Insulin Resistance and Your Fertility Story

(This article draws on my current professional development in the Toxic-Heat course by Naava Carmen from The Fertility Support Company, exploring the links between immune function, inflammation and unexplained infertility through a TCM and biomedicine lens.)

Insulin resistance shows up quietly with fatigue, brain fog, sugar cravings, a stubborn layer around the middle, long before bloods flag anything on a standard panel.

And yet insulin sits at the centre of so much I see in clinic: cycle irregularities, recurrent headaches, low SHBG, poor egg and sperm quality, inflammation that doesn’t shift and embryo implantation issues.

The mechanism traces back to the mitochondria, the energy-processing factories inside every cell. Their job goes well beyond producing energy. Mitochondria are also central to hormone production and immune regulation, which is why mitochondrial dysfunction rarely shows up as just one thing.

It plays a significant role in PMOS health and you don’t have to be overweight to have insulin resistance.

Healthy metabolism is flexible. Cells move freely between burning glucose and burning fat, and both processes happen inside the mitochondria. But when mitochondria are compromised by inflammation, oxidative stress, toxins, infection or a disordered immune response, that switching ability breaks down.

Insulin resistance is often the natural endpoint: overwhelmed mitochondria signal cell receptors to stop responding to insulin. It’s a downstream consequence more often than a starting point.

What compromises mitochondria in the first place is rarely one thing. Chronic inflammation, toxins, viruses, bacterial infections, nutritional deficiencies, weak antioxidant systems, physical or psychological stress, and certain medications all play a part. And the relationship runs in both directions…inflammation damages mitochondria, and damaged mitochondria generate more inflammation, through the release of reactive oxygen species and the effect of mitochondrial stress on immune signalling.

So inflammation = insulin resistance

and

insulin resistance = inflammation

This is exactly why so many of my clients are already doing so much right and still not seeing the shift they’re after. CoQ10 is one of the most common supplements I see people taking (and I recommended) to support egg and sperm quality, and for good reason it supports mitochondrial function directly.

But if insulin resistance is actively driving mitochondrial dysfunction upstream, that CoQ10 may not be able to do it’s job. The supplement isn’t wrong. It’s just not the whole picture.

The reassuring part is how much of this responds to targeted, evidence-based change:

• protein
• movement for muscle
• gut repair
• sleep
• structured fasting (a minimum of twelve hours overnight, ideally thirteen to fifteen)
• stress management
• sleep

None of this happens in isolation. Insulin, inflammation, mitochondrial health, stress and sleep move as one current…nudge one, and the others shift too. This is exactly why I look beyond the reproductive system when I assess a client’s fertility profile as the answers so often sit somewhere else in the body.

Things I now look for when assessing insulin resistance

• HBA1C
• Fasting glucose
• Fasting insulin
• SHBG
• Liver function tests
• Lipid studies
• Case history – including family history and body changes over time, diet history
• Continuous glucose monitor – track over a menstrual cycle and comparing with symptoms like mood changes and headaches has been helpful

If you’d like to know more about your own insulin resistance picture, email me at hello@paigewatersacupuncture.com.au – Paige

*A quick note: I’m not a journalist. I use Claude to help me get my thoughts down clearly. The ideas are mine, the editing is mine, the voice is mine (with help from Danielle at Readcity Writing), but the execution has a little AI help along the way. It means I get to spend more of my time doing what I love most…working out how to support your fertility.