can eat carbs, again, this is amazing. Or oh, these are these foods are actually really nourishing, like potatoes and fruit and plantains and Juca and stuff like that. It’s like, yeah, it’s really actually good for you. It’s just that we want to balance it with that protein so that you’re not going to have this huge spike after eating it. Yeah, exactly. And I think that’s definitely a mistake that I see too. And that can just make you feel really crappy, and then not want to include the carbohydrate. So at the end of the day, I like to remind people too, that, you know, focusing on sort of the slow carbs or carbs that are, you know, really rich in fiber and micronutrients is amazing in terms of, you know, all that deep nutrition that they provide. But at the end of the day, across the board, carbohydrates are meant to be rapidly digested, right, whether they’re like, you know, refined and more, more highly processed, which is, you know, those types of carbs are often more demonized in our culture. But even the the nutrient dense, deep, deep nutrition, carbohydrates are rapidly digested, because that is their job. So the idea is that we want to, you know, utilize carbohydrates in a really smart and supportive way. And that’s going to be thinking about what we’re pairing those things with. I’m also obsessed with potassium, I’m sure you’ve seen my posts and stuff on this. And I feel like we we nerd it out so much about minerals, the last time we all got together. But potassium actually has insulin like effect on the cells, which is, especially during pregnancy, which is just so cool. So if you’re someone that has insulin resistance, and you’re nervous about getting pregnant and developing gestational diabetes, like all these things can also be applied to that situation and just really just be helpful with avoiding that really rapid increase. And it’s just kind of like how can we make it easier for your cells to take up those nutrients? Potassium is really helpful. I always talk about adrenal cocktails, but also also those like those carbs, those like potatoes, a ton of potassium, you know, like butternut squash and stuff like that winter squash is tons of potassium fruit. So a lot of those sources of carbs that we’re talking about that are beneficial, they’re also beneficial because they’re going to give you those micronutrients that are going to support that blood sugar too. Yeah, yeah, exactly. And that

where, yeah, the potassium, you know, and Amanda’s the the mineral expert, but the potassium and the magnesium and all of these, and your zinc, zinc balance, really, but all of these things really, you know, are very, very important for,

Amanda Montalvo 35:15
you know, supporting kind of all of these processes with blood sugar. And that’s where to it’s like, it’s about a lot more than just macros or calories. And we actually have to look at, you know, the, the quality of the food and the micronutrients that we’re bringing in, since a lot of these things are needed for, you know, our bodies to work well. Can you talk a little bit more about how over exercising can make it so that you have more insulin resistance and less balance within that blood sugar? Yeah, absolutely. So, in terms of exercise, exercise is one of those tricky things where you, you know, exercise is a good thing until it’s not, right. So there’s that delicate balance that that we all need to find where, you know, exercise, you know, by nature is inflammatory or, or stressful on the body. So it,

Jillian Greaves 36:05
you know, is a is a form of stress, and in the right sort of context, stress and inflammation produced from exercise can actually be adaptive and supportive and sort of improve our resilience. But in the wrong context, if we are bringing in exercise, a situation where there’s already tons of other stressors on the body, or we’re not providing sort of appropriate recovery and sort of repair support for the body, it can actually just do more harm than good in terms of increasing those stress hormones driving inflammation, both of which, you know, suppressing immune function, all of those things can contribute to dysglycemia, and worsening blood sugar balance. So that’s where it’s like, work smarter, not harder, more is not always better when it comes to exercise. And something that I talk to my clients about a lot is, is evaluating context of things. So like, you know, if you haven’t slept well, or maybe your schedule was crazy, and you recognize, like, Hey, I didn’t really eat enough today, right? And fuel super Well, today’s not the day to jump in and do like an intense workout, hit training going on a long run. So we really need to look at all of these pieces together. Otherwise, we can end up implementing these, you know, seemingly health promoting behaviors, but they’re not healthy in the context of what’s going on in our life. Yeah. And so it’s like just keeping it in context to yourself and your situation. And, you know, is exercise adding more stress to your plate? You know, are you are you getting up insanely early, so that you can get a workout in before your workday, or before your kids get up? Like that sort of thing? And is it really necessary, you know, five to six days a week, and it’s just finding that balance that’s going to work for you. It’s hard, it takes experimentation, but it’s just like food, like, if you’re someone that is going to be increasing protein, I’d focus on that first. But if you’re someone that maybe you feel like you eat enough protein, but you’ve been avoiding carbohydrates, because you’ve been struggling with insulin resistance, but it’s not helping, like it’s not changing anything. And when we think about it, ourselves should be able to use glucose, that is their preferred energy source. So whenever they cannot, whenever someone says, I don’t tolerate carbs, well, I’m like, Okay, why? Right, we want to find out the why, then just slowly starting to add those in and build up your carbohydrate tolerance, like it does take time, I think that’s another big mistake I see people see is that they do like too much too fast. And then they gain weight, and they don’t feel as good and they’re upset. And it’s like, well, we probably just need to go a little bit slower, and make sure that you’re getting enough protein with those carbs. And that’s going to be different for everyone. But I think one of the recommendations or protein I like to give is like point eight grams per pound of body weight works for most people, a minimum of 100 grams a day is a very easy one as well, if you don’t feel like doing math, but even just starting there, and like tracking your food for a few days to see how much am I getting? Most people are shocked to see how little protein they’re getting. And then they’re or just under eating, which is another thing that can drive up the insulin resistance because if you’re not eating enough, you’re gonna have more low blood sugars, more cortisol, more insulin resistant cells. Yep, yeah. And in the case of PCOS, too, it is very, very normal for me to work with an individual that is eating very little exercising a ton and everything is getting worse. All of their, their symptoms are getting worse. And they were given recommendations to eat less and exercise more for insulin resistance. So they’re, they’re thinking that they’re doing something good and everything is going haywire. And as we maybe peel back on the intensity or frequency of workouts, and we start to like really nourish and fuel their bodies more adequately. It’s amazing. And like you said, it definitely can take time and there can be some transitional periods at

Have the body sort of, you know, adapting to the new changes, but it’s really amazing how well the body responds to those things. And everything you know often will start to get better when you’re reducing stress. And there’s more kind of alignment with how you’re fueling and how you’re moving your body. And I feel like PCOS is like one of the more obvious things with blood sugar imbalances and insulin resistant. It’s kind of like okay, well, we know why this is here for the most part. And then of course, doing like, I love hair mineral testing, because you get a bigger look at like our Do you have enough potassium, magnesium, are you using a ton of those? Are they depleted? how stressed out is your body getting that nice picture of stress? But then of course, you know, digging deeper into like hormone levels, do you have digestive issues, which are often paired with a lot of a PCOS symptoms as well. But something that I feel like does not get talked about a lot is thyroid health and how our thyroid function can impact our blood sugar and insulin resistance. Can you go into like why this could be an issue for someone I think no one wants they get a normal TSH and they they’re like, oh, thyroid isn’t my issue. I’m like Brawley is, what can you go into that a little bit more blood sugar, thyroid connection is a, it’s a meaty one, it’s in a really important connection. And it’s the type of situation where blood sugar can directly impact thyroid function. And thyroid function can directly impact blood sugar and blood sugar balance, blood sugar issues alone can drive thyroid issues, primarily because you know, blood sugar, just dysregulation like I mentioned, it’s kind of inflammatory by nature. So persistent low blood sugar triggers all of these stress hormones that can suppress and disturb thyroid function. And then on the other end, you know, the persistent highs with blood sugar and insulin surges can lead to inflammation and be damaging to the thyroid in another way. So that’s sort of how blood sugar issues can disturb the thyroid, but the thyroid or low thyroid function can also really contribute to the blood sugar issues. So basically, when the thyroid isn’t functioning properly, or the thyroid function is low, glucose cannot get into our cells as quickly. And glucose is also not absorbed by the gut as quickly as it should be in sort of a normal circumstance where the thyroid is functioning optimally. Basically, thyroid hormones have a huge, huge impact on glucose metabolism. And something I always like to mention too, is that glucose transporters do require T three inside the cell to work even with early stages of thyroid dysfunction, where maybe things aren’t being picked up on you know, with bloodwork yet, or there’s kind of this cellular hyperthyroidism going on that can lead to blood sugar issues, really, really important, you know, connection there with the thyroid and blood sugar. There’s such a lack of understanding around what optimal thyroid health means. It’s like, it’s not always just oh, we need more thyroid hormone, like you might just need more micronutrients or protein and carbs like proteins. So important low protein diets and research show us that it does lead to a higher TSH, which means slower thyroid function. And then low carb, same thing it and again, it’s because of that cortisol, cortisol has a huge impact on our ability to make and then convert thyroid hormone and the sneaky as part of cortisol is that it can make your TSH low. So it can make it look like if you’re super stressed. At first you can have an actual optimal TSH where that’s that’s a blood marker and your doctor is like nope, thyroid looks good. And so it’s so it’s so hard for people I feel like to get an accurate look at their thyroid without them having to have a really good understanding the way that we treat thyroid health. I mean, it’s just like everything else with that conventional medical system. Like it’s, it’s just such a symptom issue. It’s like oh, okay, your TSH is high, then we’ll give you more thyroid hormone. Whereas it could be that maybe you don’t have adequate iodine maybe you don’t have enough Selenium or zinc or iron. If you can’t use that iron in your body properly, right from low copper and vitamin A. So it’s, there’s usually a way, way deeper issue going on than just thyroid. But I find most often it’s not being picked up. And then it’s it ends up being like the last thing that people are addressing. Oh, yeah, yeah. And or it’s not addressed until there’s like full blown disease if the gland right, you know, I think what you’re describing to in terms of like, you know, nutrient deficiencies are cortisol. And at the end of the day when thyroid dysfunction is spring, or it’s in the early stages, it’s an adaptive protective response to stressors and sometimes we think about stress only as like emotional stress or something like significantly happening in our life. But nutrient deficiencies, the lack of sleep, the imbalances with exercise, all of these different things, you know, really stress the body out and that’s what can you know,

Speaker 2 45:00
really start to lead to this compensation or adaptation with the thyroid, we’re everything sort of slowing down.

Amanda Montalvo 45:06
And it’s, you know, it’s it’s always just a really good reminder that nothing works in isolation in the body, all of our systems work together, even how you were describing how we need T three, that’s the active form of our thyroid hormone in the cell in order to transport that glucose. It just, it really does show. It’s like everything’s connected. And so, I mean, I see a lot of PCOS and thyroid issues. I don’t know if you do in practice. I know it’s super common with PCOS. But sometimes they don’t even have PCOS. And it’s just a thyroid issue.

Speaker 2 45:34
Yep. Yeah. And all of those sorts of symptoms are things that we look for, you know, overlap, right. So sometimes it takes like a bit of digging to figure out like, what’s, what’s sort of causing what, but I see so many thyroid issues in the women I work with, and oftentimes, too, because, you know, women with PCOS are at a much higher risk for thyroid issues. I find that even when women are having, you know, lab work done, even if it’s just a TSH with their conventional health care provider, sometimes their TSH is like, you know, off the charts, and they’re like, oh, you know, you have PCOS. So we sort of expect this and there’s not much done about it, which is wild to me. But yeah, so all that to say, I see a lot of thyroid issues in PCOS, whether it be sort of overt kind of outward thyroid dysfunction, or some of the sort of sub subclinical thyroid dysfunction where people are, you know, super, super symptomatic. And you know, the thyroid is a piece of that picture.

Amanda Montalvo 46:33
The last thing I’ll say on this, I know we have to wrap up is like, when we look like Dr. Broda Barnes he’s I think he’s one of the best kind of researchers and the his work around thyroid health is it’s the most inclusive where it’s like, okay, we can’t just look at the labs, we also have to look at your basal body temperature that can tell you a ton about your thyroid and your symptoms. So basically, for him, it was like some his patients did not need to have sub optimal thyroid bloodwork in order to be treated for a thyroid issue. Now, I don’t think everyone needs thyroid hormone. I think most people need things like iodine and vitamin A, I still love that like where he’s coming from with like, if you have the all the symptoms that line up with it, if you’re cold all the time, you have hair loss, acne, depression, anxiety, so much of depression is misdiagnosed. And it should be hypothyroidism. Which is terrifying, because all these people are not getting treated correctly. And I just think it’s like, if you are struggling with thyroid health, whether you have PCOS or not, and maybe you’re relating to a lot of these blood sugar imbalances, and you’re like, oh, like I like check everything off that list that Jillian just went through. It’s like you want to take that comprehensive look, it’s okay if your bloodwork is not like showing big red flags and completely off, look at your symptoms, look at your body temperature, and then all the things that Jillian went through for like eating enough protein, protein and carbs at your meals, eating regularly throughout the day circadian rhythm, like probably one of the most underutilized things other than walking and just trying to like eat when you’re awake is like really important people that do fasting. I’m like, No, but there’s so many things you can also apply from this episode that are going to help with that thyroid health. Yeah,

Speaker 2 48:13
yeah, absolutely. And I love what you’re describing too. And I think picking up on the early stages of thyroid dysfunction is something that I wish all of us were paying attention to. And again, not waiting until there are these full blown issues requiring, you know, more significant intervention, because you can often support in reverse these things with more sort of nutrition, lifestyle supplement type support.

Amanda Montalvo 48:36
Yeah, so hopefully, people have a better understanding of blood sugar balance and all the different things that impacted stress, thyroid, the foods that we’re eating, sleep, you know, physical activity too much or lack thereof, like so many different things are going to impact this, I do think nutrition is the best place to start. But if you feel like you have that piece covered, I would definitely look into some other areas that Jillian went through. She also has a quiz that you can take if you’re like I don’t know if this is like applicable to me at all. And she has a free guide with 10 key strategies to balance your blood sugar so I’m going to put both of those in the show notes. And then of course follow Julian on Instagram at Julian grieves R D and then I’m going to link her website in the notes as well is there anything you want to leave people with?

Speaker 2 49:21
What I would leave people with is focus on the basics focus on nourishment and if you’re not getting the answers that you are looking for, you know from your provider but your body is telling you something different keep advocating for yourself you know connect with the right people that are going to support you but focus on the basics with with your body

Amanda Montalvo 49:43
no one wants to address their stress let’s just be real. Myself included.

Jillian Greaves 49:48
It’s It’s hard but it’s it’s like those basic things really do help make a difference. So hopefully this episode was helpful. Thank you for being here, Julianne and answering all my questions. Thank you for having me. This was so much

but of course I’m sure we’ll have you on again in the future

Amanda Montalvo 50:08
Thank you for listening to the RU menstrual podcast. If you enjoyed today’s episode, please consider leaving us a review and sharing the podcast with someone you think it will help. If you are new here, we can’t recommend enough to start with our mineral imbalance quiz. This is gonna give you an idea if you are at low, moderate or high risk for mineral imbalances. And then of course, make sure you follow us on Instagram at hormone healing rd. And consider signing up for our newsletter if you like nerding out and you’re just loving these podcasts but maybe you’re a little bit more visual and you want to see things too. We go into a ton of detail in our weekly newsletter. So we would love to have you join us there. All right, thank you and we will see you in the next episode.

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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