Metabolic Syndrome?

[Ms. Brightside 121]

Well, the timing on this couldn't be more perfect. After years of being overweight and yo-yo dieting (with PERFECT blood work), my pre-op lab results (surgery is scheduled for 5/22/17) now indicate that I am in the beginning stages of metabolic syndrome. And I had perfect labs just a year ago! This is a warning to those who thing that they are "overweight, but healthy". Overweight does not = healthy in any way!

So, my question: is it possible to reverse metabolic syndrome through bariatric surgery (and adhering to the post-op guidelines, of course)? Has anyone been through this? My main motivator in having this surgery was to avoid high blood pressure, diabetes, and heart disease, all of which runs in my family.

Thanks for any input you may have to offer. I will be researching this like a madwoman over the weekend!

Edited May 12, 2017 by Ms. Brightside

[PatientEleventyBillion 851]

Metabolic Syndrome is not a simple disease it's a multitude of them and it takes quite a few tests of different things (and often times follow-ups to them) to diagnose this.. what are your underlying causes and their severity? ie diabetes hba1c, liver staging, etc.

Edited May 12, 2017 by PatientEleventyBillion

[OutsideMatchInside 10,166]

@PatientEleventyBillion is right. It is like an umbrella term for a lot of things going wrong. It is just a blanket term for being fat is slowly killing you, although everyone with metabolic syndrome isn't fat most people are unless they have some seriously screwed genetics.

That being said dropping weight completely reversed all my metabolic issues.

[Berry78 4,261]

Excellent timing, indeed! I had similar timing... Was put on blood pressure meds for the first time at a preop Dr's visit 20 days before surgery.

Even though metabolic syndrome is multifactoral, a doctor might use the term based on an elevated blood pressure reading combined with an elevated fasting glucose level.

In my opinion, every obese person that stays that way will eventually develop the syndrome, given enough time.

[PatientEleventyBillion 851]

I would have easily fit under the metabolic syndrome's 3/5 criteria.

https://www.nhlbi.nih.gov/health/health-topics/topics/ms/diagnosis

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A Large Waistline

Having a large waistline means that you carry excess weight around your waist (abdominal obesity). This is also called having an "apple-shaped" figure. Your doctor will measure your waist to find out whether you have a large waistline.

A waist measurement of 35 inches or more for women or 40 inches or more for men is a metabolic risk factor. A large waistline means you're at increased risk for heart disease and other health problems.

Check. My waistline was around 55 at peak while my stomach was 61.

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A High Triglyceride Level

Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic risk factor. (The mg/dL is milligrams per deciliter—the units used to measure triglycerides, cholesterol, and blood sugar.)

A Low HDL Cholesterol Level

HDL cholesterol sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries.

An HDL cholesterol level of less than 50 mg/dL for women and less than 40 mg/dL for men (or being on medicine to treat low HDL cholesterol) is a metabolic risk factor.

These two are the only ones I don't have. My good cholesterol was fine and my bad cholesterol was only slightly elevated but nothing of concern.

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High Blood Pressure

A blood pressure of 130/85 mmHg or higher (or being on medicine to treat high blood pressure) is a metabolic risk factor. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

If only one of your two blood pressure numbers is high, you're still at risk for metabolic syndrome.

My peak blood pressure was in 2015 and it was 170-180/110-120. Was normally getting 140-160/100-115 until around my pre-op diet.

Since pre-op diet it fell to around 105-120/75-90, my latest blood pressure post-op since stopping two of my meds (Forxiga for diabetes and HCTZ for blood pressure) was 103/81.

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High Fasting Blood Sugar

A normal fasting blood sugar level is less than 100 mg/dL. A fasting blood sugar level between 100–125 mg/dL is considered prediabetes. A fasting blood sugar level of 126 mg/dL or higher is considered diabetes.

A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat high blood sugar) is a metabolic risk factor.

About 85 percent of people who have type 2 diabetes—the most common type of diabetes—also have metabolic syndrome. These people have a much higher risk for heart disease than the 15 percent of people who have type 2 diabetes without metabolic syndrome.

HBA1c in March (1 month into pre-op diet) was 7.9mmoL, or in US numbers 142 mg/dl)

Regular fasting results of late (endoscopy in March, surgery day in April, post-surgery recovery before discharge) all were at 4.4-4.6 (80-82 mg/dL).

Nonetheless, I qualify for the 3/5+ criteria (not even counting liver disease), but I was never diagnosed with metabolic syndrome. There must be other factors too I'm thinking... like age and other stuff.

Edit: This forum code is acting really stupid.

Edited May 13, 2017 by PatientEleventyBillion

[Berry78 4,261]

Just because a doctor never officially diagnoses a patient with the condition doesn't mean the patient doesn't have it. Doctors don't TREAT metabolic syndrome, they treat diabetes, or high triglycerides, or high blood pressure instead.

[Ms. Brightside 121]

I am well-aware of how metabolic syndrome works. I've been keeping a close eye on my blood work (which is done annually), as well as my blood pressure, as my mother and father both suffer from this syndrome. I've had a large waistline, however, as of last year's blood work, everything else was good. My consultation with my surgeon uncovered borderline hypertension (which has continued at several other appointments since then). My pre-op blood work (they took 10 tubes of blood) reflected low HDL Cholesterol and fasting glucose levels in line with pre-diabetes.

My amylase level was low, as well, which further indicates MetS.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102610/

Anyway, the point of this post (and as @Berry78 also pointed out), is that "perfect blood work" does not = "perfect health", as I've seen posted in these forums (and as I thought for years...I've been kidding myself!). If you are overweight, you are unhealthy and, basically, a ticking time bomb.

I was also wondering how those who had the syndrome were doing post-operatively. Thanks for sharing your experiences, @OutsideMatchInside & @PatientEleventyBillion.

12 hours ago, Berry78 said:

Just because a doctor never officially diagnoses a patient with the condition doesn't mean the patient doesn't have it. Doctors don't TREAT metabolic syndrome, they treat diabetes, or high triglycerides, or high blood pressure instead.

Yes! This is the problem with healthcare, as a whole; doctors treat symptoms, not causes.

[Introversion 1,876]

Since diabetes runs strongly in my family (my father has it, my mother had it, three out of four grandparents had it, multiple aunts, uncles and cousins have it, etc.), I developed insulin resistance and metabolic syndrome at a young age. A highly processed diet of boxed macaroni & cheese, Rice-A-Roni, Breakfast cereals and fast food didn't help, either.

When I was 24 years old, my former endocrinologist said insulin resistance was the potential reason I kept rapidly regaining after major weight losses. Metabolic syndrome keeps us hungry and craving carb-laden foods. Also, insulin drives fat storage, making it easier for those of us with metabolic syndrome to store fat and gain weight.

I had the low HDL, borderline blood pressure readings, and elevated waist circumference. I also had the acanthosis nigricans (velvety hyperpignemtation) on the back of my neck. This is a classic marker of insulin resistance and prediabetes.

After weight loss surgery, my HDL (good cholesterol) went from 45 to 112. My waist circumference is 27 to 28. My blood pressure readings are low normal. My fasting blood glucose is usually in the 80s.

Edited May 13, 2017 by Introversion

[OutsideMatchInside 10,166]

I too had the dark neck. I had it so long I thought it was normal, but a Dr once told me it was a metabolic issue and because of my diabetes. When I lost weight it completely reversed and my neck is the same color as my chest, after being darker for at least 20 years.

My "waist" was 66.5 before, I carried all most of my weight in my stomach and on top of the mucle, not below (which now I know is a really good thing). Currently my waist is 29 to 30.5 depending the day.

I relieved a lot of my symptoms by low carbing off and on for over a decade but I could never lose enough weight to cure myself on my own.

Edited May 13, 2017 by OutsideMatchInside