Jillian Stansbury, ND
We have all seen patients who struggle with their weight and for whom, on taking a look at their diets and their activity levels, we conclude that their biochemical balance must be working against them. Results of tests for thyroid function, diabetes mellitus, insulin resistance, and liver function may help us uncover precise diagnoses in some cases, but in others the hormonal and metabolic imbalances are subtle and the cause of much frustration when patients are told that everything checks out fine. Those with subtle hypothyroidism fall into this category owing to metabolic insufficiency, albeit not severe enough to fit the classic diagnostic criteria. Those with liver and digestion dysfunction may struggle with their weight because biliary insufficiency or simply congestion may lead to an inability to process fats, particularly when in tandem with intestinal atony. Furthermore, the huge and growing category of patients with insulin resistance and metabolic syndrome often struggle with their weight. Therefore, some of the most successful therapies for dropping the excess weight will be multifaceted and involve improving insulin sensitivity, reducing elevated androgen levels, adopting a low glycemic index diet, and enhancing liver and digestive function—not just eating less and exercising more. Improving hormonal balance will support weight loss efforts, and losing weight will support hormonal balance in a mutually reciprocal way. Natural agents that help reduce insulin resistance are chromium, inositol (especially d-chiro-inositol), vitamin D, prickly pear cactus, Stevia, and legumes, among others. A complete list of agents that help reduce insulin resistance includes the following:
- Vitamin D
- Chromium
- Magnesium
- N-acetylcysteine
- d-chiro-inositol
- Pinitol
- Opuntia species (prickly pear cactus fruits)
- Legume foods and herbs
- Glycyrrhiza (licorice)
- Mahonia (Oregon grape roots)
- Stevia leaves
Opuntia Species (Prickly Pear Cactus)
Prickly pear cactus species, including Opuntia ficus subsp indica, are valuable herbal tools for improving insulin resistance. Prickly pear cactus fruits yield a beautiful magenta flesh and juice that have a delicious flavor, something like a cross between strawberries and watermelon. Modern research on Opuntia has shown that these fruits normalize and optimize basic metabolism,1,2 including normalizing blood glucose and cholesterol levels in animal models of diabetes.3 Opuntia juice lowered elevated blood glucose level,4 and diabetic animals achieved improved glucose control under the influence of Opuntia.5 A clinical trial among patients with metabolic syndrome investigated the efficacy of Opuntia on blood fats. Opuntia was found to improve levels of triglycerides and total, high-density lipoprotein, and low-density lipoprotein in as little as 14 days.6 Other studies have confirmed that Opuntia can reduce blood fats7 and promote the liver and muscles to take in glucose, which not only gets the damaging fats and sugars out of the bloodstream but also assists those tissues in using (or “burning”) fats and sugars.8 Although it may take a bit of searching, you can purchase bottles of prickly pear cactus juice, which patients may use to prepare drinks and smoothies. Mix several tablespoons of the brightly colored juice with sparkling water to prepare a delicious and healthy drink, or blend with vinegar and seed or nut oils to prepare a salad dressing.
Stevia rebaudiana (Stevia or Sweet Leaf)
Stevia rebaudiana (Stevia or sweet leaf), a remarkably sweet-tasting leafy herb from the South American Andes, appears to improve insulin resistance and has no calories and a glycemic index of zero.9 Therefore, Stevia is not just a natural sweetener: it is a medicine for processing sweets. Stevia is also naturally high in chromium, which contributes to its medicinal effects. The studies are few and mainly on animals, but Stevia is reported to improve insulin output from the pancreas for type 1 diabetes mellitus and to improve insulin resistance in type 2 diabetes mellitus.10,11 An animal study11 showed that Stevia protects the insulin-producing cells in the pancreas from drugs that typically harm them. Stevioside, one of the most studied compounds in Stevia, has been credited with reducing blood pressure,12 blood glucose level,13 and blood fats14 and with improving insulin production in the pancreas and insulin sensitivity in cells.15-17
Investigators found that whole Stevia leaf may reduce the synthesis of glucose in the liver by affecting enzymes involved, but the researchers reported that isolated stevioside lacked this effect.18 This finding is significant in that some commercial producers are attempting to isolate and refine the sweet-tasting compounds, such as purifying stevioside to yield a table sugar–like product. While products like purified Stevia are certainly healthier than sugar and high-fructose corn syrup and have shown some beneficial effects, it is unlikely that all the antidiabetic effects of the whole Stevia plant can be extended to its isolated molecules. It may be less aesthetically pleasing, but using finely ground whole Stevia leaf in cooking and recipes may be superior to using commercially processed Stevia products.
Commiphora mukul (Guggul)
The steroidal compounds in Commiphora mukul (guggul), the guggulsterones, lower elevated blood fats and sugars through several different mechanisms, including improvement in the liver’s metabolism of fat, enhanced uptake of iodine by the thyroid, and increased production of thyroid hormones.19 Animal investigations have also shown that guggulsterones inhibit the development and maturation of fat-storing cells, called adipocytes.19 Guggulsterones exert direct inhibitory effects on adipocytes, inducing decreased synthesis of new cells, reduced fat accumulation in existing cells, and increased destruction (apoptosis) of fat cells.20 Specific proteins associated with adipocyte functions are suppressed by Commiphora.
Hibiscus sabdariffa
Hibiscus sabdariffa and other species of Hibiscus are beautiful flowering shrubs of tropical regions, whose flowers produce a sour-tasting tea and are emerging as having numerous vascular and medicinal benefits. Hibiscus has the highest chromium content of any plant known, which may contribute to its blood glucose–balancing effects. A clinical trial involving 60 patients with diabetes evaluated the effects of H sabdariffa tea on lipid and lipoprotein levels.21 Patients were randomly divided into 2 groups and were given black tea or Hibiscus tea twice daily for a month. The patients receiving Hibiscus tea showed significantly lower lipid levels, without significant differences in lipoprotein levels compared with the group receiving black tea.
Berberine Alkaloids for Metabolic Support
Mahonia vulgaris (formerly Berberis vulgaris) and Hydrastis canadensis are well-known bitter roots that are used to improve digestive and liver function, and both may support weight loss efforts. Both Mahonia and Hydrastis contain the isoquinoline alkaloid berberine, which has been shown to improve insulin resistance in human investigations.22 Clinical trials among patients with type 2 diabetes mellitus have shown significant reductions in blood glucose, fats, and insulin as evidence of improved insulin response and general metabolism with berberine.23 Researchers in China reported that berberine lowers blood fats by numerous complex effects on cellular enzymes, insulin signals inside cells, and other direct effects on fat cells.24
The Legume Family (All Types of Beans)
Legumes offer many health benefits for blood glucose level, obesity, and metabolic syndrome.25 Legumes in the diet and medicinal herbs in the legume family are beneficial for insulin resistance, hormonal balance, and improved blood glucose and cholesterol levels. Legumes contain fiber, choline, magnesium, lecithin, saponins, and other beneficial compounds, which have been investigated together and individually. Legumes contain d-chiro-inositol (also found in lecithin), and both d-chiro-inositol and the related pinitol enhance the reception of insulin at the cell membranes. Pinitol may be converted to d-chiro-inositol in the body. Pinitol from soy has been shown to support high-density lipoprotein cholesterol and to promote antioxidant enzymes in the liver.26 Legumes and leguminous herbs may supply these inositols and, when eaten on a daily basis, can help those with liver problems, insulin resistance, and blood glucose and cholesterol elevations.
Many Leguminous Herbs May Support Weight Loss
Pueraria Species
Pueraria tuberosa has been shown to support the reception of insulin at cell membrane receptors and transmission of the signal inside the cell.27 A Chinese species of Pueraria, Pueraria thomsonii, has also been demonstrated to have the ability to reduce insulin resistance.28
Astragalus membranaceus (Milk Vetch)
Astragalus membranaceus (milk vetch) may enhance insulin response in cells.29 Astragalus may also improve high blood glucose level by helping the liver and the muscles take up glucose and use it for fuel or convert it to less harmful storage forms.30 The polysaccharides in A membranaceus are credited with an ability to enhance insulin signaling pathways in muscle cells,31 and a small clinical trial reported reduced insulin resistance in patients with diabetes who received Astragalus.32
Medicago (Alfalfa)
Medicago species, such as alfalfa (another legume family herb), contain saponins33 and d-chiro-inositol. Medicago has been a traditional folkloric herbal remedy for diabetes, and modern research has suggested possible enhancement of glucose metabolism with the use of Medicago sativa.34
Glycyrrhiza (Licorice)
A saponin in Glycyrrhiza (licorice) called glycyrrhizic acid demonstrated an ability to improve insulin resistance and fat metabolism in animal models of metabolic syndrome.35 Glycyrrhiza has been found to reduce inflammation and support function in animal models of diabetic kidney damage,36 to improve insulin sensitivity and decrease fat deposition in tissues,35 and to suppress abdominal fat accumulation.37
Trigonella foenum subsp graecum (Fenugreek)
Trigonella foenum subsp graecum (fenugreek) is another legume family plant credited with improving glucose metabolism. One study38 reported that Trigonella lowered blood glucose level in animals with type 1 diabetic mellitus “almost” equally to insulin itself, and another study39 found that it lowered blood glucose level in animals with type 2 diabetes mellitus equally to metformin. Trigonella improves glucose tolerance and reduces elevated blood fats.40 A clinical study41 investigated the effects of Trigonella on blood glucose level in patients with diabetes who were not responding well to sulfonylurea drugs. The study participants were divided into 2 groups; half were given Trigonella and the other half a placebo for 12 weeks. The group receiving Trigonella was reported to have improved fasting blood glucose levels, enhanced glucose control after eating, and better glycated hemoglobin level.
In Conclusion
Finally, I close with a recipe for a high-chromium metabolic support tea:
- Medicago leaves (3 oz)
- Astragalus roots (3 oz), shredded
- Hibiscus flowers (3 oz)
- Berberis roots (2 oz), finely shredded
- Glycyrrhiza roots (2 oz), shredded
- Stevia leaves (1 oz)
- Steep 1 tablespoon of the tea mixture per 1 cup of hot water.
Jillian Stansbury, ND has practiced in SW Washington for nearly 20 years, specializing in women’s health, mental health and chronic disease. She holds undergraduate degrees in medical illustration and medical assisting, and graduated with honors in both programs. Dr Stansbury also chaired the botanical medicine program at NCNM and has taught the core botanical curricula for more than 20 years. In addition, Dr Stansbury also writes and serves as a medical editor for numerous professional journals and lay publications, plus teaches natural products chemistry and herbal medicine around the country. At present she is working to set up a humanitarian service organization in Peru and studying South American ethnobotany. She is the mother of two adult children, and her hobbies include art, music, gardening, camping, international travel, and studying quantum and metaphysics.
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