Challenge Test, the patient often responds, “I was already checked for diabetes. that there is a continuum, from normal, to overt pathology (diabetes) …
DO YOU NEED A CARBOHYDRATE CHALLENGE TEST? | |
|By Dr Joseph A Debé |
|From fatigue to hair loss, from anxiety to obesity, impairments in |
|carbohydrate metabolism can be the underlying cause One researcher |
|has concluded that 7 out of 10 Americans have some degree of |
|abnormal carbohydrate metabolism The Carbohydrate Challenge Test is|
|the premier test to uncover this source of poor health, accelerated |
|aging, and premature death |
| |
|Although carbohydrate metabolism is a very complex process, two |
|important players are glucose blood sugar and the pancreatic |
|hormone, insulin Blood glucose is the main fuel supply for the |
|brain If glucose levels fall to low or too rapidly, the central |
|nervous system brain is adversely affected by this interruption in|
|its fuel supply Symptoms that can result from low blood sugar |
|include: hunger, fatigue, irritability, mood swings, anxiety, |
|nervousness, confusion, headache, heart palpitations, blurred |
|vision, dizziness,
trembling, sudden profuse sweating, awakening in |
|the middle of the night, and, in severe cases, loss of |
|consciousness On the flip side, elevated blood glucose is very |
|destructive to body tissues This is exemplified by the |
|complications of diabetes mellitus: cardiovascular disease and |
|nerve, eye, and kidney damage |
| |
|The body needs blood glucose levels to be maintained within a narrow|
|range When blood sugar rises, the pancreas secretes insulin, which |
|enables glucose to be transported into the cells When blood sugar |
|levels fall too low or too quickly, the body produces increased |
|levels of the insulin-opposing hormones, cortisol, glucagon, |
|epinephrine, norepinephrine and growth hormone to restore higher |
|levels |
| |
|One of the most common health misconceptions I find with my patients|
|involves the subject of carbohydrate metabolism When I suggest the |
|patient should have
a Carbohydrate Challenge Test, the patient often|
|responds, I was already checked for diabetes The belief, with |
|respect to carbohydrate metabolism, is that either you are diabetic |
|or you are normal Reality is as with all functions in the body |
|that there is a continuum, from normal, to overt pathology |
|diabetes Most people start off with normal carbohydrate |
|metabolism Over years, improper diet, lifestyle and stress |
|gradually cause alterations in carbohydrate metabolism The first |
|change that occurs is what is called reactive hypoglycemia, which is|
|a rapid rise in blood sugar followed by an excessive burst of |
|insulin secretion with resultant crashing blood sugar levels |
|Eating large amounts of refined carbohydrates like bread, pasta, |
|cookies, cakes, muffins, crackers, bagels, soda, fruit juice, |
|cereals, and French fries is usually the most important factor in |
|causing a rapid rise in blood sugar levels The body then responds |
|to the insulin-stimulated blood sugar dive by secreting the |
|insulin-opposing hormones in order to raise blood sugar levels How |
|do these hormones raise blood
sugar? By releasing stored sugar from |
|liver and muscle and by converting body protein primarily muscle |
|into sugar This is obviously an undesirable process to have |
|occurring on a regular basis |
| |
|The next step along the path of altered carbohydrate metabolism, |
|after reactive hypoglycemia, is insulin resistance Insulin |
|resistance is a term that refers to the bodys cells liver, muscle,|
|and fat cells not responding efficiently to insulins signals to |
|transport sugar from the blood The body compensates for this by |
|producing more insulin Chronically elevated insulin levels will |
|result in cellular insulin resistance Hyperinsulinemia high blood |
|levels of insulin and insulin resistance occur together and |
|perpetuate each other When the cells of the body are continually |
|exposed to elevated insulin levels, they begin to tune-out |
|insulins message to transport sugar The pancreas responds, Hey |
|Youre not listening to me Ill have to shout More insulin is |
|secreted to get the message through With the aid
of additional |
|insulin, the sugar is transported into the cells, and blood sugar |
|levels are kept in the normal range There are, however, very |
|serious consequences to chronically elevated insulin levels Insulin|
|has many effects in the body, beyond glucose transport Insulin |
|influences genetic expression which genes are turned on, which are |
|turned off For example, insulin increases the activity of the |
|enzyme that produces cholesterol in the liver Hyperinsulinemia is |
|the driving force behind most cases of high blood cholesterol |
|Elevated insulin levels adversely impact widespread bodily |
|functions Some of the results of hyperinsulinemia are: increased |
|appetite, increased triglyceride fat production, body fat storage,|
|fatty infiltration of muscle cells, reduced burning of body fat, |
|stress, anxiety, fatigue, inflammation, fibromyalgia, depression, |
|increased appetite, increased fat around the midsection |
|apple-shape or visceral adiposity, sleep apnea, gout, heart |
|disease, stroke, osteoporosis, Alzheimers disease, certain cancers,|
|fatty liver, liver fibrosis and cirrhosis, kidney
dysfunction, |
|parasympathetic nervous system dysfunction, retinopathy, type 2 |
|diabetes, impaired wound healing, immune suppression, Sarcopenia |
|age-associated loss of lean healthy body tissue, reproductive |
|disorders, irritability, fluid retention, hypertension, high blood |
|cholesterol, insomnia, skin wrinkles, arthritis, reduced thyroid |
|function, and acceleration of the aging process |
| |
|One common effect of hyperinsulinemia is polycystic ovary syndrome |
|This condition is characterized by cessation of periods or |
|infrequent and scanty blood flow, chronic lack of ovulation, ovaries|
|with multiple cysts, weight gain and increased fat around the |
|midsection, infertility, mood swings, fatigue, increased blood |
|triglycerides and reduced HDL cholesterol, scalp hair loss, male |
|pattern hair growth, and acne Elevated insulin increases adrenal |
|and ovarian production of androgens male hormones like |
|testosterone and reduces the livers production of sex hormone |
|binding globulin Lower sex hormone binding globulin
results in |
|increased levels of free biologically active testosterone |
|Elevated levels of androgens is the most common hormonal abnormality|
|in premenopausal women, affecting an estimated 1 out of 10 |
| |
|The next step in deterioration of carbohydrate metabolism is |
|continuation of hyperinsulinemia combined with rising blood sugar |
|levels In this stage, there is waning ability of the pancreas to |
|produce enough insulin to overcome cellular resistance and glucose |
|transport diminishes This condition is called impaired glucose |
|tolerance In this state, fasting blood glucose levels are between |
|110 and 125 |
| |
|When things deteriorate further and blood sugar continues to rise, a|
|new label is used: diabetes The higher the blood sugar, the more |
|serious are the health effects However, most people will never |
|become diabetic but will, nevertheless, suffer the ill effects of |
|hyperinsulinemia-insulin resistance
|
| |
|Measurements of fasting blood sugar levels are only slightly more |
|valuable than screen doors on submarines Unless the bodys |
|metabolism has deteriorated to the point of impaired glucose |
|tolerance or diabetes, the message patients come away with from |
|analysis of fasting blood sugar is no problem Additionally, Im |
|shocked how often doctors minimize the significance of impaired |
|glucose tolerance Nothing to worry about, patients are told |
|Actually, a study has found a significant increased risk of death in|
|people with fasting blood sugars of 100 compared to those with |
|values of 85 |
| |
|The most sensitive way to evaluate carbohydrate metabolism is with a|
|Carbohydrate Challenge Test The Carbohydrate Challenge Test is like|
|an endocrine system stress test It picks up subtle insulin |
|resistance that can be missed with fasting glucose and insulin The |
|Carbohydrate Challenge Test is performed at a blood drawing
facility|
|in the following way: A high carbohydrate meal, such as white bread,|
|a banana, and orange juice, is eaten in the morning, after taking a |
|blood and saliva sample Over the next three hours, additional blood|
|and saliva samples are taken Glucose, insulin and cortisol are |
|measured from these samples Heart rate is also monitored during the|
|test, as an indication of autonomic nervous system function An |
|abnormality in any of these parameters points to the underlying |
|cause of the dysfunction in carbohydrate metabolism Because the |
|test uses whole food, it can point to delayed emptying of food from |
|the stomach, impaired carbohydrate digestion, and malabsorption as |
|root causes of abnormal blood sugar levels Natural treatments are |
|customized, based on the exact nature of the results The |
|Carbohydrate Challenge Test can pick up problems early - before |
|damage has been done - even before symptoms are present |
| |
|Because I have a strong family history of diabetes, I did a |
|Carbohydrate Challenge Test a few years ago It showed the
very |
|beginning stage of impaired carbohydrate metabolism- a mild reactive|
|hypoglycemia With that information, I am able to make dietary and |
|supplement changes to improve things This is a proactive approach |
|that applies to all aspects of physiology One can assess how the |
|body is functioning and then take steps to improve health This is |
|in contrast to the reactive approach of conventional medicine, which|
|takes no action until something is broken The average persons |
|carbohydrate metabolism is not addressed until a diagnosis of |
|diabetes can be made Decades of declining health usually lapse |
|between the initial stages of impairment of physiology and the |
|development of an end-stage disease, like diabetes |
| |
|I feel the Carbohydrate Challenge Test is better than the commonly |
|used glucose tolerance test for several reasons The Carbohydrate |
|Challenge Test gives us a more complete picture of carbohydrate |
|metabolism because it also measures insulin and cortisol levels and |
|assesses autonomic nervous system function The Carbohydrate
|
|Challenge Test is also superior because it utilizes real food, as |
|opposed to a glucose drink After all, the use of real food better |
|imitates real life A good illustration of this involves Robert, a |
|patient who consulted me about symptoms of intermittent debilitating|
|fatigue, blurred vision and headaches He had a comprehensive |
|medical work-up, including eye and neurological examinations, an MRI|
|of the brain, and an EEG He had also finally persuaded his doctor |
|to do a glucose tolerance test All results were normal His |
|symptoms sure sounded to me like hypoglycemia We had Robert take a |
|Carbohydrate Challenge Test He did indeed have hypoglycemia The |
|reason it was picked up with the Carbohydrate Challenge Test but not|
|with the glucose tolerance test is that Roberts low blood sugar |
|levels were due to maldigestion and malabsorption Part of Roberts |
|treatment involved improving his digestion and absorption His |
|symptoms quickly improved |
