“My glucose is creeping up. Does that mean I’m becoming diabetic?”
“My doc says I have high cholesterol. Do I need to be on cholesterol meds?”
I hear questions like these all the time.
And one of the first things I want people to understand is that cholesterol, blood sugar and stress are not three completely separate conversations.
They’re connected.
Your body isn’t a collection of individual parts working independently. Your liver, hormones, pancreas, muscles, nervous system, sleep, stress response and the food you eat are constantly communicating with one another.
So if your cholesterol is elevated or your glucose is starting to creep upward, rather than simply asking:
“How do I get this number down?”
I think there’s a much more useful question:
“Why might this number be changing in the first place?”
Let’s break it down.
First, what exactly is glucose?
Glucose is simply sugar in your bloodstream, and we need it. It’s one of the body’s primary sources of energy.
When you eat carbohydrates, your body breaks many of them down into glucose. Your pancreas then releases a hormone called insulin.
Think of insulin a little like a traffic director.
It helps move glucose out of your bloodstream and into your cells, where it can be used for energy or stored for later. Some of that glucose gets stored in your liver and muscles as glycogen, and both have limited storage capacity. When there’s more energy coming in than your body can use or store, that excess gets stored as fat for later. (Or, let’s be real… sometimes never. #IYKYK)
This is also where insulin gets its reputation as a “fat-storage hormone.” Insulin doesn’t just help move glucose out of your blood; it signals that fuel is available and encourages the body to store energy while temporarily putting the brakes on releasing stored fat.
And that’s exactly what it’s supposed to do. This is normal, healthy physiology.
The problem isn’t insulin. The challenge develops when we’re asking insulin to do this job over and over again, particularly in the context of lots of sugar and refined carbohydrates, more energy coming in than the body needs, inactivity, loss of muscle, poor sleep and chronic stress.
Over time, the cells can become less responsive to insulin.
We call this insulin resistance.
The body often compensates by making more insulin. For a while, that extra insulin may be enough to keep blood glucose looking relatively normal.
That means insulin resistance can sometimes be developing before fasting blood glucose becomes obviously elevated.
Eventually, however, the body may have more difficulty keeping up. Blood glucose can start creeping higher and A1C may rise.
That’s when you may start hearing terms such as prediabetes or type 2 diabetes.
Fasting glucose vs. A1C — what’s the difference?
These are two numbers people often see on their bloodwork.
Fasting glucose is essentially a snapshot. It tells us how much glucose is circulating in your blood at that particular time, usually after you haven’t eaten overnight.
A1C gives us a broader view. It estimates your average blood glucose over approximately the previous two to three months.
Neither number tells the entire metabolic story by itself, but together they can provide useful information.
If glucose or A1C is elevated, it’s important to discuss it with your healthcare provider. Prediabetes and diabetes are diagnosed according to established medical criteria, not simply by how someone feels.
But from a natural-health perspective, I’m also interested in what may be contributing to those numbers.
And that brings us to cholesterol.
What does blood sugar have to do with cholesterol?
Potentially quite a bit.
For years, many of us were given a very simple message:
High cholesterol = you’re eating too much fat or cholesterol.
But human metabolism is considerably more complicated than that.
Your liver actually produces much of the cholesterol found in your body.
And cholesterol itself isn’t something we want to eliminate.
We need cholesterol.
Your body uses it to help build cell membranes and produce steroid hormones, bile acids and vitamin D.
The question isn’t whether cholesterol is “good” or “bad.”
The better question is:
What does your overall lipid pattern tell us about your health and cardiovascular risk?
And glucose and insulin can be part of that story.
Here’s where carbohydrates come into the picture
Carbohydrates aren’t inherently bad.
Vegetables contain carbohydrates. Fruit contains carbohydrates. Beans and lentils contain carbohydrates. Many incredibly nutritious foods contain carbs.
So this isn’t about becoming afraid of carbohydrates.
What matters is the type, amount and context.
A diet containing large amounts of sugar and highly refined carbohydrates can create a very different metabolic response than one built primarily around whole foods, vegetables, fibre, adequate protein and minimally processed carbohydrate sources.
When we’re regularly consuming more carbohydrate and overall energy than the body can use or store efficiently, the liver can convert some of that excess energy into fat.
The liver packages some of these fats into particles called VLDL and sends them into circulation.
One of the things we may then see on bloodwork is higher triglycerides.
Insulin resistance is also commonly associated with a particular lipid pattern:
Higher triglycerides
Lower HDL cholesterol
Changes in LDL particles
And this is the connection I really want you to understand: when your body isn’t handling glucose and insulin well, the effects don’t necessarily stay confined to your blood sugar. Your liver is right in the middle of this conversation. It helps manage both glucose and fats, so changes in glucose and insulin metabolism can change the amount and types of fats and cholesterol-carrying particles the liver sends into your bloodstream.
In other words, a blood sugar problem can also show up as a cholesterol/triglyceride problem.
That’s an important distinction, and one of the reasons I don’t look at cholesterol in isolation.
So what do LDL, HDL and triglycerides actually mean?
If you’ve ever looked at a cholesterol panel and wondered what all those letters mean, you’re not alone.
Here’s the simplified version.
LDL
LDL particles carry cholesterol from the liver through the bloodstream to tissues throughout the body, where it can be used.
I like to think of LDL particles as delivery trucks on the highway. The cholesterol is the cargo, and LDL particles are the trucks carrying that cargo where it needs to go.
So when we see a lot of LDL circulating in the blood, it’s a little like looking out at the highway and seeing an unusually large number of delivery trucks.
Yes, the number of trucks matters. Too many LDL particles circulating over time can increase cardiovascular risk.
But I also want to know why there are so many trucks on the road in the first place.
That’s the difference between looking at an isolated number and looking at the bigger metabolic picture.HDL
Is the liver sending out more? Is the body having difficulty clearing them? What role might genetics, insulin resistance, thyroid function, menopause, diet, inflammation or other metabolic factors be playing?
In other words, I don’t want to simply look at the traffic and say, “We need fewer trucks.”
I want to understand why the traffic increased.
HDL
HDL is commonly called “good cholesterol.”
If we continue with our highway analogy, you might think of HDL as part of the return or clean-up crew. It helps collect excess cholesterol from tissues and transport it back toward the liver, where it can be recycled or eventually eliminated from the body.
This is one reason higher HDL has traditionally been associated with better cardiovascular health.
But it isn’t quite as simple as saying:
High HDL = protected.
Having a higher HDL doesn’t automatically cancel out elevated LDL or other cardiovascular risk factors. The number of particles on the road, what they’re carrying, how your body is handling them and the overall metabolic environment all matter.
Again, it’s the pattern we’re interested in… not one number in isolation.
Triglycerides
Triglycerides are a form of fat circulating in your bloodstream.
This is a number I find particularly interesting from a metabolic perspective.
Elevated triglycerides can accompany insulin resistance and can also be influenced by excess energy intake, refined carbohydrates, added sugars, alcohol, body composition, genetics and certain health conditions.
When triglycerides are climbing while HDL is dropping and glucose is creeping upward, I start paying particular attention to the overall metabolic picture.
What about ApoB?
You may also hear about a marker called ApoB.
ApoB can give us information about the number of potentially artery-damaging lipoprotein particles circulating in the bloodstream.
For some people, it provides useful information beyond LDL cholesterol alone and can help a healthcare provider assess cardiovascular risk more completely.
You don’t necessarily need every advanced test available.
The important point is that total cholesterol alone doesn’t tell the whole story.
Now let’s add cortisol
This is where things get even more interesting.
Cortisol often gets called the “stress hormone,” and somehow we’ve turned cortisol into another thing we’re supposed to get rid of.
But cortisol isn’t bad.
You need it.
Cortisol helps regulate your sleep-wake cycle, blood pressure, immune activity and energy availability.
One of its jobs is to make sure you have enough fuel available when you need it.
Imagine you’re being chased by a bear.
Your body doesn’t stop and think:
Hmm. Sharlene hasn’t eaten in four hours. Perhaps we shouldn’t raise her blood sugar.
It gets fuel into your bloodstream.
Fast.
Your liver can release more glucose so your muscles and brain have immediate energy available to deal with the threat.
That’s a brilliant survival mechanism.
The problem?
Most of us aren’t being chased by bears.
We’re lying awake worrying.
We’re rushing from appointment to appointment.
We’re dealing with deadlines, finances, relationships, caregiving, constant notifications, poor sleep and a brain that never seems to completely switch off.
Your thinking mind knows the difference between an angry bear and an overflowing inbox.
Your stress physiology may still respond to both.
Can cortisol raise blood sugar?
Yes.
One of cortisol’s roles during stress is to make sure there is plenty of glucose available in your bloodstream for immediate energy.
That’s helpful during short periods of stress.
But when stress becomes chronic (especially when combined with poor sleep, inactivity, excess energy intake or other metabolic challenges) it can make glucose regulation more difficult in susceptible people.
Over time, chronic stress and disrupted sleep can contribute to insulin resistance, increased appetite, changes in body-fat distribution and poorer metabolic health.
And now we can start connecting the dots.
Food can affect glucose.
Insulin helps manage glucose.
Stress hormones such as cortisol can also increase glucose availability.
Chronically poor glucose and insulin regulation can influence triglycerides and other lipid patterns.
Suddenly, cholesterol, cortisol and glucose don’t look like three unrelated subjects anymore.
Does stress cause high cholesterol?
This is where I want to be careful.
It would be overly simplistic to say:
“Stress causes high cholesterol.”
There are many reasons someone’s cholesterol may be elevated.
Genetics can play a role. So can thyroid function, menopause, diabetes and insulin resistance, body composition, dietary patterns, smoking, alcohol, certain medications and other medical conditions.
Dietary saturated fat can also significantly increase LDL cholesterol in some people.
But chronic stress can influence the metabolic environment in which cholesterol problems develop.
If stress is disrupting sleep, increasing blood glucose, worsening insulin sensitivity, changing appetite, contributing to abdominal fat gain and reducing someone’s ability to move and recover well, it can become one piece of a much larger metabolic puzzle.
That’s why I want to know what’s happening in someone’s life, not just what’s happening on their lab report.
And then midlife enters the conversation
For women, there’s another important layer.
Menopause can change the metabolic landscape.
Estrogen influences insulin sensitivity, lipid metabolism, vascular health and where we tend to store body fat.
As estrogen declines through perimenopause and menopause, LDL cholesterol often increases.
Some women also become less insulin-sensitive. Muscle mass can gradually decline, particularly without resistance training, and body fat tends to shift toward the abdominal area.
Then add disrupted sleep and increased stress, both incredibly common during midlife, and suddenly the body may respond very differently than it did at 30 or 35.
This is something I hear from women constantly:
“I’m eating the same way I’ve always eaten. Why isn’t it working anymore?”
Because your body isn’t exactly the same body metabolically.
That doesn’t mean you’re doomed to gain weight, develop diabetes or have high cholesterol.
It means the strategy may need to change.
This is why I don’t look at one number in isolation
Let’s imagine a woman comes to me because her cholesterol has increased.
I want to know more.
What’s happening with her triglycerides?
What is her HDL?
What is her LDL?
What does her fasting glucose look like?
What about A1C?
If available and appropriate, what does insulin tell us?
What’s happening around her waist?
How is her blood pressure?
How does she sleep?
How much muscle does she have?
Does she resistance train?
How much does she move during the day?
What kinds of carbohydrates is she eating?
Is she getting enough protein and fibre?
What kinds of fats make up most of her diet?
How much alcohol is she drinking?
What’s happening with her thyroid?
Is she menopausal?
How much stress is she under?
And what’s her family history?
Now we’re no longer trying to “fix cholesterol.”
We’re trying to understand the person who produced the cholesterol result.
That’s a very different conversation.
So what can you actually do?
This is the part I want you to remember.
We don’t need to become afraid of cholesterol.
We don’t need to become afraid of carbohydrates.
And we certainly don’t need to become afraid of cortisol.
We want to create an environment in which the body can handle glucose, insulin, fats and stress more effectively.
Start with real food
Build most meals around minimally processed whole foods.
Prioritize vegetables, adequate protein, fibre and foods that provide good nutritional value.
If your diet contains significant amounts of sweets, sugary drinks, white flour products and highly processed foods, reducing those can make a meaningful difference to glucose and triglyceride regulation.
That doesn’t mean you can never eat bread or dessert again.
It means your everyday pattern matters.
Pay attention to the fats you’re eating
Reducing sugar doesn’t mean replacing everything with unlimited butter, cream and other saturated fats.
For cardiovascular health, emphasizing unsaturated fats from foods such as extra-virgin olive oil, nuts, seeds, avocado and fish can make sense for many people.
Again, we’re looking for balance rather than another extreme.
Eat enough protein
Protein becomes increasingly important as we age.
It supports muscle maintenance, satiety and blood-sugar regulation and can make meals much more satisfying.
Build and preserve muscle
I cannot emphasize this enough.
Muscle is metabolic currency.
Your muscles are an important place for glucose to go.
Maintaining and building muscle through resistance training can improve insulin sensitivity and becomes increasingly important as we move through midlife and beyond.
Move after you eat
It doesn’t have to be complicated.
Even a short walk after a meal gives your muscles an opportunity to use some of the glucose circulating in your bloodstream.
Sometimes the simplest interventions are incredibly powerful.
Protect your sleep
Poor sleep isn’t just about feeling tired the next day.
Sleep deprivation can affect appetite, glucose regulation, insulin sensitivity and stress hormones.
If we’re trying to improve metabolic health while consistently sleeping five hours a night, we’re fighting an uphill battle.
Don’t forget your nervous system
We can’t eliminate stress.
Nor should that be the goal.
But we can give the body opportunities to come out of a constant state of activation.
That might mean walking outside, breathing practices, meditation, yoga, spending time with people you love, laughing, playing, resting or simply having periods of the day when you’re not consuming information or trying to accomplish something.
These things aren’t “extras.”
They’re part of taking care of the physiology that regulates your metabolism.
One last thing: don’t panic over one lab result
If your glucose or cholesterol comes back elevated, take it seriously, but don’t immediately assume something terrible is happening.
One result is information.
It gives us somewhere to start asking questions.
And depending on what’s elevated and by how much, your healthcare provider may want to repeat testing, investigate further or recommend treatment.
Lifestyle and natural-health strategies can be incredibly valuable. And so can appropriate medical assessment, particularly when LDL cholesterol, triglycerides or glucose are significantly elevated.
The bigger picture
Here’s what I hope you take away from all of this:
Glucose isn’t just about diabetes.
Cortisol isn’t just about feeling stressed.
Cholesterol isn’t simply about how much fat or cholesterol you eat.
They’re part of a much bigger metabolic conversation.
Your blood sugar affects your hormones.
Your hormones affect your metabolism.
Your stress response can affect your blood sugar.
Your liver is responding to the nutrients and energy coming in.
Your muscles affect how efficiently you dispose of glucose.
Your sleep affects almost all of it.
And during midlife, changing hormones can alter the entire landscape again.
Your body isn’t a collection of separate parts.
That’s why I’m much more interested in understanding the pattern than simply chasing one number on a lab report.
Instead of asking only:
“How do I lower this number?”
Ask:
“What might be contributing to this number? and what can I do to help my body work better?”
Because when we understand what’s driving the pattern, we have a much better idea of what to do next.
And that, to me, is what a whole-body approach to metabolic health is all about.
Want to understand cholesterol a little better?
If LDL, HDL and triglycerides still feel like alphabet soup, you may also want to read Five Cholesterol Myths (and What Actually Matters), where I break down what cholesterol does and some of the nutrition and lifestyle strategies that can help support a healthier lipid profile.
Or, if you’re confused about what any of this means for you, or where to even start, let’s chat. We can look at the bigger picture and figure out what might make sense for you.
This article is for educational purposes only and is not intended to diagnose, treat or replace individualized medical care. Elevated cholesterol, triglycerides or blood glucose should be discussed with your healthcare provider, particularly when levels are significantly elevated or you have other cardiovascular or diabetes risk factors.
