Articles

Metabolic Syndrome

By Paul Hueseman, R.Ph, Pharm.D.

Much is in the news recently about the alarming increase in the number of people with "metabolic syndrome", also known as "syndrome X" or "prediabetes". Nearly one-quarter of adults in the U.S. have metabolic syndrome.1 The great concern is that this is likely to lead to significant future increases in cases of diabetes and heart disease. There is also a concerning increase in obesity in children and adolescents, as well as increases in the number of young people with type 2 diabetes. In fact, the CDC has sounded an alarm that if lifestyle habits do not change, 1 in 3 children today will become diabetic by age 40. 2

Metabolic syndrome is defined as a clustering of several metabolic disorders that are influenced by obesity, increased blood sugars, increased blood pressure, unfavorable changes in cholesterol that include increased triglycerides and low HDL (good) cholesterol levels, and resistance to insulin secreted by the body.3 The following are the key measures of metabolic syndrome proposed by the National Cholesterol Education Program (NCEP) in 20014:

- Abdominal obesity (waist circumference >40 inches for men, > 35 inches for women)
- Blood pressure (>130 / >85 mmHg)
- Triglycerides (>150 mg/dl)
- Low HDL cholesterol (<40 mg/dl for men; <50 mg/dl for women)
- Fasting blood sugar > 110 mg/dl

These increases in blood sugar levels lead to inflammation. This inflammation in the body increases the risk for heart disease and other chronic diseases. Chronic elevated blood sugars also leads to glycation in which the glucose attaches to fat and proteins in the body damaging enzymes and other tissues and the way they function in the body.

Some literature suggests that this syndrome may have some link to deficiencies in vitamins, minerals, and nutrients that have a role in controlling blood sugar.2 The following are some suggested supplements that may improve the metabolic profile.

Low serotonin levels in addition to being affiliated with depression, are sometimes linked food cravings and hunger. Serotonin can be elevated with 5-HTP, a precursor to serotonin.

Chromium polynicotinate has been shown in some literature to improve the body’s ability to utilize glucose in the blood. Chromium does this by enhancing the effects of insulin. Insulin is the pancreatic hormone that provides cells with glucose for energy and maintains normal blood glucose levels. Chromium may also improve protein and fat metabolism.4

Omega-3 fatty acids such as eicosapentanoic acid (EPA) can enhance insulin sensitivity by regulating the actions of insulin through interactions with the PPAR-receptors.

Alpha lipoic acid (ALA) is important as a potent antioxidant to improve glucose uptake by cells. It has also been shown to be beneficial in patients with type 2 diabetes by significantly reducing the complications of diabetes including neuropathy, cataract formation, blood vessel damage, and kidney damage. The recommended dose for a diabetic is 600 mg daily in divided doses.

Coenzyme Q10 helps to improve blood pressure and blood sugar control. CoQ10 is important in repleting energy within cells. Typical dosages are 90-400 mg per day in divided doses.

N-Acetyl Cysteine is another essential supplement in the care of patients with diabetes by reducing the damage to blood vessels that occurs with diabetes. It also may help with the glycation process that occurs in diabetes. The typical dosage of N-Acetyl Cysteine is 1200-1800 mg per day in divided doses.

Carotenoids such as lycopene may reduce the potential risks for people who have diabetes or metabolic syndrome, as high lycopene levels are associated with reduced heart disease. Carotenoids are potent antioxidants.

Zinc plays an vital role in the manufacturing, storage, and release of insulin. Zinc is also associated with a higher prevalence of hypertension, hypertriglyceridemia, and LDL cholesterol levels which are all associated with metabolic syndrome and diabetes. The recommended dose of zinc supplementation is 50-100 mg per day in divided doses.

Magnesium supplementation is also associated with improved insulin production and sensitivity. The typical recommended dose is 600-1000 mg per day in divided dose.

Vitamin E may reduce glycation of tissues and is associated with reducing complications of diabetes.

1. LaValle J. Diabetes: The Sleeping Giant Awakes; Nutri-News. Douglas Laboratories, 2005.
2. Diabetes Care 27:2761-2763, 2004.
3. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatement of high blood cholesterol in adults. JAMA 285:2486-2497,2001.
4. Holt S. Combat Metabolic Syndrome X; Nutri-News. Douglas Laboratories, 2005.
5. Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome amound U.S. adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356-359, 2002.