Published January 27, 2023 Last year, I decided to get serious about balancing my blood sugar so that I could finally reach my fitness goals and improve my hormones – more specifically, my insulin and testosterone levels, which were getting a little too high for my doctor’s liking. High insulin drives chronic inflammation and increases testosterone production, creating symptoms like hair thinning, weight gain, acne, and excessive body hair that we often see in those with PCOS. Elevated insulin also lowers sex hormone binding globulin, resulting in greater amounts of free, unbound estrogen. This contributes to symptoms of estrogen excess i.e. fibroids, heavy periods, and PMS. And what causes our insulin to be chronically high? Blood sugar spikes from the meals, snacks, and sweets that we eat! If you’re new to this concept, start with this blog to learn what a blood sugar spike is and exactly how it leads to hormonal chaos. When I first explored this concept, I wasn’t all that happy with my weight, or rather, my body composition (which is what really matters vs. obsessing over the scale) – and yet no matter how healthy I thought I was eating, I wasn’t necessarily seeing tangible results. When I thought about my labs, and how my fasting insulin and blood sugar were creeping higher and higher each year, I realized that I had to learn how to eat to balance my blood glucose levels so that my hormones were in a better place. I began working with an incredible sports nutritionist who helped me implement a three fold plan to resensitize my tissues to insulin, balance my blood sugar and get my hormones in check: Consistent weight training 3x/weekEating way more protein and fiberUtilizing medicinal herbs and foods therapeutically to help my body utilize glucose more effectively I started with diet and upping my protein intake. I realized I wasn’t eating nearly enough protein to not only build more muscle mass and achieve the body shape + composition I desired – but I wasn’t even consuming enough to maintain the muscle mass I currently had! You need at least 30g protein per meal to stimulate muscle protein synthesis (MPS). Eating protein-forward also drastically blunts your post-meal glucose spike, which you can learn all about in this podcast episode with my doctor. As soon as I centered my meals around protein and added more fiber from veggies, beans and fruit (which also lowers blood sugar), I started to see a huge change in my body composition thanks to better glucose regulation! Next up, weight training was the best gift I ever gave myself… but it didn’t come easily. It took a lot of practicing form at home before I even had the confidence to step foot in a gym, but once I did I never looked back. Lifting is such a valuable practice because the more muscle you build, the more insulin sensitive you’ll become. Why? Because muscle is the most insulin sensitive tissue in the body, and the more you have of it, the more that the glucose you eat gets shuttled into muscle instead of floating around in your blood creating inflammation and hormonal chaos. Finally, I utilized an unsuspecting food-as-medicine tool before meals to help my body utilize carbohydrates more effectively: good old apple cider vinegar (ACV)! Simply taking anywhere from a teaspoon to a tablespoon of vinegar diluted in water before meals can actually blunt glucose spikes by up to 30%. This is because the acetic acid in vinegar helps those beautiful muscles that you’re building uptake glucose more effectively so that it’s used for energy instead of, again, hanging around in your blood creating inflammation. Furthermore, vinegar also reduces the amount of insulin present, helping you to stay in fat burning mode. Not only did this trick help my digestion, but within two weeks I saw a difference in three things: my energy levels post meal (no longer getting “the itis”)my midsection – which can be a very stubborn area for meand my chin hair!!! The fact that I was no longer weekly sprouting brand new chin hairs was a major sign that my testosterone levels were normalizing thanks to a reduction in my insulin levels (remember, chronically high insulin in response to blood glucose spikes is what drives high testosterone and contributes to PCOS). Pre-meal vinegar shots were so effective for me that I went back to my herbalist roots and made it even more powerful by infusing full strength blood-sugar-balancing herbs into a base of apple cider vinegar instead of my usual alcohol or glycerin. GlucoBitters was born, an herbal vinegar tincture that combines the benefits of ACV with the power of craving-crushing and blood-sugar-reducing botanicals. WHY IS VINEGAR A POWERHOUSE FOR REDUCING BLOOD SUGAR? Not only does vinegar help flatten glucose spikes when taken before meals (by up to 30%), it reduces the amount of insulin we need to release to compensate for that glucose response (similarly by about 20%!) which is huge for fat burning, body composition, and hormones. Vinegar’s mechanism of action is two-fold: The acetic acid in vinegar temporarily blunts the effect of the enzyme that turns complex food → to simple glucose when carbohydrate-rich foods come into contact with our saliva. Sugars and starches are converted to glucose at a much slower rate, meaning that glucose hits our bloodstream at a slower rate, too!That same acetic acid found in vinegar also has an effect on our muscle tissue, helping our muscles uptake and utilize that food-turned-to-glucose much more effectively. When your muscles can uptake glucose for fuel, less of it is left floating around in the blood creating “high blood sugar.” THE SCIENCE ON VINEGAR Thanks to the scientific method (and the diligence of researchers who decided to study little old vinegar!), we now have data showing just how powerful vinegar can truly be for blunting glucose spikes and supporting us in everything from weight loss to PCOS management and insulin resistance. VINEGAR + WEIGHT MANAGEMENT In a Japanese study, researchers set out to understand the effects of vinegar intake on the reduction of body fat in overweight subjects. The subjects were randomly assigned to three groups based on similar body weight, body mass index (BMI), and waist circumference. During the 12-week experiment, the subjects in each group ingested 500ml daily of a beverage containing either no vinegar (placebo, 0 ml), 15 ml of vinegar, or 30 ml of vinegar. Body weight, BMI, visceral fat area, waist circumference, and serum triglyceride levels were all significantly lower in both vinegar intake groups than in the placebo group. In another study, two groups of participants were put on a standard weight-loss diet with only one group taking vinegar before meals. The vinegar group lost twice as much weight (11 vs. 5 pounds) even though caloric intake was identical across both groups. They also saw improvements in visceral fat (which hangs out in the abdomen, around our organs) as well as triglyceride levels. VINEGAR + METABOLIC HEALTH In a meta-analysis reviewing the body of data surrounding vinegar, metabolic health, and glucose control, researchers found that amongst available clinical trials, there was a significant reduction in post-meal glucose and insulin levels in participants who consumed vinegar compared with control groups who consumed no vinegar or a placebo. Another review stated, “based on available evidence, we hypothesize three pathways by which vinegar may improve blood glucose: the inhibition of α-amylase action; increased glucose uptake; and mediation by transcription factors. When evaluating the current body of literature, daily vinegar intake [..] appears to improve the glycemic response to carbohydrate-rich meals.” VINEGAR + PCOS Seven patients seeking an alternative treatment for PCOS were instructed to consume a diluted beverage containing 15g of apple vinegar daily over the course of about 3 months. Ovulation, cycle length, fasting blood glucose, fasting insulin, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testosterone were compared before and after implementation of their daily vinegar. Intake of the vinegar beverage resulted in a decrease of all markers related to insulin resistance in 6 out of the 7 patients (as evaluated by something called the homeostasis model assessment insulin resistance index aka HOMA-R). There was also a significant decrease in the LH/FSH ratio in 5 of the 7 patients, which is important as this ratio affects ovulation. Ovulatory menstruation was additionally observed within 40 days in 4 out of the 7 patients. The researchers state, “These findings suggest the possibility of vinegar to restore ovulatory function through improving insulin sensitivity in PCOS patients, thus, avoiding pharmacological treatment.” THE FUTURE OF THERAPEUTIC VINEGAR: ACV + HERBS? While vinegar alone is shown in the above studies to be a highly successful and reliable intervention as a therapeutic food for reducing blood glucose and insulin resistance, supporting weight management, as well as remedying the root cause factors seen in PCOS, there’s always potential to improve and innovate on such a powerful foundation. As I worked with my nutritionist to reduce my own early markers and signs of a possible PCOS trajectory, I was using not only plain ACV, but a blend of herbs as well to help resensitize my tissues to insulin and speed the process of metabolic restoration. These botanicals include therapeutic herbs like Gymnema, Bitter Melon, Fenugreek, Cinnamon, and more – all of which have solid and ever-evolving data to back up their benefits in the lens of glucose regulation, PCOS, and even type 2 diabetes. I thought about the PCOS study above, where by the end 4 out of 7 (about 50%) of the participants had restored, ovulatory cycles… and wondered how much better their results could have been if the herbs I’d studied for years in school and (was using myself!) were added into their integrative treatment protocol. Synergy is what happens when the whole is greater than the sum of its parts alone, and I knew that stacking blood sugar botanicals with vinegar would yield the most robust outcome. I began to experiment as I formulated and extracted my own blend of the herbs I was taking into a base of pure vinegar, which is called an “herbal vinegar” or vinegar extract in the herbalism world (you can click here to read all about an herbal vinegar and how to make one!) MEET GLUCOBITTERS After my herbs were finished extracting, I switched from plain ACV to my newly concocted herbal ACV which contained not only the acetic acid that makes vinegar so powerful, but the potent phytochemical extracts from the herbs that were synergistically helping my journey and transformation. I found this formula to be even more powerful than plain vinegar alone, and have been utilizing it ever since before carb-heavy meals, sweets and desserts (especially if I’m having those sweets without additional protein and fiber to blunt any glucose spike). These studies make it clear that plain ACV is not only a powerful tool, but extremely cost effective – so as always, feel free to use the kitchen medicine style most accessible version of this tool. However, for those who want their vinegar to pack an extra punch, my GlucoBitters formula is launching next week and combines ACV with evidence-based, blood-sugar balancing botanicals in one simple vinegar tincture that you can bring with you on the go to restaurants and while traveling. My passion is refining and innovating to create the best possible tools that I wished for in each stage of my journey, and this is something I’m really proud of. I hope you love this formula, and as always, if it’s not for you I’d love to hear how you’re implementing classic vinegar as a tool into your life!