Insulin Resistance: Signs, Symptoms, and What Your Labs May Be Telling You
You eat fairly well. You exercise. Maybe your annual bloodwork even comes back “normal.”
But something still doesn't feel right.
Your energy crashes in the afternoon. You feel hungry shortly after eating. Losing weight has become harder than it used to be. Your triglycerides are creeping up. Maybe your fasting glucose is still technically within the normal range, but it has been slowly increasing year after year.
These changes can sometimes be part of a larger metabolic pattern—including insulin resistance. Insulin resistance can begin long before someone develops prediabetes or type 2 diabetes, which is one reason looking at metabolic health before glucose becomes significantly elevated can be valuable.
At Pillar Health Co., our functional medicine and nutrition approach looks at your symptoms, nutrition, lifestyle, health history, and laboratory findings together to better understand what may be influencing your metabolic health.
What Is Insulin Resistance?
Insulin is a hormone produced by your pancreas. One of its primary jobs is helping regulate glucose in your bloodstream and facilitating its uptake into tissues such as skeletal muscle.
After you eat, blood glucose rises. Your pancreas releases insulin, helping your body use or store that available energy. When tissues become less responsive to insulin, your pancreas may compensate by producing more of it to help maintain normal blood glucose. That is insulin resistance. Early on, the body can compensate remarkably well. Your fasting glucose and A1C may remain within standard reference ranges even while insulin demand is increasing.
We've previously discussed how blood sugar can affect your energy, focus, and workout recovery. Insulin resistance takes that conversation one step further by looking at how effectively the body is responding to insulin in the first place.
Insulin Resistance Doesn't Automatically Mean Diabetes
This distinction is important. Insulin resistance can occur before blood glucose reaches the threshold for prediabetes or diabetes. Someone may have relatively normal glucose while other changes are beginning to appear, such as:
Higher fasting insulin
Increasing triglycerides
Changes in HDL cholesterol
Increasing abdominal or visceral fat
Elevated blood pressure
Fatty liver
Difficulty with weight management
Eventually, if the body's ability to compensate declines, blood glucose may begin to rise.
This is one reason we care about tracking bloodwork and metabolic trends over time rather than only asking whether a single test result falls inside or outside a reference range.
Are There Symptoms of Insulin Resistance?
Insulin resistance often does not cause obvious symptoms on its own. However, certain symptoms and health patterns may lead us to take a closer look at metabolic health.
These can include:
Persistent fatigue
Energy changes after meals
Frequent hunger or cravings
Difficulty losing weight
Increasing abdominal weight
Elevated triglycerides
Lower HDL cholesterol
Elevated blood pressure
Fatty liver
Acanthosis nigricans, or areas of darker, thicker skin
PCOS or irregular menstrual cycles
None of these symptoms confirms insulin resistance by itself. Instead, they provide context that may help determine whether a more comprehensive metabolic evaluation is appropriate.
What Labs Can Help Us Understand Insulin Resistance?
There isn't one perfect laboratory test that tells us everything about metabolic health.
Instead, we can look at several markers together.
Fasting Glucose
Fasting glucose tells us how much glucose is circulating in your bloodstream after a period without food.
It is useful—but it is still a snapshot.
Someone's body may be producing more insulin to maintain a relatively normal glucose level, particularly earlier in the development of insulin resistance.
Hemoglobin A1C
A1C estimates average blood glucose over approximately the previous two to three months.
It is an important marker for evaluating glucose regulation, but it doesn't directly tell us how much insulin the body is producing to maintain those glucose levels.
Fasting Insulin
Depending on the individual, fasting insulin may provide another piece of the metabolic picture.
Looking at insulin alongside glucose and other cardiometabolic markers can sometimes provide additional context about how hard the body is working to maintain glucose regulation.
Triglycerides and HDL
Your lipid panel can provide additional information.
Elevated triglycerides and lower HDL cholesterol are commonly seen as part of the metabolic syndrome pattern associated with insulin resistance.
And there is another laboratory marker that most people don't immediately associate with metabolic health: Uric acid.
Uric Acid: More Than Just a Gout Marker
Most people associate uric acid with gout. And for good reason. When uric acid levels become sufficiently elevated, monosodium urate crystals can accumulate in joints and trigger the intense pain and inflammation associated with gout. But uric acid also has an interesting relationship with metabolic health. Higher serum uric acid levels are commonly associated with insulin resistance and other features of metabolic syndrome.
That doesn't mean an elevated uric acid level proves you have insulin resistance—and it doesn't mean uric acid is necessarily the cause. Instead, uric acid can be another clue within a larger metabolic pattern.
Why Are Uric Acid and Insulin Resistance Connected?
The relationship is complicated. One explanation involves insulin itself. Higher circulating insulin levels can decrease the kidneys' excretion of uric acid. That means hyperinsulinemia may contribute to increasing uric acid levels. Researchers have also investigated whether elevated uric acid could contribute to metabolic dysfunction through mechanisms involving oxidative stress, inflammation, vascular function, and insulin signaling. However, the relationship in humans is still being studied, and association does not automatically establish causation.
For us, the practical takeaway is simpler: Glucose, insulin, triglycerides, HDL, blood pressure, liver health, body composition, uric acid, nutrition, and lifestyle can sometimes create a pattern that tells us more than any single value can on its own. This is exactly why being told your labs are “normal” doesn't always answer why you don't feel your best.
Where Does Fructose Fit Into This?
There is another interesting connection between uric acid and metabolic health: fructose metabolism. Fructose is metabolized differently from glucose, and its metabolism in the liver can contribute to uric acid production. But this doesn't mean you need to become afraid of fruit. Whole fruit comes packaged with fiber, water, vitamins, minerals, and phytonutrients. Eating an apple is very different from drinking a large soda or consuming a diet dominated by highly processed foods and added sugars. The bigger concern is typically the overall dietary pattern and frequent consumption of added sugars, particularly through foods and beverages such as:
Soda
Sweetened coffee drinks
Energy drinks
Sweet tea
Candy
Desserts
Highly processed snack foods
Foods containing significant amounts of added sugar
Instead of labeling one nutrient as the enemy, we want to ask a better question:
What does your overall dietary and metabolic pattern look like?
What Contributes to Insulin Resistance?
There usually isn't one single cause. Insulin resistance can develop through a combination of genetics, lifestyle, body composition, age, medical conditions, medications, and environmental factors. Some of the factors we may consider include:
Nutrition
Dietary patterns high in excess calories, refined carbohydrates, added sugars, and highly processed foods can contribute to metabolic dysfunction in susceptible individuals.
That doesn't mean carbohydrates are inherently bad. The amount, type, timing, and context matter—especially for active people who require adequate carbohydrates to fuel training and recovery.
Muscle Mass and Physical Activity
Skeletal muscle plays an important role in glucose disposal. Regular physical activity—and particularly resistance training—can help improve insulin sensitivity while supporting muscle mass, function, and long-term metabolic health.
Sleep
Poor or insufficient sleep can negatively affect glucose regulation, appetite, recovery, and other aspects of metabolic health.
Stress
Chronic stress can affect sleep, food choices, physical activity, recovery, and hormonal signaling—all of which can influence metabolic health.
Body Composition
Higher levels of visceral fat—the fat stored around the abdominal organs—are strongly associated with insulin resistance and cardiometabolic risk.
Hormonal and Medical Conditions
PCOS, menopause, sleep apnea, certain endocrine disorders, medications, and other health conditions may influence insulin sensitivity.
Genetics and Family History
Some people have a greater inherited susceptibility to insulin resistance and type 2 diabetes. This is why two people can have similar lifestyles and very different metabolic responses.
Improving Insulin Sensitivity Isn't Just About Eating Less
When people struggle with weight or blood sugar, the advice they receive is often simply:
“Eat less and exercise more.”
But metabolic health is more nuanced than that. Depending on the individual, supporting insulin sensitivity and overall metabolic health may involve:
Building meals around adequate protein
Increasing fiber-rich vegetables
Reducing excessive added sugar
Choosing carbohydrates appropriate for your activity level and health goals
Strength training regularly
Increasing daily movement
Improving sleep quality and duration
Managing stress and recovery
Limiting excessive alcohol consumption
Building or maintaining skeletal muscle
Addressing relevant medical or hormonal conditions with the appropriate healthcare provider
The goal isn't to put everyone on the same restrictive diet. It's to identify the factors that matter most for you and create changes that are realistic enough to maintain.
Looking Beyond a Single Lab Value
One of the most useful things we can do when evaluating metabolic health is stop asking only:
“Is this lab value normal?”
And start asking:
“What pattern do these results create when we look at them together?”
Fasting glucose, A1C, insulin, triglycerides, HDL, uric acid, liver enzymes, blood pressure, body composition, symptoms, nutrition, exercise, sleep, medications, and health history may provide considerably more information together than any single measurement provides alone. That doesn't mean every mildly abnormal laboratory value needs treatment. And it doesn't mean every symptom is caused by insulin resistance.
It means context matters.
A Functional Medicine Approach to Metabolic Health
At Pillar Health Co., our functional medicine and nutrition services in Champaign begin with understanding the whole picture.
That can include your:
Current symptoms
Medical and family history
Nutrition
Exercise and recovery
Sleep
Stress
Current medications and supplements
Previous laboratory findings
Personal health goals
When appropriate, additional laboratory testing may be discussed to help gather a more complete picture. From there, we can create an individualized plan focused on the factors that are actually relevant to you—rather than applying the same diet, supplement, or lifestyle protocol to everyone. If you've been told your labs are “normal” but feel like your energy, weight, blood sugar, or overall metabolic health is moving in the wrong direction, it may be worth taking a closer look.
Learn more about Functional Medicine & Nutrition at Pillar Health Co. and schedule a consultation to take a deeper look at your nutrition, lifestyle, laboratory findings, and metabolic health.
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