A letter every Sunday.
Five minutes, no noise.

Today’s Sunday Three. Same shape: three small ideas, two things worth your attention, one question to think about. This week grew out of a post I’ve been writing about blood sugar in slim women, the conversation that often never happens because of how someone looks.

Three small ideas

I.

Insulin resistance gets treated as a body size, something that belongs to bigger bodies. It isn’t. It’s how well your cells listen to insulin, and a slim woman can be a poor listener while her blood sugar reads perfectly normal, because her body simply makes more insulin to hold it there. So the standard test comes back fine, and the thing affecting her cycle goes unmeasured.

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II.

If you’re waiting for glucose to move before anyone takes an interest, you’re waiting years. Insulin sensitivity starts drifting long before fasting glucose does, sometimes a decade before. The marker that shows it earlier is fasting insulin, measured at the same time as glucose, and it’s an ordinary test that mostly just doesn’t get run.

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III.

The usual advice here is cut the carbs. That’s rarely what changes it. In a woman already eating well, most of the shift comes from the shape of the day, protein at breakfast rather than only at dinner, what you eat alongside the carbohydrate, whether you’re eating enough at all. Undereating and overtraining push insulin around too, and a slim woman trying to conceive is often quietly doing both.

Two things worth your attention

I.

Move your protein earlier. If breakfast is usually toast, fruit or nothing, add a proper source of protein to it, eggs, yoghurt, whatever you like, and see how the afternoon feels by the end of the week.

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II.

Ask for the fuller number. Next time you have bloods done, ask for fasting insulin alongside fasting glucose, not glucose on its own. It’s the pair that tells you how hard your body is working to look normal.

One question to think about

Where have you been reassured by your size, when your cycle has been telling you something different?

You don’t need to overhaul your food or cut anything out. Pick one small thing, the earlier protein or the request for that fuller panel, and hold it for the week. A small thing you keep does more than a strict plan you drop.

— Lauza

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This week on the blog: You’re not overweight, so no one checked your blood sugar, why blood sugar is one of the first things skipped in slim women, and which markers are worth asking for.