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Written by: Jennifer Chesak, MSJ
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Medically reviewed by: Orville Kolterman, MD and John Eid, PhD
Hemoglobin A1C is a blood test that reflects your average blood sugar over the past 90 days. It’s used to diagnose prediabetes and type 2 diabetes and as a metric for how well plasma glucose concentrations are controlled in these conditions, and others. You can lower your A1C naturally before your next reading through lifestyle changes.
If your hemoglobin A1C (also called HbA1C or A1c) is high or has been creeping upward, you may be asking yourself, “How much can A1C drop in three months? And, can I do it naturally?”
Of course, medications have their place, and you should follow your health care provider’s recommendations, but many people see significant improvements in their glucose metabolism through lifestyle changes. Taking steps to get your blood sugar levels within the desired target range could slow or prevent prediabetes from advancing to type 2 diabetes. Lifestyle changes, if maintained over time, may also reverse these conditions.
In this article, we’ll explore what A1C is, how the test is used, how to lower A1C quickly but sustainably, and more.
Understanding A1C
A1C has long served as a measure of how well your body is metabolizing glucose and whether you have prediabetes or type 2 diabetes. (For type 1 diabetes, A1C is not a diagnostic test, but it’s still used to monitor glucose control.)
The test result shows the percentage of your red blood cells that have glycated hemoglobin. Hemoglobin, a protein in your red blood cells that carries oxygen, becomes glycated when glucose (sugar) molecules “stick” to it. This sticking or coating occurs over time. The rate at which the glycation occurs is driven by the prevailing glucose concentration. Thus, the higher your average blood sugar, the higher your A1C.
Red blood cells have a lifespan of about three months, so that’s why A1C reflects your average blood sugar over roughly the past 90 days. In contrast, other tests—like a fasting glucose test or a post-meal reading—only capture a single moment in time and can be influenced by short-term factors like recent meals, stress, or illness. Because A1C represents a long-term average, it offers a more stable and reliable indicator of your overall blood glucose control.
How A1C becomes elevated
To understand more about A1C, learning about how your body metabolizes glucose can help:
- When your blood sugar rises, beta cells—specialized cells in your pancreas—release the hormone insulin.
- Insulin signals your body’s cells to “soak up” the glucose, which then lowers the level in your bloodstream.
- Your cells will either store glucose (as glycogen) to be used later or metabolize it to produce adenosine triphosphate (ATP), your body’s universal form of energy.
Issues can arise when your body becomes insulin resistant, which means that your body’s response to insulin is decreased compared to that seen in someone with normal insulin sensitivity. A decreased response to insulin can lead to higher glucose levels in the bloodstream.
Additionally, repeatedly eating foods that cause a quick and dramatic rise in blood sugar can overwork the beta cells in your pancreas to the point where they can no longer produce enough insulin to help counteract high blood sugar.
When insulin secretion can no longer increase to compensate for the rise in insulin resistance, hyperglycemia emerges leading to prediabetes and type 2 diabetes.
What your A1C result tells you
Your A1C test reflects where you are on a continuum of having normal blood sugar to having type 2 diabetes.
- Below 5.7%: normal
- 5.7%-6.4%: prediabetes
- 6.5% or higher: type 2 diabetes
A medical professional can help you understand your results and account for any issues that can skew your results.
“One of my favorite resources to share is this poster from diaTribe that shows the 42 factors that affect blood glucose,” says Jennifer McManus, RD, LDN, CDCES, at Pendulum Therapeutics. “Some are controllable factors, like food intake, alcohol consumption, medication, your personal microbiome, and physical activity/movement, but some are uncontrollable factors, like stress and illness, allergies, puberty, and menstruation.” Genetics can also play a role.
In some cases, even if your A1C appears slightly higher on a subsequent test despite the fact that you’ve been making lifestyle changes to lower your A1C, a recent illness could be the culprit of the higher result—rather than worsening glucose metabolism.
Other considerations include whether you have certain underlying conditions or factors that can affect the lifespan of your red blood cells and therefore alter your A1C results, including:
- Sickle cell anemia
- Thalassemia, an inherited blood disorder
- Spherocytosis, a disease in which red blood cells change shape and die prematurely
- Anemia (including iron-deficiency, infection-induced, and tumor-induced anemia)
- Kidney failure
- Liver disease
- High triglyceride levels
- Organ transplantation
- Blood transfusion
Some vitamin deficiencies or supplements can also impact your A1C. For example, a deficiency in B12 or D can produce a falsely elevated result.
Where you live or spend time is another factor. People at a higher altitude, when compared with those at sea level, may have a higher A1C because altitude can affect both hemoglobin levels and glucose metabolism.
Pregnancy can throw off an A1C reading, too. Increased blood cell turnover may lead to a lower test result in the first two trimesters, though it may rise again during the third.
Why lower A1C?
Taking steps to lower your A1C can make you more insulin sensitive. “Without lifestyle changes, those with prediabetes are at a greater risk of eventually developing type 2 diabetes,” says Lila Rawlings, MS, RD, at Pendulum Therapeutics. “Lowering A1C—even slightly—can delay or even prevent the onset of type 2 diabetes.” In some cases, prediabetes and type 2 diabetes can even be reversed, or put into long-term remission.
“Elevated blood sugar levels may damage blood vessels and nerves over time,” Rawlings says. Halting the progression of or reversing these diseases is good for your health for multiple reasons.
Lowering A1C reduces the risk of:
- Heart disease
- Stroke
- Kidney disease
- Nerve damage
- Retinopathy (damage to the retina which may impair vision)
Lowering your A1C can also improve energy and daily functioning, Rawlings explains. “High blood sugar can cause other health concerns like fatigue, brain fog, and increased thirst or urination,” she says. “Better glucose control often results in better daily energy levels and overall well-being.”
Even for people who are nearing the prediabetes range, lowering A1C can be beneficial. “If A1C is just under 5.7%,” Rawlings says, “[an upward trend] in blood sugar could indicate insulin resistance, visceral fat accumulation, poor dietary patterns, or sedentary lifestyle.”
She adds, “Early intervention may be more effective than reactive intervention. Lifestyle changes, like diet, exercise, and sleep, can have a greater impact earlier in the metabolic process. At this stage, the pancreas is typically still producing enough insulin, making reversal more achievable.”
For people with type 1 diabetes or latent autoimmune diabetes in adults (LADA), which are both autoimmune disorders, A1C provides an assessment of glucose control, but many other factors also indicate successful management of the disease, including weight management, blood pressure and lipid control, and early treatment of any complications, including emerging eye disease. However, these conditions cannot be cured with lifestyle changes. (There is no known cure for either aside from rare circumstances involving cell or organ transplants.)
How much can A1C drop in three months?
“If someone has a very high A1C (think: 9% or higher) and can make meaningful diet and lifestyle changes,” McManus says, “they could see a larger drop.”
A large drop might mean lowering your A1C by 1 to 2 percentage points, from 9% to 7% or 8%, for example. However, if you have a lower A1C to start, such as 6%, then you might see a smaller drop of 0.3 to 0.5 percentage points, to 5.7% or even 5.5%.
What does the research say? In a 2013 study, researchers looked at 51 participants with type 2 diabetes who had A1C levels ranging from 7% to 9% who changed their lifestyle habits. After three months, about 35% of the patients experienced an average A1C reduction of 0.74 percentage points. That’s a meaningful A1C reduction that can improve your metabolic health.
How to lower A1C quickly and safely
If you have an increasing A1C or a high result consistent with prediabetes or type 2 diabetes, you may be curious how to get your A1C down—stat.
“The body needs time to adjust,” McManus says. “Since A1C reflects around three months of average blood sugar, changes take time to show up in the result.” Making lifestyle changes to physical activity, sleep, or diet also take time to implement and take effect.
Rawlings agrees, noting that she coaches people to develop sustainable lifestyle changes that support steady or stable blood glucose levels throughout the day. This helps avoid large blood sugar spikes, which elevate blood sugar, and therefore A1C, over time.
The following are some diet and lifestyle changes to consider.
How to adjust your diet to lower A1C
Altering your diet is one of the best ways to lower your A1C and improve your metabolic health. Here are a few strategies to consider.
Prioritize fiber
“Fiber slows glucose absorption, steadies blood sugar spikes, and improves insulin sensitivity,” Rawlings says. Aim for at least 25 to 35 grams per day. Options include:
- Non-starchy vegetables (spinach, broccoli, cauliflower)
- Legumes (lentils, black beans, chickpeas)
- Seeds (chia, flaxseeds, psyllium)
- Berries, apples (with skin), pears
- Fiber supplements (as needed)
Eat carbs with protein or fat
“Pairing carbs with protein or fat slows digestion and reduces blood sugar spikes,” Rawlings says. Consider adding:
- Nut butter, Greek yogurt, or cottage cheese when eating fruit
- A protein source like eggs, tofu, or chicken when eating whole grains
- Healthy fats like avocado, olive oil, or nuts to meals
Choose low-glycemic and complex carbs
The Glycemic Index (GI) is a ranking of foods based on how fast they cause a blood sugar surge, which can elevate your A1C over time. “Low-glycemic index foods digest more slowly, causing smaller and steadier glucose rises,” Rawlings says. Try:
- Quinoa, steel-cut oats, barley
- Sweet potatoes (with skin)
- Beans and lentils
- Sprouted or whole-grain breads (like Ezekiel)
- Berries, apples, and citrus fruits
Reduce added sugars and refined carbs
By adding some of the beneficial foods mentioned above, you may naturally eliminate or reduce your reliance on added sugars, refined carbohydrates, and ultra-processed foods in general. To take this strategy a step further, Rawlings recommends:
- Cutting back on sugary drinks, white bread, and candy
- Watching for added sugars in yogurt, sauces, and granola or protein bars
Limit alcohol consumption
The relationship between alcohol and blood sugar is complicated. On one hand, drinking can cause dangerously low glucose levels, especially in people with diabetes. Your liver has to metabolize alcohol, which affects the organ’s functioning and how it helps stabilize blood sugar.
But drinking regularly can also elevate your A1C through several mechanisms. One key factor is that many mixed alcoholic drinks are carbohydrate heavy, which can spike your blood sugar.
Lifestyle tips to improve A1C in 3 months
“To lower A1C,” Rawling says, “it’s important to build habits that address blood sugar control from different angles—movement, sleep, stress, and timing—not just diet alone.” Here are a few lifestyle changes to get you going.
Engage in physical activity
Getting adequate exercise is a top tool for improving A1C, while sedentary behavior can elevate it. Physical activity helps your cells uptake glucose without the need for insulin.
The Centers for Disease Control and Prevention (CDC) recommends getting at least 150 minutes of moderate-intensity physical activity (or 75 minutes of vigorous exercise) per week. Whether running, cycling, dancing, or playing pickleball, find activities you enjoy.
And think about moving more throughout your day. Rawlings recommends taking a 10- to 20-minute walk after a meal, which can blunt a blood sugar spike and lessen its duration, helping to keep A1C down.
We tend to lose muscle as we age, putting us more at risk for insulin resistance and, therefore, prediabetes and type 2 diabetes. Preserving the muscle you have and building more through weight-bearing exercises, can help you control your A1C.
The CDC also recommends two full-body strength training sessions per week, incorporating weights or bodyweight exercises.
Prioritize quality sleep
According to Rawlings, sleep impacts your A1C in three ways:
- Sleep regulates key hormones.
- Sleep impacts glucose overnight.
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Insulin resistance worsens with poor sleep.
For these reasons and for overall health, getting adequate sleep, which the CDC defines as at least seven hours a night for adults, is crucial. Set a sleep schedule and stick to it as much as possible, while reducing factors that disrupt sleep, such as light or noise pollution.
Reduce stress
Our stress response is meant to keep us safe by giving us energy to respond to a threat. But in today’s world, we aren’t typically running from predators as our distant ancestors had to. Instead, we often face chronic stress, which causes the release of cortisol, the stress hormone. While we need cortisol to function in our daily lives, chronic stress can dysregulate our cortisol response.
Cortisol increases production of glucose in the liver via a process called gluconeogenesis. This keeps glucose elevated in the bloodstream so that you can continue to respond to a potential threat. But chronic elevation can contribute to a higher A1C.
With that in mind, find ways to reduce or manage stress, whether through yoga, meditation, exercise, or other hobbies or creative pursuits.
Support your gut health
The health of your gastrointestinal (GI) tract also plays a role in glucose metabolism. Research published in a peer-reviewed journal revealed that taking a five-strain probiotic twice a day for 12 weeks helped lower A1C (by 0.6 percentage points) in participants with type 2 diabetes—when compared with a placebo group.
“Probiotics may help lower A1C by modulating gut microbiota in ways that improve glucose metabolism,” Rawlings says.
You have a whole microbiota, a community of bacteria (and fungi) living in your gut as probiotics, and consuming probiotics via supplements or certain foods, such as yogurt or kimchi, impact this community.
When your gut microbiome ferments some of the foods you eat, it produces short-chain fatty acids (SCFAs). SCFAs stimulate the production of glucagon-like peptide 1 (GLP-1), a gut hormone that has beneficial effects on blood sugar.
If you have type 2 diabetes, your body may secrete less GLP-1. But anyone can also have a lack of beneficial bacterial strains in the gut to produce adequate GLP-1, which does the following:
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Helps your pancreas produce more insulin, which can then help lower blood sugar.
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Slows gastric emptying, which can slow the absorption of glucose into the bloodstream, lessening the chance of a post-meal blood sugar spike.
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Reduces gluconeogenesis, glucose production in your liver.
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Stimulates areas in the brain that help you feel full, which helps reduce appetite and cravings that can contribute to elevated blood sugar.
Tips for meeting your A1C goals
Knowledge is power. But likely you’ll only undergo an A1C test every three to six months, or at even longer intervals, depending on what your healthcare provider recommends and what your health insurance plan covers. Between A1C readings, you can keep tabs on your blood sugar in other ways.
For example, some people check their blood glucose readings regularly using the fingerstick method and a glucometer. Others choose to wear a continuous glucose monitor (CGM). CGMs have historically been used in people with diabetes to help monitor their glucose and any insulin needs.
But people who do not have diabetes can also use CGM to improve their metabolic health. “As long as it does not lead to obsessive behavior,” McManus says, “it can be a super cool tool to learn how your body personally responds to different factors that affect blood glucose.”
You might only wear a CGM for a short time—such as three months, until your next A1C check—or longer term. “I like to call it a ‘science experiment’ when I wear one, as it’s fun to see how timing, meal composition, and movement impact my CGM readings in different settings,” McManus adds. “Ultimately, it is best to do this under the supervision and guidance of your healthcare provider for the most comprehensive and safe learning experience.”
Additionally, keeping a food log to track beverages, meals, and snacks—along with any symptoms you experience after eating—can help. By tracking what you eat, you can see patterns related to your meals, glucose readings, and how you feel. If you’re working with a certified diabetes care and education specialist (CDCES), they can review your log and recommend any strategic changes to your diet to help you improve your A1C.
Key takeaways
- Your A1C percentage tells you about how much glucose is sticking to hemoglobin—the part of your red blood cells that carries oxygen throughout your body.
- A1C measures your average blood sugar over the past three months.
- A higher A1C means your body is having trouble with glucose metabolism and insulin sensitivity, factors that can lead to prediabetes and type 2 diabetes.
- What lowers A1C naturally and effectively? Try the sustainable lifestyle changes mentioned in this article.
FAQ
Can A1C go down in 3 months?
Yes, you can lower your A1C in three months. How much you can lower it in this timeframe will depend on your current A1C, lifestyle changes, particularly to diet and physical activity, medications, and other factors unique to you.
What is considered a significant drop in A1C?
Even lowering your A1C by 0.5 percentage points, going from 7.5% to 7% for example, is considered a clinically significant drop.
Will losing 20 pounds lower my A1C?
If you’re researching how to lower your A1C, you’ve probably learned that weight management is one key factor. Research shows that even just a 2% to 5% reduction in body weight helps reduce A1C.
How many points can your A1C drop in three months?
The answer will vary from person to person and depends on several factors. Everything from your health status now to the lifestyle changes you implement will affect how many points your A1C can drop within that time frame.
How much can your A1C drop in a month?
If you make lifestyle changes or change your diabetes treatment plan, you may notice a slight reduction in your A1C after a month. However, your A1C is a measure of your average blood sugar over the past three months. So you may need about three months or longer to see more significant changes.
Is 8.5% HbA1C reversible?
Yes, you can lower an HbA1C of 8.5% with lifestyle changes and careful management of your blood sugar through other treatments.
Content is for educational purposes only and has not been evaluated by the Food & Drug Administration. Statements and products are not intended to diagnose, treat, cure, or prevent any disease.
