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What is Syndrome X?
Syndrome X is a condition that occurs when patients have atypical angina chest pain, their electrocardiograms are abnormal during a stress test, but they have no signs of blocked arteries. It is more likely to occur in women. Although it unclear what causes this condition, sensitive imaging tests are suggesting that the Syndrome may also be caused by ischemia, as is angina. Syndrome X, also known as the "insulin resistance syndrome," may be the surest route to a heart attack. It is as powerful a predictor of coronary heart disease as elevated cholesterol or LDL "bad" cholesterol, if not more so.
Signs & Symptoms
• Insulin resistance If you have 3 or more of the above, you should consider yourself either having or at high risk of Syndrome X.
Can't Lose Weight? Syndrome X May Be the Culprit With nearly 4 million Americans weighing in at over 300 pounds, is it any wonder the above cries are heard each and every day by countless frustrated people who can't lose weight? One such cause for the ever increasing need to buy larger pants is a disease known as Syndrome X. Types of Syndrome X
Other Diet-Related Conditions
What Causes Syndrome X? The underlying cause of Syndrome X is insulin resistance - a diet-caused hormonal logjam that interferes with your body's ability to efficiently burn off the sugar you eat. The more sugar you eat, the higher the risk for syndrome X. Syndrome X occurs when the high insulin level damages our bodies' internal systems, producing a crop of symptoms. Specifically, this group of health problems includes insulin resistance (the inability to properly deal with dietary carbohydrates and sugars), abnormal blood fats (such as elevated cholesterol and triglycerides), being overweight, and high blood pressure.
No one knows for sure what causes syndrome X. Some scientists think that a defect in specific genes may cause insulin resistance and intensive research is now underway. What we do know so far is: • Insulin resistance is aggravated by obesity and physical inactivity; both of which are increasing in the U.S. • The more sugar you take in, the higher the chance of you developing Syndrome X. The fact that many obese people have high insulin levels but do not develop diabetes or syndrome X is interesting. Many obese people have high insulin sensitivity and do not have insulin resistance at all. There is evidence of a widespread variability in insulin mediated glucose disposal by muscle in non-diabetic individuals. In a study conducted by Dr.Reaven on 500 individuals, there is an apparent ten-fold difference between the most insulin sensitive and the most insulin resistant non-diabetic individual. Syndrome X may be caused when the small blood vessels in the heart don't expand enough. Postmenopausal women and women who have had surgical menopause are at risk for experiencing symptoms of syndrome X because their declining estrogen levels may affect the small blood vessels in their hearts. Because this condition is a small vessel disease, it can't be seen on an angiogram (an x-ray with dye that identifies blockages in the blood vessels). Special imaging tests, such as PET scanning or MRI, may help with the diagnosis in the future. Today, however, syndrome X is usually a diagnosis of exclusion—meaning you may be diagnosed with this condition after tests provide no other cause for the chest pain. Some health care professionals use the same tests used to diagnose CAD, such as an EKG, echocardiography, or coronary angiography. Many women with syndrome X have no risk factors and are otherwise healthy. Medications commonly used to treat heart conditions may help to relieve pain caused by Syndrome X. The prognosis is generally excellent, but the symptoms can be debilitating.
Risk Factors: Syndrome X is not an exotic disease visited on a few genetically unlucky people. Between 60 and 75 million of us are insulin resistant. A small percent of those millions, perhaps 5 to 10 percent, will develop Type 2 diabetes because their pancreases simply can't produce enough insulin to overcome the insulin resistance. The pancreases of the remaining people will furiously secrete insulin until the resistance is overcome, thus setting the stage for heart disease. Although we haven't yet mapped out all the genes responsible for triggering Syndrome X, we do know that there must be abnormalities in several genes before the disease can manifest itself. We also know that ethnicity plays a role, with people of non-European origin being at a much greater risk. Family history also factors into the equation, with your odds of developing Syndrome X increasing substantially if you have a family history of diseases related to insulin resistance, such as heart attack, hypertension and type 2 diabetes. Lifestyle factors are apparently as important as the genetic: improper diet, obesity, lack of physical activity and cigarette smoking worsen Syndrome X. The fact that our behaviour plays a role in the syndrome is good and bad news. We can't alter our genetic heritage, but we can change our diets and daily habits. This deadly heart ailment begins in the bloodstream, shortly after we eat. That's not a startling idea, for we know that eating fatty or cholesterol-laden foods can be bad for our hearts. However, the Syndrome X culprit isn't red meat or butter, it's carbohydrates. Yet these carbohydrates are reluctant, inadvertent offenders. Before entering the body proper, our food is broken down into various constituent parts in the intestine. One of these is glucose (blood sugar) from carbohydrates. Upon entering our cells, some of the glucose is put right to work providing the energy that cells need to perform their various tasks. The rest is stored in certain cells for later use. But the glucose doesn't simply flow into the storage cells. Instead, it must be guided in by insulin, a protein secreted by the pancreas. Insulin acts like a shepherd, herding its precious flock into the cellular "corrals." Unfortunately, in many of us, glucose behaves like a group of errant sheep, stubbornly refusing to go where the shepherd directs. When that happens, the pancreas pumps out more and more insulin. That's the biochemical equivalent of sending out more and more "shepherds" to get the "sheep" into the "corrals." Imagine hundreds of shepherds chasing thousands of sheep across a pristine field covered with thick, beautiful green grass. Those hundreds of feet and thousands of hoofs will quickly tear up the field, ripping out or flattening down clumps of grass. Soon, the field that once looked so green and lush will be trampled and scarred, brown and dirty. Something similar happens inside your body when glucose refuses to move into the storage cells at insulin's command. The interior linings of your arteries, like the grassy field, are "ripped" and "trampled" as the body attempts to overcome this problem. Eventually, the insulin "shepherds" corral the glucose, and order is restored in the body. But all is not well, for the "field" (the lining of your coronary arteries) is damaged, and there's other damage, as well. This damage sets the stage for heart disease. We don't know exactly how many hearts have been attacked by Syndrome X, although it may be responsible for as many as 50 percent of all heart attacks - or even more. Unfortunately, very few people are aware of Syndrome X, know whether or not they have it or are doing anything about it. And their doctors aren't telling them
Prevention: The best way to prevent Syndrome X is to choose your parents carefully. After all, if you have a family history of heart attack, you run a greater risk of having one yourself. But since the wonders of modern biology have yet to give us the option of choosing our parents, we must find a more practical solution. There are numerous heart attack prevention programs and diets. But none of them gives you the complete and effective approach that attacks all risk factors simultaneously, for none deals with Syndrome X and insulin resistance. In fact, much of their dietary advice makes the syndrome decidedly worse.
Not all cells need insulin in order to absorb blood sugar. Brain cells, for example, do so without the help of the hormone. It's as if evolution realized that getting fuel (glucose) into brain cells was too important a task to depend on the presence of insulin at the right time, in the right amounts. Kidney and red blood cells also "grab" the glucose they need without insulin's assistance. On the other hand, muscle and fat (adipose) cells depend on insulin's aid, and that's where the problems with insulin resistance arise. Excess insulin in the bloodstream prompts the damage associated with Syndrome X, but the insulin is only trying to do its job. The underlying problem is insulin resistance. About 25 to 30 percent of Americans are resistant to their own insulin - their "shepherds" are simply not strong enough to properly herd glucose. This means that greater amounts of insulin are required to get the job done. Unfortunately, excess insulin is the first in a series of events which triggers the damage to arteries that may precipitate a heart attack. Insulin resistance is at the heart of Syndrome X. That's why simply lowering total cholesterol or LDL "bad" cholesterol won't solve the problem. And that's why the low-fat, high-carbohydrate diet so highly recommended by most physicians and health organizations is so dangerous for those with the disorder. Remember, carbohydrates become glucose, and glucose must be herded into certain cells. That requires insulin. More carbohydrate equals more glucose equals more insulin: that's the formula for disaster for those with this "unknown" syndrome. Up until about ten years ago, insulin resistance was recognized as a malady which, if not compensated for, could lead to type 2 diabetes. Thanks to thirty years' worth of research into Syndrome X, we now know that even if you never develop diabetes, you can still suffer other ill effects from insulin resistance and high insulin levels: you may suffer from a constellation of changes that greatly increases your risk of coronary heart disease. In short, if you are insulin resistant, you are in real trouble.
When to seek Medical Advice: The additional independent risk factor: Just how important are the Syndrome X risk factors? Several studies have shown that a low HDL cholesterol, a central feature of Syndrome X, is at least as powerful, if not more so, in increasing risk of heart attack as is high LDL cholesterol. Studies have shown that every separate component of Syndrome X is an individually significant heart attack risk factor. That means that the more components of Syndrome X you have, the greater the heart attack risk. The most reputable research studies reflect this profound fact. For example, the Quebec Cardiovascular Study found that for each 30 percent elevation in insulin levels, there was a 70 percent increase in risk of heart disease over a five-year period. The risk increased with each added component of Syndrome X.
Treatment/Therapy: Physicians have been concentrating on treating the symptoms of Syndrome X such as hypertension and dyslipidemia rather than concentrating on the underlying problem, which is insulin resistance. Since over 50% of the prescriptions filled in the United States are for hypertension, elevated cholesterol levels, heart disease, and diabetes, you can get a glimpse of the economic importance of this problem. Syndrome X is usually totally reversible without drugs. The key is to slow down carbohydrate absorption while increasing insulin sensitivity. This can be done by lowering your carbohydrate intake (the low-carb diet), together with a nutritional supplementation program designed to slow carbohydrate absorption, increase insulin sensitivity, and normalize blood sugar levels. However, human nature (and human metabolism) being what it is, the majority of patients with syndrome X cannot accomplish these goals. In these cases, each metabolic disorder associated with syndrome X needs to be treated individually, and aggressively. A short-term treatment with drugs is seldom but may be needed. Treating the lipid abnormalities. The lipid abnormalities seen with syndrome X (low HDL, high LDL, and high triglycerides) respond nicely to weight loss and exercise. Treatment should be aimed primarily at reducing LDL and triglyceride levels, and raising HDL levels. Successful drug treatment usually requires treatment with a statin or one of the fibrate drugs, or a combination of a statin with either niacin or a fibrate. It should also be noted that the use of statin drugs is not without its problems. Treating the clotting disorder. Patients with syndrome X have several disorders of coagulation that make it easier to form blood clots within blood vessels. These blood clots are often a precipitating factor in developing heart attacks. Patients with metabolic syndrome X should generally be placed on daily aspirin therapy to help prevent such clotting events. Treating the hypertension. High blood pressure is present in more than half the people with metabolic syndrome X, and in the setting of insulin resistance, high blood pressure is especially important as a risk factor. Recent studies have suggested that successfully treating hypertension in patients with diabetes can reduce the risk of death and heart disease substantially. Low dose diuretics should be used according to Dr.Reaven. No more than 12.5 mg of hydrochlorathiazide should be prescribed. People with Syndrome X should not be prescribed the anti-hypertensive dosages of thiazides that have been recommended in the past. Difficult cases should be controlled with ACE inhibitors. ACE inhibitors increase levels of nitrous oxide (a potent endothelium generated vasodilator), resulting in vasodilatation and blood pressure reduction. ACE inhibitors also have been shown to improve endothelial function, and so have HMG-CoA reductase inhibitors (such as lovastatin and pravastatin), and to a lesser degree, calcium channel blockers (such as verapamil and nifedipine). • Pancreas. Two major classes of drugs are the sulonylureas and the meglitinides. Sulfonylureas have been used for more than 4 decades. Their primary goal is to increase the level of endogenous insulin by stimulating the pancreatic secretion. These agents have no direct effect on insulin resistance. • Intestines. Alpha-glucosidase inhibitors are currently represented by acabose. The primary mechanism of action of these agents is to inhibit specific enzymes that break down carbohydrates in the small intestine. Absorption of carbohydrates is delayed, resulting in a reduction of postprandial hyperglycemia. No specific action on insulin resistance has been reported. • Liver. The biguanides, of which metformin is the agent used in the U.S., mainly decrease hepatic glucose production, They also increase peripheral insulin sensitivity, leading to reduced plasma glucose level. They also have some effect in reducing intestinal glucose absorption. Clearly this is a better drug to use than the previous two.
• Muscle. This class of oral agents is known as the thiazolidinediones, of which troglitazone is approved for use in the U.S. It reduces insulin resistance by increasing the uptake of glucose by peripheral tissues such as skeletal tissue. It is therefore uniquely designed to attack insulin resistance.
Diet change strategies: While there are no drug treatments that can directly reverse the insulin resistance that causes syndrome X; there is, in fact, a way to reverse the insulin resistance - and that is through diet, exercise, and nutritional supplementation. 1. Diet Clearly, the following goals should be met in any diet for Syndrome X sufferers: a. Reduction of carbohydrates. With less carbohydrates around, there will be less insulin needed. The question is: If you reduce carbohydrate, and reduce fat, then how are you going to get enough calories? If one food group is reduced, the calories must be supplied by another food group. The strategy is clear - reduce carbohydrates, especially simple refined carbohydrates. How you make up the calories is less clear. There are only two options available: carbohydrates can be replaced with proteins or with fats. Clearly saturated fats should be restricted to reduce the risk of cardiovascular disease and to lower LDL cholesterol level. Therefore, part of the carbohydrate should be replaced with "good" fat. Replacing carbohydrates with proteins ignores the fact that protein, once in the intestinal tract, converts to amino acid. Amino acids increase insulin secretion. It is unclear, however, whether proteins are as potent as carbohydrates in stimulating insulin secretion It has been postulated that use of low glycemic-index carbohydrates will avoid worsening the manifestations of Syndrome X due to its slow glucose release and absorption rate. There is little doubt that low glycemic-index carbohydrates such as fruits and vegetables are superior when compared to high glycemic-index carbohydrates such as white flour and white bread. In a recent paper, substantial increases in the fiber level (exceeding the ADA recommendation) resulted in improved metabolic characteristics, as compared to a high carbohydrate/low fat diet. No comparison was made between the very high fiber diet vs. a diet low in carbohydrates and high in unsaturated fats. The simplest and most effective approach is to replace the carbohydrates with poly- and mono-unsaturated fats and restrict saturated fat intake, to achieve both lower LDL cholesterol and improve Syndrome X.
2. Nutritional Supplementation. A variety of natural non-toxic food based compounds can be used. The goals are to normalize blood sugar, and increase insulin sensitivity. Treating the lipid abnormalities. For Dyslipidemia, the following can be considered: pantethine (300 -1,200 mg), panthothenic acid (300-1,300 mg), guccolipid (50-150 mg), polycosinol (5-10 mg), mineral ascobates (2-5 grams), lysine (2-5 grams), proline (1-2 grams), chromium polynicotinate (400 -1200 mcg), and fish oils (1000 to 4000 mg). Treating the clotting disorder. To reduce the blood clot risk, natural compounds such as vitamin E (300 to 1200 I.U.) and gingko biloba extracts (30 to 150 mg) have blood thinning properties and help promote circulation. Antioxidant therapy with optimum doses of Vitamin A, C, and E helps to stabilize plaques, improve vascular tone, and reduce thrombus. Treating the hypertension. To lower blood pressure, antioxidant therapy helps to stabilize plaques and improve vascular tone by inhibiting oxidation of LDL cholesterol.
Treating high blood sugar. For glucose normalization and to increase insulin sensitivity, natural non-toxic compounds that have sugar modulation effects include chromium polynicotinate (400 -1200 mcg), venadyl sulfate (25 -100 mg), lipoic acid (100-300 mg) can be considered. For rebalancing the internal terrain to enhance digestive balance and efficiency, digestive enzymes, green foods such as chlorella, spirulina, algae, soluble fiber, and probiotics should be considered For antioxidant deficiency: a strong multi-vitamin with at least 10,000 I.U. of beta carotene, 500 mg of vitamin C, 200mg of selenium, 100 mg of grape seed extract, 30 mg of co-enzyme Q10. For normalization of adrenal function, pantethine 300-900 mg, pantothenic acid 400-1,200 mg should be considered.
3. Exercise. Epidemiological studies have shown that modest exercise is beneficial. However, unequivocal metabolic benefits from exercise will not be achieved from a casual walk a couple of nights a week. Significant, regular, chronic exercise is required to see improvements in insulin action, triglycerides, and HDL cholesterol. Exercise is as powerful a tool as weight loss. 4. Weight Management. Every attempt should be made to reduce total body weight to within 20% of the "ideal" body weight calculated for age and height. If this is done Syndrome X will improve significantly. There is little question about its effectiveness. 5. Other lifestyle Factors: a. Alcohol. In population-based studies, moderate drinkers are found to have lower insulin levels as compared to non-drinkers. Our small-scale studies have shown moderate drinkers to be more insulin sensitive. There have been no intervention studies to show that initiating alcohol consumption in individuals who are insulin resistant with low HDL is beneficial. So it is not reasonable to suggest that non-drinkers should start to drink 1-2 drinks per day. On the other hand, we do not have the evidence to recommend abstaining from alcohol. b. Smoking. Smoking is unequivocally bad, asspciated with high triglycerides, low HDL cholesterol and insulin resistance.
Two of the key factors that affect our health is glucose (also known as blood sugar) and the hormone insulin. Because of the high carbohydrate foods we, as a whole population, now eat, our bodies' levels of glucose and insulin have gone out of control. Such high carbohydrate foods probably include cereals, muffins, breads and rolls, pastas, cookies, donuts, and soft drinks. Quite simply, we are overdosing on glucose and insulin -- two substances which in high doses will accelerate the aging of our bodies and encourage the onset of diseases. Insulin resistance is the body's way to resist excessive sugar and carbohydrate levels, and 60 million Americans have this problem. When insulin resistance is accompanied by compensatory hyperinsulinemia- (not explained in article), the systemic damage is collectively known as Syndrome X. Fortunately, Syndrome X can be reversed with dietary, lifestyle, and nutritional supplements and a diet high in unsaturated fat (45%), low in protein (15%), and moderate in carbohydrate (40%). Exercise, weight management, and optimum nutritional supplements such as chromium polynicotinate, vitamin C, proline, lysine, and other antioxidants help to normalize sugar and increase insulin sensitivity.
Vitamin & Nutrient Associations It's for this reason that more and more medical authorities are advocating the use of vitamin and mineral supplements. However, finding them in the right combination can be both confusing and costly. The nutrition products I am going to recommend you make use of knowledge gained from the botanical world's 6,000 year history. They incorporated health building nutritional herbs with the best modern technology to help our bodies cleanse and detoxify so that the cells - the tiniest living units - can be as fully nourished as possible. This allows the cells to grow, repair and to perform their functions with the best possible efficiency so that we feel and look better and are more able to prevent and fight disease. Once the body begins to clear itself of toxins it can more efficiently absorb nutrition.  Further reading through our articles on health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your problem through giving your body the nutrition products that will assist you body to heal from the inside out. We wish you well in your search for solutions to this problem and your movement towards better health in all areas. More Resources available about Syndrome X : For the latest anti-aging related health issues, visit Dr. Lam at www.LamMD.com.
Below here are examples of Health Success Results other people have had with using a self care strategy for dealing with Syndrome X: We would be very interested to hear your result stories with your problem if you are using some of our nutrition products. To send us your story just fill out the form below.
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