GLUT4

And the requirement for aggressive potassium replacement during this protocol is rooted in the sodium-potassium ATPase pump.

When insulin binds to its receptor on the cell surface, it doesn't just trigger the translocation of GLUT4 transporters to bring glucose inside.

It also heavily stimulates the NAK ATPase pump.

This pump actively drives three sodium ions out of the cell and pulls two potassium ions into the cell.

So IL-6 can signal to the liver to break down glucose because the liver stores glycogen, just like the muscle, and it can then undergo glycogenolysis breaking down glycogen and then that glucose is released into the blood and then that can be available for muscle contraction so it can be metabolized by the working muscles it can also signal in adipocytes to release fatty acids which then can be metabolized by the working muscles It can signal actually the level of the muscle itself to increase the number of glucose transporters present on the surface of the muscle fibers.

So GLUT4 gets translocated or moved to the surface of the muscle fibers to help basically suck up glucose from the blood into the muscle.

So all of these things seem to be beneficial.

And another interesting component seems to be that IL-6 at least has been implicated as signaling within the brain and the central nervous system to actually cause us to experience fatigue.

very important for everything that I do in my clinical work.

Those use these GLUT4 transporters, which are insulin dependent.

And so when those areas are under stress, and the whole organism's under stress, which is true from adverse childhood events, chronic stress from your job or your relationships, poor sleep, poor diet, you're under stress, that's going to lead to that insulin resistance in those specific areas of the brain.

And you could have a perfectly normal, hemoglobin MNC can be 5.0 and your fasting insulin could be four.

So, you know, if in your job, you know, all of a sudden everything's changing and you feel like you can't change along with it, you think of how much stress you're gonna feel, right? And then you're not sleeping well and then you are afraid to go to work and then you get in trouble and then you're even more depressed.

And so these are the areas that lead to people having these mental health challenges.

And those are, again, those are the areas that are really susceptible to insulin resistance because they rely on these GLUT4 transporters.

Unlike other areas of the brain, which, you know, don't, they use other types of glucose transporters that don't rely on an insulin signal.

Inside your muscle cells are little glucose doorways.

Scientists call them GLUT4 receptors.

When you do strength training, you build more of them and move them to the surface so sugar can get out of your blood and into the muscle without needing as much insulin at all.

That's a good thing.

The team also took muscle biopsies to look for a mechanism.

They found more of a protein called GLUT4 moving to the surface of muscle cells in the creatine group.

GLUT4 is the glucose transporter that muscle uses to pull glucose out of the blood.

And exercise and insulin both move it to the cell surface so it can effectively work.

Creatine appeared to amplify that effect.

Here's how it works.

Inside your muscle cells are glucose transporters called GLUT4.

Think of them as transport proteins that can be brought to the cell's outer membrane.

Both insulin and muscle contraction can signal those transporters to move to the cell surface.

They help glucose move from the blood to inside the muscle cell, where it can be used for energy or stored for later.

That means that movement gives your body another way to handle circulating glucose.

And when physical activity becomes a regular habit, it can increase the amount of GLUT4 in muscle and improve insulin action.

Over the long term, regular walking is associated with a lower risk of developing type 2 diabetes.

And then just think what could happen when you do move and if you exercise.

And like you say, the role of muscle is being much better understood nowadays, isn't it? We've got the, I think it's the sort of the GLUT4 transporter, which actually effectively sucks glucose out of the bloodstream independently of insulin levels and pancreas.

So if you're diabetic and you exercise, that will help control your blood sugar levels even better than what you may be able to do

with drugs alone.