Metabolic Syndrome (Syndrome X)

Metabolic syndrome 

There are variations of this syndrome of course but these are the classic signs and symptoms.

  • hyperlipidemia (too many fats in the body especially saturated and partially hydrogenated)
  • high blood pressure
  • hyperinsulinemia (high insulin levels)
  • blood sugar high normal or higher
  • high triglycerides and LDL cholesterol (bad type) >150 triglycerides and > 100-125 LDL
  • low HDL cholesterol (good type) <50 for females – < for males60
  • a waist measurement in a man of more than 40 inches and a woman more than 35 inches.

The Metabolic Syndrome ( once known as Syndrome X), a stress-related disease that is becoming so prevalent in the western world that it is fast overtaking first place over AIDS. According to the 2002 census, about forty seven million Americans have Metabolic Syndrome; that is about one in four people. Metabolic Syndrome is also being seen in our children. At this point in time it is estimated that about one million teenagers have Metabolic Syndrome. This could be the first generation of children with a shorter life expectancy than their parents. Stressed parents tend to overfeed their children, perhaps in a misguided attempt to compensate for the parents being stressed and therefore more volatile. We tend to offer food as a panacea or a peace offering for hurt feelings or lack of quality time. And many stressed parents don’t have the time to shop for and cook live food (food with vitamins, minerals, complex carbohydrates and healthy fats.) Add to this the fact that many of our children play video games a lot more than baseball or football or soccer; and spend hours per day watching TV, while they are often also snacking on empty calorie foods. One can of soda can have as much as ten teaspoons of sugar, and it is not unusual for a young person to consume two or three of these a day. While much of the world suffers from the lack of food, we in the West are killing ourselves with an abundance of the wrong type of food.

And when we are under time pressure we tend to eat the worst kind of foods: fast food or processed food that are relatively inexpensive and easy, but are low in nutrition and high in the worst kinds of fat. I am sure we have all noticed that when we eat in restaurants often meals involve mammoth portions of everything. A caveat here about evolution: In the days of mist there was a survival gene for eating as much as possible when food was available to most mammals. They ate when they could and as much as possible since it was not unusual to go for long periods without finding adequate food. Unfortunately this gene exists still today in humans. That is why we need to be careful especially with buffets.

Tthe Metabolic Syndrome develops as a result of a high stress in life which introduces ( of should I say seduces) a lot of the following: a diet high in sugar or high fructose corn syrup (HFCS) which is worse then sugar, unhealthy fat (especially hydrogenated fat), overeating (especially foods low in nutrition), lack of exercise, and lack of down time.

Note that diabetes is often related to obesity and hypertension, which make up part of the Metabolic Syndrome. Many recent studies are now showing that high fructose corn syrup (HCFS) in so many foods is also a high contributing factor in raising uric acid which seems to play a major role in the symptoms of the metabolic syndrome according to Richard Johnson M.D. professor of Medicine from the Univ. of Colorado. In his excellent book, The Sugar Fix, Dr. Richard Johnson talks about the dangers of a diet high in fructose. Fructose raises uric acid, which contributes to: high blood pressure, obesity, inflammation in the arteries, heart disease, stroke and kidney disease. He also explains how when we eat fructose it doesn’t signal the brain that we have had enough food. In fact, other research has shown that rats given a sugar water solution will binge on it but not get fat, as they will reduce the amount of rat chow accordingly. However, give these rats a HFCS sweetened water solution and they will gain weight. This is still controversial but why take a risk?

Alcohol consumption can be another factor in the development of the Metabolic Syndrome. As we seek comfort and relief in our stress-saturated society many of us turn to alcohol (which has a high sugar content and high in calories) as well as the sugary pacifiers mentioned above and often consumed with the alcohol. The negative effects of sugar in the body go beyond the obvious weight gain, or rather feed into a complicated feedback mechanism that compounds the weight gain.

Serotonin receptors in the body accept the sugar as if it were serotonin, The job of serotonin is to keep us calm. (That is why serotonin modifiers are prescribed for sufferers of depression and bipolar disorder. The medications are called Selective Serotonin Re-uptake Inhibitors [SSRIs]; they inhibit the re-absorption of serotonin, so that serotonin levels in the blood remain higher, keeping the mood elevated. Consumption of alcohol and sugar provides a similar serotonin effect, but because the serotonin receptors are being tied up by the sugar, thereby leaving more serotonin in the blood and not on the receptors. The sugar is short lived and therefore more is required to counteract the down feeling leading to binging on processed snacks.

So let’s review the role of insulin in the stress response and therefore in the Metabolic Syndrome.

The stress response releases more cortisol from the adrenals. The cortisol tells the liver that we are under attack and need fuel to cope with the situation, to fight or to run. The liver obliges by dumping its stores of sugar (the fuel) into the blood stream. The elevated blood sugar levels tell the pancreas that more insulin is needed so that the sugar can get into the cells to function. (this is all explained in more but simple detail in the book: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it).

If we are indeed fighting someone or running away, all well and good. We fight or run, and then everything goes back to normal and the fuel (sugar) is used up and not produced in more great quantities. But when the stress is chronic, when it is constant or in very frequent bursts, the constant outpouring of sugar from the liver into the blood causes a constant outpouring of insulin into the blood from the pancreas. The insulin receptors of the cells cannot handle all that sugar, so it is deposited as fat for future use. This is how stress can sabotage even the most committed dedication to a weight loss diet and exercise program. This fat is deposited in men in the abdominal area, and in women at first in the buttocks and thighs and eventually in the abdomen.

If this insulin output keeps going, eventually the cell receptors for insulin get tired of being hit and start to resist. This is the stage of insulin resistance that is pre-diabetic. The pancreas, in an effort to get the sugar into the cells where it can do some good, puts out higher and higher amounts of insulin, and the cells continue to resist it. The sugar cannot get into the cells and remains in the blood. Eventually the blood sugar levels rise to the disease we call diabetes II. It is not that a diabetic has too little sugar; it is just that the sugar is not in the right place: the cells.

Insulin, like all hormones, does its job efficiently only if it is in natures physiological quantities. At high levels the insulin itself is toxic to the arteries. When the body’s cells do not receive the proper glucose (sugar)—because insulin resistance is keeping it locked out of the cells so that it stays in the blood — they cannot function properly. As we have seen, nature turns a lot of the excess sugar into triglycerides (fat). The arterial cells, especially the inner lining that is called the endothelium, are going through the same trauma as other cells in the body in regard to the high fats floating through the blood. The fat, especially the LDL or bad fats, seeps into the endothelium.

This fat should not be there and is therefore considered an invasion of the endothelium. The body’s response to invasion is to mobilize the immune system, which in this case releases an army of white blood cells known as “macrophages.” The macrophages ingest the LDL, oxidize, and die. When dead they become a toxic hazard inside the endothelium. This signals other macrophages to come and clean up the mess and the same thing happens to them. (They are now called “foam cells” because they are so bloated with fat.). Eventually, there is such a build-up that the internal arterial circumference is compromised, narrowing the blood passage and elevating the blood pressure. Eventually this build-up compromises the integrity of the arterial wall, so that the fat seeps out, causing fatty streaks and hardening of the artery, leading to still higher blood pressure and restriction of blood flow.

So, the stress response due to financial pressure, or to an unruly teenager, or to any combination of the myriad stresses that are a fact of modern life— especially when combined with a stress-related high sugar diet, set in motion a cascade of events that promotes hardening of the arteries (atherosclerosis). This is why people with diabetes have 3-4 times the problems of atherosclerosis than those without. This brings on hypertension and peripheral artery disease (PAD) with all of their attendant complications to the organs and tissues of the body, including heart attacks and strokes.

Do not get depressed if you seem to fit into this category since this is all reversible. Even hardening of the arteries can be alleviated or reversed. Yes it can! The first thing one should do is find a physician that believes in a holistic attack on the Metabolic Syndrome. Three organizations that you can contact for the latter are #1-The American Integrative-Holistic Medical Association: #2 The American College for the Advancement of Medicine: #3 The American Holistic Medical Association. I do suggest that you interview for a short period any healer since being alternative, complementary or holistic (see my blog on the differences) may not give immediate knowledge nor the right personality for you.

Then certain laboratory tests should be done that are not conventionally done.

  • Fasting insulin level along with a fasting blood sugar. Very important! This is because a blood sugar can be in the normal (usually high normal) range; but this could be because the insulin level is high keeping it within the normal range. I consider this to be pre-diabetes which is much easier and healthy to treat then overt diabetes II. If the sugar level is high then an HgAiC is necessary which notes whether the sugar is constantly high over the last 3 months.

  • Cholesterol panel

  • Marker for inflammation such as C-reactive protein, ESR (Erythrocyte Sedimentation Rate, homocystiene. Whichever your doctor prefers or all of them.

  • Uric acid since this is now being thought to be quite the villain for cardiovascular problems especially with people that are in the Metabolic Syndrome category.

I believe that you should be taking care of the stress in your life either by alleviating it or reacting to it in a different manner then the past. It is stress that brought you to this point. My personal preference is through hypnosis and interactive guided imagery. Both you can learn to do on your own after being taught by a therapist that gives unconditional love and is non-judgmental.

I am not presenting here the medicinal solutions, whether they are allopathic or alternative. I have used botanicals along with lifestyle change for clients for many years with successful results. But I know, from my own health challenges and those of my patients, that if one wishes to get to the cause of dis-ease stress management is mandatory. It is not always the stress but how we respond to a stress!Yoga, meditation, sports and exercise can give relief and relaxation, but ultimately the cause needs to be uncovered and dealt with. I would prefer someone who also practices hypnosis and/or interactive guided imagery. (You can check the website of the Academy for Guided Imagery for a qualified practitioner near you:

Hypnosis and imagery are tools that allow access to the deeper levels of the mind, and can not only get to the core of the problem relatively quickly and cheaply but also recruit the vast resources of the deeper levels of the mind to offer solutions.

There is a place and need at times for pharmaceuticals but I believe these usually should be a last resort, or used as a temporary remedy to give relief while we make the necessary adjustments to lifestyle and seek understanding and healthier solutions to the sources of stress in our lives. But whichever road you choose to travel, I believe that with the Metabolic Syndrome with all the imbalances we are discussing — the most beneficial path is to get to the reason why this is happening, and learn how to change those circumstances. Metabolic Syndrome is a set up for many potential serious illnesses: arteriosclerosis, cardiovascular disease, stroke and diabetes with all of its co-morbidities, and yes even Alzheimer’s Disease. People with Metabolic Syndrome have a seventy percent greater chance of developing Alzheimer’ Disease than those without it.

So what I am stressing here (no pun intended) is that there are many things one can do to improve physical health and quality of life. But always, one has to include ways of alleviating the everyday vampires of stress, along with diet, exercise and the silver bullet of learning to relax. Easier said then done. I am still working on this last point and find it invigorating when I neutralize another emotional vampire. But I need help; luckily for me my wife is in the field of stress management. What, did you think I just know all this stuff!

Alan J. Sault MD, ABHM

Author: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it.

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