Hypoglycaemia as a metabolic impossibility

Last Thursday, the day before the operation, the dental surgeon told me: “Make sure you have a good breakfast. I don’t want you to get hypoglycaemic. It will last several hours.” I replied: “I never have breakfast, and it is impossible for me to become hypoglycaemic.” He was like: “What? What are you talking about? I don’t understand what you’re saying.” I just said: “Because I don’t eat carbohydrates, I cannot become hypoglycaemic.” I’m not sure he understood what I meant, but I suppose that given my response, he figured I knew what I was talking about.

I’m sure you’ve heard, at one point or another in your life, someone say: “I’m hypoglycaemic, I need to have something”, and then seen them pull out a can or bottle of juice, an apple or an orange, a granola or a chocolate bar? Maybe you’ve said it yourself! It sounds scientific; like we know what we’re talking about. Don’t you think? Maybe we’ve heard a doctor or a nurse say it. Maybe we’ve heard other people say it, here and there. And over time, saying this has become common parlance in North America, and surely in the UK as well. But what does it mean? What do we mean when we say that?

Do you know why I said what I did to the dentist? Do you understand why it is impossible for me, (and possibly you too), to become hypoglycaemic, even without eating for 12, 24, or 36 hours? Why is it that so many people suffer from hypoglycaemia on a daily basis, especially type II diabetics, and all the while, I’m writing that it is ‘a metabolic impossibility’? Am I wrong? Am I lying? Am I confused or trying to be confusing? And why is there so much hype about hypoglycaemia? Just Google it and you’ll see: 6.35 million hits! There’s even a Hypoglycaemic Health Association!

First of all, if you don’t already know what it means, hypo means low, and glycaemia means ‘sugar in the blood’. So, hypoglycaemia just means low blood sugar. But the thing is that what people usually mean when they say this, is that they are feeling tired, slow, flat, low-energy, light headed, maybe even dizzy, and interpret these symptoms to reflect a state of low blood sugar, which it usually does. But there’s a caveat: different people will feel the same symptoms at different blood sugar levels! Isn’t that a little weird? Doesn’t that make you wonder about what this means and implies? If there is such as thing as hypoglycaemia, why would it be different for different people? Meaning, why would a certain blood sugar level be fine for one person, and too low for another?

But what is low blood sugar? What is high blood sugar? What is normal blood sugar? Do you have any idea? And how much sugar is that, actually, circulating in the bloodstream? Any idea about that?

Let’s make it simple. Most people have between 5 and 6 litre of blood. Let’s take 5 litres as our baseline to make the numbers easier. Most people, on average, have around 100 mg/dl of glucose in their blood (even if they should have less!) Since there are 10 dl in 1 litre, and 100 mg =0.1 g, this makes 5*10*0.1 g = 5 g. Think on that for a second: in your entire body, there are 5 litres of blood, and in this volume of blood, there are 5 measly little grams of glucose. That’s a teaspoon!

For very low blood sugar levels, we can go down to about 50 mg/dl (half the normal average). This would amount to just 2.5 g in your whole body! And for critically (as in dangerously) high levels, we can go up to around 400 mg/dl (four times the average). In this case, that would amount to still just 20 g! Therefore, we can say that at any given time in our body there is on average 5 g of sugar, very rarely less than 2.5 g, and only extremely rarely, when we are severely diabetic, up to 20 g. So, all things considered, it’s not much, is it?

Now, why is it that most people feel hypoglycaemic at one point or another if they don’t eat for a while, sometimes in as little as a few hours? Why would different people feel these symptoms more or less intensely? And why would different people feel the same unpleasant or even debilitating symptoms of hypoglycaemia at different concentrations of blood glucose?

Well, if you feel symptoms of hypoglycaemia it means that 1) your blood glucose levels are significantly lower than your own usual average level, the level at which your system and cells have gotten used to functioning. This average level could be 200, 150, 120, 100 mg/dl or whatever. And the lower threshold before you start feeling weak, tired or even dizzy could be 40, 50, 60, or even 90 mg/dl. In fact, diabetics or soon-to-be-diabetics, could be walking around, going about their business with an average of 150, 200 or even 300 mg/dl without knowing it, until they get a blood test and someone notices. And they would definitely feel hypoglycaemic at levels that could be quite high. How come?

The key to understanding this conundrum in the apparent subjectivity of hypoglycaemia is the notion of glucose tolerance. But what is glucose tolerance if it is not insulin sensitivity? And what is insulin sensitivity if it is not the flip side of insulin resistance? I hope that by now, having been reading this blog for a while, you know everything about insulin resistance, how it develops and how it manifests itself in the biochemistry and metabolic functions of the body. (If you don’t, then just reread the posts you’ll find in the Diabetes and Carbs categories.)

This notion of tolerance explains it all very neatly: with chronic exposure to glucose, (as in high average levels of glucose in the blood for an extended time), insulin resistance increases, and thus, insulin sensitivity decreases. As insulin sensitivity decreases, more insulin is needed to clear the glucose from the bloodstream, and more glucose stays in circulation longer. The cells get used to this high level of insulin, and become less and less sensitive to it, allowing less and less glucose to get in. When the level of glucose drops below the threshold at which the cells can use it without much effort, muscle but especially brain cells, we feel hypoglycaemic. This is why hypoglycaemia is defined on a subjective and relative scale that depends on our own cells’ sensitivity to insulin, the hormone that shuttles the glucose in. We become hypoglycaemic when the body cannot use fat to fuel its cells, and ketones to fuel its brain. And the more insulin resistant, the more prone to hypoglycaemia.

Moreover, insulin sensitivity, or resistance, exists on a continuous spectrum in the population. It goes from extreme sensitivity to extreme resistance. On the side of high resistance, we have type II diabetics; and on the side of high sensitivity, we have those people like me, and maybe also like you, who restrict carbohydrates, getting most of their calories from fat, and whose cells are consequently fuelled primarily by fat and not by glucose. This makes them, it makes us, not only highly metabolically efficient, but also impervious to hypoglycaemia.

This is why I said what I did to my dentist over the phone the other day: for a body whose cells are highly insulin sensitive from being minimally exposed to glucose/insulin in the bloodstream, the levels of which are delicately and sensitively regulated by the liver (glucose) and pancreas (insulin) throughout the day based on food intake, activity and stress levels, the cells are primed to burn fat efficiently, and the liver is primed to produce all the fat-derived ketones to nourish the brain, which they do far better than glucose can. For a body that works like that, it is physiologically impossible to become hypoglycaemic.

By the same token, it is also physiologically impossible to ‘hit the wall’, just because the cells are fuelled by burning fat, not glucose, and there is always a large reservoir of fat in the body, in terms of calories, at least an order of magnitude larger than the reserves of glycogen in the liver and muscles combined, and this, no matter how thin you may be. For example, even at 8% body fat (like me), which is quite low, a person weighing 63 kg (like me), has 5 kg of fat to draw on, providing a reservoir of 45 000 kcal! This is why we see more and more high level long distance athletes and professionals (like this one), and even power lifters (like this one) switching to a very low carb high fat diet (often abbreviated VLCHF). They do this to get lean and to tap into the metabolic advantages of nutritional ketosis.

Two final points:

1) Insulin sensitivity depends sensitively on exposure to insulin, which depends sensitively on the presence of glucose, which depends sensitively on carbohydrate intake. And it is as simple as this: the less carbohydrate, the less glucose; the less glucose, the less insulin; the less insulin, the more insulin-sensitive. This is always true even if different people have different genetic predispositions to insulin resistance.

2) Nutritional ketosis depends on the ratio of calories derived from fat to those derived from carbs, as well as on a specific maximum amount of insulin-stimulating carbohydrates per day. This threshold depends on each person individually. For one person it can be as high as 100-120 g, whereas for another it could be at low as 15-20 g. In addition, if you deplete your glycogen stores from going for a really long bike ride, for example, you can eat as much as 200 or even 300 g of carbs, and still remain in ketosis, because all of it will go to replete glycogen in the muscles and liver. In most people and in most cases, however, a standard guideline is less than 50 g per day. But, remember, the lower the better.

So, are you clear on what the deal is with hypoglycaemia? And now, what’s it gonna be: carbs, hypoglycaemia, feeling tired and irritable, low in energy and mentally slow, light headed and dizzy; or fats and protein, nutritional ketosis, feeling good and strong, high in energy and mentally sharp, stable and alert.  That’s a no-brainer, right? What do you say?

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Reversing diabetes: a four-week programme

The key factors of the process of reversing diabetes are: dropping blood sugar concentration and keeping it low, dropping insulin concentration and keeping it low, and alkalising the blood, fluids, tissues and organs—especially the pancreas, to eliminate accumulated acids and reverse the physiologically debilitating effects of chronic acidosis so common to diabetes.

We have examined both the process of developing and that of reversing diabetes in several previous articles. Now, we present a detailed four-week programme to put things into practice, begin recovering correct metabolic function, and get you on your way to ridding yourself of diabetes, if this happens to be a condition from which you are already suffering, towards which you are moving, or simply want to make sure it never develops.

As you will see, beyond the manipulation of the biochemistry through what is consumed, there are in addition several tweaks that are employed to ensure the best possible response to and outcome of the programme. These have mostly to do with timing: when we do things, when we drink, and when we eat. But also include important supplements (in addition to other ones you are taking like B12, ubiquinol, etc); as well as physical exercise, and specific types of exercise done under specific conditions.

The programme is constructed based on a four-week period because this is the amount of time that is needed, in the majority of cases, for the hormonal system to rebalance itself around the much lowered insulin levels, and for the cells and metabolism to regain insulin sensitivity and switch from using glucose and breaking down muscle tissue to satisfy energy needs, to instead use primarily fat, and naturally, as we would expect, the fat stored in the body’s adipose tissues throughout, which means sub-cutaneous—the fat that sits under the skin, intra-abdominal—the fat that is between the various digestive organs in the abdomen, and even the fat that is stored inside the tissues of organs like the liver and heart, and in the muscles themselves.

It is very important to understand, however, that even though the startup programme lasts four weeks, it is a transition period and a complete re-education that marks the beginning of a different way of doing things in order to first allow the body to heal itself and for you to regain your health, and then to maintain and refine this state of health over the course of the rest of your life.

It is also very important to understand that what leads and has led you to a diabetic or pre-diabetic condition are factors related primarily to diet and lifestyle, which if adopted by most will cause similar metabolic dysfunction, and obviously, if adopted anew following this four week programme will inevitably lead back to diabetes, and all that much faster for those whose system has already been compromised by the years and decades that led to this metabolic dysfunction in the first place.

Therefore, you must absolutely understand that this is a four-week programme intended to correct major imbalances and dysfunction and get you on your way to reversing your diabetes and tuning your metabolism to efficiently run on fats as the primary cellular fuel. But that it is also intended to re-educate and teach you a completely new way of doing things on a daily basis in order to empower you in knowing what to do to be and remain in perfect health, why you do what you do, and why it works on a physiological and biochemical level.

Lastly, because of its strict timing and numerous elements throughout the day on a very regular schedule, you have to make this programme a priority, and, ideally, make it your primary activity during this period. You will probably find it close to impossible to follow if you are trying to maintain other demanding and time consuming activities like a full time job at the same time. So, just take a break from everything else, and concentrate on your health for a month. Afterwards, once many of these new ways of taking care of yourself have become more habitual, you will find it far easier to maintain a similar routine while working and doing other things simply because it will be far more natural for you.

The first five days

Background

For maximal effectiveness, we start with a period of intensive cleansing and alkalisation during which the key nutritional element is fresh juice of green vegetables, and the sources of calories are restricted to coconut oil, coconut milk, coconut flesh and milled chia seeds. Like a traditional juice cleanse, everything that is consumed is raw and therefore living, enzyme rich, and easily absorbed with minimal digestive stress; and nothing is acid-forming and acidifying, for this would defeat one of the fundamental purposes of the healing protocol which is essential to restore correct pancreatic function.

Highly unlike a traditional juice cleanse, however, there are virtually no simple sugars consumed and entering the bloodstream, and there is a significant amount of fat, almost all derived from coconut oil. This serves several purposes: it provides the metabolism a perfect fuel for cellular function that is easily broken down and generally not stocked away in fat cells; it enhances the production of ketone bodies necessary to fuel the brain in the absence of glucose, at the same time helping heal and repair the brain by promoting the evacuation of plaques from cerebral arteries and thus increasing blood flow to these starved brain cells; it maximises the absorption of the rich array of minerals, antioxidants and phytonutrients in the green juices; and finally, but also importantly, it very effectively suppresses hunger.

During this period the body will quickly and efficiently make the metabolic transition from using exclusively glucose as is always the case in diabetics and insulin resistant individuals, to burning fat reserves as the cellular fuel of choice; significantly decrease the level of systemic inflammation and release several kilograms of the water that is retained under conditions of chronic inflammation and insulin resistance, in great part responsible for hypertension, swelling of the joints and extremities, and poor blood circulation; thoroughly alkalise, cleanse and begin to rejuvenate, heal and repair the vital digestive organs: the stomach and intestines, and the kidneys, pancreas and liver; alkalise the blood and eliminate large amounts of accumulated acids stored throughout the body in the joints, soft tissues and muscles.

All of these processes are very physiologically tiring. For this reason it is important to rest in the afternoon, and have long nights of deep sleep every night. Hence, only walking is recommended as a form of exercise during this period, ideally in the morning (between 9:00 and 10:00) and in the evening after the last meal (anywhere between 20:00 and 22:00).

Detailed schedule

Here is what and when to eat and drink during this period (times can be adjusted slightly according to sleep patterns):

8:00-9:00 (or upon getting out of bed) – Water and Mg oil

  • Put on Mg oil all over the legs, arms, chest and abdomen, shoulders and back (as best you can). Leave on for at least 30 minutes before showering.
  • Large glass of plain water (400-500 ml)
  • Supplements:
    • Proteolytic enzyme complex (3; Baseline Nutritionals)
    • Spirulina (3; Nutrex) / Chlorella (5; Healthforce Nutritionals)
    • Tulsi extract
    • Lugol’s iodine solution (in water; 5%: 6 drops, 15%: 2 drops)
    • ATP Cofactors (Optimox)
    • Probiotics (Prescript-Assist)

9:30-10:00 – Green juice and chia seeds

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tablespoon, melted and emulsified with hand-held blender)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))
    • Krill Oil (2; Mercola)
    • Astaxanthin (Nutrex)
    • A/D/K2 (DaVinci Laboratories)
    • Zinc (MegaFood)

11:30-12:00 – Lemonade

  • Lemonade: 1 medium (or 2 small) pressed lemon, 1/2 tsp salt, 2 mini spoon stevia in 500 ml of water.
  • Vitamin C: 1/2 tsp with small amount of water, stir until fizzing stops, fill small glass half way. (Ultimate Ascorbate C Powder by Source Naturals mixed with highest quality, food grade, powdered sodium bicarbonate in ratio 2:1)

12:00-12:30 – Salty veggies

  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Tulsi
    • Lugol’s
    • ATP Cofactors

13:00-13:30 – Green juice and coconut milk pudding/ice cream

  • Green juice without coconut oil
  • Coconut milk pudding (blueberry, raspberry, blackberry or cacao-chia)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))
    • Krill Oil (2)
    • Astaxanthin
    • A/D/K2
    • Zinc

14:00-15:30 – Sleep

Sleep (very important for the first 5 days that will be very tiring for the body in terms of cleansing and repair)

16:00-16:30 – Water

  • Large glass of water
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Probiotics

16:30-17:00 – Green juice and chia seeds

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tbs melted)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

18:00-18:30 – Lemonade

Lemonade and Vitamin C (as above)

19:00-19:30 – Salty veggies

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)

20:00-20:30 – Green juice and coconut macaroons

  • Green juice without coconut oil and coconut macaroons (but not with cacao).
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

22:00-22:30 (just before bed) – Psyllium and charcoal

  • Large glass of water with psyllium husks (2 rounded teaspoons, mixed and allowed to swell for a few minutes)
  • Supplements:
    • Charcoal (Source Naturals)
    • Valerian root extract (Bluebonnet Nutrition)
    • NightRest (Source Naturals)

Beyond the first five days

Background

At this stage, the body will have undergone a radical transformation biochemically and physiologically from the inside out. Most noticeable will be the loss at least 4-6 kilos of water (about 2 kg) and fat (about 2-4 kg), with the accompanying feeling of being much lighter and thinner at the waste with a deflated abdomen and gut. The digestive system will have experienced a very effective cleansing and bowel movements will be noticeably more regular and quite different in texture, smell and sensation. The smell and volume of both urine and sweat will have evolved markedly during this period. And all the vital digestive organs will have been given a powerful boost and rejuvenation, but this cannot really be felt. You should as mindful as possible of all of these details and everything else you can notice over the course of the first five days. This will give you a much deeper appreciation of the process and of its importance in regards to your moving towards better health.

We can now continue with a regime that includes two green juices per day instead of four, dropping the afternoon green juice, and replacing the evening green juice by a large green leafy salad with small amounts of nuts, seeds or fish (sardines, anchovies or wild smoked salmon, for example). We will also reduce quantity and frequency of supplements.

In addition, we will introduce a component of exercise that is absent in the first five days, which will greatly enhance the body’s response to the new regime and metabolic environment. The exercise will take the form of fast walking with very light weights for strengthening the shoulders and arms, Pilates workouts to develop strength in the core muscles (abs and back) for postural balance, high intensity interval training coupled with resistance as well as cross-fit training with weights to increase cardiovascular and metabolic efficiency, fat and glucose utilisation, muscle mass, done density, and tendon and ligament strength and flexibility.

Detailed schedule

8:00-9:00 (or upon getting out of bed) – Water and Mg oil

  • Put on Mg oil all over the legs, arms, chest and abdomen, neck, shoulders and back (as best you can). Leave on for at least 30 minutes before showering.
  • Large glass of water (400-500 ml)
  • Supplements:
    • Proteolytic enzyme complex (3)
    • Spirulina (3) / Chlorella (5)
    • Tulsi extract
    • Lugol’s solution (in water; 5%: 6 drops, 15%: 2 drops)
    • ATP Cofactors
    • Green tea extract
    • Green coffee bean extract
    • Probiotics

9:00-9:45 – Walk

Fast walk with 1 kg weights in each hand, using them to do shoulder rotations, biceps curls and triceps extensions while walking.

10:00 – Green juice

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tbs, melted and emulsified with hand-held blender)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))

11:30-12:00 – Lemonade

  • Lemonade and Vitamin C (as above)

12:00-12:30 – Salty veggies

  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Tulsi
    • Lugol’s
    • ATP Cofactors
    • Green tea extract
    • Green coffee bean extract

13:00-15:00 – Workout

  • Resistance and high intensity interval training on Mondays
  • Pilates on Tuesdays, Wednesday and Thursdays
  • Cross Fit training on Fridays
  • Rest on Saturdays and Sundays

15:00-:15:30 – Gren juice and coconut milk pudding (or ice cream)

  • Green juice without coconut oil
  • Coconut milk pudding or ice cream (blueberry, raspberry, blackberry or raw cacao and chia)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)
    • Krill Oil (2; Mercola)
    • Astaxanthin (Nutrex)
    • A/D/K2 (DaVinci Laboratories)
    • Zinc (MegaFood)

15:30-16:30 – Sleep

Sleep (highly recommended; optional after the first five days)

16:30-17:00 – Water

  • Large glass of water
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Probiotics
    • Green tea extract
    • Green coffee bean extract

17:30-18:00 – Lemonade

Lemonade and Vitamin C (as above)

18:00-18:30 – Salty veggies

Cucumber, kohlrabi or celery with salt

19:00-20:00 – Green juice, salad and coconut macaroons

  • Green juice without coconut oil (then wait 30 minutes)
  • Green leafy salad with oil and salt (no vinegar), and small amount of either walnuts, anchovies, sardines or salmon (smoked, grilled or pan fried)
  • Coconut macaroons for dessert.
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

22:00-22:30 (just before bed)

  • Supplements:
    • NightRest
    • Valerian root extract

Concluding remarks

This is a programme designed for reversing type II diabetes, and will, without any doubt, do exactly this. What might vary from one person to another is really only the time that will be required to recover ideal insulin sensitivity.

It is important to appreciate, however, that it would be just as effective in treating any kind of degenerative condition like arthritis, but also atherosclerosis of the coronary or cerebral arteries, and arteriosclerosis due to the accumulation of calcium in the tissues; kidney or liver disease but also pancreatic fatigue or dysfunction; stomach and peptic ulcers, but also candida overgrowth and infection, as well as leaky gut syndrome; and of course, probably the most fearsome of them all—cancer.

Why? Because all health problems and disease conditions stem from biochemical and hormonal imbalances, and metabolic and physiological dysfunction. Therefore, in order to either prevent or correct any one problem, all problems must be prevented and corrected. For some of us—very few of us indeed—this is plainly obvious. It is, however, also obvious that this understanding is definitely absent—conspicuously and painfully absent—from modern conventional health care, no matter what it is intended to treat and no matter where we look.

Hence, it is my hope that this programme will not only help diabetics and pre-diabetics permanently reverse their diabetes and all the associated problems related to the underlying metabolic dysfunction, but also help all those who wish to treat whatever health concern they may have, as well as those who wish to prevent any such health problems from developing.

The only way to develop and nurture optimal health is for every cell, organ and system of the body to function optimally. Therefore, this is what we must do, and that’s the bottom line. Good luck with the programme. Naturally and as usual, you are welcome to post you comments, questions and observations, especially those from your experience with the programme. I would be very happy to hear from you.

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Reversing diabetes: understanding the process

The fundamental problem, the cause of all the complications associated with diabetes, is the chronically elevated glucose and insulin levels. Independently of the fact that each individual, each one of us, has a different tolerance to carbohydrates, a different metabolic response to the presence of glucose and insulin in the blood, there are basically only two ways that blood glucose can be elevated: the first is by the consumption of sugar or starch that finds its way into the bloodstream through the intestinal wall; the second is by the stimulation by stress hormones of liver glucose production whereby the glycogen reserves are broken down and the resulting glucose released into the blood. Therefore, in order to most effectively bring down chronically elevated blood sugar levels, it is essential to eliminate insulin-stimulating carbohydrates, but it is also essential to eliminate chronic stress.

The sugar

The vast majority of the millions of type II diabetics that constitute the body of what is now generally considered to be a diabetes epidemic in many western countries, have developed the condition primarily from the consumption of dietary insulin-stimulating carbohydrates, from eating high-sugar and high-starch diets over the course of decades. The process of growing insulin resistance due to chronic consumption of carbohydrates is described in several other posts (like, for example, We were never meant to eat simple or starchy carbohydrates, A diabetic’s meal on Air France, and Cure diabetes in a matter of weeks). It is for this reason that the same vast majority of type II diabetics responds extremely well to the elimination of these carbohydrates from their diet, whereupon glucose levels drops, insulin levels drop, the cells gradually regain insulin sensitivity, and the tissues and organs gradually recover from years or decades of the toxic environment created by continuously being exposed both to glucose and insulin. Naturally, the recovery process depends intimately on how long and how bad things were before implementing these dietary changes, but it happens in more or less the same way in every person.

The stress

The tendency, in many western societies and especially in North America, to create and generate in all sorts of ways, very high levels of stress in most spheres of our activities and our life, and, in fact, thrive on this stress throughout most days, often for years and even decades, in order to be highly “productive” and “successful”, or at least, make ourselves feel or believe that we are, is extremely bad. This, compounded with the fact that most of our standard western diets are very top-heavy in insulin-stimulating carbohydrates, makes one’s evolution towards of type II diabetes faster, more pronounced and much more harmful. As a consequence, there is without a doubt an non-negligible fraction of diabetics that suffer from both a high intake of sugary and starchy foods, as well as high stress levels.

In the extreme, however, it is definitely possible to develop diabetes uniquely or primarily due to chronically high levels of stress. The most important, and indeed, very important difference between elevating blood sugar through diet or as a consequence of stress hormones, is that the former is naturally corrected by the secretion of insulin, which helps put aways the sugar either as glycogen or as fat, whereas the latter, the presence of high levels of stress hormones, simultaneously induces insulin resistance in order to keep the glucose in circulation as long as possible. This makes perfect sense from an evolutionary standpoint because under stress, under a fight or flight situation, we need lots of glucose in the blood and we want it to stay there to allow us to respond physically to whatever needs to be done: to run, jump, climb, fight, survive. The problem is that our high levels of stress are not only chronic, but they are not associated with a situation in which we need to have access to high levels of sugar in the blood in order to respond to the stressor physically with our muscles. And so, glucose remains high and circulates, insulin remains high but is not effective, and from this, all our blood vessels, tissues and organs get damaged: glycated from the glucose, oxidised from the free radicals, and literally corroded by the insulin.

This clearly implies that chronically high levels of stress are far worse than a high carbohydrate diet, and explains in no uncertain terms why high-stress professionals—even low-carb eaters—can not only suffer from chronically elevated blood sugar levels and the full array of damaging consequences, but also develop diabetes, and almost inevitably, heart and artery disease, because they all come from the same place: high stress leads to high levels of cortisol and other stress hormones; high levels of stress hormones lead to high glucose and insulin resistance no matter what is eaten because it comes from the liver; high glucose levels and insulin resistance leads to artery disease which leads to heart disease, and it also leads to type II diabetes. This is why, for those high work volume and high stress high-strung high-achievers, it is essential to eliminate all insulin-stimulating carbohydrates, but it is crucial to significantly reduce, and ideally, eliminate chronic stress. (We have looked at many of the physiological effects of stress in The kidney: evolutionary marvel and in At the heart of heart disease.)

The physiological consequences

As every diabetic knows, or at least should know, the consequences or complications associated with the condition of diabetes are horrific. What is very unfortunate is that it appears as though many doctors do not understand the biochemical and physiological connections and chains of  reactions and responses that develop and grow more sever over time as a consequence of the underlying chronically elevated blood sugar and insulin levels (as you may remember from your reading of Why do diabetics have high blood pressure?). What happens in the body when levels of blood sugar and insulin resistance stay high? Let’s follow this through:

High blood pressure, atherosclerosis and heart disease

The most immediate consequences are the rise in blood pressure and increased damage to blood vessels from glycation: the elevated levels of glucose that the kidneys have evolved to keep in circulation causes a rise in osmolarity (blood concentration), which the kidneys try to counter by retaining water in order to keep the blood from getting too concentrated. Since blood pressure is mostly a function of the amount of water in the blood, this causes the pressure to rise. Because glucose is meant to remain in minimal circulating concentrations or otherwise be quickly cleared from the bloodstream by pancreatic insulin shuttling it into cells, long-lasting elevated sugar concentration leads to the glycation of tissues, which is the damage of protein or fatty structures of the cells due to the glucose molecules “sticking” in the wrong places and in the wrong way. This, in combination with the higher blood pressure, is the perfect recipe for much increased damage to the blood vessels, especially the large arteries in which the pressure is greatest, the increased production of cholesterol and lipoproteins for cholesterol transport and damage repair, and the consequent plaque buildup termed atherosclerosis, which eventually (sooner than later) leads to artery disease, heart disease, and heart attacks from the occlusion of vessels bringing blood to the heart muscle (the coronary arteries).

Kidney disease

Even though it is the kidney that regulates the blood pressure and retains water in order to keep the blood from getting too concentrated with the increasing concentration of glucose, the higher blood pressure puts great strain on all of its micro filtering units, the nephrons, whose function is to filter out acidic metabolic waste from the bloodstream and get rid of it through the urine. The nephron works optimally under optimal conditions, but optimal for it, which means ideal blood pressure: not too low, but especially, not too high. It’s a self-regulating system in that if we are relaxed and at rest, then breathing is slow, heart beat is slow, blood circulation is slow, blood pressure is low and the kidneys are under little strain. As we get moving, through exercise, for example, then breathing is faster, heart beat is faster, blood flow is faster, blood pressure is higher, and the kidneys filter a larger volume of blood per second in order to eliminate as much of the acid that is building up from the activity and that needs to be eliminated in order for the muscles to continue working in ideal conditions.

With chronically high blood pressure, the kidneys are continually under stress and the nephrons get damaged. However, because there are millions of nephrons in each of the two kidneys, and it has been estimated that we can live with only 1/3 of the nephrons in only one of the two kidneys, this problem of the gradual deterioration of kidney function is not really considered as a big issue until the kidneys fail (or little time before), at which point it is far too late, and the situation is irreversible.

In addition, insulin resistance—to any degree—promotes the break down of muscle tissue, because as soon as sugar levels drop after a few hours after a meal or snack, during the night is the most apt example, since the cells cannot use fats for energy, the muscle tissue is broken down and constituents of its proteins made into glucose. This leads to chronically high levels of circulating creatinine that, as a metabolic waste product, must also be filtered out and eliminated by the kidneys. This happens in everyone with insulin resistance, and the amount of muscle breakdown is a function of the degree of insulin resistance. In the case of extreme insulin resistance as is seen in type II diabetics, the process is far more pronounced. The excessive stress on the kidneys inevitably leads to deterioration, nephron dysfunction, and eventually to failure. (You can read more about kidney function in The kidney evolutionary marvel.)

What makes things even worse is that most diabetics/heart disease sufferers have elevated lipoprotein (and cholesterol) levels due to the excessive inflammation and speed at which tissue damage is taking place in the blood vessels and all over the body. This, as you all know, has been wrongly interpreted and widely promoted as a major risk factor for heart attacks. The “treatment” of choice for these patients are a lifelong prescription for statin drugs. Very unfortunately, not only do statin drugs not confer any health or longevity benefits, but they accelerate the speed at which muscle breaks down, causing even greater amounts of creatinine to make its way into the bloodstream, and thus creating a heavy additional load on the kidneys. Is it any wonder that the rise in kidney disease closely reflects the rise in diabetes but also in statin consumption? If you’ve been taking statins, don’t get overly worried: physiological degradation is a slow process, and it is rarely too late to make the intelligent choices and changes that will help stop and reverse the disease process, and in time allow the body to heal itself.

Systemic acidosis

The way in which the kidney regulates blood pressure upwards is by secreting different hormones that prevent water from being eliminated, that thicken the blood, and that contract the blood vessels. In most people, the majority of which is chronically dehydrated, there is already a shortage of water and therefore a dehydration response by the kidneys; the elevated sugar concentration makes this far worse, of course. And under dehydration conditions, the means by which the kidney can retain even more water, as much water as it can, is by increasing the concentration gradient in the interstitial medium through which the nephron passes in order to pull as much water out of the filtrate as possible.

Increasing the concentration gradient is done by keeping and concentrating sodium and uric acid. It is more important to retain water than to eliminate uric acid, because water is primordially important for all body functions. Consequently, urea and uric acid levels rise, gradually but consistently over time. Because acid cannot accumulate in the blood, whose pH must absolutely be kept pretty much exactly at 7.4 (7.35-7.45), but because, at the same time, it cannot be eliminated by the kidneys under the given circumstances, it is stored away in the tissues all over the body: joints, ligaments, tendons, muscles and organs. Chronically high levels of uric acid in the blood lead to the condition known as gout. The buildup of acid in the tissues leads to pain, inflammation, arthritis, cartilage breakdown, bone demineralisation and osteoporosis, and a slew of other undesirable consequences, including increased susceptibility to all forms of infections: yeast, viral and bacterial, and severely depressed immunity. (You can read more about acidosis and alkalisation in A green healing protocol, Detoxification, and Such a simple and yet powerful natural anti-inflammatory.)

Maybe the most critical point about acidosis in how it relates to diabetes is that the pancreas and its precious beta cells, those that produce the insulin, are extremely sensitive to pH, and simply cannot function when the blood and cellular environment is acidic. The cells simply stop functioning because of the overload of acid that is not excreted and not neutralised. This makes the pancreas more and more dysfunctional over time, and eventually leads to exhaustion and the complete inability to secrete insulin or do any of the other functions that it is intended to perform. Something very similar happens in the liver, and, in fact, everywhere else, when chronic acidosis defines the internal environment of the body.

Pancreatic exhaustion

The distinction between type I and type II diabetes is usually highlighted by calling the first insulin-dependent diabetes, and the second insulin-resistant diabetes. Type I diabetics are usually identified and diagnosed as children or young adults because their pancreas does not produce insulin, and are then “treated” by having to inject themselves insulin after they eat for the rest of their lives. Naturally, over time, from the continual and usually excessive exposure to insulin, their cells become insulin-resistant, and they subsequently develop all the same problems as type II diabetics, whose condition is, in a way, exactly the opposite, in the sense that they suffer from chronic hyper-insulinemia, because their pancreas that senses the elevated glucose concentration in circulation, produces more insulin in order to clear it out and store it away. The problem is that the cells are not sensitive to the presence of insulin, and therefore do not take in the sugar. The pancreas is then forced to produce and secrete more insulin, and on it goes. Amazingly, type II diabetics are also “treated” by insulin injections, which increase insulin levels even more, and increase insulin resistance even more, obviously making the situation far worse. Eventually, the pancreas of the type II diabetic gets completely exhausted, and loses the ability to manufacture and secrete insulin. At this point, the type II becomes a kind of type I. Interesting how this goes, isn’t it.

The pancreas’ main function is not to secrete insulin, even though in our diabetic-centric worldview it is certainly considered as such. This is one of its functions, but not the most important. By far the most essential is the production and secretion of enzymes, the specialised proteins that break down foods but also do everything else that needs to be done, especially tissue building and repair throughout the body. The third essential function of the pancreas is the concentration and secretion of sodium bicarbonate in the small intestine following the movement of the pre-digested chyme from the stomach into the small intestine. This is also extremely important because all absorption and digestion in the intestine must take place in an alkaline environment, compared to the acidic environment required in the stomach when protein is present. Pancreatic exhaustion from the over-production of insulin for years on end, therefore spells disaster on many more fronts than just insulin and glucose metabolism. It spells disaster for all digestion and absorption processes, and all enzyme regulated activities, which basically means everything, really. This is very serious.

Liver dysfunction

The liver does an amazing amount of vital work, most of it incredibly complex. This includes filtering the blood from all sorts of toxins, both biological and chemical in nature, and breaking those down for elimination; it includes the manufacture of cholesterol and lipoproteins, vital for survival, but the details of which are so intricate that they are still not completely understood after a century of study; it includes the transformation of excess glucose into glycogen and into fat for storage; and in includes the manufacture of glucose from liver-stored glycogen to continually adjust the levels of glucose in the circulation depending on the body’s needs, or more specifically, on the hormonal and biochemical environment. The distinction may appear subtle, but it is quite important in the sense that it is really the hormones and biochemistry of the blood that regulates the function of most tissues and organs, especially those of the vital glands like the liver, pancreas and adrenals, and there is hardly anything more disruptive and unbalancing to the hormonal and biochemical makeup than chronically elevated glucose, stress hormones and acid levels.

Under such conditions, the liver must manufacture an inordinate amount of glucose from the glycogen stores that it itself must also replenish, but also from the broken down muscle tissue. At the same time it converts as much as it can of the glucose into fat for storage, but unfortunately, insulin resistance makes it impossible for the triglycerides to be used, and they are therefore left in circulation for longer than they should before eventually being stored in our fat cells. To top up the list, the free-radical and glycation damage to the vessels and tissues require the liver to also manufacture an inordinate amount of cholesterol and lipoproteins in an attempt to repair these damaged cells, which is no small feat, (you can read more about cholesterol and lipoproteins in But what about cholesterol? and in Six eggs per day for six days: cholesterol?). All of these processes are perfectly natural. However, they are not meant to be running in overdrive for years on end. It is no surprise then that imposing upon the liver to cope with this, eventually leads to dysfunction, deterioration, exhaustion and failure.

Towards a working solution

This is definitely not the end of the list of the complications and physiological consequences that develop from chronically high circulating glucose and insulin levels, but they are some of the most important. Also, it is essential to understand the process by which these consequences first arise and then grow in severity and into the disease process over time. It is, however, infinitely more useful to know what to do in order to maintain a biochemical and hormonal environment in which none of these various dysfunctions and complications can arise if they haven’t yet, or how they can be stopped and reversed if they have.

It shouldn’t be surprising that these are the same, and that they are keys to any optimal health plan, simply because the cells, tissues and organs that make up the human body function, or rather, should function in the pretty much the same way in everyone, allowing for small differences in some of the details. For example, the fact that different people have different tolerances to carbohydrates does not change anything to the consequences of chronically elevated glucose levels on physiological function. It only changes the details relating to the thresholds and time scales involved in developing the same problems. The same goes for vitamin D: the fact that different people require different amounts of vitamin D in order to remain healthy does not in the least alter the basic fact that virtually all complex living creatures depend on it for life. So, yes, everyone is different, but, at the same time, everyone is the same.

No sugars, no starches, no dairy

The first step to take is to eliminate from the diet foods that cause glucose and insulin levels to rise. For this, we must

  1. Eliminate all simple sugars: that’s basically anything that tastes sweet, including sweet fruit, because all simple sugars will elevate blood glucose levels almost immediately after consumption;
  2. Eliminate all starchy carbohydrates: that’s all grains and grain products (at least 90% carb), beans (typically more than 70% carb), potatoes (virtually 100% carb), and other starchy veggies like sweet potatoes, yams, taro, etc, because the starches they contain are broken down to glucose by enzymes in the digestion process; but also sweet root vegetables like carrots and beets, which are just full of simple sugars (you’ll know this if you’ve ever had carrot or beet juice?)
  3. Eliminate dairy: that’s all milk products, which, even those low in sugars like hard cheeses, cause a rise in insulin levels. Besides, most people are allergic or intolerant to dairy products, whether they are aware of it or not.

And aside from just glucose and insulin levels, as we discussed in At the heart of heart disease, insulin-stimulating carbohydrates are highly inflammatory, triggering more than 300 inflammatory pathways. So, excluding them from our diet not only brings about plenty of positive metabolic and physiological changes, but it is, as far as I am concerned, a requirement to make those positive changes happen.

Drop the stress

For those people to whom we referred to earlier that suffer mostly from the chronically elevated stress hormone levels, it is crucial to eliminate the causes of stress, ensure long hours of high quality sleep, and incorporate exercise and activities that effectively reduce stress levels, as well as supplements that can help with that. Obviously, the most important sources of stress for most professionals are psychological ones. But what is also well established is that the level of stress that is experienced (i.e., the amount of stress hormones secreted and in circulation) depends entirely on each person’s outlook and attitude. Therefore, it is this—the attitude and outlook—that are the most influential factors in generating or relieving stress on a daily basis.

Having said this, it is also obvious that going to a remote holiday house on sandy beach without access to phone or internet communications, and making a point of simply relaxing, going for walks, swimming in the sea, reading good books, watching good films, taking naps, eating healthfully and sleeping long and soundly every night, is inherently far more conducive to eliminating stress than the usual school year and work day conditions. What we must find a way to do is to function well in all circumstances with minimal stress, and most importantly, without chronic stress. It is chronic stress that is the problem; not relatively short periods of high stress. And stress, it shouldn’t be surprising, is also happens to be extremely acidifying (haven’t you ever noticed the strong, acidic smell of underarm stress sweat?).

Very helpful in this is taking Tulsi in the morning and at lunchtime (only during the day), and valerian root before bed. But exercise, conscious relaxation, and modifying outlook and attitude towards a more open and relaxed position are definitely most important.

Lower blood pressure

Lowering glucose levels will automatically lower blood pressure. Lowering stress will also automatically lower blood pressure. Biochemically though, the most important muscle relaxant—and this most definitely applies to the smooth muscle cells that line the blood vessels—is magnesium. Therefore, magnesium baths, oil and oral supplementation is essential. On the other hand, calcium is contractile and unfortunately, much more present in the foods we eat. Therefore, most of us are magnesium deficient but also over-calcified. Hence, minimising calcium intake is also very important. (You can read more about these topics in Minerals and bones, calcium and heart attacks, and in Why you should start taking magnesium today.)

Proper mineral balance, especially sodium and chloride, are essential for blood pressure regulation. Eating plenty of unrefined sea salt with meals (and with drinks) is also crucial. Naturally, we seek balance, and salt intake has to be balanced with water intake, and this leads to optimal kidney function. (You can read more about water, salt and physiological function in How much salt, how much water and our amazing kidneys, Why we should drink water before meals, and in Water, ageing and disease)

Support the kidneys

The kidneys want to maintain optimal blood pressure; regulate water, sodium and mineral content of the blood; and clear out metabolic wastes, mostly uric acid. To have them do what they are trying to do as best they can, we must very simply provide plenty of water, plenty of unrefined salt rich in sodium and all the other essential minerals, plenty of alkalising sources in drink and food, minimise glucose levels and minimise creatinine levels. The importance of alkalising the body intensely at first and continuously thereafter cannot be overstated with regards to the proper function of all the vital organs discussed here, and everything else really: every cellular process and every enzymatic action; everything depends on this.

Rejuvenate the pancreas

The pancreas senses and responds to glucose in the blood by manufacturing and secreting insulin. It responds to the movement of food from the stomach to the intestines by manufacturing and secreting sodium bicarbonate and digestive enzymes. To rejuvenate the pancreas, we need to not only give it a break, but help it recover. For this, we need to minimise glucose levels in the blood, and thereby minimise the need for it to manufacture insulin; maximise intake of enzymes to minimise the need for it to produce them; and, especially in light of what we discussed under acidosis, we need to maximise alkalisation, including through oral and transdermal absorption of sodium bicarbonate and magnesium chloride, with a focus on chlorophyl and chlorophyl-rich foods and drinks.

Cleanse the liver

The liver’s most taxing function is the breakdown of toxins (all substances foreign and dangerous to the body). Another taxing function of the liver is the manufacture and recycling of cholesterol and lipoproteins that, as we said earlier, are in production overdrive because of the excessively fast free-radical and glycation damage to the lining of the blood vessels, as well as the damage these cause everywhere else in the tissues of the body, accompanied by the chronic systemic inflammation this leads to (you can read more about systemic inflammation in Treating Arthritis and At the heart of heart disease.)

To help the liver, we must therefore first stop ingesting chemically manufactured medications, and we must eliminate sources of toxins and chemicals from the things we eat and drink; from the air we breathe, especially from those toxic cleaning products we use; and from all the chemicals we absorb through the skin in soaps, shampoos, lotions and creams. Second, we eat and drink to minimise inflammation and internal tissue damage, therefore minimising the strain of excessive manufacture of cholesterol and lipoproteins. And third, we must take regular toxin cleansing and alkalising baths with sodium bicarbonate and magnesium chloride. This simple therapy is the most effective means of detoxifying the body from chemicals and toxins or all kinds, including the most notorious radioactive isotopes that can make their way into our bodies from nuclear weapons, spills and power plant accidents through the air, water and food. Here again, chlorophyl and chlorophyl-rich foods and drinks are essential.

In conclusion

The basic conclusion is the same as what we have come to whenever we discussed type II diabetes: while it is a devastatingly damaging condition that affects every metabolic and physiological function of the body, it is incredibly easy to prevent, and even after many years of deterioration for the diabetic sufferer, it is relatively easy to reverse the condition and cure the disease, including the beta cells of the pancreas, by understanding the disease process thoroughly, and by adopting an appropriate healing protocol. Here, we have detailed several of the key problems or complications that stem from chronically elevated glucose and insulin levels, with specific discussion of the ensuing dysfunction in some vital organs, and highlighting the crucial importance of considering the effect of stress in addition to the effects of dietary insulin-stimulating carbohydrates.

You might have noticed that a discussion revolving around overweight, obesity and fat metabolism is missing, maybe conspicuously so. This is not an oversight, but a conscious move towards a focus on the underlying causes of the metabolic, hormonal and physiological natures of the disorder instead of the superficial and rather inconsequential repercussions of it that take expression in the form of excess body fat. The only point I want to mention about this is that by correcting the causes of the disorder, excess body fat stores will melt away on their own. Some help from supplements and hormonal manipulation through diet and timing here and there will be useful. But, the point remains that if the body is in optimal biochemical balance, then physiological and metabolic functions will also be optimal, and no excess body fat will remain, no matter how young or old we are, and no matter what our genetic makeup happens to be.

The overview of the basic strategy for preventing and overcoming diabetes should make it clear that what it implies, although in some aspects quite specific and targeted, is very simple in that it relies mostly on drinking clean water, eating unrefined salt and clean foods, especially those that are chlorophyl-rich, eliminating damaging foods, chemicals and toxins, alkalising and detoxifying with sodium bicarbonate and magnesium chloride, and finally, using a number of important supplements to correct deficiencies and restore optimal biochemical balance. In a subsequent post we will formulate a detailed programme that incorporates all of the elements and strategies discussed here in general terms, together with some additional considerations about details like the timing and amount of food, drink, exercise and supplements.

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Why do diabetics have high blood pressure?

This is the question that someone in the audience asked at the end of a presentation on diabetes that I attended a few months ago. Remarkably, the speaker was unable to answer this question. Amazingly, neither could any one of the three medical doctors that were in attendance. I was, naturally, quite shocked by this obvious display of ignorance on all of their part. At the same time, I wasn’t really surprised, and, in fact, relieved to be vindicated in my belief that probably the majority of MDs don’t understand the most basic things about human physiology and metabolic function.

Now, you, on the other hand, you who has been following and reading this blog, might (or even should), I believe, be able to answer that question. But since you’re reading this, and therefore cannot be put on the spot, as was the speaker and those MDs at that presentation, you don’t have anything to worry about if you can’t. And yes, I am going to explain. On top of that, I’ll be as quick as I can about it.

As always, first things first: How is blood pressure regulated? What is it that does the regulating? And why is it important?

Blood pressure regulation is of the utmost importance for the proper functioning of every organ because every cell in the body depends on a properly functioning circulatory system to bring nutrients and carry away waste. Blood pressure is like the voltage that drives current through wires and electronic components: it is a driving force. And exactly like it is for electric and electronic devices, the driving force must be just right: it cannot be higher and it cannot be lower than what it needs to be in every moment depending on what the immediate circumstances and needs happen to be. Therefore, blood pressure regulation is essential for the moment to moment adaptation of every metabolic and physiological function, to the different activities we do, and circumstances we find ourselves in.

The main organ responsible for blood pressure regulation is the kidney. I use the singular because the two kidneys work in the same way. It’s just that their function is so vitally important that there are two of them, most logically for redundancy, as a fail-safe system. I have written at length about kidney function in two articles entitled The kidney: evolutionary marvel; and How much salt, how much water, and our amazing kidneys. By the way, this is what I meant earlier: if you’ve read those, understood and happen to remember a few essential bits, then you would be in a good position to answer the question as to the relationship between diabetes and blood pressure. Here it is in a few words; well, maybe a few paragraphs.

The kidney’s vital role is filtration of metabolic acids out of the blood, and elimination of these through the urine. To do this as best it can, because the first and most important part of the filtration process relies on the separation of the liquid from the solids in the blood, and because this is done through what is a mostly “mechanical” filtering through a membrane as it is in water filters, the kidney must maintain optimal pressure to ensure optimal function of the little filtering units, the nephrons. If pressure is too low, the membrane filtering does not work well. If pressure is too high, the membrane tears or pops, and the filtering units stop working altogether.

The good news is that damaged nephrons can sometimes recover when the conditions are made conducive to it, and that there are millions of them in each kidney. The real bad news is that when they die, they do not come back to life. Another bit of bad news, although some would surely take this as good news instead, is that this process of deterioration of kidney function and death of nephrons takes place gradually but silently over the years and decades of our life. When the consequences of poor kidney function become noticeable or even critical, and we finally go see our MD because we’re not feeling good, or worse, are brought directly to the emergency room, it is far too late, for most of the nephrons are already dead.

And to be perfectly clear on this, if the kidneys fail and we don’t get immediate attention and artificial filtering of the blood through dialysis, we die within hours. This is what is meant by the word vital when qualifying the kidney as such an organ.

As I often highlight, the cells, tissues and organs that constitute the entirety of the body that we erroneously call ours and mistakenly believe this to be the case, do not care about you in the least. They do not know anything about you and never will. They, as all living things, are only concerned with survival and self-preservation. It is for this reason that they continually adapt in all sorts of ways to the environment in which they find themselves: this is the internal environment of the body. And it is for this reason that the kidney regulates blood pressure so accurately and so well when allowed to function as it should.

How does it do this regulating? By very closely monitoring the concentration of the blood and secreting hormones to induce the necessary adjustments. The concentration of the blood is the balance between the amount water and the amount of solutes (things dissolved in the water). Most important is the amount of water, because it gives the blood its volume and thus pressure within the closed circulatory system of somewhat malleable veins and arteries. Of the solutes, the most important is sodium, because it holds and must be held in the highest concentration of all solutes, accounting for about half of the overall solute concentration (140/300 mOsmol/L). But the kidney works to keep the entire spectrum of natural solutes, especially the minerals, each in its optimal physiological range.

Two nutrients that the kidney works to keep in circulation are proteins and glucose for the obvious reason that they are essential to proper physiological function, and, evolutionarily speaking, rather rare to come by and thus precious. As they are also solutes circulating in the blood plasma, each contributes to the total concentration. And this is where we get to the point:

As glucose concentration rises, the total concentration of the blood rises accordingly. For insulin-resistant diabetics whose cells have lost their sensitivity to insulin, and with that their ability to take up glucose from the blood, there is no outlet for this excess glucose that just keeps on rising in concentration. But unlike what the kidney does in regulating the concentration of sodium and other minerals by excreting any excesses through the urine, glucose is kept in circulation, as much as possible.

After some time, whether because the concentration is through the roof, because the kidney cannot anymore function as it should to keep the glucose in the blood, or both, glucose spills into the urine. This is how, in fact, it was discovered that all of the symptoms that we described as the condition of diabetes are due to a dysfunctional metabolism of glucose: because the urine of diabetics was sweet smelling and sweet tasting. (What dedicated MDs we had 100 years ago! Do you think your MD would taste your piss today to make sure you’re not sick?).

In response to this, to maintain the concentration as close to 300 mOsmol/L as possible, the kidney retains water to dilute the blood from the excessive glucose. This makes the blood volume increase and therefore also the blood pressure. This is why diabetics have high blood pressure. This is also why diabetics have very high incidence of kidney disease. This is also why diabetics have water retention and circulatory problems.

But this is also why they suffer from a lot more strokes, heart attacks, Alzheimer’s, dementia, arthritis, why they have elevated cholesterol, why they age so much faster, and why they go blind.

Chronically elevated glucose leads to chronically elevated levels of glycation. Glycation damages cells and tissues everywhere in the body, but firstly in the veins and arteries, which are already significantly more susceptible to damage because of the chronically elevated blood pressure. This leads to more and faster plaque formation, as well as cholesterol production for damage control and repair. Elevated glucose levels and heightened glycation lead to a flood of free radicals and vastly increased systemic inflammation, which makes everything worse, much worse.

And all of these conditions, all stemming from insulin resistance and chronically elevated blood sugar, give rise to the multiplicity of the health problems just enumerated that are the main causes of death in the general population, but which are seen with an approximate three to four fold increase (that’s 300-400% more!) in incidence for a given age in the diabetic population.

What about non-diabetics? Do they need to be concerned about this? Does it mean that there is a direct relationship between blood sugar and blood pressure in all of us? Does it mean that all of us suffer from the whole lot of direct and indirect consequences of having high blood glucose concentrations in the same way as diabetics do, but in proportion to the concentration and the time it takes for it to drop depending on insulin sensitivity? What do you think?

Is any of this surprising? Not in the least: it makes perfect sense. Is it difficult to understand why it happens? Not really: when we understand some basic physiology and biochemistry, everything becomes relatively easy to grasp and explain. At least that’s what I hope I was able to show here, and at the very least, in regards to the question posed in the title that we set out to answer in the first place. You got it, right? And you’ll remember? And next time you see your MD, (if you have one, that is), ask them why diabetics have high blood pressure, and see what they say…

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Cure diabetes in a matter of weeks

Both the incidence and growth rate of insulin-resistant diabetes have reached epidemic proportions in many countries. It is most remarkable in the US with probably close to 30 million by now, and thus about 10% of the population (1, 2). Globally, the numbers are even more impressive: 370 million with diabetes predicted to grow to 550 by 2030 (3). This entails that as a disease, type-II diabetes (90% of diabetics) is one of the fastest growing causes of death, now in close competition with the well-established leaders, cardio-vascular disease and cancer, that each account for 25% of deaths in more or less all industrialised countries.

Insulin-resistant diabetes is very similar to both vascular disease (cardio and cerebro) and cancer, as well as intestinal, kidney, pancreatic and liver disease, arthritis, Parkinson’s and Alzheimer’s, in the sense that it is also a degenerative disease that develops over a lifetime, or at least over several decades. It is, however, quite different from all other chronic degenerative diseases because it is, in a way, the ultimate degenerative disease, in which the occurrence of all others increases markedly, and in some cases two to four times (4).  That’s not 10 or 15%, this is 200 to 400% more!

For this reason alone, it seems clear that all these degenerative conditions are intimitely related, and that furthermore, understanding insulin-resistant diabetes will most definitely give us keen insights into the genesis of degenerative diseases in general.

What boggles the mind is that, in a very real sense, we understand precisely and in exquisite detail how and why insulin-resitant diabetes develops, how and why it is related to all other degenerative diseases, and consequently, both how to prevent diabetes and all disease conditions for which it is a proxy, and why what is needed to achieve this actually works (5, 6).

In fact, type-II diabetes can be cured; not just controlled or managed, but cured; not just partially or temporarily, but completely and permanently. And this, in a matter of weeks.

This may seem simply impossible to the millions of suffering diabetics that live with their disease for years and more often decades, but it is the plain and simple truth, which has been demonstrated by more than one, but unfortunately rather few exceptional health care practitioners, already several decades ago by Robert Atkins (7), and more recently by Ron Rosedale and Joseph Mercola, for example (89), in a remarkably repeatable, predictable and immensely successful manner on most probably tens of thousands of people by now.

About insulin and glucose (or should it be glucose and insulin)

Insulin is a master hormone one of whose important roles is to regulate uptake of macronutrients (carbs, proteins and fats) by facilitating their crossing the cellular membrane through channels guarded by insulin receptors, from the bloodstream into the cell, either for usage or storage. It is for this role that insulin is mostly known.

However, arguably insulin’s most important and critical role is the regulation of cellular reproduction and lifespan, a role which is, as amazing as it may seem, common to all animals that have been studied from this perspective, from microscopic worms to the largest animals.

As such, insulin is a master and commander for regulating reproduction and growth in immature and therefore growing individuals, and regulating lifespan and ageing in mature and therefore full-grown adults (10).

Insulin is absolutely essential to life because in its absence cells can neither use glucose—a most basic cellular fuel, nor reproduce correctly—making growth impossible. It is, however, needed in only very small amounts. Why? Because insulin is very damaging to tissues and especially blood vessels, something that has been well known for a long time (look at this short review on the role of insulin in atherosclerosis from Nov 1981—that’s 32 years ago!, and you’ll see what I mean.)

Insulin is secreted by the beta cells of the pancreas in response to glucose concentration inside of these. As blood passes through the pancreas, these special cells that produce and store insulin, sense how much glucose there is by taking it in, and release insulin into circulation proportionally. This release is pulsed (while eating, for example) with a period of between 5 and 10 minutes, but only in response to blood sugar concentration, meaning that insulin is released only if blood sugar rises above the individual’s threshold, which depends on the metabolic and hormonal state of that individual.

However, it is important to note that pretty much no matter what the metabolic or hormonal states may be, eating fat and having fatty acids circulating in the bloodstream does not stimulate the release of insulin, while eating protein, in particular the animo acids arginine and leucine, does, albeit a lot less than glucose. This is because insulin is generally needed for cells to take in and use amino acids.

An insulin molecule that has delivered a nutrient to a cell can be degraded by the cell, or it can be released back into the bloodstream. A circulating insulin molecule will be cleared by either the liver or the kidneys within about one hour from the time of release by the pancreas.

Exposure to most substances, including lethal poisons such as arsenic and cyanide, naturally and systematically decreases sensitivity, or from the reverse perspective, increases resistance to it (as demonstrated by generations of Roman emperors and their relatives). This applies to cells, tissues and organs, and happens in the same way for biochemical molecule like messenger hormones, for the one that concerns us here, insulin. Thus, as cells are more  frequently and repeatedly exposed to insulin, they lose sensitivity and grow resistant to it.

Insulin primarily acts on muscle and liver cells where glucose is stored as glycogen, and on fat cells where both glucose and fats are stored as … fat, of course. Muscle cells grow resistant first, then liver cells and in the end, fat cells. Fortunately or unfortunately, endothelial cells (those that line the blood vessels), do not become resistant to insulin, and this is why they continue to store glucose as fat, suffer severely from glycation, and proliferate until the arteries are completely occluded and blocked by atherosclerotic plaques.

What happens when a large portion of the muscle and liver cells, and enough of the fat cells have become insulin-resistant? Glucose cannot be cleared from the bloodstream: it thus grows in concentration which then stays dangerously high. This is type-II, adult onset, or most appropriately called, insulin-resistant diabetes.

Unnaturally high glucose concentrations lead to, among other things, increased blood pressure, extremely high rates of glycation (typically permanent and fatal damage) of protein and fat molecules on cells throughout the body, heightened stimulation of hundreds of inflammatory pathways, and strongly exaggerated formation of highly damaging free radicals, which, all in all, is not so good. This is why insulin is secreted from the pancreas so quickly when glucose is high in the first place: to avoid all this damage and furiously accelerated ageing of all tissues throughout the body.

The five points to remember

  1. Insulin is a master hormone that regulates nutrient storage, as well as cellular reproduction, ageing and therefore lifespan.
  2. Insulin is vital to life, but in excess concentrations it is highly damaging to all tissues, especially blood vessels.
  3. If blood sugar is high, insulin is secreted to facilitate the uptake of the glucose into cells, but at the same time, because it is present, also promotes the storage of amino and fatty acids (protein and fat); if blood sugar is low, insulin is not secreted.
  4. Chronically high blood glucose is remarkably damaging to the organism through several mechanisms that are all strongly associated with degenerative disease conditions in general.
  5. Chronically high blood glucose concentration leads to chronically high insulin concentration; chronic exposure to insulin leads to desensitisation of muscle, liver and fat cells, and, in the end, to type-II or insulin-resistant diabetes.

And in this succinct summary, in these five points to remember, we have the keys to understanding not only how diabetes develops and manifests, to understand not only the relationship between diabetes and other degenerative diseases, but also to understand how to prevent and cure diabetes as well as degenerative conditions in general.

And I’m suppose to say …

But you already know what I’m going to say:

Because the basic, the underlying, the fundamental cause of insulin-resistant diabetes is chronic over-exposure to insulin, it means that to prevent—but also reverse and cure it—what we need is to not have chronic over-exposure to insulin. And this means to have the very least, the minimal exposure to insulin, at all times, day after day.

The good news, which is indeed very good news, is, on the one hand, that it is utterly simple to do and accomplish, and on the other, that almost independently of how prone we are to insulin resistance (genetically and/or hormonally) or how insulin-resistant we actually are right now, insulin sensitivity can be recovered quite quickly. And here, “quite quickly” means in a matter of days, which is truly remarkable in light of the fact that our state of insulin resistance grows over decades, day after day, and year after year. It is rather amazing, miraculous even, that the body can respond in this way so incredibly quickly.

Now, type-II diabetes is nothing other than extreme insulin-resistance. Naturally, the longer we are diabetic, the more insulin-resistant we become. But unbeknownst to most (almost all MDs the world over included), if your fasting blood glucose is higher than 75-80 mg/dl or your insulin higher than 5 (mU/L or microU/ml), then the muscle and liver cells are insulin resistant. And the higher the insulin, the more resistant they are. In fact, if you have any amount of excess body fat, your cells are insulin resistant. And the more body fat, especially abdominal but also everywhere else, the more insulin resistant they are.

Because insulin sensitivity is lost gradually over our lifetime through daily exposure, some consider that everyone is becoming diabetic more or less quickly, and that eventually, if we live long enough, we all become diabetic. But this is only true in a world where virtually everyone suffers from chronic over-exposure to glucose and insulin. It is not true in a world in which we eat and drink to promote optimal health.

In practice, because basically everyone is more or less (but more than less) insulin-resistant, concentrations around 10 mU/L are considered normal. But when I wrote earlier that insulin is vital but needed in very small amounts, I really meant very small amounts: like optimally between 1 and 3, and definitely less than 5 mU/L (or microU/mL; and the conversion from traditional to SI units is 1 mU/L = 7 pmol/L).

So how do we do it?

You already know what I’m going to say:

Because insulin is secreted in response and in proportion to glucose concentration, when it is low, insulin is not secreted. Therefore, insulin sensitivity is regained by completely eliminating insulin-stimulating carbohydrates. This means zero simple sugars without distinction between white sugar, honey or fruit; zero starchy carbs without distinction between refined or whole grains, wheat or rice, bread or pasta, potatoes or sweet potatoes; and zero dairy, which triggers insulin secretion even when sugar content is low. It also means minimal protein, just enough to cover the basic metabolic needs (0.5-0.75 g/kg of lean mass per day). Consequently, it means that almost all calories come from fat—coconut oil, coconut cream, animal fats from organic fish and meats, olive oil and avocados, as well as nuts and seeds—and that the bulk of what we eat in volume comes from fibrous and leafy vegetables.

And what happens? In 24 hours, blood glucose and insulin have dropped significantly, and the metabolism begins to shift from sugar-burning to fat-burning. In 48 hours, the shift has taken place, and the body begins to burn off body fat stores, while it starts the journey towards regaining insulin sensitivity. In a matter of days during the first couple of weeks, the body has released a couple to a few kilos of water and has burnt a couple to a few kilos of fat. We feel much lighter, much thinner, much more flexible and agile, and naturally, much better. In four weeks, blood sugar and insulin levels are now stable in the lower normal range. All of the consequences and side effects brought on by the condition of insulin-resisitant diabetes decrease in severity and amplitude with each passing day, and eventually disappear completely. In eight weeks, the metabolism has fully adapted to fat-burning as the primary source of energy, and we feel great. (See 11 for more technical details.)

The result is that within a matter of weeks, we are diabetic no longer: we have regained insulin sensitivity, and have thus cured our insulin-resistant diabetes. Over time, a few months or maybe a few years, feeling better with each passing day, there remain very few if any traces of our diabetes, and we live as if we never were diabetic. Amazing, isn’t it? So simple. So easy. So straight-forward. And yet, still so rare.

And what about the relationship between diabetes and heart disease, diabetes and stroke, diabetes and cancer, diabetes and Alzheimer’s? Why do diabetics suffer the various health problems that they do, like high blood pressure, water retention, blindness, kidney disease, and how do those come about? What of the lifespan-regulating functions of insulin, how does that work? All these interesting and important questions and issues will have to wait for another day. This article is already long enough.

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A diabetic’s meal on Air France

A few days ago, I was updating a reservation on the Air France website in anticipation of my trip from Madrid to Toronto on my way to the Origin of Stars and their Planetary Systems conference at  McMaster University. Looking through my personal profile, I found a section where to define a preference for the meals served on long flights. Looking through the list, I was intrigued by the “Diabetic” option.

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The fact is, I’ve read more than I ever intended about diabetes. That’s because the authors of most, if not all books that relate to natural health and nutrition in some way or another, usually have something to say about diabetes, more specifically, insulin-resistant or adult-onset or type II diabetes. One simple reason for this is that diabetes is so widespread in the populations of industrialised countries that it is almost ubiquitous. Another reason, certainly just as important if not more, is that the most common causes of death in industrialised countries—heart disease, stroke, alzheimer’s and cancer—are all much more common in diabetics than they are in non-diabetics, and in all cases, several-fold more common. Doesn’t this very naturally suggest that there is a fundamental relationship between insulin-resistant diabetes and these other conditions? Maybe even that what causes the development of the diabetic condition also causes the development of the others?

Type II diabetes, also called adult-onset diabetes, should instead always be referred to insulin-resistant diabetes in order to highlight the actual problem—insulin resistance. Unfortunately, it is only rarely referred to as such. Insulin resistance is a description of the state of a cell that does not allow insulin through its membrane to carry glucose to the inside of the cell—it resists insulin’s plea to let the glucose enter. The consequence of this is high levels of blood-glucose and insulin that don’t drop down as they should to acceptable, let alone ideal physiological levels. In fact, as far as I know, the primary, if not the only criteria used by  most MDs to diagnose the onset of diabetes is blood-sugar levels. It is considered normal to have blood-sugar levels anywhere between 65 and 110 mg/dl, but at 120 or above we are considered at risk of developing diabetes.

Interestingly, although fasting insulin concentration is a much better, more robust, indicator of not only the condition of insulin-resistant diabetes, but also of the gradual development of it, which does not appear from one year’s blood test to the next but rather develops over an entire lifetime, slowly and surely, it is almost never performed in standard blood tests ordered by general practitioners. It should.

And why is it better? Because instead of being subject to large fluctuations due to a myriad of different factors as is blood-sugar, such as carbohydrate intake, stress and physical activity, for example, fasting insulin is much more stable, decreasing steadily over the course of several hours, and reflects well the overall state of insulin resistance or sensitivity of our cells.

There is another more direct and accurate way of testing insulin sensitivity that involves measuring blood-sugar and insulin concentrations at regular intervals after ingesting a large amount of glucose. But this method is much more involved and lengthy. Fasting insulin is simple, easy, accurate and cheap. It really should always be done in standard blood tests. Request it on your next blood test. Although, if you follow the dietary advice on this blog, you should never even have to think about getting any blood tests done at all. I just do them because I find it interesting.

I discussed the insulin mechanism in We were never meant to eat simple or starchy carbohydrates, and also in When you eliminatie insulin-stimulating carbohydrates. But for just a second, forget what you remember about it, and consider the following:

Insulin is necessary to clear out excess sugar in the blood: it is the hormone that regulates fat storage. The greater the amount of sugar, the greater the amount of insulin required, and the greater the fat storage. The more often there is sugar, the more often insulin is needed. Insulin resistance in cells develops over time due to over-exposure to insulin, snack after snack, meal after meal, day after day and year after year.

Would we not then immediately conclude that in order to avoid developing insulin resistance we simply and straight-forwardly need to avoid raising blood-sugar levels? Furthermore, would we not immediately hypothesise that in order to reverse insulin resistance and regain insulin sensitivity we need to do just that: avoid raising blood-sugar levels? And how might we do that? You already know this: by not eating simple or starchy carbohydrates. Instead, eating most of our calories from fat to provide all the energy and calories needed for healthy cellular and hormonal activity throughout the body, and never or rarely be hungry.

Now, what was I served as the special order diabetic meal on the flight from Paris to Toronto that I am still sitting on? The salad was of grated carrots sprinkled with super dry, also kind-of-grated white meat, either of chicken, turkey of tuna, (I can’t tell because it didn’t have a smell and I don’t eat meat, so I didn’t taste it). The main course was of a piece of super-dry white fish on a bed of pre-cooked, dry, white rice with boiled frozen ripple-cut carrot slices. This was accompanied by not one of the classic crusty, refined white flour, mini-baguettes they serve on Air France flights, but by two of them. There were also two deserts, a small, dry-baked apple cut in two halves, and a soy-based pudding-like desert. Needless to say that I didn’t eat much of this meal. It was an experiment anyway: I was curious to see what a diabetic would be served, and now I know.

Before reading the next sentence, could you now tell me what is the main characteristic of the meal I just described?

It is a low-calorie, low-protein, super-low fat meal. As a consequence, it is a very high carbohydrate meal: there’s obviously nothing else it could be. Well, that’s not quite true: it is a very low-mineral and enzyme content meal, highly processed and totally dead. But that’s not really important, right? Only calories are important, right? And it is only important that it be low-fat, right?

Therefore, a diabetic that goes to the effort of ordering a special meal instead of the standard menu will end up consuming less protein, a lot less fat, and a lot more carbohydrates. This will cause a much greater rise in blood-sugar levels, that will in turn cause a much greater rise in insulin, and in the case of most diabetics will, in fact, require the injection of additional insulin because their cells are already mostly insulin-resistant. This will inevitably cause increased insulin resistance. But to make matters even worse than this already is, because they are eating very little fat, they will be increasingly hungry after each meal, and thus tend of overeat every time they get the chance. And overeat what? … carbohydrates. This is the definition of a vicious cycle. How sad. How incredibly sad.

I was just offered by second meal: it was pretty much the same thing with a cold dry meat salad instead of the re-heated dry fish with rice dish. What a laugh. This time, I just turned in down.

Oh, and by the way, the first meal was frozen almost solid. Every component, including the carrot salad, baked apple, soy desert and water: everything except for the main course that had been heated. And the second meal was also frozen, but this time, the air flight attendant felt quite sorry about it, and was rather sheepish when offering it to me. How funny! It’s a good thing I am used to fasting.