Insulin has gotten a bad
reputation in the low carb and keto communities. But insulin isn’t a bad thing.
Too much insulin, too often, is a bad
thing. If you ask people whose homes are threatened by wildfires whether lots
of rain would be a good thing, you’ll probably get a very different answer than
if you ask people whose homes have just been destroyed by hurricane floods.
Water is not a problem; too much or too little water is a problem, and it’s
the same with insulin.
So I’m not trying to demonize
insulin. I wrote an 8-part blog series detailing the gnarly and nefarious effects of chronically
elevated insulin (soon to be 9 or 10 parts -- new posts coming soon!), but the
operative phrase there is chronically elevated. In and of itself, insulin isn’t
a problem. (Just ask a type 1 diabetic.) The bad stuff happens only when
insulin is too high, too often. Now that that’s out of the way, on with the
show!
We know for certain that PCOS
(polycystic ovarian syndrome)—which is “is the most common endocrinopathy of
reproductive aged women affecting 6-10% of the population,”—is driven primarily by chronic hyperinsulinemia.
(Incidence may be as high as 18% among certain cohorts when different diagnostic criteria are
used, putting the number of women affected worldwide at around 10 million.)
“Hyperinsulinemia associated with
insulin resistance has been causally linked to all features of the
syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism and
metabolic disturbances.” (De Leo et al., 2004)
In fact, the causal link (not
just an association!) between hyperinsulinema and PCOS is so well-known (and so
powerful) that metformin—best known as a diabetes drug—is among the frontline
pharmaceutical interventions for PCOS. Keep this in mind as you read about the
men’s issues here.
Facial hair, acne, oily skin,
mood swings, weight gain, menstrual irregularities, and infertility are not the
only signs and symptoms of PCOS. These signs & symptoms are driven by the
underlying hormonal disturbances, which include: elevated insulin, increased
adrenal androgen synthesis (more testosterone and/or DHEA), decreased sex
hormone binding globulin (SHBG), increased luteinizing hormone (LH), and
decreased follicle stimulating hormone (FSH). And while the stereotypical PCOS
patient is overweight or obese, as many as 50% of women with PCOS are not overweight or obese. (Remember, chronic hyperinsulinemia leads to
obesity in some people, but not all. There are millions of people walking
around with a “normal” body weight, but sky-high insulin levels.)
Since men produce all of
these hormones as well, could there be a male equivalent of PCOS?
You bet your bald spot there is!
Let’s take a look at three
different areas where chronic hyperinsulinemia has adverse effects on men:
- Early onset androgenetic alopecia (a.k.a. male-pattern baldness)
- Erectile dysfunction
- Benign prostatic hypertrophy (BPH) – enlargement of the prostate gland
