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hat else does insulin do? Insulin mediates blood lipids. That patient who had a triglyceride of 2200, one of the easiest things we can do is lower triglyceride levels. It is so simple. There was just an article in J.A.M.A. an article and they were saying that the medical profession doesn't know how to reduce triglycerides dietarily, that drugs still need to be used. It is so ridiculous because you will find that it is the easiest thing to do. They come tumbling down. There is almost a direct correlation between triglyceride levels and insulin levels. In some people more than others. The gentleman who had a triglyceride level of 2200 while on all the drugs only had an insulin level of 14.7. That is only slightly elevated, but it doesn't take much in some people, all we had to do was get his insulin level down to 8 initially and then it went down to six and that got his triglycerides down to under 200.
The way you control blood lipids is by controlling insulin. We won't go into a lot of detail, but we now know that LDL cholesterol comes in several fractions, and it is the small, dense LDL that plays the largest role in initiating plaque. It's the most oxidizable. It is the most able to actually fit through the small cracks in the endothelium. And that's the one that insulin actually raises the most. When I say insulin, I should say insulin resistance. It is insulin resistance that is causing this.
Cells become insulin resistant because they are trying to protect themselves from the toxic effects of high insulin. They down regulate their receptor activity and number of receptors so that they don't have to listen to that noxious stimuli all the time. It is like having this loud, disgusting rap music played and you want to turn the volume down. You might think of insulin resistance as like sitting in a smelly room and pretty soon you don't smell it anymore because you get desensitized. You can think about it, its not that you are not thinking about it anymore. But if you walk out of the room and come back, the smell is back. You can get resensitized is what that is telling you. It would be like you are starting to go deaf and your are telling others to speak up because you can't hear them, so if I was your pancreas, I would just start talking louder, and what does that do to your hearing? You would become deafer. Most cases of deafness, especially in old age is due to excessive noise exposure. All the noise exposure your ears have been exposed to, well the hair cells that end up triggering your brain to allow you to hear eventually get killed. Sometimes it just takes a single firecracker.
This is the same thing with insulin resistance. What happens is that if your cells are exposed to insulin at all they get a little bit more resistant to it. So the pancreas just puts out more insulin. I saw a patient today, her blood sugar was 102 and her insulin was 90! She wasn't sure if she was fasting or not, but I've seen other patients where their blood sugar was under 100 and their fasting insulin has been over 90. That is a fasting insulin. I'm not sure how many people are familiar with seeing fasting insulins. But if I drank all the glucose I could possibly drink my insulin would never go above probably 40. So she was extremely insulin resistant. What was happening was she was controlling her blood sugar. Statistically she was not diabetic. She is not even impaired glucose tolerant. Her glucose is totally normal supposedly. But her cells aren't listening to insulin, she just has an exceptionally strong pancreas. Her islet cells that produce insulin are extremely strong and are able to compensate for that insulin resistance by producing thirty times more insulin than what my fasting insulin is. And just by mass action her pancreas is yelling so loud that her cells are able to listen, but they are not going to listen forever. Her pancreas is not going to be able keep up that production forever. Well the usual treatment once she becomes diabetic, which would be inevitable, once her production of insulin starts slowing down or her resistance goes up any more, than her blood sugar goes up and she becomes a diabetic. For many years, decades before that her insulin levels have been elevated. They have been elevated for thirty years probably and have never been checked. That insulin resistance is associated with the hyperinsulinemia that produces all of the co-called chronic diseases of aging or at least contributes to them. As far as we know in many venues of science, it is the main cause of aging in virtually all life. Insulin is that important. So controlling insulin sensitivity is extremely important.
hat else does insulin do? Insulin mediates blood lipids. That patient who had a triglyceride of 2200, one of the easiest things we can do is lower triglyceride levels. It is so simple. There was just an article in J.A.M.A. an article and they were saying that the medical profession doesn't know how to reduce triglycerides dietarily, that drugs still need to be used. It is so ridiculous because you will find that it is the easiest thing to do. They come tumbling down. There is almost a direct correlation between triglyceride levels and insulin levels. In some people more than others. The gentleman who had a triglyceride level of 2200 while on all the drugs only had an insulin level of 14.7. That is only slightly elevated, but it doesn't take much in some people, all we had to do was get his insulin level down to 8 initially and then it went down to six and that got his triglycerides down to under 200.
The way you control blood lipids is by controlling insulin. We won't go into a lot of detail, but we now know that LDL cholesterol comes in several fractions, and it is the small, dense LDL that plays the largest role in initiating plaque. It's the most oxidizable. It is the most able to actually fit through the small cracks in the endothelium. And that's the one that insulin actually raises the most. When I say insulin, I should say insulin resistance. It is insulin resistance that is causing this.
Cells become insulin resistant because they are trying to protect themselves from the toxic effects of high insulin. They down regulate their receptor activity and number of receptors so that they don't have to listen to that noxious stimuli all the time. It is like having this loud, disgusting rap music played and you want to turn the volume down. You might think of insulin resistance as like sitting in a smelly room and pretty soon you don't smell it anymore because you get desensitized. You can think about it, its not that you are not thinking about it anymore. But if you walk out of the room and come back, the smell is back. You can get resensitized is what that is telling you. It would be like you are starting to go deaf and your are telling others to speak up because you can't hear them, so if I was your pancreas, I would just start talking louder, and what does that do to your hearing? You would become deafer. Most cases of deafness, especially in old age is due to excessive noise exposure. All the noise exposure your ears have been exposed to, well the hair cells that end up triggering your brain to allow you to hear eventually get killed. Sometimes it just takes a single firecracker.
This is the same thing with insulin resistance. What happens is that if your cells are exposed to insulin at all they get a little bit more resistant to it. So the pancreas just puts out more insulin. I saw a patient today, her blood sugar was 102 and her insulin was 90! She wasn't sure if she was fasting or not, but I've seen other patients where their blood sugar was under 100 and their fasting insulin has been over 90. That is a fasting insulin. I'm not sure how many people are familiar with seeing fasting insulins. But if I drank all the glucose I could possibly drink my insulin would never go above probably 40. So she was extremely insulin resistant. What was happening was she was controlling her blood sugar. Statistically she was not diabetic. She is not even impaired glucose tolerant. Her glucose is totally normal supposedly. But her cells aren't listening to insulin, she just has an exceptionally strong pancreas. Her islet cells that produce insulin are extremely strong and are able to compensate for that insulin resistance by producing thirty times more insulin than what my fasting insulin is. And just by mass action her pancreas is yelling so loud that her cells are able to listen, but they are not going to listen forever. Her pancreas is not going to be able keep up that production forever. Well the usual treatment once she becomes diabetic, which would be inevitable, once her production of insulin starts slowing down or her resistance goes up any more, than her blood sugar goes up and she becomes a diabetic. For many years, decades before that her insulin levels have been elevated. They have been elevated for thirty years probably and have never been checked. That insulin resistance is associated with the hyperinsulinemia that produces all of the co-called chronic diseases of aging or at least contributes to them. As far as we know in many venues of science, it is the main cause of aging in virtually all life. Insulin is that important. So controlling insulin sensitivity is extremely important.
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