INL Articles - Metabolic Syndrome, Obesity and Natural Medicine

Metabolic syndrome is more than just obesity and natural medicine has robust solutions that might be able to help

Welcome to the June edition of the INL newsletter. Throughout this month we have been looking more in depth at metabolic syndrome and the opportunities for its treatment via lifestyle and nutraceutical applications such as Berberine.

In this newsletter we revisit the basics of this constellation of conditions and how natural medicine can have a broader effect on its management.

Prevalence of Metabolic Syndrome

With obesity becoming a focal point for COVID-19 complications through the first half of 2020, healthcare practitioners now have a larger role to play in helping people to change their body composition for the better.

In a lot of cases though, there is more to the story. Metabolic syndrome is characterised by a cluster of a minimum of three out of five cardio-metabolic abnormalities that occur together. These abnormalities are hyperglycaemia, hypertriglyceridemia, low HDL-cholesterol, and hypertension. (1) (2) (3)

There is also a well established association with NAFLD (fatty liver). (4)

Astonishingly, it is estimated that 12-37% of the Asian population and 12-26% of the European population suffer from metabolic syndrome. (5) In Hong Kong, this percentage is estimated to be around14%. (6)

Nigella (Black Seed Oil) for AMPK Regulation and Metabolic Syndrome

AMP-activated kinase, referred to in detail within the Berberine instalment of INL’s Message from Graeme series (Missed it? Click Here), is now considered to be a major therapeutic target in the development and progression of metabolic syndrome.

As well as being involved in glucose transport, fuel metabolism and lipid and protein synthesis, AMPK regulates a wide array of physiological processes, including mitochondrial function and biogenesis, cellular growth and proliferation and factors that have been connected to insulin resistance such as inflammation, oxidative and ER stress and autophagy.

Berberine’s role in managing the broad spectrum of markers for metabolic syndrome via AMPK  is well documented but an option often missed is the middle eastern herb Nigella Sativa. Thymoquinone, the main constituent in Nigella has been found to up regulate GLUT-4 in the muscle via its effect on AMPK. (7) The same study also found an important effect on PPAR-y leading to an amelioration in hyperglycaemia, hypoinsulinemia, dyslipidemia offering an entry level for the treatment of diabetes.

These revelations have transferred over to human studies, a notable one using 1g of Nigella after breakfast for the space of 2 months in menopausal women saw significant improvements in total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and glucose. (8)

This brought Nigella and Thymoquinone into the conversation both as a treatment intervention as well as a protective measure for women advancing in age.

Vitamin E and Metabolic Syndrome

Vitamin E has numerous applications for metabolic syndrome. Research has revealed that Vitamin E possesses anti-oxidative, anti-inflammatory, anti-obesity, anti-hyperglycaemic, anti-hypertensive and anti-hypercholesterolemic properties. (9)

As an extension of this Vitamin E has garnered much attention due to its role in the regulation of many of the pathways considered critical in the development of metabolic syndrome. Initial research into fatty liver, a condition closely related to metabolic syndrome expressed that tocotrienol supplementation unique to Annatto showed results within just 12 weeks of 300mg Delta-T3 supplementation twice daily.

Significant improvements across biomarkers of hepatic stress, including 15-16% reduction in ALT and AST, 11% decrease in triglycerides, 14% reduction in MDA and 18% reduction in hs-CRP. (10)

Alpha Lipoic Acid and Metabolic Syndrome

Alpha lipoic acid (ALA) is a well-known natural measure for blood sugar management and impaired glucose tolerance. Its role in the management of pro-inflammatory markers and oxidative stress markers that contribute to metabolic co-morbidities less so.

A key meta-analysis supported the beneficial impacts of ALA administration on decreasing inflammatory markers such as CRP, IL-6 and TNF-a among patients with metabolic syndrome and related disorders, particularly neuropathies. (11)

This key action coincides with key metabolic benefits such as the activation of PPAR-g and PPAR-a and AMPK within cardiac tissue and aortic smooth muscle. (12)

Interestingly, ALA can also play an important antioxidant role via the increase of intracellular glutathione through vitamin C and E regeneration as well as the important induction of the Nrf-2 antioxidant pathway. (13)

Key dose ranges for the use of ALA range from 600-1000mg daily for the duration of 12 weeks to one year depending on the type of condition being treated.

Natural medicine-oriented interventions show key influence in the treatment of metabolic syndrome

Lifestyle interventions through diet and exercise are key to the success of any protocol treating metabolic syndrome and its complexities. The key agents outlined above and within the formulas listed below can play a key role in attenuating the biomarkers we associate with metabolic syndrome in an evidence-based fashion that is reliable and standardised.