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Metabolic Disease

Metabolic Disease and Insulin Resistance

Metabolism is the chemical reaction in the body’s cells that change food into energy. Our bodies need this energy to do everything from moving to thinking to growing. Specific proteins in the body control the chemical reactions of metabolism. Thousands of metabolic reactions happen at the same time, all regulated by the body, to keep our cells healthy and working.  These chemical reactions can become impaired by poor nutrition, obesity, chronic inflammation, or deficiencies of vital nutrients.  We call this metabolic disease which sets us up for major disease processes such as insulin resistance, diabetes, stroke, heart attack, dementia, and degenerative joint disease.

We perform a deep dive into your current metabolic state and will design a plan to optimize each aspect.  Below are some examples of biomarkers that we can optimize.

Fasting Glucose level helps us understand if you have any insulin resistance.  Insulin is a hormone secreted by the pancreas that is responsible for controlling blood glucose levels.  As we gain visceral fat from a high sugar, high carbohydrate diet, the body has to secrete more and more insulin to keep the blood sugar at physiologic levels.  When the pancreas cannot produce enough insulin to keep blood glucose normal, we call this diabetes mellitus.  Elevated glucose over the course of years and decades causes tremendous damage to our body.  When we have normal insulin physiology and no insulin resistance, we expect the blood glucose to ideally be less than about 97 mg/dl. 

Fasting Insulin – We can also measure insulin levels while fasting, and if these are elevated, then we can infer that there is significant insulin resistance as the body requires more insulin to maintain a normal glucose during a fasted state.

Hemoglobin A1c is a measurement of average glucose levels over about 90 days.

HS CRP (High Sensitivity C Reactive Protein) is a measurement of inflammation, particularly vascular inflammation.  As our understanding of disease processes has increased, it has become clear that many diseases are caused by or exacerbated by chronic inflammation.  Chronic inflammation can cause atherosclerotic plaque in arteries which causes stroke and heart attack.  This is just one piece of the puzzle when assessing your cardiovascular risk factors.  Multiple cancers are highly associated with chronic inflammation as well.  Visceral fat is the most profound cause of chronic inflammation.  We can help find ways to minimize inflammation. 

Uric acid is a byproduct from the breakdown product of fructose and purines from animal protein.   Elevated uric acid causes chronic inflammation and drives metabolic dysfunction and chronic diseases, including hypertension, obesity, kidney disease, sleep apnea, stroke, arthritis, and vascular dementia.  Some medications can increase uric acid as well, including heartburn medications, aspirin, and diuretics.

Vitamin D (Cholecalciferol) is actually a hormone made from cholesterol and is essential for multiple metabolic processes and optimal health.  Cholecalciferol is produced in the skin with exposure to sunlight.  Suboptimal levels of vitamin D may be associated with an increased risk of osteoporosis and fractures, inflammatory conditions, heart disease, colon cancer, prostate cancer, breast cancer, and diabetes.

Vitamin B12 is an extremely important vitamin that is involved with multiple metabolic processes within our cells.  It is water-soluble and excreted in the urine rapidly, and we do not have enough in our diet.  It has been shown to reduce homocysteine which is associated with an increased risk of cardiovascular disease.  

Ferritin is a large protein that stores iron and helps transport iron in the blood.  It is a reflection of your iron levels, and low ferritin can cause severe fatigue and anemia. 

Homocysteine is a byproduct of normal metabolism.  Elevated homocysteine levels are associated with increased cardiovascular risk of CAD and MI.  This can be caused by genetic variants known as SNPs, single nucleotide polymorphisms that impair normal metabolism of folic acid and other nutrients. Other factors can contribute to high homocysteine levels: insufficient B vitamins, high-methionine diet (including red meat and dairy products), smoking, advancing age, and obesity.  

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