Tuesday, March 8, 2011

The Metabolic Syndrome

What it is and how to avoid it...


The metabolic syndrome (TMS) is a cluster of symptoms that is often seen as a precursor to diabetes. It is frequently referred to as "Syndrome X," and the estimates of how many people have it are going through the roof. In the United States it's estimated that 2 in every 5 adults are affected. That's a lot of people.

The American Medical Association lays it out like this--if you have three of the following, you're in the Metabolic Syndrome club. If you have them all, you're a VIP.

1. Waist measurement of 40 inches or greater in men, and 35 or greater in women.
2. Serum triglycerides level greater than 150mg/dL.
3. HDL cholesterol less than 40 mg/dL in men and less than 50 mg/dL in women.
4. Blood pressure of 135/85 or higher
5. fasting glucose of 100mg/dL or higher,

It all boils down to controlling your insulin levels and the corresponding blood sugar levels. If you are insulin resistant from eating too many carbs (especially refined carbs, but anything higher on the glycemic index will take its toll, such as all cereal grains), not getting enough exercise (more on this in a minute), not getting enough sleep, and/or getting too stressed out (guilty!), then you're either on your way to TMS, or you're already there. Fortunately, there are ways to reverse it.

Regular readers will not be shocked to hear me say that the number one way to reduce the effects of TMS is to stop eating grain products such as wheat, corn, and rice. Read my previous post on grains for details. Along with the grains, though, are the other sweet treats that permeate the check out lines and teachers' lounges of the world. Sugar can rob you of your health on multiple levels.

Insulin resistance happens when too many carbs have to be dealt with on a regular basis. Glucose is stored in muscle and liver tissues as glycogen. When those cells get full (which doesn't take much), the rest is stored in the form of triglycerides, which is bad. Your muscle and liver cells will literally "down regulate" insulin receptors on their cell membranes, which is akin to putting a "No Vacancy" sign on the marquee. All full at the inn, go somewhere else. So, we get fatter when extra carbs can find no room at the inn. Bummer.

The way to re sensitize your cells to insulin is to stop eating so much of the foods that are causing the problems in the first place. That's a good start. But if you really want to ditch TMS, you need to cause your cells to up regulate insulin receptors. This can be done most effectively with high intensity exercise. This doesn't mean running on a treadmill at a moderate pace for an hour. This means working so hard in short bursts that having a conversation or reading a magazine is out of the question. This means getting red faced and sweaty and icky. And this can save your life.

Extra insulin running around in your system leads to systemic inflammation, which I mention in just about everything I write. And, men, extra insulin in our systems is notorious for reducing testosterone levels, which can lead to depression, decreased libido, and reduced muscle mass. None of this is too appealing to me personally, so I avoid eating the afore-mentioned carbs (especially anything refined), and when I exercise I won't be able to answer the phone because talking will not be an option at the preferred level of intensity.

Because TMS is not just a precursor to diabetes. It is an indicator of systemic inflammation, and systemic inflammation is a precursor to all of the diseases of the west that get us in the end, including heart disease, cancer, Alzheimer's disease, arthritis, and on and on. What you get depends on what you're most genetically predisposed to getting. If you know your family history, and you have metabolic syndrome, it's likely that you're on your way to fulfilling your genetic destiny.   But it doesn't have to be that way.

The first step in determining where you stand, is to get some objective data. There are some blood tests that will tell you what you need to know--glucose panels, cholesterol (I recommend the VAP test to really know what's going on. It breaks the LDL into smaller categories to identify the particle size. Large and fluffy LDL particles don't worry me), hemoglobin A1C, CRP (which is a favorite of mine--it tests for a marker of systemic inflammation), and fibrinogen (to see if your blood is clotting too easily, which happens with elevated insulin levels).

There are supplements that can take the edge off TMS. Vitamin D, fish oil, magnesium, B vitamins, and a few antioxidants can all do wonders for your blood chemistry, but they do nothing compared to eating right and getting the right kind of exercise. Try taking my 30 day grain free challenge and see for yourself. This is the biggest stumbling block for most, but there are other things to eat. I promise. I've been doing this for years.

Exercise, by the way, doesn't have to take up your entire life to get the benefits. It's a matter of finding the perfect amount to get the job done. Some of us are gluttons for punishment. If that's not you, I can tell you that huge gains in health can be made in an hour a week if you do it right. That sounds like a subject for a future post.

By the way, if you're in the Houston area, and are interested in any of the blood test I mentioned, give us a call at Green Chiropractic. I can send you to any Lab Corp and we can get this thing going.

Wednesday, March 2, 2011

Tummy Troubles = Autoimmune Disease?


Well, not exactly "tummy," if by "tummy" you're thinking, "stomach." What I really mean is your small intestine, specifically the upper part of your small intestine, know as the duodenum. I've written about small intestine bacterial overgrowth (SIBO) before, but I think it's worth delving back into for a minute to give you options for dealing with it.

Before telling you how to manage SIBO, let's review why it should be eradicated in the first place. It basically goes like this: bacteria from your colon have overpopulated their home, so they move up the plumbing. If they get far enough up, they make it to the duodenum, where about 75% of the absorption of what you eat takes place. If you have increased gut permeability from too many lectins in your diet (which are found in high concentrations in all grains, as well as legumes), that bacteria can get into your bloodstream. The literature is starting to lean heavily on the idea that most auto-immune diseases start in the gut.

Common symptoms for SIBO are everything from reflux to diarrhea, and it has been implicated in Crohn's disease, ulcerative colitis, and rheumatoid arthritis, and some are even connecting it to lupus. Go to Pubmed.gov and start searching. It will blow you away. I have one paper on my hard drive at home where 100% of the fibromyalgia patients and and 84% of the IBS patients tested had SIBO. When fibromyalgia patients walk through the door here, we go hard core anti-inflammatory, otherwise we're just chasing symptoms.

To overcome the SIBO, you have to do two things: starve it and kill it. This is a war for your health, after all, so you can't be nice to the bugs. The prescription for starving SIBO is fairly straight forward--get off the grains. The indigestible carbs in grains are what feeds the bacteria. This is one of the major ways that grain consumption is so inflammatory. Uncontrolled inflammation leads to a whole host of the diseases of the west. Want to know what you're genetically susceptible to getting? What's your family history? Heart disease? Cancer? There's your answer. For me it's heart disease (dad's side), and dementia (mom's side). Both of those diseases are caused, in part, by uncontrolled inflammation. I think I'll do my best to pass.

As far as killing SIBO, my recommendation is to try 600 mg a day of oil or oregano for six weeks. Oil of Oregano (OoO) should be in an emulsified form that will help it make it to the bad bugs. OoO is also a potent anti-inflammatory in it's own right, so it's something that I dance with on occasion. If I even have an inkling that there's some gastro intestinal upset in the works I throw some down the hatch. If I had any kind of auto immune disease I would treat with OoO just to see what happens. There are no contraindications that I'm aware of, so the worst case scenario is that nothing happens and you're out a few bucks, but the potential benefits are huge. So, why not?

There are drug therapies for SIBO, too, most notably an antibiotic called rifaximin, which targets the specific area of the gut where SIBO does the most damage. Either way you go, the rub is that it will come back, even after a good killin', if you don't change the habits that started the whole process in the first place. So join me in the grain free challenge. People who did just that in January reported losing weight (some were dropping a pound a day for a couple of weeks straight), and less joint pain (which is something I ask people about all day long, since that's why they're here in the first place).

If OoO interests you, let it be known that I sell some here, and the brand I sell was recommended to me by the guy who wrote Integrative Rheumatology, which is a textbook that I regularly review when I write this kind of stuff.