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Insulin

Complete Testing & Optimization Guide

Optimal ranges, provider comparison, and strategies to improve your Insulin levels

7/10
Providers Include It
METABOLIC
Test Category
2-4x
Annual Testing
✓ Evidence-Based Information✓ Provider Comparison✓ Optimization Strategies✓ Clinical References

✓ Widely Available

Included in 7 of 10 major testing providers

📊 Test Category

Metabolic Health / Glucose

🎯 Reference Range

Fasting:2.6-24.9 μIU/mL, Optimal:<10 μIU/mL

Why Insulin Testing Matters

⚠️ What Can Go Wrong

Abnormal Insulin levels can indicate underlying health issues that may go undetected without proper testing. Regular monitoring helps catch problems early when they're most treatable.

✓ Benefits of Testing

Understanding your Insulin levels enables targeted interventions, tracks treatment effectiveness, and helps optimize your overall health and performance.

What is Insulin?

Insulin is a peptide hormone produced by beta cells in the pancreas in response to rising blood glucose (after meals). Insulin's primary job is to shuttle glucose from the bloodstream into cells (muscle, fat, liver) for energy or storage. It also promotes fat storage, suppresses lipolysis (fat breakdown), and inhibits gluconeogenesis (liver glucose production). Measuring fasting insulin provides critical insight into insulin resistance—the condition where cells become less responsive to insulin, forcing the pancreas to produce more insulin to maintain normal blood glucose.

Here's the critical insight:insulin rises YEARS before glucose. In the progression toward type 2 diabetes, the pancreas compensates for insulin resistance by secreting more and more insulin to keep glucose normal. You can have perfectly normal fasting glucose (70-90 mg/dL) and HbA1c (<5.7%) while having dangerously high insulin (>10 mcIU/mL), indicating severe insulin resistance and metabolic dysfunction. By the time fasting glucose rises above 100 mg/dL, you've already had insulin resistance for 5-10 years, and your beta cells are starting to fail. Measuring fasting insulin catches metabolic disease a decade earlier than glucose or HbA1c.

HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is the gold standard calculated marker:(Fasting Glucose × Fasting Insulin) / 405. HOMA-IR >2.0 indicates insulin resistance;>2.5 is concerning;>5.0 is severe. HOMA-IR is more sensitive than glucose or HbA1c for detecting early metabolic dysfunction and predicts future diabetes, cardiovascular disease, and all-cause mortality.

Why Insulin (and Insulin Resistance) Matters for Longevity

  • Metabolic health:Insulin resistance is THE root cause of metabolic syndrome—obesity (especially visceral fat), hypertension, dyslipidemia (high triglycerides, low HDL), fatty liver, type 2 diabetes.
  • Cardiovascular disease:Insulin resistance drives atherosclerosis, hypertension, and inflammation. High insulin (hyperinsulinemia) independently predicts heart attacks, stroke, and CVD mortality, even with normal glucose.
  • Alzheimer's disease (Type 3 Diabetes):Insulin resistance in the brain impairs glucose metabolism and promotes amyloid plaque accumulation. Alzheimer's is now called "Type 3 Diabetes."High insulin associated with 2-3x higher dementia risk.
  • Cancer:Insulin is a growth factor. Chronic hyperinsulinemia promotes cell proliferation and cancer growth (breast, colon, prostate). Insulin resistance associated with 30-50% higher cancer risk.
  • Aging and longevity:Lower insulin and insulin sensitivity are hallmarks of longevity. Centenarians have exceptional insulin sensitivity. Calorie restriction and fasting extend lifespan partly by lowering insulin.
  • PCOS:Insulin resistance drives androgen excess in women, causing PCOS (irregular periods, hirsutism, infertility). Lowering insulin reverses PCOS.

Bottom line: TSH and Free T4 alone miss people with conversion problems. Free T3 is the only way to know if you have enough active thyroid hormone at the tissue level.

Optimal vs Standard Reference Ranges

Range TypeLevelClinical Significance
Optimal (Longevity)<5 mcIU/mL (fasting)Exceptional insulin sensitivity. Associated with longevity, low CVD risk, optimal metabolic health. Target for healthspan optimization.
Good (Standard)5-7 mcIU/mLNormal insulin sensitivity. Acceptable for most people but room for improvement with lifestyle optimization.
Suboptimal (Early Insulin Resistance)7-10 mcIU/mLMild insulin resistance. Beta cells compensating to maintain normal glucose. Intervene NOW with diet, exercise, weight loss to reverse.
Insulin Resistance10-15 mcIU/mLModerate insulin resistance. HOMA-IR likely >2.5. High risk of progressing to prediabetes/diabetes. Requires aggressive lifestyle intervention.

Standard lab range:Fasting:2.6-24.9 μIU/mL, Optimal:<10 μIU/mL

How to Optimize Insulin

1. Severe Insulin Resistance

>15 mcIU/mL

2. Severe hyperinsulinemia. HOMA-IR likely >5. Metabolic syndrome, prediabetes, or early type 2 diabetes. May need metformin + intensive lifestyle.

Very High (Beta Cell Failure)

3. >20 mcIU/mL or declining from high

Very high insulin (>20)=severe resistance. If insulin starts DROPPING despite worsening glucose, beta cells are failing (advanced diabetes).

4. Reverse Insulin Resistance with Diet (Most Effective)

Low-carb or ketogenic diet:Restrict carbs to <100 g/day (low-carb) or <50 g/day (keto). Eliminates insulin spikes, depletes liver glycogen, forces fat oxidation. Lowers insulin by 30-50% within weeks.

Intermittent fasting (IF):16:8 (fast 16 hours, eat within 8-hour window) or alternate-day fasting. Fasting drops insulin to baseline, enhances insulin sensitivity, promotes autophagy.

Eliminate processed carbs and sugar:White bread, pasta, rice, sugary drinks, desserts spike insulin. Replace with whole foods, vegetables, protein, healthy fats.

Prioritize protein and fiber:Protein (1.6-2.2 g/kg) preserves muscle during weight loss. Fiber (25-35 g/day) slows glucose absorption, reducing insulin spikes.

5. Exercise (Resistance + HIIT)

Resistance training:THE most effective exercise for improving insulin sensitivity. Heavy compound lifts (squats, deadlifts, bench) 3-4x/week build muscle, which is metabolically active and glucose-hungry. Increases GLUT4 receptors (glucose transporters) in muscle.

High-intensity interval training (HIIT):20-30 min sessions 2-3x/week improve insulin sensitivity more than steady-state cardio. Depletes muscle glycogen, forcing insulin-independent glucose uptake.

Post-meal walks:10-15 min walk after meals lowers post-meal glucose and insulin by 20-30%. Simple and effective.

Symptoms of Abnormal Insulin

Low Insulin

  • Weight Loss (Especially Visceral Fat)

Note: Lose 5-10% body weight:Even modest weight loss dramatically improves insulin sensitivity. Losing 10 kg (22 lbs) reduces fasting insulin by 30-40%. | Target visceral fat:Visceral (belly) fat is metabolically toxic, secreting inflammatory cytokines and free fatty acids that worsen insulin resistance. Measure waist circumference;goal <40 inches (men), <35 inches (women). | Calorie deficit + resistance training:Preserve muscle mass while losing fat. Muscle is insulin-sensitive;fat (especially visceral) is insulin-resistant.

High Insulin

  • Metformin (if lifestyle insufficient)

Note: Metformin:500-1000 mg twice daily. First-line medication for insulin resistance and prediabetes. Reduces hepatic glucose production, improves insulin sensitivity, aids weight loss. Lowers fasting insulin by 20-30%. | Evidence:Diabetes Prevention Program showed metformin reduces diabetes incidence by 31% in prediabetics (lifestyle changes were more effective at 58%). | Side effects:GI upset (diarrhea, nausea) in 20-30%, usually resolves. Start low (500 mg once daily), titrate up. May lower B12—supplement or check annually.

Causes of Abnormal Insulin

Low Insulin:

  • Sleep and Stress Management

High Insulin:

  • Sleep 7-9 hours:Sleep deprivation (even one night) acutely worsens insulin resistance by 30-40%. Chronic sleep debt (≤6 hours) doubles diabetes risk.
  • Manage stress:Chronic stress elevates cortisol, which promotes gluconeogenesis and insulin resistance. Meditation, deep breathing, yoga improve insulin sensitivity.
  • Avoid late-night eating:Eating close to bedtime worsens insulin resistance due to circadian misalignment. Stop eating 3 hours before bed.

When to Retest

Scientific Evidence

High fasting insulin >10 mcIU/mL indicates insulin resistance even if glucose is normal. HOMA-IR >2.0 confirms insulin resistance.

Low insulin is rare and usually indicates:|Type 1 diabetes:Autoimmune destruction of pancreatic beta cells. No insulin production. Requires exogenous insulin replacement.|Advanced type 2 diabetes with beta cell failure:After years of hyperinsulinemia, beta cells burn out and insulin production drops. Glucose rises dramatically.|Hypopituitarism:Pituitary failure reduces growth hormone and other hormones that stimulate insulin secretion.

Source:Low insulin with high glucose=beta cell failure (type 1 or advanced type 2 diabetes). Requires insulin therapy.

Obesity:Visceral fat secretes inflammatory cytokines (TNF-alpha, IL-6) and free fatty acids that block insulin signaling.|Sedentary lifestyle:Physical inactivity reduces GLUT4 expression in muscle, worsening insulin resistance.|High-carb, processed diet:Chronic carb/sugar intake causes chronic hyperinsulinemia → downregulation of insulin receptors → resistance.|Metabolic syndrome:Cluster of visceral obesity, hypertension, dyslipidemia, insulin resistance. Affects 35% of US adults.|Genetics:Family history of type 2 diabetes increases risk 2-6x. Certain ethnicities (South Asian, Hispanic, African American) have higher risk.|PCOS:Insulin resistance drives ovarian androgen production in 70-80% of PCOS cases.|Chronic stress and cortisol excess:Cortisol promotes gluconeogenesis and antagonizes insulin.|Sleep deprivation:Even short-term sleep restriction (≤6 hours) worsens insulin resistance by 30-40%.|Medications:Glucocorticoids (prednisone), atypical antipsychotics (olanzapine), protease inhibitors (HIV meds).|Aging:Insulin sensitivity declines with age due to sarcopenia, fat gain, and mitochondrial dysfunction.

Type 1 diabetes:Autoimmune destruction of pancreatic beta cells → no insulin production → high glucose, low/absent insulin.|Advanced type 2 diabetes with beta cell exhaustion:After years of compensatory hyperinsulinemia, beta cells fail → insulin production drops → glucose rises.|Insulinoma (very rare):Insulin-secreting pancreatic tumor causes episodic hypoglycemia with inappropriately high insulin. Diagnosed with supervised fasting test.|Exogenous insulin use:Type 1 diabetics or advanced type 2 diabetics on insulin therapy will have high measured insulin.

Source:Baseline:Check fasting insulin (with fasting glucose) if risk factors for insulin resistance:overweight/obesity, family history of diabetes, PCOS, metabolic syndrome, fatty liver.|Calculate HOMA-IR:(Fasting Glucose mg/dL × Fasting Insulin mcIU/mL) / 405. HOMA-IR >2.0=insulin resistance;>2.5=significant;>5.0=severe.|After lifestyle intervention:Retest fasting insulin and glucose after 3-6 months of diet, exercise, weight loss. Expect 30-50% drop in insulin with successful intervention. Goal:insulin <7 mcIU/mL, HOMA-IR <2.0.|If starting metformin:Retest after 3 months. Metformin should lower fasting insulin by 20-30%.|Annual screening:For anyone with prediabetes, metabolic syndrome, PCOS, or strong family history of diabetes.|Fasting required:Must fast 8-12 hours (water only). Test in morning. No food, coffee, or supplements before test.

Insulin Resistance Predicts Diabetes Decades Before Diagnosis

Fasting insulin rises 5-10 years before glucose becomes abnormal. Studies show elevated insulin (>10 mcIU/mL) predicts type 2 diabetes development with 3-4x higher risk over next decade, even with normal glucose. HOMA-IR >2.5 predicts diabetes with 5-6x higher risk. Measuring insulin catches pre-diabetes much earlier than glucose or HbA1c.

Source:Tabak AG, et al. Trajectories of glycemia, insulin sensitivity, and beta cell function before diagnosis of type 2 diabetes. Lancet. 2009;373(9682):2215-2221.

Hyperinsulinemia and Cardiovascular Disease

Elevated fasting insulin independently predicts cardiovascular events (heart attack, stroke) and CVD mortality, even after adjusting for glucose, BMI, and other risk factors. Meta-analyses show each 5 mcIU/mL increase in fasting insulin associated with 20-30% higher CVD risk. Insulin promotes atherosclerosis, hypertension, and vascular smooth muscle proliferation.

Source:Despres JP, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med. 1996;334(15):952-957.

Insulin Resistance and Alzheimer's Disease

Insulin resistance in the brain impairs glucose metabolism and promotes amyloid-beta accumulation. Alzheimer's is increasingly called "Type 3 Diabetes."High insulin and HOMA-IR associated with 2-3x higher dementia risk. Metformin and lifestyle interventions that improve insulin sensitivity may reduce Alzheimer's risk.

Source:De la Monte SM, Wands JR. Alzheimer's disease is type 3 diabetes. J Diabetes Sci Technol. 2008;2(6):1101-1113.

Which Providers Test Insulin?

✓ Superpower
Included in standard panel
✓ Blueprint
Included in standard panel
✓ Mito Health
Included in standard panel
✓ Function
Included in standard panel
✓ InsideTracker
Included in standard panel
✓ Marek Health
Included in standard panel
✓ Life Ext.
Included in standard panel
7 out of 10 providers include this test in their standard panels.

Compare Providers

ProviderIncludes TestAnnual CostTotal Biomarkers
Superpower logoSuperpower$199100+
WHOOP Advanced Labs logoWHOOP Advanced Labs$34965
Labcorp OnDemand logoLabcorp OnDemand$39830+
Life Extension logoLife Extension$48640+
Everlywell logoEverlywell$46883
Mito Health logoMito Health$798100+
InsideTracker logoInsideTracker$68048
Function Health logoFunction Health$499100+
Marek Health logoMarek Health$90070+
Blueprint Advanced logoBlueprint Advanced$1150110
Quest Health logoQuest Health$Varies75+

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Frequently Asked Questions About Insulin

What does Insulin test for?

Insulin is a metabolic health / glucose biomarker that Hormone that regulates blood sugar The normal reference range is Fasting:2.6-24.9 μIU/mL, Optimal:<10 μIU/mL. Regular testing helps track changes and identify potential health issues early.

Which blood test providers include Insulin?

7 out of 10 major blood testing providers include Insulin in their standard panels. These include Superpower, Blueprint, Mito Health and others.

How often should I test Insulin?

For most people, testing Insulin 2-4 times per year is recommended to establish baseline levels and track trends. If you have abnormal results or are actively working to optimize this biomarker, more frequent testing (quarterly) may be beneficial. Always consult with your healthcare provider for personalized testing frequency recommendations.

What is the optimal range for Insulin?

The standard laboratory reference range for Insulin is Fasting:2.6-24.9 μIU/mL, Optimal:<10 μIU/mL. However, many functional medicine practitioners recommend tighter "optimal" ranges for peak health and performance. Your ideal range may vary based on your age, sex, health goals, and other individual factors. Work with a healthcare provider familiar with optimal ranges to determine your target levels.

Do I need a doctor's order to test Insulin?

Most direct-to-consumer blood testing services that include Insulin provide the physician order as part of their service. However, some states have restrictions on direct-to-consumer testing. Check with your chosen provider about availability in your state and whether they provide the necessary physician authorization.

Why is Insulin important for my health?

Elevated fasting insulin indicates insulin resistance before blood sugar rises. Early marker of metabolic dysfunction and diabetes risk. Essential for assessing metabolic health.

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Medical Disclaimer

This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs and before making decisions about blood testing.