Photo by Molly the Cat for Unsplash+
“Metabolic Health” is a recent addition to my vocabulary.
Prior to being introduced to the term several months ago, everything I knew about metabolism was this: When I had rapid metabolism, I could eat whatever I wanted and not gain weight. One day it disappeared. Now I can eat whatever I want and gain LOTS of weight.
Metabolic health, I’ve learned, is slightly more sophisticated. It’s about achieving balance in the body’s internal chemistry. I became familiar with the phrase when, at the urging of good friends, my wife and I agreed to become patients of a functional medicine practice.
Functional medicine, if you are not familiar with it, is a new specialization that today falls just outside the boundaries of conventional medicine. That may be just because it’s new, and/or because its main treatments are supplements that are unregulated by the Food and Drug Administration. Functional medicine’s goal is to restore healthy bodily function by treating the root causes of disease and imbalance, which it traces to metabolism. In practical terms, that means a focus on the body’s processes for using and storing energy: what we ingest, how well we digest, and how efficiently we move waste to the egress.
Here’s an example of what I mean by focus: At my annual physical exam, my primary care doctor orders routine blood tests, including one that measures whether my glucose level is higher than, lower than, or within the normal range. At the functional medicine practice, my blood test results indicate not only whether my glucose is within normal range but also if it is within the optimal range. That’s just for starters. The labs also measure estimated average glucose, fructosamine, glucose fasting, triglyceride-glucose index, and hemoglobin AiC. I don’t pretend to understand what any of that means, but the functional medicine staff connect the dots and interpret their meaning.
While “metabolic health” eludes easy definition, what you don’t want to have is“metabolic syndrome,” a condition marked by interrelated issues related to metabolism. A person with at least three of the five risk factors – excess abdominal weight, low levels of HDL cholesterol, elevated levels of triglyceride, elevated blood sugar levels, and high blood pressure – is considered to have metabolic syndrome.
The chemistry of metabolism can affect many connected systems, so functional medicine has no other option but to be holistic. Unlike most medical specialties, it sees the internal organs in their Relationships to one another, connected by blood and the nutrients traveling in it. Its practitioners address body, mind, and spirit, as well as outside environmental factors.
Metabolism even affects mental health. “When your metabolism isn’t healthy, it can interfere with your mood,” says Dr. Komal Patil-Sisodia, an endocrinologist. “People who struggle with high blood sugar, high blood pressure, or abnormal cholesterol are more likely to feel depressed.”
My wife and I had our blood tested. In addition, we followed detailed directions for taking our own urine and stool samples. Not an experience for the plus column, but there is nothing quite like getting up close and personal with the byproducts of your own digestion.
After all those tests, I walked into the functional medicine practice feeling fit and healthy for a man in his mid-70s. I walked out burdened by the knowledge that my blood sugar needed immediate treatment and I had a 50% to 95% likelihood of gastrointestinal, cardiovascular, immune system, kidney, liver, gall bladder and sex hormone dysfunction.
Functional medicine’s main answer to fixing metabolic imbalance is taking supplements. (Supplements, as I said, are unregulated by the FDA, which makes many doctors leery.)
Another important caveat: To paraphrase Robin Williams, functional medicine is nature’s way of saying you have too much Money. It is a boutique or concierge practice with the fees to match, and the recommended supplements for the two of us cost more than $600 per month. As you might expect, neither fees nor supplements are covered by Medicare or private insurance.
If you choose to follow a more traditional medical pathway, a primary care physician can prescribe drugs that control blood pressure, cholesterol, and blood sugar.
Beyond that, those same lifestyle changes that doctors repeatedly recommend are also key for metabolic syndrome. You know the drill: lose excess weight, Exercise regularly, follow a heart-healthy Diet such as the Mediterranean Diet, get enough good Sleep, quit smoking, and manage Stress.
But whatever path you choose, don’t wait until those metabolic risk factors evolve into Diabetes, Heart Disease, or kidney failure. It’s safer, cheaper, and less painful to address them early.
