Insulin Excess Test (Hyperinsulinism)
Assess your insulin level with this questionnaire inspired by the work of Dr. Thierry Hertoghe. Insulin excess (hyperinsulinism) is a sign of insulin resistance, often linked to a diet too rich in simple sugars and refined carbohydrates.
Insulin is the key hormone regulating blood sugar, produced by beta cells in the pancreas. When diet is too rich in simple sugars and refined carbohydrates for years, cells gradually become resistant to insulin. The pancreas compensates by producing ever more insulin, creating a state of chronic hyperinsulinism. This vicious cycle drives metabolic syndrome: abdominal weight gain, sugar cravings, postprandial fatigue, chronic inflammation, and ultimately type 2 diabetes. Dr. Thierry Hertoghe, a Belgian endocrinologist and president of the World Society of Anti-Aging Medicine, considers insulin resistance one of the most widespread and underdiagnosed hormonal imbalances of our time. His clinical approach allows detection of hyperinsulinism signs through body observation and eating behavior analysis. This questionnaire is inspired by his work and his Atlas of Hormonal Medicine.
Points forts
- + Detects insulin resistance early before the diabetic stage
- + Links common metabolic symptoms (abdominal fat, cravings) to hyperinsulinism
- + Guides toward dietary and natural solutions (low glycemic index, chromium, berberine)
Limites
- - Symptoms can be confused with other imbalances (thyroid, cortisol)
- - The questionnaire contains only 5 questions, which limits accuracy
- - Blood work (fasting insulin, HOMA-IR, glycated hemoglobin) remains essential
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Understanding the role of insulin
Insulin is an anabolic hormone produced by beta cells in the islets of Langerhans of the pancreas, in response to elevated blood sugar after a meal. Its main role is to allow glucose entry into muscle and fat cells by activating GLUT4 transporters on cell membrane surfaces. When your cells are sensitive to insulin, a small amount is sufficient to do the job: this is called insulin sensitivity, as opposed to insulin resistance where cells no longer respond properly to the signal. This metabolic flexibility is key to health: it allows your body to easily switch from using glucose to using fat as fuel, according to current needs.
Monitoring markers
Clinical signs described by Dr. Hertoghe to monitor your insulin sensitivity include waist circumference (reflecting visceral fat), energy stability between meals (absence of energy crashes or sugar cravings), and absence of food cravings after meals. Biologically, optimal markers to check once a year are: fasting insulin below 10 mIU/L (ideally between 3 and 7), fasting blood sugar below 0.90 g/L, HOMA-IR index below 1.5 (calculated by blood sugar x insulin / 405), HbA1c below 5.5%, and triglyceride/HDL ratio below 2. These optimal values are stricter than standard laboratory ranges but reflect true metabolic health.
Daily prevention
Prioritize low glycemic index foods daily: legumes, green vegetables, sweet potato, quinoa, oat bran, whole fruits rather than juices. Systematically accompany each meal with fiber (vegetables, flax seeds, psyllium) which slows glucose absorption and moderates insulin spikes. Start your day with a protein-rich breakfast (eggs, goat cheese, nuts) rather than toast or sugary cereals, which stabilizes blood sugar for several hours. Walk 15 to 20 minutes after main meals: muscle contraction directly activates GLUT4 transporters, absorbing glucose without even requiring insulin. Avoid snacking between meals to allow insulin to decrease and let your body draw on fat reserves.
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Pathophysiology of insulin resistance
Insulin resistance develops progressively in several stages. Chronically high refined carbohydrate and sugar intake causes repeated insulin spikes that eventually desensitize GLUT4 receptors on your muscle and liver cell surfaces. The pancreas compensates by producing more insulin (compensatory hyperinsulinism), but this excess promotes lipogenesis: excess glucose converts to triglycerides and stores as visceral fat. This abdominal adipose tissue becomes an active endocrine organ secreting pro-inflammatory adipokines (TNF-alpha, IL-6, resistin) that further worsen insulin resistance, creating a true vicious cycle. Meanwhile, the liver becomes fatty (non-alcoholic fatty liver disease), SHBG drops (releasing androgens responsible in women for acne, hirsutism, and PCOS), and protein glycation by AGEs accelerates vascular and tissue aging. This process damages the vascular endothelium and stimulates arterial smooth muscle cell proliferation, increasing cardiovascular risk long before diabetes appears.
Health markers versus laboratory markers
Clinical signs described by Hertoghe allow detection of insulin resistance without blood tests: abdominal obesity (waist circumference above 94 cm in men and 80 cm in women), sugar cravings (especially postprandial energy crash with irresistible sugar urge), excessive thirst and urination, easy weight gain, intense postprandial fatigue (the famous food coma), acanthosis nigricans (brown skin thickening in neck and armpit folds), and skin tags. Biologically, ask your doctor for: fasting insulin (above 10 mIU/L indicates resistance, above 15 it is significant), HOMA-IR (above 2.5 confirms resistance), fasting blood sugar (above 1 g/L), HbA1c (above 5.7% is a warning sign), triglycerides (above 1.5 g/L), triglyceride/HDL ratio (above 3 is a reliable marker of insulin resistance), and uric acid (often elevated in hyperinsulinism).
Low glycemic index diet
The absolute priority is eliminating refined sugars and white flours that cause sudden blood sugar spikes. Replace them with low glycemic index carbohydrates: legumes (lentils, chickpeas, red beans with a GI of 25 to 30), sweet potato (GI 50), quinoa, oat bran, and unlimited green vegetables. Include a protein source at each meal (eggs, fish, poultry, legumes) because proteins stimulate glucagon which counterbalances insulin. Always pair carbohydrates with healthy fats (olive oil, avocado, nuts) because lipids slow gastric emptying and smooth blood sugar curve. Powerful tip: take a tablespoon of apple cider vinegar diluted in water before meals, which reduces the blood sugar spike by 20 to 30% by inhibiting salivary amylase. Aim for 30 to 40 g of fiber daily and regularly consume chromium-rich foods (broccoli, Brazil nuts, nutritional yeast).
Targeted supplementation
Chromium as picolinate or chloride at 200-400 mcg daily improves insulin receptor sensitivity via chromodulin, a protein that amplifies intracellular insulin signaling. Berberine at 500 mg two to three times daily activates the AMPK pathway exactly like metformin, reducing hepatic glucose production and improving cellular glucose uptake. Ceylon cinnamon (Cinnamomum verum) at 1-2 g daily has an insulin-mimetic effect by directly activating insulin receptors. Alpha-lipoic acid at 300-600 mg daily improves muscle cell glucose uptake and protects against oxidative damage from glycation. Magnesium bisglycinate at 300-400 mg daily is essential because insulin resistance is consistently correlated with magnesium deficiency, and vice versa. Inositol (myo-inositol) at 2-4 g daily is particularly interesting in women with PCOS linked to insulin resistance, as it restores intracellular insulin signaling.
Anti-insulin resistance lifestyle
Walking 15 to 20 minutes after each meal is the most powerful gesture: muscle contraction activates GLUT4 transporters independently of insulin, directly absorbing glucose without taxing the pancreas. HIIT (high-intensity interval training) two to three times weekly depletes muscle glycogen stores and durably improves GLUT4 expression. Intermittent fasting 16/8 (16 hours fasting, 8 hours eating) reduces fasting insulin by 20 to 31% according to studies. Strength training transforms your muscles into true glucose sponges: the larger your muscle mass, the greater your glucose storage capacity. Sleep 7 to 9 hours nightly because a single night of poor sleep increases insulin resistance by 25%. Cold exposure (cold showers, cold baths) activates brown fat which consumes glucose to produce heat, improving insulin sensitivity.
Anti-diabetic herbal medicine
Berberine (Berberis vulgaris) is the herbal medicine cornerstone: this alkaloid activates the AMPK pathway, true metabolic switch that improves insulin sensitivity, reduces hepatic gluconeogenesis, and promotes fat oxidation. Gymnema sylvestre is an Ayurvedic plant whose gymnemic acids reduce intestinal sugar absorption, decrease sugar cravings by blocking sweet taste receptors on the tongue, and promote pancreatic beta cell regeneration. Fenugreek contains 4-hydroxyisoleucine, a unique amino acid that stimulates glucose-dependent insulin secretion and improves peripheral sensitivity. White mulberry (Morus alba) inhibits intestinal alpha-glucosidase, slowing complex carbohydrate digestion and smoothing postprandial blood sugar curve. In gemmotherapy, walnut bud (Juglans regia) supports pancreatic exocrine and endocrine function, while olive bud (Olea europaea) is indicated for overall metabolic syndrome with hypoglycemic and hypotensive properties.
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Urgent blood work and cardiovascular evaluation
At this score level, complete blood work is imperative and cannot be postponed. Request as priority: fasting insulin and HOMA-IR (the most direct markers of insulin resistance), glycated hemoglobin HbA1c (reflecting average blood sugar over 3 months), fasting and 2-hour post-meal blood sugar. Complete with cardiovascular evaluation: comprehensive lipid panel (triglycerides, HDL, LDL, triglyceride/HDL ratio), high-sensitivity CRP (vascular inflammation marker), uric acid and homocysteine. Also screen for fatty liver disease with liver enzyme dosing (AST, ALT, gamma-GT) and abdominal ultrasound to visualize liver fat overload. This comprehensive work-up will allow your doctor and naturopath to measure precisely the extent of the imbalance and objectively track your progress.
Strict carbohydrate restriction
At this stage, frank carbohydrate restriction is necessary: limit total carbohydrate intake to less than 100 g daily, equivalent to 2 to 3 servings of low glycemic index starches only. Completely eliminate added sugars, white flours, fruit juices, sodas (even diet ones, as sweeteners maintain sugar taste dependence and disrupt the microbiome), breakfast cereals, and white bread. Each meal must be structured around protein (at least 25-30 g per meal), quality fats (olive oil, avocado, nuts, fatty fish) and unlimited green vegetables. Systematically start meals with vegetables and protein before touching carbohydrates, which reduces blood sugar spike by 40 to 70%. Apple cider vinegar before each meal and soluble fiber (psyllium, chia seeds, konjac) further slow sugar absorption.
Therapeutic-dose supplementation
Berberine at therapeutic dose of 1500 mg daily (500 mg three times daily before meals) is the first-line supplement, with efficacy comparable to metformin on blood sugar and HbA1c in clinical studies. Associate chromium picolinate at 400 mcg daily, magnesium bisglycinate at 400 mg daily (magnesium deficiency directly worsens insulin resistance), alpha-lipoic acid at 600 mg daily (dual action: improves glucose uptake and protects against oxidative stress from glycation), and Ceylon cinnamon at 2 g daily. In women with associated PCOS signs, add inositol (myo-inositol 4 g + D-chiro-inositol 100 mg daily in physiological 40:1 ratio). Finally, high-dose omega-3s (2-3 g EPA+DHA daily) reduce triglycerides and systemic inflammation.
Daily physical activity non-negotiable
Physical exercise is no longer optional at this stage, it is true metabolic medicine. Walking after each meal (minimum 20 minutes) must become a non-negotiable daily ritual to muscularly capture glucose without taxing insulin. Add 3 to 4 weekly resistance or strength exercise sessions: muscle is your primary glucose storage organ, and each kilogram of muscle gained improves insulin sensitivity. HIIT twice weekly depletes muscle and liver glycogen, forcing the body to restore GLUT4 transporters. Intermittent fasting 16/8 is strongly recommended: it drops fasting insulin by 20 to 31% and promotes cellular autophagy. Weight loss of just 5 to 10% of body weight improves insulin resistance by nearly 50%, meaning every lost kilogram counts and produces measurable metabolic effects.
Herbal medicine and gemmotherapy for metabolic support
In therapeutic-dose herbal medicine, combine berberine (Berberis vulgaris, AMPK activator) with gymnema sylvestre (beta cell regenerator and intestinal sugar absorption reducer) and fenugreek (4-hydroxyisoleucine, insulin-sensitizer). White mulberry (Morus alba) as standardized extract inhibits intestinal alpha-glucosidases, reducing postprandial glycemic load. Milk thistle (Silybum marianum) is essential to support the liver overloaded by fatty liver disease, with demonstrated hepatoprotective and insulin-sensitizing action. In gemmotherapy, combine walnut bud (Juglans regia) for pancreatic support, olive bud (Olea europaea) for its hypoglycemic and antihypertensive action in metabolic syndrome, and fig bud (Ficus carica) to reduce food cravings linked to stress. Standard dosage: 10 to 15 drops of each concentrated glycerin macerate, in 3-week courses renewable.
Professional support essential
At this score level, professional support is no longer a luxury but a necessity. Consult your primary care physician for complete blood work, cardiovascular evaluation, and fatty liver disease screening. A naturopath trained in micronutrition can develop a personalized protocol combining low glycemic index diet, targeted supplementation, and herbal medicine adapted to your constitution. Insulin resistance is at the crossroads of many diseases (type 2 diabetes, cardiovascular disease, PCOS, fatty liver disease, certain cancers), but it remains fully reversible when actively managed. First biological results appear in 4 to 8 weeks with rigorous protocol, which is a powerful motivator to maintain changes long-term.
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Voir tous les questionnairesCe questionnaire est un outil d'auto-évaluation et ne remplace en aucun cas un diagnostic médical. Consultez un professionnel de santé pour toute préoccupation.
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