Modern Metabolic Health with Dr. Lindsay Ogle, MD

Metabolic Syndrome, Explained Clearly

• Lindsay Ogle, MD

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We explain what metabolic syndrome is, why it predicts heart disease, and how to treat the root causes with practical steps and targeted medications. We share the five criteria, simple lifestyle wins, medication options like metformin and GLP-1s, and how to monitor progress.

• definition of metabolic syndrome and why it matters
• the five diagnostic criteria using waist circumfirence, blood pressure, glucose, triglycerides, HDL
• links to cardiovascular risk and insulin resistance
• nutrition priorities for whole foods, protein, fiber, and lower sugar
• exercise targets and the role of muscle
• weight loss goals of 5 to 10 percent body weight
• medication options including metformin and GLP-1 agonists
• monitoring every six to twelve months with a trusted clinician
• long-term focus on prevention and quality of life

If you live in Missouri and want a doctor who focuses on root causes, I’m accepting new patients at MissouriMetabolicHealth.com. Subscribe for my weekly videos to learn more about improving your metabolic health. Please share with a friend, subscribe, and write a review.


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Dr. Lindsay Ogle:

Welcome to the Modern Metabolic Health Podcast with your host, Dr. Lindsay Ogle, Board Certified Family Medicine and Obesity Medicine Physician. Here we learn how we can treat and prevent modern metabolic conditions such as diabetes, PCOS, fatty liver disease, metabolic syndrome, sleep apnea, and more. We focus on optimizing lifestyle while utilizing safe and effective medical treatments. Please remember that while I am a physician, I am not your physician. Everything discussed here is provided as general medical knowledge and not direct medical advice. Please talk to your doctor about what is best for you. Here to talk to you about a condition you may have never heard of, a metabolic syndrome. And I will be honest, when I was working in my primary care practice, I did not think about metabolic syndrome too often, and there is a variety of reasons for that. One is that we're very busy in our practice, and there's a lot of things that we need to cover with each visit. But the reason that I put so much emphasis on this in my telehealth practice, and where I want to share with you the importance of recognizing metabolic syndrome, is that we will be able to take a step back and treat the underlying cause of multiple conditions rather than treating the kind of downstream effects of the pathology as individual parts, we can take that step back and treat the underlying cause, which is a combination of things, genetics, but insulin resistance plays a big role here. But to get started off on metabolic syndrome, a great place to start is what is it? And what metabolic syndrome is to meet the diagnostic criteria, you need three out of five objective findings. And the first one is increased abdominal obesity. And so to check that you just get a tape measure and you measure around your abdomen, and so right above like your hip bone, you take that tape measure, measure around, and for men, if your waist is 40 inches or more, and women your waist is 35 inches or more, then you meet that criteria, that initial criteria. The second is elevated blood pressure, and so we're looking for the top number to be 130 or above, and the bottom number to be 85 or above, or you're on a blood pressure-lowering medication already. Number three is elevated blood sugar, and so this would be a fasting blood sugar of 100 or greater, is usually how we check this measurement. You also could have an A1C of 5.7 or above, or already have a diagnosis of prediabetes or diabetes. Number four is triglycerides, and this is usually checked with a standard lipid or cholesterol panel, and this is something that you definitely want to have done when you're fasting. But if that number is 150 or above, then you meet that criteria. The fifth is another part of that cholesterol or lipid panel, and this is the HDL, the high density lipoprotein level, which is sometimes referred to as the healthy cholesterol. So this is a number that we actually want to be high. So when it's low, then that's something that we worry about. And so to meet this criteria, um, men have a number, an HDL of 40 or below, and then women 50 or below meet that criteria. And so those are the five criteria of metabolic syndrome, and you only need to have three to have that diagnosis. And you can see that these are really common conditions that are seen in a primary care clinic, and they're often noted and addressed individually, but again, when you put those together, then you can say somebody has metabolic syndrome, let's take a look at that and treat that underlying cause. And why this is so important? A couple of reasons. One, metabolic syndrome, we know is highly associated with cardiovascular disease. And cardiovascular disease, meaning heart attack, heart failure, stroke, these are the most common reasons that people die. And so if you have a risk factor for that, then we want to address it and lower that risk as much as possible. And so addressing metabolic syndrome is going to lower your risk of cardiovascular disease later on in life. And then another reason it's important to address is again that we are going to be addressing the root cause rather than addressing these conditions as individual diseases, we're really looking at the underlying cause. So, like I said, genetics play definitely play a component in metabolic syndrome, but insulin resistance also is a major factor, and lifestyle is a major factor. So, what can we do to help treat and manage and prevent metabolic syndrome? One, we can definitely focus on our nutrition. So focusing on whole foods, limiting added sugars, reducing our refined carbohydrate intake, getting enough protein and fiber, limiting alcohol, all of those things are going to have a huge impact on your metabolic health, treating or reversing or preventing metabolic syndrome. Physical activity plays a major role here as well. Exercising at least 150 minutes per week will help treat, reverse, and prevent metabolic syndrome. Weight management. So if you know you have metabolic syndrome, losing just 5 to 10% of your body weight can help improve or reverse your metabolic syndrome. There are some medications that may also be helpful. Metformin is a medicine that helps improve insulin resistance. People tend to lose a little bit of weight on it and can really help with metabolic syndrome. It's a very inexpensive medication, very easy to get at the pharmacy. Most common side effect is GI-related, upset stomach. Taking your metformin with food, starting at low doses and slowly increasing over time, and making sure that you are taking the extended release formulation can help limit those side effects. Our GLP1 agonists are also great for metabolic syndrome. I'm referring to Ozempic, we govey, Monjaro, and Zeppound. These medications can help all parameters of metabolic syndrome, can help lower the blood sugar, it can help improve cholesterol levels, can help with weight loss, which can then help with blood pressure. They are an excellent choice for addressing the underlying causes of metabolic syndrome rather than starting a medication for the blood pressure, the cholesterol, the high blood pressure. Using a GLP1 agonist can treat that underlying cause and prevent the need for multiple medications down the line. Metabolic syndrome is something that you are going to want to monitor over time. So you're gonna want to make sure that you are established with the primary care doctor that you trust to check in on your abdominal circumference and your weight and your blood sugar and cholesterol and blood pressure every six to 12 months so you know that you are managing this condition in a healthy way long term. Again, our goal is really to prevent cardiovascular disease down the line and recognizing metabolic syndrome now, treating it to help you live a longer, healthier, happier life. That's truly our goal, truly my goal for you. And again, if you live in Missouri, if you know anybody who lives in Missouri who would benefit from having a doctor who really focuses on the root cause and can help prevent and treat metabolic syndrome or diabetes or pre-diabetes, PCOS. I'm accepting new patients at Missouri Metabolic Health.com. This is a virtual clinic, telehealth only, and I see patients all throughout Missouri. But please reach out if you have any questions, and as always subscribe for my weekly videos where you can learn more about how to improve your metabolic health. Take care and stay well. Thank you for listening and learning how you can improve your metabolic health in this modern world. If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health. I look forward to our conversation next week.