"My blood sugar is fine, but I can't lose weight no matter what I do."
This is one of the most common frustrations I hear, and it's often the first sign that insulin resistance is already underway, long before a fasting glucose or A1c shows anything abnormal. By the time those numbers move, the pattern has usually been building for years.
Here's how we think about it differently.
This conversation tends to come up in a few different ways. Maybe your labs are borderline, not diabetic, but not quite normal either, and you're looking for a more natural, whole-body approach before things progress. Or maybe you're in the maintenance phase of a GLP-1 medication, or thinking about coming off one, and you want to know what actually supports your metabolism once the medication isn't doing the heavy lifting. Both of these are the same underlying question: how do I support my body's insulin sensitivity for the long run, not just treat a number.
What Insulin Resistance Actually Is
Insulin's job is to help glucose move out of your bloodstream and into your cells for energy. When your cells stop responding to insulin efficiently, your pancreas compensates by producing more of it. For a long stretch of time, this compensation can keep your blood sugar numbers looking normal, even while insulin itself is climbing.
That's the part conventional screening often misses. Fasting glucose and even A1c can stay in range while fasting insulin is already elevated. By the time glucose numbers shift, insulin resistance has typically been present for a while.
Why a Functional Medicine Lens Matters Here
Insulin resistance isn't caused by one thing, and it rarely responds to just one intervention. A functional medicine approach looks at the full picture: diet, stress, sleep, activity level, inflammation, and nutrient status, rather than treating it as a single number to bring down.
This matters because two people with the same fasting glucose can have very different drivers. One might be dealing with chronic stress and elevated cortisol. Another might have a nutrient deficiency affecting how their cells respond to insulin. The plan should reflect the person, not just the lab value.
Common Contributing Factors
- •Chronic stress and elevated cortisol
- •Poor sleep quality or insufficient sleep
- •A diet high in refined carbohydrates and low in fiber
- •Sedentary patterns, especially prolonged sitting
- •Underlying nutrient deficiencies (magnesium, chromium, vitamin D, zinc, and others)
- •Visceral fat accumulation, which itself worsens insulin sensitivity over time
The Power of Targeted Supplements
Diet and movement are the foundation, but for many patients, specific nutrients and botanicals can meaningfully support the picture alongside those changes. This isn't about replacing lifestyle work with a supplement, it's about giving your body additional tools while you make those changes.
Some of what we consider, depending on your labs and history:
Berberine
Often discussed as a natural counterpart to metformin for its effects on blood sugar and insulin signaling. Response varies by individual.
Chromium
May support insulin sensitivity and help reduce sugar cravings, particularly relevant for patients who struggle with afternoon or evening cravings.
Alpha lipoic acid
An antioxidant that may support insulin sensitivity and is also studied for nerve-related symptoms in longstanding blood sugar dysregulation.
Magnesium
A large percentage of people are insufficient in magnesium, and low levels are linked to impaired glucose uptake at the cellular level.
Zinc
May help support balanced blood sugar levels as part of a broader nutrient strategy.
CoQ10
Supports cellular energy production, which matters since insulin-resistant cells are, in a sense, energy-inefficient.
B-complex vitamins
Play a role in glucose metabolism and may help reduce sugar cravings.
Cinnamon (as a concentrated extract)
Has been studied for modest effects on blood sugar regulation as part of a broader plan.
None of these work in isolation, and none of them are a substitute for addressing diet, sleep, and stress. They're tools we may layer in based on your specific labs and symptoms, not a generic stack everyone gets handed.
Supplements can interact with medications and aren't right for everyone. What's appropriate for you depends on your full history, current medications, and lab results, which is why this is a conversation with your provider rather than something to self-start.
Supporting Your Metabolism During GLP-1 Maintenance or Taper
If you've been on a GLP-1 medication and you're now in the maintenance phase, or planning to come off it, this is actually one of the most important times to pay attention to nutrition and metabolic support, not less.
Here's why: GLP-1 medications work partly by significantly reducing appetite and intake. That's the point, but it also means many patients unintentionally take in less protein and fewer micronutrients during treatment. Over time, this can contribute to muscle loss, not just fat loss, and muscle is one of your body's most metabolically active tissues, the more of it you have, the better your insulin sensitivity tends to be.
So as you taper down or come off the medication, the goal shifts: you want your body's own insulin sensitivity, appetite regulation, and metabolic rate to be as strong as possible, since the medication is no longer doing part of that work for you. This is where the same nutrients discussed above become especially relevant, alongside making sure you're getting enough protein and key vitamins that may have been running low during treatment.
What this often looks like in practice
- •Prioritizing protein at each meal to help preserve and rebuild muscle
- •Rechecking nutrient levels that commonly run low with reduced intake (B12, iron, vitamin D, magnesium)
- •Continuing targeted blood sugar support (like the options above) to help maintain the insulin sensitivity gained during treatment
- •Reintroducing food volume gradually and mindfully, since appetite regulation is still recalibrating
Getting These Nutrients Through Food, Not Just Supplements
Supplements can help fill specific gaps, but food is still doing most of the work, especially if your appetite has been reduced for a while and every bite needs to count nutritionally.
- •Magnesium — leafy greens, pumpkin seeds, almonds, black beans
- •Zinc — meat, shellfish, legumes, pumpkin seeds
- •Chromium — broccoli, whole grains, green beans
- •B-complex vitamins — eggs, leafy greens, whole grains, lean meats
- •Alpha lipoic acid — red meat, spinach, broccoli, Brussels sprouts
- •CoQ10 — organ meats, fatty fish, whole grains
- •Protein (especially important during and after GLP-1 use) — lean meats, fish, eggs, Greek yogurt, legumes
Metabolically, this combination does double duty: the protein and B-vitamins support muscle maintenance and energy production, the magnesium and chromium support how your cells respond to insulin, and the antioxidants (alpha lipoic acid, CoQ10) help offset some of the cellular stress that comes with blood sugar dysregulation. Food and supplements aren't competing strategies here, they're working on the same system from two directions.
What We Test
Since standard screening can miss early insulin resistance, we often look beyond a basic glucose check:
- •Fasting glucose and HbA1c
- •Fasting insulin, which frequently rises before glucose does
- •A comprehensive metabolic panel
- •Lipid panel
- •Relevant nutrient levels (magnesium, vitamin D, and others depending on your history)
Questions I Get Asked Often
What causes insulin resistance?
A combination of factors, most commonly chronic stress, poor sleep, a diet high in refined carbohydrates, inactivity, and underlying nutrient deficiencies. It usually builds gradually rather than appearing suddenly.
How can I improve insulin sensitivity naturally?
Diet quality, regular movement, stress management, and sleep are the foundation. Targeted supplements may support the process alongside those changes, based on your individual labs and history.
What are the best supplements for insulin resistance?
There's no single answer, it depends on your labs, symptoms, and other health factors. Berberine, chromium, magnesium, and alpha lipoic acid are commonly discussed options, but the right combination is individualized.
Does berberine work for insulin resistance?
Many patients and studies point to meaningful effects on blood sugar and insulin signaling, similar in some ways to metformin, though individual response varies and it should be used under guidance given potential interactions.
What is a functional medicine approach to blood sugar?
It means looking at the underlying drivers, stress, sleep, nutrient status, and inflammation, rather than only treating the glucose number itself.
What should I take after stopping a GLP-1 medication?
This depends on your labs and how your appetite and intake changed during treatment, but it often includes protein prioritization, rechecking key nutrient levels, and continuing targeted blood sugar support to help maintain the insulin sensitivity gained during treatment.
How do I maintain my results after coming off a GLP-1?
Focus on preserving muscle through adequate protein, continuing movement, and supporting your body's own insulin sensitivity, since the medication is no longer providing that support. This is individualized and worth planning with your provider before you taper.
If This Sounds Like You
Whether your labs are borderline and you're looking for a natural, whole-body approach, or you're navigating the maintenance phase of a GLP-1 and want to protect your progress long-term, this is worth a real conversation rather than guesswork.
Ready to take the next step?
Book a consultation with Blaise Integrative Medicine to review your symptoms and build a personalized plan.
This post is for general education and does not replace individualized medical advice.
— Dr. Yana Blaise, DNP, FNP-BC
Blaise Integrative Medicine | Optimize. Restore. Thrive.
