In functional medicine one of the most common causes we see for many health disorders is imbalanced blood sugar. The good news is it is also one of the easiest things to remedy. A powerful tool in this process is a botanical compound called berberine.
An epidemic of blood sugar imbalances
According to the CDC, nearly 84 million American adults — more than one out of three — have prediabetes, or metabolic syndrome, a serious health condition in which blood sugar levels are too high but not high enough to be diagnosed as type 2 diabetes.
Ninety percent of people with prediabetes don’t even know they have it. Prediabetes puts you at increased risk of type 2 diabetes, heart disease, stroke, obesity, autoimmunity, infertility, dementia, and other disorders.
In fact, high blood sugar is so clearly linked to Alzheimer’s that researchers refer to the disease as “Type 3 diabetes.”
Berberine for high blood sugar and diabetes
A natural plant compound, berberine is found within the stems, bark, roots, and rhizomes (root-like subterranean stems) of numerous plants such as barberry, goldenseal, Oregon grape, tree turmeric, and Chinese goldthread.
Berberine is generally well tolerated and has been used in Chinese and Ayurvedic medicine for thousands of years to treat digestive issues and infections. The extract has a deep yellow color and is also commonly used as a dye.
Recently, berberine has become known for its ability to reduce high blood glucose. By working at a cellular level, it helps move glucose (sugar) from your blood into your cells where it’s most needed.
Berberine also promotes healthy blood sugar levels that are already in normal range.
Berberine works by activating AMPK (adenosine monophosphate-activated protein kinase), an enzyme that that regulates how the body produces and uses energy.
AMPK senses and responds to changes in energy metabolism on both the cellular and whole-body level. It regulates biological activities that normalize lipid, glucose, and energy imbalances.
Metabolic syndrome happens when AMPK-regulated pathways are turned off. This triggers fat storage and burning abnormalities, high blood sugar, diabetes, and energy imbalances.
Depleted energy activates AMPK while excess energy inhibits it. In other words, high blood sugar inhibits AMPK while exercise and calorie restriction activates it.
Berberine’s effect is similar to what you’d see in someone who increased exercise while restricting calorie intake because it activates AMPK, making it a useful tool in the management of type 2 diabetes.
Berberine as effective as metformin
Other known AMPK activators include resveratrol and the diabetes drug metformin. Berberine is so effective at balancing blood sugar that both animal and human studies compare it to metformin in its effectiveness.
Berberine has also been shown to be as effective in treating other conditions that respond positively to metformin, including polycystic ovary syndrome (PCOS), the reduction of weight gain triggered by antipsychotics, and potentially cancer.
While berberine is most commonly considered for metabolic syndrome, inflammation, and cancer, its potentially helpful for a long list of other disorders, including high cholesterol, obesity, small intestine bacterial overgrowth (SIBO), leaky gut, lung inflammation, Alzheimer’s disease, and heart disease due to these actions.
Stimulates the release of nitric oxide, a signaling molecule that relaxes arteries, increases blood flow, and protects against atherosclerosis.
Stimulates bile secretion and bilirubin discharge.
Reduces dysfunction of the intestinal mucosal barrier.
How much berberine should I take?
For diabetes and blood sugar support, the recommended dose is 500 mg two or three times a day. It’s important to spread your dose out throughout the day because berberine has a short half-life in the body and taking it all at once might rob you of the full benefits. Make sure to take berberine prior to or with a meal.
Studies show that gut bacteria play an important role in transforming berberine into its usable form. Therefore, supporting microbiome diversity and abundance is a smart way to increase its effectiveness. Make sure to eat varied and plentiful produce (go easy on the sugary fruits) and consider supplementing short chain fatty acid supplementation (SCFA) to help your gut bacteria thrive.
How long should I take berberine?
Continual use of berberine can impact cytochrome P450 (CYP) enzymes in the liver which may affect drug-to-drug interactions. Therefore, it’s recommended to use it in a pulsed 8-week cycle with two to four weeks off, then starting again if symptoms have not resolved.
Research has shown that combining berberine with cinnamon may increase its bioavailability. What’s more, cinnamon has also been shown to support insulin sensitivity.
While berberine is highly recommended for high blood sugar issues, it does come with some cautions:
Berberine is considered UNSAFE for pregnant women and nursing mothers. It may cross the placenta during pregnancy, and some newborns exposed to berberine developed a type of brain damage. It also can be transferred to babies through breast milk.
Berberine can interact with a number of medications, increasing the risk of adverse reactions.
Taking berberine when you are on medications that reduce blood sugar can push your blood glucose levels too low.
Berberine can lower blood pressure, so it should be used with caution by anyone who already has low blood pressure.
If you are concerned about your blood sugar status and want to discuss non-medical methods for helping regulate your blood sugar, contact my office.
Weight training is not the first exercise choice that comes to mind for seniors. Instead we think of chair yoga, walking, dancing, or aqua aerobics. However, science shows weight training is one of the best types of exercise for aging whether you’ve been doing it your whole life or have never touched a barbell in 60-plus years.
Of the 57 million deaths worldwide in 2008, more than 5 million were caused by lack of physical activity. Roughly 80 percent of adults fail to meet recommended guidelines for physical activity.
For seniors in particular inactivity and a sedentary lifestyle are dangerous, increasing the risk of health conditions such as:
High blood pressure
There is a common misperception that the elderly should stay away from strenuous activity. It is important to use safe equipment, focus on correct form, and warm up and cool down properly, but using your muscles as you age isn’t inherently dangerous.
In fact, studies show that lifting weights — whether heavy or light — helps us in many ways as we age.
Weight training reduces the risk of falling by maintaining or even increasing muscle mass and helping maintain bone density. This makes the elderly much less susceptible to age-related and disabling bone breaks from falls or accidents.
This also helps stave off loss of independence, one of the greatest worries around aging.
Strength training can promote mobility and function and even help combat depression and cognitive decline.
An analysis of the National Health Interview Survey (NHIS) database found that adults 65 and older who strength trained twice a week had a 46 percent lower mortality rate. He also found strength training reduces all causes of death, including cancer and cardiac death.
Drawing from the data, the analysis outlined 78 science-backed benefits for seniors who lift weights. The main categories include:
Combat age-related muscle loss and sarcopenia
Burn fat and increase muscle mass
Support functional independence
Improve quality of life
Improve osteoarthritis and bone health
Increase cardiovascular health
Improve mental health and cognitive functioning
Reduce mortality risk
Fight Type 2 diabetes
Improve quality of sleep
Recover from hip fractures
The study showed that those who had lifted regularly for some time were protected against numerous age-related health issues related to neuromuscular functioning, sarcopenia, muscle force-generating capacity, cognitive functioning, overall functional capability and performance, and mitochondrial impairment.
Lifting weights risks at any age, however, hundreds of studies have shown weight training to be safe, enjoyable, and beneficial as we get older.
Anyone can get injured when working out, so knowing how to safely use equipment, warming up and cooling down properly, and using proper form will keep you in action.
Before starting, have a medical checkup or ask your doctor for clearance. This is especially true if you haven’t exercised before or have taken a long break from physical activity.
What type of weight training is best?
Weight training is an activity anyone can start regardless of age. It doesn’t take lifting like a competitor to gain major benefits, and many of the benefits are immediate. As you train, your cardiovascular and musculoskeletal fitness will improve, thus helping you to prevent injuries as you progress.
Whether you train using your body weight, dumbbells, systems weights, full Olympic style, or with some other style, focus on gradually increasing intensity and power.
A personal trainer can help you meet your goals with a form that works for you, plus teach you how and when to safely increase your challenges. Finding a weight training style you like will motivate you so you keep showing up for workouts — whether it’s at the gym or in your living room.
Before starting any exercise program, be sure to consult with your health care practitioner, and if you are uncertain where to begin, reach out to a local certified personal trainer who can guide you.
If you would like help understanding the benefits of weight training for seniors, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Fats are a hot topic of debate in the health-conscious community, and recent reports have made it hard to separate facts from fear-mongering. Canola and coconut oils are two popular fats that have received a lot of attention over the years, and thankfully recent studies are showing us more clearly which fats to embrace, and which to avoid.
To understand which fats are healthy, it’s helpful to understand “good” HDL and “bad” LDL cholesterol, small fat and protein packages that transport cholesterol throughout the body.
High-density lipoprotein (HDL) or “good” cholesterol helps protect your arteries from cholesterol and removes excess arterial plaque.
Low-density lipoprotein (LDL) or “bad” cholesterol can accumulate in the arteries to form plaque that narrows them and makes them less flexible (atherosclerosis).
Triglycerides. Elevated levels are linked to heart disease and diabetes. Risk factors include smoking, physical inactivity, excessive drinking, overweight, and a diet high in sugars and grains.
HDL, LDL, and triglycerides come in small and large particles. While the large particles are practically harmless, the small, dense particles are more dangerous. They can lodge in arterial walls, leading to inflammation, plaque buildup, and damage that eventually leads to heart disease.
When considering test results, your doctor will note:
HDL levels versus LDL levels
The ratio between triglycerides to HDL
The ratio between total cholesterol and HDL
The size of the particles
Here’s where the former warnings about fats and cholesterol have been misleading: We now understand that more important than knowing your total cholesterol is knowing the ratio between your HDL and your LDL, and especially the size of the particles.
In addition, the Mayo Clinic says many doctors now believe that for predicting heart disease risk, total non-HDL may be more useful than calculating your cholesterol ratio. Non-HDL cholesterol is figured by subtracting your HDL cholesterol number from your total cholesterol number.
Finally, either option appears to be a better risk predictor than your total cholesterol level or simply your LDL level.
Note: In some cases, people have a genetic tendency toward extremely high cholesterol. In those situations, it may take more than diet to manage cholesterol levels.
Should I consume saturated fats?
Sourced from tropical oils and animal products, saturated fats are typically solid or semi-solid at room temperature. Common dietary sources include beef, pork, lamb, poultry skin, high-fat dairy, palm oil, and coconut oil.
Saturated fat sits at the forefront of the debate about dietary oils. Why? For years, we’ve been warned that it increases the risk for cardiovascular disease because it raises LDL, the “bad” type of cholesterol.
This recommendation was based on four hand-picked studies done nearly 40 years ago and doesn’t reflect recent studies that shine a different light on fat intake. What the studies didn’t do is take into consideration other things saturated fats do to help balance the equation:
Raise HDL (“good”) cholesterol.
Change LDL (“bad”) cholesterol from small, dense particles — dangerous for heart health — to large particle LDL, which does not increase heart disease risk.
Support brain health.
Possibly reduce stroke risk.
In fact, a recent meta-analysis of studies showed there is no significant evidence that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease.
For some people there are legitimate reasons to moderate saturated fat intake:
Saturated fat intake can be associated with lighter, less restorative, more disruptive sleep (yet increased fiber can help increase sleep quality).
ApoE4 carriers (increased Alzheimer’s risk) see a much higher spike in LDL cholesterol from high saturated fat in the diet, without a matching rise in HDL. They may benefit from lower intake of saturated fat which can lower LDL cholesterol and improve HDL/LDL ratio.
A small percent of the population does experience a skyrocketing increase in LDL concentrations along with increased inflammation levels measured by C-reactive protein.
Ask meabout a diet that is sufficient in healthy fats, void of bad fats, and customized to your dietary needs.
If you struggle with chronic exhaustion, insomnia, poor immunity, and persistent low blood sugar symptoms, you likely have poor function of the adrenal glands, which sit atop the kidneys and secrete stress hormones. However, your conventional doctor may have told you there is no such thing as adrenal fatigue based on guidance from The Hormone Foundation. What they may not understand is that there is a continuum of adrenal function and that the brain plays a role in adrenal fatigue.
The debate about adrenal fatigue versus primary adrenal insufficiency
The term “adrenal fatigue” has become a household word in the chronic illness world, and for good reason. The adrenal glands are our frontline against stressors large and small. In our constantly chaotic and nutritionally-depleted lives, these hard-working little glands can become worn down, sometimes to the point of barely working, right along with the areas of the brain that govern them.
What’s confusing is a recent statement by The Hormone Foundation which claimed adrenal fatigue does not exist and is not supported by any scientific facts, and that primary adrenal insufficiency is the only real version of adrenal dysfunction.
However, according to integrative physician Richard Shames, MD, both adrenal fatigue and primary adrenal insufficiency exist along the same continuum but are separated by the severity of symptoms and treatment methods. In a nutshell, adrenal fatigue can also be referred to as mild adrenal sufficiency.
Primary adrenal insufficiency is caused by damage to the adrenal glands, such as by an autoimmune condition like Addison’s disease that attacks and destroys adrenal tissue. Primary adrenal insufficiency is diagnosed through blood tests and can be treated with medications that replace adrenal hormones.
Symptoms of primary adrenal insufficiency include:
Loss of appetite with weight loss
Craving salty foods
Dizziness, low blood pressure
Feeling lightheaded when standing up
Gastrointestinal symptoms such as nausea, vomiting, and abdominal discomfort
Adrenal fatigue describes when lab tests don’t support a diagnosis of primary adrenal insufficiency but a person still experiences adrenal-related symptoms such as:
Excessive fatigue and exhaustion
Feeling overwhelmed by or unable to cope with stress
Craving salty foods
Functional medicine practitioners diagnose adrenal fatigue by considering symptoms as well as results from a 24-hour saliva cortisol test.
Current blood tests are good at diagnosing severe forms of adrenal insufficiency such as Addison’s disease but not mild adrenal insufficiency, or adrenal fatigue.
This debate between adrenal fatigue and primary adrenal insufficiency is reminiscent of the former debates about “mild” hypothyroidism. Twenty years ago, many endocrinologists denied mild hypothyroidism as a true diagnosis because they believed that as long as a patient was within conventional TSH reference ranges they could not possibly be sick.
However, doctors trained in functional medicine recognize that a functional reference range — a narrower TSH range that reflects optimum thyroid health — means that a serious thyroid problem can exist within the conventional TSH range.
As testing and recognition of adrenal fatigue, which affects many people, continues to gain medical acceptance, we will start to refer to it as mild adrenal insufficiency.
The role of the brain in adrenal fatigue
It’s important to understand the brain plays an important role in adrenal fatigue. This explains why nutrients to support your adrenal glands may not go the full mile when the real problem is happening between your ears.
Adrenal fatigue has at its roots poor function of the hypothalamus-pituitary-adrenal (HPA) axis. The HPA axis refers to the feedback loop between your body and areas of your brain that govern adrenal function. Unrelenting stress beats up this entire system, not just the adrenal glands, and it is more complicated and involved that simply low cortisol. The problem is compounded by the brain’s predilection for efficiency, in this case becoming so efficient at stress until the tiniest thing triggers a big stress response. Or, you are so advanced you are too tired to respond to anything.
How the adrenals become fatigued
When our bodies experience stress, no matter how small or large, our adrenals pump out hormones such as adrenaline and cortisol to help us fight or take flight. Our bodies are designed to return to baseline after a stressor so the nervous system can return to a “rest and digest” state necessary for daily function.
However, in our chronically stressed modern lifestyles, our bodies are constantly reacting to stressors, many we are not even aware of, such as dietary triggers, toxins, and even electromagnetic frequencies.
This constant state of high-stress hormones damages tissues in the body and brain and is linked to:
Insulin resistance and diabetes
High blood pressure
Increased belly fat
Removing all stressors in life is impossible, but there is much we can do to support adrenal function and buffer the damage of stress.
Many of us start the day with a small breakfast as we run out the door, followed by a medium sized lunch and a large dinner. We also tend to snack throughout the day and even grab a bite before bed. However, while what we eat is important, a growing body of research suggests when we eat matters too.
The digestive system’s circadian rhythm
While you have likely heard of the circadian rhythm, the master “clock” in the brain that governs our sleep-wake cycle, we actually have a variety of circadian clocks that govern the daily cycle of activity for every organ.
These rhythms exist because every organ needs downtime for repair and regeneration.
The digestive system is no exception. During the day, the pancreas increases production of insulin, which controls blood sugar levels, and then ramps it down at night.
Circadian clocks optimize our health by aligning our biological functions with regular and predictable environmental patterns. Disrupting our circadian clocks — such as by skipping breakfast or eating at midnight — can result in health issues such as weight gain, metabolic syndrome, cancer, cardiovascular disease, and more, and if you want to know more about YOU and YOUR health, schedule a FREE 15-minute consultation with Dr. Celaya.
Eat breakfast daily
About 20 to 30 percent of American adults skip breakfast. Some do it to save time, many do it in an effort to lose weight. However, studies show that people who eat breakfast daily are less likely to be obese, malnourished, suffer from impaired blood sugar metabolism, or be diagnosed with diabetes.
They are also less likely to have the heart disease risk factors of high blood pressure and high cholesterol. Even the American Heart Association recently endorsed biologically appropriate meal timing to reduce the risk of heart disease.
Just eating breakfast isn’t the only important thing, however. It’s critical to start the day with a breakfast that provides plenty of protein and healthy fats, and a minimum of sugars. This helps support blood sugar balance and proper brain function throughout the day.
Make breakfast the largest meal for weight control and fat loss
The timing in relation to the size of our meals is also important.
Research shows having the largest meal in the morning appears to help with weight control compared to having a large meal in the evening.
In fact, a person eating the identical meal at different times of day might deposit more fat after an evening meal than a morning meal.
This is partially because insulin, a hormone that helps with blood sugar control, appears to be most efficient in the morning. In addition, we burn more calories and digest food more efficiently in the morning than later in the day when most of us eat our largest meal.
In one study, a group of overweight women with metabolic problems were put on a 1400 calorie-per-day diet. Half consumed 700 calories at breakfast, 500 calories at lunch, and 200 calories at supper and the other half reversed that pattern.
Women in both groups lost weight and experienced reduction in fasting glucose, insulin, and ghrelin (a hunger hormone), but in the same time frame the large-breakfast group experienced added benefits:
They lost 2.5 times the weight compared to those who ate the largest meal at dinner.
They had a significantly greater decrease in fasting glucose, insulin, and triglyceride levels.
Their satiety (sense of fullness) scores were significantly higher.
They also lost more body fat, especially in the belly.
According to the researchers, a high-calorie breakfast and a reduced calorie dinner is beneficial and might be a useful alternative for managing obesity and metabolic syndrome.
The body needs fasting periods for optimum health
Fasting signals to the body to start burning stores of fat for fuel. Most of us eat meals and snack from the time we wake up until shortly before bed — or even in the middle of the night. In fact, studies show the average person eats over a 15-hour period during the day. This short fasting time period may interfere with optimal metabolism and increase weight gain.
Researchers put a group of prediabetic men through two eating cycles. In one phase, they ate meals within a 12-hour window for five weeks.
Then in another phase, they ate the same meals in a time-restricted six-hour window starting in the morning.
They ate enough to maintain their weight, so they could assess whether the time-restricted regimen had benefits unrelated to weight loss.
In addition, the men who ate only one or two meals per day fared better than those who ate three meals.
A recent review of the dietary patterns of 50,000 adults over seven years provides added evidence that we should ingest most of our calories early in the day, including a plentiful breakfast, a smaller lunch, and a light supper.
The researchers said that eating breakfast and lunch five to six hours apart and making the overnight fast last 18 to 19 hours may be an effective method for preventing long-term weight gain.
Another recent study found that subjects who added snacks to their daily meals tended to gain weight over time, while those who had no snacks tended to lose weight.
Light exposure is key for proper metabolism
Sufficient exposure to natural light and darkness also play an important role in how we metabolize food for either energy production or fat gain.
At night, the lack of sunlight signals our brain to release melatonin, the hormone that prepares us for sleep. In the morning, the light stops melatonin production and we wake up.
When we change that signaling — whether from a late-night meal, artificial lighting at night (especially blue screen light), shift work, flying and travel, or changing our eating patterns — it confuses our bodies’ circadian clocks. Eating at the wrong time of day strains the digestive organs, forcing them to work when they are supposed to rest.
Shift workers, who account for about 20 percent of the country’s workforce, have a particular problem with disturbed circadian clocks. Many frequently work overnight shifts, forcing them to eat and sleep at odd times. Nighttime shift work has been linked to increased risk of obesity, diabetes, heart disease, and breast cancer.
Studies have linked poor melatonin activity and disrupted sleep-wake cycles with an increased risk of dementia and Alzheimer’s, cancer, autoimmune flare-ups, obesity, and more.
Low blood sugar may require a before-bed snack
One important exception to the “don’t eat right before bed” rule is for those who have chronic low blood sugar. For these people, keeping blood sugar stable throughout the day — and night — is critical for brain health, energy level, and more.
If you suffer from the following chronic low blood sugar symptoms, it may be best to take a small, high-protein low sugar snack just before bed:
Constant sugar cravings
Nausea or lack of appetite in the morning
Irritability, light-headedness, dizziness, or brain fog if meals are missed
Craving caffeine for energy
Eating to relieve fatigue
Afternoon energy crashes
Waking around 3 a.m.
Daily habits to maximize your dietary rhythm
To help maximize your meal timing and metabolism, incorporate the following habits into your day:
Make breakfast your largest meal and make dinner your smallest. While this may prove difficult for those with a busy social life or family that sits down to a big dinner every evening, make the evening meal smaller whenever possible.
Prioritize protein and healthy fats with breakfast, and minimize sugar and caffeine intake especially before lunch, to stabilize blood sugar and regulate metabolism.
Avoid between-meal snacks and bedtime goodies. The exception is for those who have chronic low blood sugar as mentioned above.
Try a time-restricted eating pattern, or intermittent fasting, to maximize weight management.
Manage exposure to blue light at night:
Avoid screen light in the evening
Install the f.lux app on your phone and computer
Read a book
Wear blue-blocker glasses at night
Install amber or red light bulbs for evening use
If you have chronic low blood sugar, a small before-bed snack with plenty of protein may be a good idea to keep your blood sugar stable all night and prevent that 3 a.m. wake-up.
While studies suggest that prioritizing larger meals early in the day helps support metabolic health, it does not necessarily mean that you should skip dinner. Instead, have your dinners earlier and make them relatively light.
The take-home message here is like the old proverb, “Eat breakfast like a king, lunch like a prince and dinner like a pauper.” Schedule a FREE 15-Minute Consultation with Dr. Celaya.
Have you ever wanted to know everything there is to know about your thyroid? This 7-part video series will cover thyroid lab testing, nutrition and infections that affect the thyroid, toxins, thyroid hormone conversion, lifestyle, and adrenal interplay.