Metabolic dysfunction is a rising problem in Western societies, with up to 25% of adults meeting the criteria for Metabolic Syndrome. Metabolic Syndrome is defined as a cluster of clinical symptoms including obesity, hyperglycaemia, dyslipidaemia and hypertension. Together, these factors greatly increase the risk of cardiovascular disease and type 2 diabetes.¹ Dietary and lifestyle changes are a key component of treatment,¹ along with the use of carefully selected herbs and nutrients to support weight loss and healthy metabolic function.

Initial Presentation

A 59 year old male patient presented with elevated body weight of 110 kg. He exhibited features of insulin resistance, moderate hypertension, and mildly elevated cholesterol. He also suffered with asthma. He was not taking any prescribed medication. All standard blood tests were unremarkable, including normal thyroid function, other than elevated total cholesterol (6.5 mmol/L).

Diet and Lifestyle Recommendations

• Increase exercise

• Reduce consumption of carbohydrates

• Follow the 8-Point Hypertension Diet:

o The key elements of the DASH diet (high in fruit, vegetables, whole grains, low-fat dairy
  products, fish, chicken and lean meats)

o Berries 50-100 g daily

o Cocoa (85% dark chocolate), 20 g per day

o Green tea and hibiscus tea, several cups daily

o Garlic, 1-2 fresh raw crushed cloves daily

o Beetroot as juice or supplement, plus sunlight (to increase nitric oxide levels)

o Fibre, including 30g per day freshly milled linseeds

o Reduce salt to 3 g daily and increase potassium

Herbal Treatment

• Allicin Releasing Garlic Tablets containing Allium sativum (Garlic) extract equivalent to fresh bulb 3.6 g; standardized to alliin 12 mg (1 twice a day)

• DNA Protection Support Tablets containing Raynoutria japonica (Polygonum/Giant Knotweed) root 8.0 g, Vitis vinifera (Grape Seed) 4.8 g, Silybum marianum (St Mary’s Thistle) fruit 4.2 g, Ginkgo biloba (Ginkgo) leaf 1.5 g and Panax ginseng (Korean Ginseng) root 250 mg (2 before breakfast)

• Bioavailable Curcumin Tablets containing 100 mg bioavailable curcuminoids (1 twice a day)

• Coleus Tablets containing Coleus forskohlii 5.61 g; standardized to contain forskolin 18.7 mg (1 twice a day)

Garlic was chosen for its lipid lowering, antiatherogenic, hypotensive and platelet inhibiting effects.² Curcumin also has hypolipidaemic, anti-inflammatory, antioxidant and antiplatelet effects,² in addition to increasing adiponectin and reducing leptin levels,³ and improving glycaemic control.⁴

Coleus was included for its hypotensive and cardiotonic activity.² Coleus can also improve insulin sensitivity⁵ and may support weight loss.⁶ Finally, the herbs present in DNA Protection Support Tablets provide polyphenols that improve mitochondrial function and microcirculation, and activate nuclear factor erythroid 2–related factor 2 (Nrf2), sirtuin-1 (SIRT1) and adenosine monophosphate-activated protein kinase (AMPK), all integral to healthy metabolic function.⁷

Follow up

Over 12 months there has been a gradual reduction in body weight, waist measurement and blood pressure. Recent readings include:

o BP 130/85

o Waist circumference reduced by 8 cm

o Body weight reduced by 6 kg

Clinical Thoughts

Metabolic Syndrome and insulin resistance represent a failure of modern living. There is no other condition that so comprehensively represents the weaknesses in our modern lifestyle. Poor eating habits, lack of exercise, high stress levels, poor quality sleep, immune challenges, polluted environment, and poor digestive health all come together in a perfect storm to create this condition of disordered energy metabolism. This is a challenge that we, as natural healthcare practitioners, are best equipped to face. Uniquely among healthcare practitioners, we are able to take the hours, weeks and months needed to work with our clients, to implement lifestyle changes and utilise carefully selected herbs and nutrients, to help our clients reverse their metabolic dysfunction.

References 

1. Samson SL, Garber AJ. Metabolic syndrome. Endocrinology and Metabolism Clinics. 2014 Mar 1;43(1):1-23. 
2.  Bone K, Mills S. Principles and practice of phytotherapy: modern herbal medicine. Elsevier Health Sciences; 2012 Dec 31. 
3. Chuengsamarn S, Rattanamongkolgul S, Phonrat B, Tungtrongchitr R, Jirawatnotai S. Reduction of atherogenic risk in patients with type 2 diabetes by curcuminoid extract: a randomized controlled trial. The Journal of nutritional biochemistry. 2014 Feb 1;25(2):144-50. 
4. Na LX, Yan BL, Jiang S, Cui HL, Li Y, Sun CH. Curcuminoids target decreasing serum adipocyte-fatty acid binding protein levels in their glucose-lowering effect in patients with type 2 diabetes. Biomed Environ Sci. 2014 Nov 20;27(11):902-6. 
5. Loftus HL, Astell KJ, Mathai ML, Su XQ. Coleus forskohlii extract supplementation in conjunction with a hypocaloric diet reduces the risk factors of metabolic syndrome in overweight and obese subjects: a randomized controlled trial. Nutrients. 2015 Nov 17;7(11):9508-22. 
6. Kamohara S. An evidence-based review: Anti-obesity effects of Coleus forskohlii. Personalized Medicine Universe. 2016 Jul 1;5:16-20. 7 López-Lluch G. Mitochondrial activity and dynamics changes regarding metabolism in ageing and obesity. Mechanisms of ageing and development. 2017 Mar 1;162:108-21.