Part 2…. STRESS….How Prolonged Periods of High Stress Can Impact Your Progress in Steps 2 and 3!

Last week I wrote about the non-medicinal ways to help with the natural blood sugar rise caused by stress hormones.   Anyone who is under stress will experience a rise in blood sugar (liver glycogen release) triggered by stress hormones such as adrenaline, epinephrine, cortisol.  Those with Met A will respond with the correct amount of insulin to match the blood sugar rise but those with Met B will over-release insulin and actually gain fat (on and in the body),  as well as experience greater fatigue, depression, anxiety, carb cravings, the desire to over-eat, and less ability to stay focused due to the insulin imbalance.  Met B’s usually don’t lose weight or their appetite when stressed; we gain weight and tend to eat more!

With that said, there are some non-medicinal ways to help keep your Met B under control while under prolonged stress:

  1. Revert to Step 1 as the liver is rendered empty of glycogen during Step 1 and will be less able to spike blood sugar and trigger insulin release.
  2. Exercise!  The act of exercise lowers the stress response because
    1. Exercise causes the release of feel good hormones like serotonin…that trump the stress hormones.
    2. Exercise allows the muscles to burn blood sugar, decreasing the blood sugar rise that would trigger excess insulin.
    3. Exercise activates muscle cells to “flag” insulin …enabling the muscles to uptake more blood sugar even after the actual exercise is complete.
    4.  Make sure to take your vitamins, especially your multivitamin at one meal and your B-complex at another as both these supplements contain stress vitamins that will replace vitamins burned from the stress response.

I am a huge fan of the non-medicinal approach to stress and it truly does work.  But what if the person’s stress is going to be so ongoing that the idea of staying in Step 1 for months on end is just too much? Imagine a  long, drawn out, stressful divorce, the lengthy illness of a loved one, intense long term pain from rheumatoid arthritis….there may be no foreseeable end in sight to the stressful situation.  What is another alternative if you can’t exercise as much as you need or can’t stay in Step 1 for months and months?

The medication Metformin, prescribed by your physician based on your metabolic syndrome labs (Met B numbers prior to MM) may be a viable medicinal approach to long term stress and its impact on Met B.

Metformin (Glucophage) is a medication that was first discovered in the 1920’s but was tabled as pharmacological focus was placed on developing insulin in the 20’s.  Decades later, in 1958, metformin was made available in the UK and has been used regularly in the US since 1995.  It was originally prescribed for those with type 2 diabetes who were overweight/obese and had normal kidney function (metformin clears the body through the kidneys).  As you know, everyone with type 2 diabetes has Met B.

You may be familiar with the use of  Metformin as a treatment of PCOS (polycystic ovarian syndrome) which is a product of Met B.   Some physicians now use metformin  to treat those with  metabolic syndrome as insulin resistance is an important factor and metformin helps to reduce resistance to insulin.  It is the only anti-diabetes medication that can help to prevent the cardiovascular complications of diabetes.  It is believed to be the most widely prescribed anti diabetic medication in the world.

Metformin helps to reduce LDL levels and triglycerides (makes sense) and may help with weight loss.  It’s important to understand that in simple terms, metformin puts an added “dam” in front of the liver to help suppress it from releasing excess insulin in times of stress.

During times of stress, Met B’s in Steps 2 or 3 of MM have a liver that is filled with glycogen.  The stress itself causes the liver to over-release blood sugar.  Metformin would help to reduce the amount of glycogen the liver would release.

The medication has few side effects, although about 10% of users experience diarrhea, gas, bloating….if this lasts more than 10 days, you simply don’t tolerate metformin.  To reduce the chance of GI side effects, it’s best to have your MD prescribe it in a graduated way:

Week 1: 500mg at bedtime with snack

Week 2: 500 mg with breakfast and  500mg at bedtime snack

Week 3: 500mg with breakfast and 1000mg at bedtime snack

A serious side effect called lactic acidosis (the build up of lactate in the blood) can occur if overdosed or prescribed to people with contraindications.

So, if your stress is at a very high level and looks as if it will be present for a long period of time, you may want to ask your MD about using metformin with along with Step 2 or 3 of  MM until the stress abates.  It would allow you to stay on Steps 2 and 3 of MM and continue to lose or maintain weight and maintain your health!


About Diane Kress

Author of The New York Times Bestseller; The Metabolism Miracle, The Metabolism Miracle Cookbook, and The Diabetes Miracle. and The Metabolism Miracle, Revised Edition. Owner, developer, and administrator of The Metabolism Miracle's support site: Registered Dietitian, Certified Diabetes Educator, Email:
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