The hemoglobin A1C is one of the best metrics we have for overall health. When it is elevated, we have work to do to restore metabolic health to the patient. There are some affiliate links in this post. Your purchases through my affiliate links help to support my writing habit, and are greatly appreciated. If you haven’t already, I hope you’ll subscribe to this Substack for cutting-edge, uncensored content.
The hemoglobin A1C is included in both my mini-wellness panel and my comprehensive wellness panel, available from DirectLabs.com. Follow this link and click on “order tests” in the menu bar, and you’ll see both these panels under “Featured Tests.”
Why does the hemoglobin A1C go up?
I wrote about this in a recent post, where I explained a few of the hidden reasons for an elevated A1C:
My Monday Masterclass a few weeks ago addressed hidden causes of an elevated A1C:
The bottom line is that the more sugar there is in the blood, the higher the A1C will be.
How do you get too much sugar in your blood?
You get too much sugar in your diet and it overwhelms your ability to metabolize it
You exhaust your ability to transport sugar into your cells where it can be metabolized
You exhaust your ability to metabolize sugar in your cells
Your hormones become imbalanced, leading to chronically high blood glucose levels (high cortisol, low thyroid hormone, low sex steroid hormones, insulin insensitivity or lack of insulin)
All of these things are caused by nutritional imbalances, the accumulation of toxins, and exposure to microbes and parasites, but that's a story for another day.
So what do we do about an elevated hemoglobin A1C?
This isn't medical advice. Consult a qualified practitioner before making changes to your diet or lifestyle. I won't get into type 1 diabetes treatment or management in this blog post. The approach is different in important ways.
The answer is always, "control the sugar coming in and fix the problem with sugar metabolism." A ketogenic diet is an obvious answer to an elevated A1C, but it isn't the only answer. Most people coming to me with an elevated A1C have already tried a ketogenic diet, and it has failed to get them well.
If we need to drop the A1C immediately, a ketogenic diet is the fastest way to do that. However, you will find that if the A1C doesn't drop to normal levels within a matter of weeks to months, then something else is the matter and you'd better expand the scope of your inquiries to find the root of the problem.
You'll often find that these people are making one or more mistakes in the fundamental habits that I include in my daily routine, and that we teach in The Fundamentals of Wellness program. We’re planning a price increase on January 5th, so this is your last chance to get the program at the current price. Don’t miss out - we’re publishing tons of new content to the course in the coming months. What is currently available for just $127.99 for 12 months will probably be $250 per month for 12 months before the end of next year. Join up now to lock in the current price.
Back to the hemoglobin A1C.
The vast, vast majority of people with elevated A1C levels has already tried most of the things I’ve mentioned above.
What do we do for them?
Testing becomes invaluable in these cases. Which is why the hemoglobin A1C is included in both my mini-wellness panel and my comprehensive wellness panel, available from DirectLabs.com. Follow this link and click on “order tests” in the menu bar, and you’ll see both these panels under “Featured Tests.”
Do they have micronutrient deficiencies that could cause hyperglycemia? Perhaps a low copper, magnesium, potassium, or zinc? What about B-vitamins? Trace elements like chromium, selenium, or iodine?
The HTMA is now my favorite test to get to the bottom of an elevated hemoglobin A1C. Toxic metals and mineral deficiencies always play a role, and mineral balancing guided by an HTMA is vital to long-term success.
We’ll be offering our HTMA course again this Spring - sign up for the waitlist here to get a notification when enrollment is live again.
Magnesium is perhaps the most important single mineral for glucose tolerance, which is why I wrote a whole post about how to replete a low magnesium level.
However the vast majority of people have sub-optimal levels of chromium and selenium on hair tissue mineral analysis - so should you take these? I answered this question in this post:
Do they need more sulfur? Sulfur is known to be helpful in restoring normal glucose levels, we think due to its effects on cell membranes. This is why sulfur-rich vegetables and animal products feature prominently in diets that quickly normalize blood glucose levels and therefore the A1C.
What’s the best way to boost sulfur levels? It’s the same as my answer to how to boost your glutathione! My recipe for boosting glutathione is my best answer to boosting sulfur levels.
Do they need more iodine? I will see how they respond to the high-dose iodine protocol.
Guess what’s loaded (pound-for-pound) with magnesium, sulfur, and iodine? Dr. Stillman’s detox powder!
Which is why I wrote about it and keep writing about it. It’s an amazing addition for practically all of my patients.
Last, but certainly not least, iron plays an enormous role in glucose homeostasis, and iron overload will inevitably lead to an elevated hemoglobin A1C.
This is why I wrote a whole post on how to get rid of excess iron:
Wash, rinse, and repeat. As I discussed here and here, heavy metals play a critical role in diabetes, one that is grossly overlooked by most practitioners.
Food allergies, believe it or not, can play a role in this. If the patient can afford a lymphocyte response assay, I'll recommend it. If not, we can always try empiric elimination diets. I wrote more about this here.
And that's the long and short of how I tackle an elevated A1C. There are many, many more variations on this theme, but in the end, this gets the job done in 99 out of 100 cases.
Until next time, be well,
Dr. Stillman