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Test America
Medical Center
Phone: 805.563-3301
Fax: 805.563-3303
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METABOLIC X SYNDROME
(INSULIN RESISTANCE SYNDROME
SYNDROME X)
What is Syndrome X (Metabolic Syndrome, Insulin Resistance Syndrome)?
Abnormalities in
glucose and lipid (blood fats) metabolism, obesity, and high blood
pressure occur together commonly enough in the same individuals as to
suggest that they are somehow interrelated. In fact, this cluster of
abnormalities has come to be known as a syndrome, going by a variety of
name, including Syndrome X, the Deadly Quartet, Insulin Resistance
Syndrome and the Metabolic Syndrome.
What seems to connect
the various features of the syndrome together is something called insulin
resistance: that is, a reduced sensitivity in the tissues of the body to
the action of insulin, which is, importantly, to bring glucose into those
tissues to be used as a source of energy. When insulin resistance, or
reduced insulin sensitivity exists, the body attempts to overcome this
resistance by secreting more insulin from the pancreas. This compensatory
state of hyperinsulinemia (high insulin levels in the blood) is felt to be
a marker for the syndrome. The development of Type II, or non-insulin
dependent, diabetes occurs when the pancreas fails to sustain this
increase insulin secretion. It is not clear how insulin resistance
contributes to the presence of high blood pressure, but it is clear that
the high insulin levels resulting from insulin resistance contribute to
abnormalities in blood lipids – cholesterol and triglycerides.
The body does not
manage insulin well. More and more people are developing the condition as
the population eats more and exercises less. The presence of any one
major feature alone substantially increases the risk of heart disease, but
when they occur together the risk is magnified way out of proportion at
the contribution of any one single factor.
What are the
causes of the metabolic syndrome?
The exact cause of the
metabolic syndrome is unknown. It is estimated that about half of the
causes of insulin resistance results from genetic variation, which affects
insulin’s effectiveness. Indeed, in Scandinavia, where the syndrome was
first described, the syndrome was clearly shown to have a genetic
component. However, heredity is less likely a cause in the United
States. Insulin resistance is also affected by factors that we can
control: body weight and fitness level. Excess intake of carbohydrates,
especially the simple carbohydrates, contributes to the syndrome and may
be a major cause.
What should I be most concerned about if I have metabolic syndrome?
The main concerns are
that metabolic syndrome or elevated blood insulin levels puts people at an
extremely high risk for heart disease, blood vessel disease, diabetes,
increased infections, micro vascular complications like retinopathy (eye
problems), nephropathy (kidney problems), neuropathies (nerve problems),
hypercholesterolemia, hypertension, premature atherosclerosis and obesity
and are at greater risk of dying from cardiovascular disease and other
causes. However, aggressive treatment can successfully decrease the risk
of life-threatening complications from metabolic syndrome.
How is Syndrome X diagnosed?
The Adult Treatment
Panel III (ATP III ) definition for the metabolic syndrome (syndrome X, or
the insulin resistance syndrome is three or more of the following:
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men, greater than 88 cm (35 inches) in
women.
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Hypertriglyceridemia: Serum triglyceride
greater than 150 mg/dL (1.7 mmol/L)
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High-density lipoprotein (HDL) cholesterol
less than 40 mg/dL (1.04 mmol/L in men, less than 50 mg/dL (1.29 mmol/L)
in women.
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Hypertension: systolic pressure greater
than 130 or diastolic pressure greater than 85 mm Hg
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Fasting Waist circumference greater than
102 cm (40 inches) in blood glucose greater than 110 mg/dL (6.1 mmol/L)
How many people have
metabolic syndrome?
According to the
Centers for Disease Control, it is estimated that approximately one in
five people in the United States (21.8%) have metabolic syndrome. One in
four past the age of 60 have it. Overall, that comes to about 50 million
Americans who have this problem.
Is there a solution to
syndrome X?
Like other chronic
diseases, metabolic X syndrome is a complex, lifestyle induced illness.
Its solutions are not difficult to understand: eat less, decrease
carbohydrate intake, and exercise more.
Lower Insulin Resistance
Since insulin
resistance is the cause of many of the problems in Metabolic Syndrome, it
makes sense that treatment would focus on decreasing insulin resistance.
- The diet should
be of a type to help lower insulin resistance. The caloric
distribution should be as follows: 40% of calories from carbohydrate,
30% of calories from protein and 30% of calories from fat. This is the
Zone Diet – a life style change.. The Zone diet will help maintain a
stable blood sugar level, reducing the presence of insulin. Excess
insulin of promotes the formation of fat, contributes to coronary heart
disease, cancer and Alzheimer’s disease. Avoid bakery products, pastas,
and all foods made from flour and anything with added sugar. The key to
lowering insulin resistance is to lower your intake of carbohydrates,
especially simple carbohydrates.
- Conjugated
Linoleic Acid (CLA).
CLA is a potent insulin sensitizer, thus lowering insulin resistance and
consequently insulin levels. By activating certain enzymes and
enhancing glucose transport into the cells, CLA acts to lower blood
sugar levels and normalize insulin levels. CLA is also anti-diabetogenic:
it helps prevent adult onset diabetes. CLA reduces body fat, and
increases muscle. CLA is an inhibitor of tumor growth and may prevent
some cancers such as breast and prostate. CLA decrease fat deposition,
especially in the abdomen and enhances muscle growth. Suggested CLA
daily dose: 3 to 6 grams.
- Chromium and
Magnesium.
These elements have been shown to help break down cellular insulin
resistance. Magnesium deficiency is another cause of excessive weight
gain. Magnesium may protect against heart attacks and stroke. Chromium
can lower cholesterol levels as well as serum glucose levels. For
chromium to be effective, it needs to have niacin present. Suggested
daily dose of chromium (with niacin): 200 mcg before meals. Suggested
daily dose of Magnesium: 500 mg
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Alpha Lipoic Acid
Lowers glucose and insulin levels, reduces insulin resistance and
improves insulin sensitivity.
Lowers cholesterol,
protects LDL against oxidation, and is beneficial in preventing and
treating Syndrome X/diabetes. As
little as 250 mg daily of alpha lipoic acid may be sufficient in healthy
individuals if used with a full spectrum antioxidant.
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Vitamin C
Lowers blood glucose and CRP levels, inhibits glycation,
prevents accumulation of sorbitol, protects against free radicals.
Vitamin C reduces C-reactive protein (CRP), a predictive factor for
diabetes. CRP is higher in individuals with clinical evidence of insulin
resistance. Administering vitamin C in amounts of 1,000 to 3,000 mg
daily (in divided doses) has been shown to significantly improve a
diabetic's prognosis and lower insulin resistance.
- Vitamin E
Vitamin E reduces oxidative stress, enhances insulin sensitivity and
glucose transport, and prevents complications arising from inflammation.
Anti-diabetic/insulin resistance value has been observed using from 400
to 1200 IU of vitamin E/day.
- DHEA
A DHEA deficiency is associated with a higher rate of obesity, insulin
resistance, and diabetes. Suggested dosage: 15 mg to 75 mg, taken early
in the day. (50 mg represents a typical daily dose).
- Metformin (Glucophage)
Metformin, sold under the trade name Glucophage is a prescription drug
used to treat diabetes. It has been use for non-diabetic purposes such
as Syndrome X. It increases insulin sensitivity of the cells.
Metformin reduces insulin levels by increasing the sensitivity of
peripheral tissues to the effects of insulin (increases cellular insulin
sensitivity), inhibits excess intestinal absorption of sugar, reduces
excess liver production of glucose, and promotes weight loss and reduces
cardiovascular risk factors. There are other positive effects
associated with metformin: decreased tumor growth and improved cellular
immunity in individuals who are prone to chronic infections associated
with high blood sugar levels. In non-diabetics, metformin reduced
low-density lipids (LDL), total cholesterol, free fatty acids, blood
pressure and fasting triglyceride levels. Metformin is not recommended
for people who have a history of kidney or liver disease, or a history
of congestive heart failure. People with a history of alcohol abuse
should also avoid taking the drug, since serious lactic acidosis can
develop in these individuals. Long-term use of metformin may cause
malabsorption of vitamin B-12 and therefore, supplementation with B-12
is recommended. When a person begins to take metformin, they may
experience some nausea and vomiting, stomach pain, bloating and
diarrhea. These side effects usually disappear once the person becomes
accustomed to the drug.
Some people with Syndrome X have blood
clotting abnormalities.
The blood clotting abnormalities are
associated with blood clots. To help prevent clots from forming, patients
with metabolic syndrome are often given aspirin because aspirin thins the
blood and helps prevent blood clots. In addition, aspirin lowered the
risk of recurrent colon polyps, reduced prostate cancer risk in men over
age 60 by two-thirds. Aspirin may also reduce the risk of pancreatic
cancer.
The Syndrome X Regimen
First thing in the
morning take:
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Three 1000 mg CLA capsules.
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One DHEA capsule (15 - 25 mg)
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One chromium-niacin capsule (200 mcg).
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Vitamin C (500 mg)
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Vitamin E (400 – 800 I.U.)
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Aspirin (81 mg tablet)
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Multivitamin
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Alpha Lipoic acid (250 mg capsule)
Five minutes before
lunch take:
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Vitamin C (500 mg).
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One 200 mcg chromium-niacin capsule.
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One DHEA 15-25 mg capsule.
Five minutes before
dinner take:
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Vitamin C (500 mg).
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One chromium-niacin capsule (200 mcg).
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One 500 mg magnesium capsule.
Before bedtime:
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Metformin (Glucophage XR) 500 – 1000 mg)
Depends on response to above supplements before using Metformin.
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