ABOUT THIS EPISODE
What if insulin resistance is quietly driving inflammation, weight gain, and thyroid dysfunction years before blood sugar ever looks abnormal?
In this episode of Modern Thyroid and Wellness, McCall McPherson sits down with endocrinologist Dr. Alessia Roehnelt for an in-depth conversation about insulin resistance and why it can be such an important marker of long-term metabolic health.
Dr. Roehnelt explains how insulin functions in the body, what happens when insulin resistance develops, and why chronically elevated insulin can contribute to inflammation, weight gain, metabolic dysfunction, and disease progression.
They also explore the bidirectional relationship between insulin resistance and hypothyroidism, including how thyroid dysfunction can worsen metabolic health and how insulin resistance can complicate thyroid function and treatment.
🔑 In This Episode:
- What insulin resistance is and how it develops
- Why insulin resistance may appear before prediabetes or type 2 diabetes
- Common physical and metabolic signs of insulin resistance
- Acanthosis nigricans, carb sensitivity, and rapid weight fluctuations
- The relationship between insulin resistance and hypothyroidism
- How insulin resistance may affect thyroid hormone absorption and conversion
- Why fasting insulin can provide useful information beyond A1c alone
- “Normal” vs. optimal fasting glucose, insulin, and A1c values
- Why population-based lab ranges do not always reflect optimal health
- The role of vitamin D in metabolic and hormonal health
- Fatty liver markers including AST and ALT
🏃♀️ Improving Insulin Sensitivity
Dr. Roehnelt and McCall discuss foundational strategies including:
- Consistent, restorative sleep
- Strength and resistance training
- Reducing refined carbohydrates
- Pairing carbohydrates with protein and fat
- Using continuous glucose monitors to better understand personal responses
- Strategic intermittent fasting when appropriate
💊 Medications Discussed
Metformin
- Improves insulin sensitivity
- Has a long history of clinical use
- Can be a cost-effective early intervention
GLP-1 receptor agonists
- Reduce appetite and slow gastric emptying
- Lower liver glucose production
- Improve insulin signaling
- May help reduce inflammation in appropriate patients
🌿 Key Takeaways
Insulin resistance can often be improved when identified early.
“Normal” lab values do not always tell the entire story, and weight gain is far more complex than calories in versus calories out.
One of the biggest themes in this episode is that inflammation connects metabolic dysfunction, thyroid disease, and autoimmunity, making individualized, whole-body evaluation incredibly important.
📖 Pre-Order Take Back Your Thyroid + Get a Free Bonus
Pre-order McCall McPherson’s new book, Take Back Your Thyroid, and choose one free bonus:
🎓 Thyroid Empowered Course — a $399 value
OR
🩺 $150 off a new patient visit at Modern Thyroid Clinic
👉 https://book.modernthyroidclinic.com/
📍 Connect with Dr. Alessia Roehnelt
Website & Practice:
Instagram:
https://www.instagram.com/endohealthdoc/
Facebook:
https://www.facebook.com/alessia.roehnelt
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https://www.mccallmcpherson.com/
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