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Metabolic Syndrome

(also known as Insulin Resistance, Syndrome X, Glucose Intolerance, Pre-diabetes, and Cardiovascular Dysmetabolic Syndrome)

Michael Lam, MD, MPH


Those who are in the sub-clinical phase (age 35-45) and clinical phase of aging (age 45 and above) have a one in three chance of getting this syndrome and not knowing it. Perhaps the following signs are more recognizable: feeling sluggish, physically and mentally, especially after a meal. Gaining a pound here and a pound there-and having increasing difficulty losing them. Having blood pressure creep up year after year and finding that the blood cholesterol, triglycerides, and blood sugar levels are doing the same. These are all accepted signs of aging. They are also all of the symptoms of Metabolic

Metabolic Syndrome can explain why you feel lousy today -- such as being tired and fuzzy-minded. It can explain why you have high triglycerides, high cholesterol or high blood pressure, why you are feeling lousy after meals, and why you are seeing your health spin out of control without knowing why. It can also explain why you are aging faster than your peers. More importantly, Metabolic Syndrome sets the stage for catastrophic health problems, such as heart disease, diabetes, Alzheimer's, cancer, and other age-related diseases.

It is estimated that this syndrome afflicts over 60 million Americans and one in four adults over age 35. Hypercholesterolemia, cigarette smoking, hypertension, and obesity are the main culprits for the development of atherosclerotic coronary artery disease (CAD). However, these account only for half of the cases of CAD. The other pathologic processes underlying atherosclerosis remain unknown. Metabolic Syndrome may be the cause of up to fifty percent of all heart attacks. It is an epidemic of massive proportion.

How do you develop Metabolic Syndrome?

Metabolic Syndrome develops slowly over time, often over a course of 20 years or more. It is the end results from years (often decades) of taking in a modern day diet high in refined carbohydrates such as breads, starches and sweets. These foods, once taken, trigger a rapid increase in blood sugar levels, and the body responds by raising levels of insulin secretion that in turn helps to move the sugar out of the blood stream into the cells. Insulin is a hormone secreted by the pancreas. It helps the body utilize glucose (blood sugar) by binding with receptors on cells like a key would fit into a lock. Once the key - insulin - has unlocked the door of the cell, the glucose passes from the blood into the cell. Inside the cell, glucose is either used for energy or stored for future use in the form of glycogen in liver or muscle cells.

The more carbohydrates you eat, the more your pancreas releases insulin to lower the excessive blood sugar. This is especially so with simple or refined carbohydrates that are converted into sugar quickly (the high-glycemic index foods like white bread and white flour) once inside your body. While insulin levels rise and fall with each meal and is part of the normal metabolic process, chronic carbohydrate overload causes chronic insulin overload. The cells of the body, be they the muscles or the fat tissues, recognize that excessive sugar is toxic. They try to shut down the influx of sugar into the cells and therefore go through a down-regulation process to resist the command of insulin. This state is called insulin resistance. The pancreas, in response to the insulin resistance and resulting lowered transport of glucose out of the blood stream to the cell, puts out even more insulin in order to avoid too high a blood sugar level. This compensatory increase in insulin output continues until the pancreas fails to keep up. Some people produce two, three or four times the normal amount of insulin. Yet, because the cells have lost their sensitivity to insulin, they require even more of it to maintain normal glucose levels. In advanced stages of insulin resistance, when the pancreas becomes exhausted and can no longer maintain the insulin production, insulin production drops, resulting in adult onset diabetes mellitus (also called type 2 diabetes). Insulin resistance plus compensatory hyperinsulinemia is nature's way of preventing the evolution into type 2 diabetes. It is often referred to as a pre-diabetic state.

As long as there is insulin resistance, the blood sugar and blood insulin levels are both high. Over time, high blood sugar and high insulin cause a myriad of destructive damages to almost every tissue they touch. It is important to recognize while insulin resistance or high blood sugar is each bad for health on its own, it takes both insulin resistance and compensatory hyperinsulinemia, to result in the various manifestations. These manifestations represent the resultant damage and surface as a compilation of symptoms representative of multi-system dysfunction. This includes the cardiovascular system, muscular system, kidney system, reproductive system, and lipid metabolic system, just to name a few.  It is called Metabolic Syndrome when the symptoms are grouped collectively in a setting of insulin resistance.  It can go undetected for up to 40 years, and a family history of type 2 diabetes, CHD, or hypertension increases the risk for Metabolic Syndrome.

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