National College of Natural Medicine
Special from Bottom Line's Daily Health News
August 15, 2006
I t is not unusual in medical practices today to treat symptoms rather than searching for and correcting the root cause of a problem. Consequently, some patients end up taking medication, maybe for life, to control a symptom rather than digging a little deeper to cure the underlying problem. Mark Stengler, ND, sees this happen often.
Patients share with him the symptoms they are suffering and the treatment protocol recommended by their MD. Meanwhile, by taking a slight step back, Dr. Stengler sees the forest through the trees when looking at symptoms and helps cure the underlying problem. I talked with him recently about one such patient, a 45-year-old woman who had been told that because of high lipid levels (LDL cholesterol and triglycerides), she should take statins for life.
PATIENT HISTORY
Dr. Stengler says that when the woman came to his office, her lipid levels were unquestionably high -- her total cholesterol was 287 with LDL at a troubling 184 and triglycerides at 268. Her blood sugar, ranging from 93 to 99, was at the high end of normal and she was mildly overweight. She complained about a moderate degree of fatigue, especially in the early afternoon, and occasional shortness of breath. Curiously, she had no strong family history of high lipid levels, which is unusual in a case like this. Although the woman's blood sugar didn't show pre-diabetes, it was certainly not optimal -- he likes fasting glucose levels to be between 65 and 86. Looking over this constellation, Dr. Stengler decided to take a different tack. Knowing that insulin resistance activates insulin receptors in the liver, which in turn activates cholesterol and triglyceride production, he concluded that this was likely a problem of insulin resistance -- and that the high lipid levels were symptoms.
TREATMENT
Dr. Stengler first reviewed an appropriate diet and eating schedule with the patient. He told her she must start eating breakfast, which would immediately help prevent blood sugar swings, and he put her on a diet designed specifically to correct insulin resistance.
The diet includes...
- High fiber to help balance blood sugar -- vegetables, nuts, seeds and whole grains, including heart-protecting soluble fiber found in oat bran, beans, nuts, seeds and apples. For example, have one tablespoon of ground flaxseeds at each meal (or close to one quarter cup daily), and drink at least 10 ounces of water per tablespoon of flaxseeds. Aim for a daily fiber total of 35 g to 50 g.
- Protein with each meal and at most snacks -- consume protein in the form of legumes, nuts, seeds and peas and lean animal protein including skinless turkey, skinless chicken and fish. Protein drinks with low sugar levels are acceptable. Protein helps even out blood sugar levels... in fact, many people who have diabetes find that increasing protein in their diet is beneficial.
- Quality fats -- fish (including salmon), nuts and seeds. Use olive and flax seed oils for salads and other oil needs.
- Plenty of chromium -- a chromium deficiency contributes to blood sugar problems. You can find chromium in brewer's yeast, wheat germ, whole grains, cheese and garlic.
- Do not go longer than three hours without eating! This will help stabilize blood sugar levels. Focus on foods with a low glycemic index.
Foods to avoid include the following, all of which spike blood sugar levels...
- Simple sugars -- such as candy, cookies and soda.
- White refined bread.
- Alcohol and caffeine (in some people, they also spike blood sugar).
- Artificial sweeteners. Choose healthier sweeteners such as stevia or xylitol in moderation.
- Reduce the amount of saturated fat as found in red meat and dairy products and eliminate trans fats completely from your diet.
In addition, Dr. Stengler started his patient on several supplements to balance her blood sugar and insulin. These included cinnamon extract (500 mg), chromium (500 mcg), vanadium (50 mcg), alpha lipoic acid (300 mg), l-carnosine (500 mg) and red yeast rice (1,200 mg twice a day) to help bring down her cholesterol.
THE AFTERMATH
Two-and-a-half months after she started treatment, this patient had a very different physical profile, says Dr. Stengler. Not only was her energy level much better with no afternoon slumps, her shortness of breath was gone and her lab results were vastly improved. Her cholesterol had dropped from 287 to 185 with her LDL dropping from its original 184 to 113... her triglycerides sank from 268 to 131.
Finally, her fasting glucose level dropped a full 10 points. She continues to do well and Dr. Stengler will likely reduce her supplements to see if the benefits hold. There is no reason to think this patient will ever need statin drugs, and the healthy base she now has will help her prevent further insulin resistance and eventual diabetes, perhaps high blood pressure as well. Dr. Stengler points out that these changes in laboratory values are actually better than what one could have expected from statin or other medications.
TAKE-HOME MESSAGE
The coming together of high triglyceride levels, low "good" or HDL cholesterol, high LDL cholesterol and insulin resistance can be part of a common health problem called syndrome X (or metabolic syndrome). This is an umbrella term for having several health problems within a particular cluster that includes high blood pressure and obesity, especially fat around the abdomen.
However, one problem that is always a symptom of syndrome X is insulin resistance, a metabolic disorder. Insulin resistance happens when the cells begin to resist this hormone that transports blood sugar throughout the body for its use. Eventually the body tries to compensate for the cells' inability to use insulin by overproducing it. The excess insulin, however, is not helpful and ends up as a contributor toward obesity, high blood pressure and an increased risk of cardiovascular disease, cancer, diabetes and other chronic illnesses.
Given that elevated triglyceride and LDL cholesterol levels are such a common symptom of syndrome X, before starting on statin medications, which are powerful drugs with frequent side effects, patients should at least consider the possibility of insulin resistance and syndrome X. Among the root causes of this, only one -- family history -- is something people can't change.
The others are unhealthy diet, chronic stress, nutritional deficiencies (especially chromium, B vitamins, zinc and vanadium), obesity and lack of exercise. A determined patient can correct every single one of those and there is a good chance he/she can improve lipid levels as well. Work with a licensed practitioner who can create the right plan, including proper supplement levels and the proper combination of supplements.
Source
- Mark Stengler, ND, associate clinical professor, National College of Naturopathic Medicine, Portland, Oregon. He practices naturopathic medicine at the La Jolla Whole Health Clinic, La Jolla, California.
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