Why you should shift your focus to your metabolic health

See what happens when you shift your focus to monitoring your metabolic health.

I have a family history of illness. My grandparents had diabetes. My father was severely obese, and on my mother’s side, I have multiple aunts and uncles with heart disease. Even though I am quite lean, I have risk factors for metabolic syndrome, including very low HDL cholesterol and higher triglycerides.

I want to live to 120 and thrive. Healthspan matters more to me than life span. I don’t want to develop diabetes or heart disease so I take care of my metabolic health. If you take care of your metabolic health, you give yourself a better chance of healthy aging, of surviving and thriving well into old age.

To improve my health span, I make sure my blood sugars and blood pressure are under good control. For those reasons, I wear a continuous glucose monitor and take targeted supplements to support better glucose metabolism. Excellent metabolic health means fasting blood sugar under 100 and fasting insulin under 7. Do you know what your blood sugar control looks like?

We know that having diabetes, pre-diabetes, and metabolic syndrome all increase the risk of heart disease and stroke. And we know that all of those conditions also increase the risk of more aggressive disease course in the setting of multiple sclerosis and other autoimmune diseases.1-4

Unfortunately, elevated blood sugar, pre-diabetes, and metabolic syndromes are silent. There are no symptoms alerting you that something is amiss. The definition for metabolic syndrome is met if three of the following five criteria are met:

1. ### waist > 40 (101 cm) inches (men) or > 35 (89 cm) inches (women)
2. ### blood pressure over 130/85
3. ### fasting triglyceride > 150 mg/dl
4. ### fasting HDL cholesterol < 40 mg/dl (men) or < 50 mg/dl (women)
5. ### fasting blood sugar over 100 mg/dl.5

While metabolic syndrome is more of a risk for those who are overweight, it can occur in thin people too.6

Do you know your risk factors for metabolic syndrome?

Do you know your fasting blood sugar, blood lipids, blood pressure, and waist circumference? It’s important to assess your risk factors. Speak with your primary care team about your metabolic health and have your lipids and blood sugar measured.

You can also get your blood lipids tested through YourLabWork, they offer accessible and affordable testing.

You can also monitor your blood sugar for two weeks to assess metabolic health. I use LEVELS to monitor my blood sugar and how it responds to my diet, sleep, stress, and activity levels.

Because metabolic syndrome, pre-diabetes, and diabetes have zero physical symptoms, are so prevalent across the world, and increase the risk of so many health problems, I urge everyone to check on their metabolic health.

It’s also important to monitor insulin resistance.

In my clinical practice, I recommend a target of fasting insulin under 7. You can ask your primary care team for a fasting insulin and glucose level test. You can also wear a continuous glucose monitor for two weeks, which I also urge my patients to do.

If you have one or more risk factors for metabolic syndrome, you would likely benefit from wearing a continuous glucose monitor and getting feedback on your how your diet, sleep, stress management, and exercise are all impacting your blood sugar levels. Again, people who have elevated blood sugars, metabolic syndrome, or diabetes have a more rapid worsening of autoimmune complications and shorter time to disability.7-9

You may also benefit from targeted supplements to support better blood sugar metabolism. Alpha lipoic acid (ALA),10,11 berberine12,13, and biotin14,15 have been observed to support insulin activity and glucose metabolism. Berberine supports achieving improved hemoglobin A1C levels.16

I have multiple risk factors for metabolic syndrome and work hard to make sure my metabolism and blood sugar are ideal. To improve my health, I wear a glucose monitor, take targeted supplements, follow a ketogenic diet, and pay attention to my sleep. All of that has improved my metabolism, which protects my brain, my heart, and my future.

Had I never checked, I might’ve been on my way to developing diabetes and earlier cognitive decline and frailty. None of those are in my plans for my future. I imagine they aren’t in yours either.

The Wahls Protocol® Collection carries Blood Sugar Synergy, designed to help support cardiometabolic health.

It delivers alpha-lipoic acid (ALA), the plant alkaloid berberine, and biotin in one convenient formula. These ingredients have been observed to support insulin activity and glucose metabolism. Research also suggests a role for berberine in supporting normal A1C levels.

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References

1. Marck CH, Aitken Z, Simpson S, Weiland TJ, Jelinek GA. Does a modifiable risk factor score predict disability worsening in people with multiple sclerosis? *Mult Scler J Exp Transl Clin.* 2019;5(4):2055217319881769.

2. Marck CH, Neate SL, Taylor KL, Weiland TJ, Jelinek GA. Prevalence of Comorbidities, Overweight and Obesity in an International Sample of People with Multiple Sclerosis and Associations with Modifiable Lifestyle Factors. *PLoS One.* 2016;11(2):e0148573.

3. Marrie RA. Comorbidity in multiple sclerosis: Past, present and future. *Clin Invest Med.* 2019;42(1):E5-E12.

4. Marrie RA, Garland A, Schaffer SA, et al. Traditional risk factors may not explain increased incidence of myocardial infarction in MS. *Neurology.* 2019;92(14):e1624-e1633.

5. Huang PL. A comprehensive definition for metabolic syndrome. *Dis Model Mech.* 2009;2(5-6):231-237.

6. Sanyal D. Lean Metabolic Syndrome: An Emerging Concept. *Indian J Endocrinol Metab.* 2018;22(3):301-302.

7. Pinhas-Hamiel O, Livne M, Harari G, Achiron A. Prevalence of overweight, obesity and metabolic syndrome components in multiple sclerosis patients with significant disability. *Eur J Neurol.* 2015;22(9):1275-1279.

8. Smith AE, Molton IR, Jensen MP. Self-reported incidence and age of onset of chronic comorbid medical conditions in adults aging with long-term physical disability. *Disabil Health J.* 2016;9(3):533-538.

9. Dao HH, Do QT, Sakamoto J. Increased frequency of metabolic syndrome among Vietnamese women with early rheumatoid arthritis: a cross-sectional study. *Arthritis Res Ther.* 2010;12(6):R218.

10. Aslfalah H, Jamilian M, Rafiei F, Khosrowbeygi A. Reduction in maternal serum values of glucose and gamma-glutamyltransferase after supplementation with alpha-lipoic acid in women with gestational diabetes mellitus. *J Obstet Gynaecol Res.* 2019;45(2):313-317.

11. Rahimlou M, Asadi M, Banaei Jahromi N, Mansoori A. Alpha-lipoic acid (ALA) supplementation effect on glycemic and inflammatory biomarkers: A Systematic Review and meta- analysis. *Clin Nutr ESPEN.* 2019;32:16-28.

12. Han Y, Xiang Y, Shi Y, et al. Pharmacokinetics and Pharmacological Activities of Berberine in Diabetes Mellitus Treatment. *Evid Based Complement Alternat Med.* 2021;2021:9987097.

13. Li C, He JZ, Zhou XD, Xu X. \[Berberine regulates type 2 diabetes mellitus related with insulin resistance\]. *Zhongguo Zhong Yao Za Zhi.* 2017;42(12):2254-2260.

14. Dakshinamurti K. Vitamins and their derivatives in the prevention and treatment of metabolic syndrome diseases (diabetes). *Can J Physiol Pharmacol.* 2015;93(5):355-362.

15. Kouzi SA, Yang S, Nuzum DS, Dirks-Naylor AJ. Natural supplements for improving insulin sensitivity and glucose uptake in skeletal muscle. *Front Biosci (Elite Ed).* 2015;7(1):94-106.

16. Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. *Metabolism.* 2008;57(5):712-717.