What is Pre-diabetes, and How does it Affect my Health?

Bill was a fit man for his age and appearing to be in good health. He said, “I am just retiring, so I want to make sure I am properly evaluating my health.” He came to see me to get blood-based laboratory testing. As I evaluated his medical records, I noticed a couple of times when his fasting blood sugars had been running a little high. They were not in the pre-diabetic range but were above the optimal range of 70–85; they were running just above 90.

“I think one of the best tests you could do is a two-hour glucose tolerance test,” I suggested. The test came back a few days later, showing a two-hour blood sugar well above 140, indicating advanced pre-diabetes. Bill wasn’t overweight and had been exercising three to four times a week, so these results caused him to reevaluate his health.

“Clearly,” he said, “what I have been doing is not enough to overcome the natural genetic tendency I have toward pre-diabetes or diabetes.” So at the next appointment, he came in with his list of many questions and said, “OK, what do I need to do that will be enough to reverse this pre-diabetes?” So he went through our twelve-week program designed to optimize blood sugars and correct the underlying causes of his health risk.

Through that process, he learned simple strategies that, when brought together, helped him totally reverse his pre-diabetes. One of the things Bill learned in the program was that the timing of exercise is really important. Remember, Bill was lean and fit—he already exercised more than most men. His blood sugars, before meals, were essentially fine—but not his blood sugars after meals. So he learned two primary strategies: to note what kinds of meals caused the biggest spike in his blood sugars—and also to note the time of his exercise that had the greatest impact on lowering his blood sugar spike after meals.

What he learned was that exercising immediately after a meal had the potential to lower his blood sugars anywhere from one to three points for every minute he exercised. So for instance, if someone’s blood sugar is typically ninety points higher than it should be one or two hours after a meal, but now they go out right after eating and exercise moderately to briskly for thirty minutes, there is a good chance they could lower their blood sugar (at three points for every minute of exercise) by up to ninety points, bringing their high blood sugar down to a much healthier level.

The second thing Bill recognized is that he needed to learn how to balance his meals. He needed to know how to use whole plant-based foods that incorporated nuts and seeds in moderate amounts, with their healthy fats and proteins. This would slow down the absorption of sugar from his meal, so his sugar would not spike nearly as much. He also needed to learn how to choose healthy starches. Not all starchy complex carbohydrates are healthy starches—these need to be unprocessed, high in fiber and full of nutrients before they help control blood sugar levels and ultimately, the health of our heart and blood vessels.

Bills story is one of many examples showing the importance of proper testing and how it guides us in making simple changes that can transform our health and greatly lower our risk for future disease. That is why I believe one of the best health assessment tests available today is the two-hour oral Glucose Tolerance Test (GTT for short). Typically, only the fasting and two-hour glucose levels are now tested in the GTT. But the most likely time to see an elevated blood sugar (glucose) is at the one-hour point after drinking 75 grams of Glucola (a standard carbonated glucose drink used to see how high blood sugar goes). So I always add the one-hour glucose test to the GTT. In addition, I always add the fasting and two-hour insulin test. Even in patients who have completely optimal blood sugar responses to the GTT, the insulin levels are among the first risk factors to indicate a risk to health.

While testing insulin levels is not currently part of standard recommendations, I learned the value of testing insulin several decades ago by paying attention to the advice of Dr. Nancy Bohannon, a preventive endocrinologist, director of the Cardiovascular Risk Reduction Program at St. Luke’s Hospital in San Francisco, and professor at UCSF. In 1991 Dr. Bohannan—who sub-specializes in diabetes prevention and management—gave a lecture sent out to family practice physicians in “Family Practice Audio Digest.” As part of the talk, she explained how the fasting insulin should always be less than 10 microIU/mL. Because of my willingness to listen to one of the world’s leading experts and not simply wait the average of twenty-five to thirty years it usually takes for good evidence to be fully accepted by the average clinician, I was able to effectively counsel thousands of patients as to their future health risk and how to transform that risk through comprehensive lifestyle medicine.

Why is this important? Because having a high insulin level predicts a three-fold increase in risk toward developing heart disease. In addition, elevated blood insulin is a major contributor to the development of high blood pressure and is closely associated with increased prostate, breast, and colon cancer risk.

Now, back to Bill’s story. Once we learned that Bill had advanced pre-diabetes, I discussed the relationship between blood sugars, insulin, and blood pressure with him. For many years he had struggled with hypertension, even while on medications for his blood pressure.

Goodbye Diabetes. Goodbye Insomnia.

At 59 years old, Stan had diabetes, high cholesterol, high blood pressure, Vitamin D deficiency, a high Cardiac CRP, and elevated serum homocysteine.

The Glucose and Insulin Tolerance Test had clearly determined that a primary cause of his diabetes was insulin resistance. Even though Stan’s cholesterol was not very high, the new NMR LipoProfile had indicated he had an excessive LDL cholesterol particle number suggesting a greater risk for heart disease.

We spent the initial two visits interpreting the tests and outlining a comprehensive lifestyle and nutritional medicine program that would optimize Stan’s ability to reverse his health risk.

“Can you help me consolidate and simplify my nutritional supplement program?” Stan asked during his third office visit. Over the years he had accumulated a total of 15 different supplements each in its own container. Concerned that he might be getting too much of some and too little of other nutrients, Stan asked, “Can we figure out a way to limit the number of supplements I take and still get the optimal nutrition I need?”

Stan’s was in luck. Recently, a new technology made it possible for wellness clinics to economically personalize a patient’s supplement program and consolidate all the supplements into just one bottle! Some patients prefer to have one bottle for the AM supplements and one for the PM supplements. Others prefer a bottle designed for each meal three main meals.

Since the volume of most supplements is primarily made up of fillers, excipients, and additives, this new technology was able to take the active nutritional ingredients from 5 to 10 different supplement capsules or tables and combine them into just one capsule!

Even after addressing Stan’s new lab findings, we were able to consolidate over 15 supplement bottles into just three bottles containing capsules that were completely free of additives, fillers, and excipients. Stan no longer feels overwhelmed when he gets the supplements out each morning, and neither does he worry about getting the right dose or if he is getting the highest clinical grade of nutrients and herbs.

Within four months of the comprehensive lab testing, Stan was able to lower his blood sugars and A1c so effectively that he no longer needs any medications. In fact his labs show he doesn’t have diabetes any more.

The high LDL particle number of over 1600 that was promoting artery plaque has now dropped into the optimal range of under 1000. His homocysteine has dropped from a high risk 14.1 to a healthy 8.2 and his Cardiac CRP as a measure of inflammation improved by 50%. These encouraging results motivate Stan to continue his daily exercise plan and his focus on a well-balanced nutrition program.

Key Lab Tests for a Wellness Tune-Up

How a Wellness Tune-up can Prevent and Reverse Disease

By Dr. Wes Youngberg

When I was 24 years old I read the studies done by Drs. Brown and Goldsteine. They had just won the Nobel Prize in Medicine for their work showing how harmful cholesterol particles can enter the artery walls and cause plaque. So I took the initiative and got tested. Since I was very fit and careful with my diet, I was shocked to learn that I had very high LDL Cholesterol and Triglycerides. At first I was depressed but I quickly realized that I had been given a gift! A second-chance of-sorts. With this new awareness I could make the necessary changes now, well before any health problems developed.

Everyone wants to be healthy but few of us recognize the underlying causes of our suboptimal health. A proper tune up requires that we first do the right blood tests. But when is the last time we took the time to get a comprehensive wellness evaluation?

Blood tests are often the best and quickest way to assess our health and to help us stay motivated. Even the healthiest among us have “chinks in our armor” and can benefit from these objective lab tests. There are many tests available to those looking for a health tune up. Here are several of the tests that I usually recommend when initiating a wellness tune-up.

1)   MTHFR test. No I’m not swearing at you. This could actually be the most important blood test of your life! It is the most significant scientific breakthrough resulting from the Human Genome Project completed in 2003. MTHFR is a blood test that tells us if we have a mutation in the gene and resulting enzyme that methylates, and therefore activates the vitamin Folate. Individuals with this mutation should avoid Folic Acid – the synthetic form of folate found in most multiple vitamins. This is also the most likely reason why studies are finding that multiple vitamin users may have higher risk of cancer and other diseases. Care should be taken to use only the best forms of nutritional supplements. About 40% of us have one copy of this mutation which results in a 30% decrease in our body’s ability to detoxify, repair DNA and suppress viruses. Having two copies creates up to 90% impairment. Because this mutation affects every cell and organ system it can be a hidden culprit in many health problem. There are five common variations of this mutation, each with it’s own easy to understand nutritional protocol that not only lowers health risk but actually produces a nutritional bypass of the mutation itself. This largely resolves the long-term health risk. My father was struggling with Congestive Heart Failure and autoimmune attacks on his blood platelets. Testing MTHFR uncovered a double mutation that once treated with the proper nutritional protocol dramatically improved his conditions within six weeks. See my YouTube presentation “Gene Management: Transforming Genetic Risk.” This presentation is a good introduction to how we can modify our genetic risk including MTHFR mutations.

Here is my 5-page information summary and general protocol for MTHFR Mutations.

2)   Glucose Tolerance Test (GTT) with Insulin, Cortisol, and A1C testing. The 2hr GTT is the best test to catch diabetes or prediabetes early. Nearly 50% of us between the ages of 40 and 59 already have diabetes or prediabetes. If you are older than 60, the odds you already have prediabetes is 66-75%! Since 90% of us who already have prediabetes are completely unaware, it makes having high blood sugar and insulin levels one of the most under diagnosed health problems in America. A simple fasting blood sugar is not adequate since it’s the after meal blood sugars that account for the majority of risk. A 4-hr GTT would help determine adrenal fatigue and low blood sugar tendencies. These can be easily treated once properly understood. For over 20 years I have recommended this test to nearly every patient and believe that this is the most underutilized and most important parts of the “health tune up”. Abnormal GTT or insulin levels are a key cause of high blood pressure, plaque buildup, weight gain, infertility, headaches, dementia, as well as breast, prostate and colon cancers. Elevated insulin at 1 and 2 hours into the test is one of the earliest indicators assessing the risk of cancer initiation and promotion. The good news is that we can dramatically improve insulin levels in our blood with completely natural approaches.

Here is the handout I give to patients who are getting the 4-hour GTT.

3)   A Functional Thyroid Panel includes TSH, Free T4, Free T3, Thyroid Antibodies, and Reverse T3. These tests provide clues about our metabolism and the health of every organ system in our body. Improperly evaluated, poor thyroid function can result in dry skin, fatigue, unhealthy nails and hair, cold feet or hands, headaches, depression, anxiety, insomnia, ADHD, allergies, chronic infections, weight gain, diabetes, constipation, high blood pressure, menstrual problems, etc. It is also important to recognize that a normal TSH doesn’t necessarily mean that there is optimal thyroid function. We can have elevated thyroid antibodies even with normal thyroid hormone levels. Fortunately there are natural approaches to treat thyroid effectively. I personally gained control of a 25 year battle with toenail fungus and 15 years of cold feet (both signs of poor circulation) when I took time to properly address my thyroid. More importantly my strong family history of heart disease, cancer and Alzheimer’s is much less of a concern now that I recognize subclinical hypothyroidism as a major contributing factor and implemented the proper nutritional and hormonal strategies.

4)   The NMR LipoProfile Cholesterol Test provides a much more comprehensive evaluation of heart attack and stoke risk. Unlike the regular Lipid/Cholesterol Profile, this test actually measures the LDL particle size and number. Even with normal levels of cholesterol, small LDL particles easily infiltrate the artery wall promoting plaque buildup. Having a higher LDL particle number also greatly increases health risk even with normal total or LDL levels. This test help us develop a natural program to prevent or reverse erectile dysfunction, heart attacks, strokes, clotting risk and therefore improve circulation of oxygen and nutrition to every organ. It is a key to any wellness tune-up.

5)   Cardiac CRP is a blood test that measures the level of inflammation throughout your body. Inflammation literally turns on genes that promote diabetes, cancer, heart disease and autoimmune conditions.  Once discovered, inflammation can be properly addressed with natural strategies that help turn off disease promoting genes.

6)   Vitamin D testing is a critical part of your health tune-up and very easy to fix. Studies estimate that 35% of all cancers could be eliminated if we optimized our blood level of Vitamin D. Low levels greatly increase our risk of infections, pneumonia, autoimmune disease, neurologic and mental health problems. Don’t think that being in the sun regularly eliminates your need to test Vitamin D. Even as a beach and sun lover my Vitamin D level has been as low as 25. Get tested and then take enough Vitamin D to achieve a 50 to 100 on your blood test.

There are specific supplements, diet protocols and other natural strategies available at lifestyle medicine clinics to help control and even reverse risk factors associated with your “tune up”.  Once baseline tests are done it is important that proper strategies be put in place to address the various causes of the health problems identified. Whether my patients are involved in the Optimal Brain Wellness series, the Diabetes Management Clinic, Detox Program, or the Total Wellness series, I generally recommend that the abnormal baseline labs be repeated at five and then 10 weeks in order to ensure success and make adjustments as needed. The good news is that the above lab tests and tune up can give us the direction we need to make the next three months a time of health transformation and healing.

Tips on getting specialized blood tests

Health insurance is changing. Many of us have lost health insurance or decided that it is just too expensive. Most with insurance have a huge deductible, or are no longer willing to let an insurance plan dictate what tests we can have done. A great option is to work with a clinic that has discount contracts with local and national labs. For instance, at our clinic, patients get a 80% discount on all labs. Likewise, I use the same discount service for all labs done for my family. That way I get exactly what I need and at a discount that is better than what my insurance would charge me. Take charge of your health and get the tune-up lab tests that can help you transform your health naturally.

 

Rheumatoid Arthritis Yields to the Power of Nutritional Medicine

This article was written by Mike Bundrant.
(NaturalNews) Anyone who doubts the efficacy of nutritional medicine hasn’t taken the time to learn about it. Skeptics certainly have never spoken to someone like Gloria, a retail clerk in Temecula, CA, who appears to have made a full recovery from medically diagnosed rheumatoid arthritis because of properly applied nutritional medicine.

Gloria has a long and painful medical history, although her primary complaint to Dr. Wes Youngberg, a nutritionist in Temecula, was chronic pain associated with advanced rheumatoid arthritis. Gloria had watched her mother suffer endlessly with the pernicious autoimmune disease and was worried that one day she would no longer be able to work because of it.

Rheumatoid arthritis was diagnosed in 2006 by a local rheumatologist, one year after the beginning of an ongoing, significant family challenge. Gloria’s rheumatologist had her on Methotrexate and Plaquenil, which were not sufficient for her pain, and was considering adding Humira, which scared Gloria due to recent FDA reports showing Humira’s side effects to include increased risk of rare cancers and other immune problems.

Why wasn’t she healing even when on very strong medication?

While the medicines she was taking did initially help decrease her pain, they were not addressing the original causes of the pain and inflammation. Gloria’s gallbladder surgery in 2000 was a major clue that she may not be effectively digesting and absorbing adequate nutrients. Most chronic disease can be traced to an inadequate level of key nutrients getting into the cells and therefore a lack of the very elements that allow for healing to take place.

Dr. Franz Ingelfinger MD, a gastroenterologist and late editor of the New England Journal of Medicine estimated that 85% of all human illnesses are curable by the body’s own healing mechanisms.As the most prominent GI physician of his day, he recognized that poor digestion would, in time, undermine every other aspect of our health.

With Dr. Youngberg’s, encouragement, Gloria chose to test for signs of imbalance in her body and had comprehensive blood tests including vitamin D, thyroid profile, glucose tolerance testing, hormones, cardiac CRP and others.

Further testing indicated that she had significant hypoglycemia both before meals and three hours after eating. She also had very large blood sugar spikes at one hour and two hours after carbohydrate intake. These tests not only documented her strong tendency toward reactive hypoglycemia and adrenal fatigue, but also indicated that without addressing the underlying causes of her problems, she was also at risk of developing diabetic and cardiovascular complications in the future.

Gloria also had a very low vitamin D. Studies show that low vitamin D levels greatly increase the risk of autoimmune diseases that include type 1 diabetes, RA and lupus.

After discussing the meaning of her labs and nutritional strategies to remedy them, Gloria set out to do her best with a balanced diet rich in whole, plant based food. She started nutritional supplements that would specifically address her lack of a gallbladder and gastric function. She balanced her meals with foods and nutrients that would optimize blood sugars, support restoration of adrenal and thyroid function, lower inflammation naturally and she took enough vitamin D to optimize her blood levels within three months.

Dr. Youngberg explained to Gloria that her condition had developed over a long period of time and would likely take many months for the healing process to noticeably impact her pain and that, with careful attention to comprehensive nutritional medicine strategies, her rheumatologist may be able to reduce her medication over the following six to twelve months.

Much to his surprise, within one month, Gloria reported Dr. Youngberg that the “vice grip” of her rheumatoid arthritis had already improved by 50%. Gloria was referred back to her rheumatologist and able to discontinue her medications. Two months after her comprehensive testing and lifestyle change and after one month without her Methotrexate and Plaquenil medications, Gloria was 90% free of her joint pain.

One month later she excitedly reported that her pain was now completely gone. At this writing Gloria has been free of medications for nearly a year. Cicero once said, “Old age must be resisted and it’s deficiencies supplied.” The body does indeed have the capacity to heal itself! Our job is to determine what’s missing and then supply its need. If Gloria persists on her current path, she will continue to benefit in health of body, mind and spirit.