METABOLIC
SYNDROME
By Alice R. Laule M.D.
If some of these symptoms sound like you or a
relative or friend, read on. Estimates say that as high as 60% of people in the
United States are affected by metabolic syndrome. About 10% of these people
will develop Type 2 diabetes mellitus. The rest, if left untreated, will spend
an unhealthy life plagued by high cholesterol, high blood pressure, overweight,
pain syndromes, intermittent low blood sugar, heart disease, osteoporosis, and
for young women trying to have a family, infertility.
This syndrome was first described almost 30 years
ago, and at that time it was called “Syndrome X.” About 8-10 years ago, when an
orthopedic condition was also dubbed “Syndrome X”, the name was changed to
“Metabolic Syndrome X.” More recently, it has been shortened to “Metabolic
Syndrome.” Under that name, it has achieved enough status to be granted a
diagnostic code for insurance filing. A synonym is “peripheral insulin
resistance.”
The last decade has given us some excellent research
on metabolic syndrome, primarily from Stanford, in particular a Gerald Reavens,
M.D. Nonetheless, in spite of many articles in mainstream medical journals,
people with metabolic syndrome are still not always getting proper dietary
advice and all the help they need.
What is it?
In metabolic syndrome, because of a genetic predisposition, a diet too full of
simple sugars, starches, or the wrong kinds of fats, the cellular membranes in
the muscles and in the liver, begin to stiffen. Cell membranes are
fantastically complex, containing a lot of tiny molecular structures called receptors.
Receptors are little docking stations for hormone molecules. The receptor we
are concerned with here is the docking station for insulin. The insulin
molecule has a particular shape, like a molecular jigsaw puzzle piece. The
receptor in normal metabolism has a shape that perfectly fits the insulin
molecule. Insulin slides itself into the docking station, which activates a
process that allows the glucose in the blood to enter the cells, feeding them
and allowing them to produce energy.
In metabolic syndrome, when the cell membranes begin
to deteriorate, the insulin receptor erodes, loses its structure, and insulin
can no longer find its docking site as readily. The result is that when we eat,
blood sugar begins to rise a little, because it cannot get into the cells. The
body’s feedback mechanisms will call for an increase in insulin production. If
the pancreas is still healthy and able to produce lots of insulin, levels will
increase until finally enough is produced that it can accidentally bump into
enough receptors to get some of the glucose into the cells. If the meal we ate
is rich only in sugars and starches and not in protein for a more slow rise in
glucose in the blood, the blood sugar can drop precipitously, causing
hypoglycemia. Eventually, insulin levels in the blood stream will stay high,
even when we are fasting. Once metabolic syndrome is well established, glucose
levels also begin to rise to “borderline” readings, yet the cells will be
chronically low in glucose, too starved to produce energy well. That’s when the
cravings for sugar kick in. If you have this problem and cannot lose weight, it
is not because you have no will power. Putting a lock on your refrigerator or
pushing back from the table sooner will not help you lose weight. The cells of
your body are starving, and are sending you messages to that effect. They want
sugar! Now! To say it merely takes will power is like telling a man who was
starving, stranded on a desert island that he has no will power when he eats
your sandwich. He was hungry – really hungry! And so are your cells, if you
have full blown metabolic syndrome.
Now that you understand a bit about metabolic
syndrome and the kinds of symptoms and problems it causes, I’m sure you want to
know what to do about it.
The first thing is a low glycemic index diet, and
eating small meals more often. While there are those who still question the
utility of the glycemic index, the research seems quite compelling to me. The
glycemic index of a food is higher the more quickly it turns to glucose in the
blood after it is eaten. The more quickly a food turns to glucose, the more
quickly insulin levels rise. The key to dietary treatment of metabolic syndrome
is to eat in such a way that the insulin levels come down. It is elevated
insulin and its downstream effects in the body that cause the whole list of
problems stated at the beginning of this article. A general rule would be to
have a protein source, and a lot of low starch vegetables, and perhaps some
whole fruits (other than bananas and raisins) with each meal. Corn, potatoes,
bananas, raisins, parsnips, and a few other vegetables have a high glycemic
index. People vary in how they react to these foods, but the glycemic index is
a good guideline. For more information, type “glycemic index” into an internet
search engine and you will find plenty of resources.
Supplements that are helpful are yeast free GTF
chromium at least 200 mcg. a day. Alpha lipoic acid or R lipoic acid will help
rebuild the eroded insulin receptor, but should not be started until a person
has had a few weeks of chromium and proper diet, lest it worsen hypoglycemia.
When the cravings are reduced, it is probably safe to start lipoic acid.
Vanadyl sulfate 10-25 mg. daily can help with the cravings. This is a huge dose
of a mineral the body only requires in trace amounts, so I am not comfortable
using this for more than 3 months. As a bridge to get a person to a healthy
diet, it moves glucose into the cells independent of insulin. It stops the
cravings by feeding the cells. Once metabolism normalizes and cravings stop,
stop the vanadium. Exercise also moves glucose into the cells independent of
insulin, so keep moving. In fact, I doubt that a person can fully reverse their
metabolic syndrome without exercise.
When I evaluate a person in my office for metabolic
syndrome, I will often add other specific nutrients, personalized for them.
Sometimes a medical food meal replacement is helpful, too. There are various
meal replacement drinks out there for this purpose, some of high quality and
others rather questionable. Check with your practitioner.
The bottom line is this is common, a huge cause of
illness in the United States, and with proper diet, supplements and exercise,
can be reversed. Don’t let this metabolic syndrome ruin your health! Get help.
Alice R. Laule M.D.
