Many patients with autoimmune diseases are often unaware that symptoms such as low energy levels, muscle and joint pain, mood fluctuations, and gastrointestinal disorders are directly linked to insulin resistance.
Insulin Resistance: A Metabolic Disorder Leading to Extreme Fatigue & Chronic Inflammation in Patients with Autoimmune Disease
Insulin resistance, a critical metabolic disorder, is often the underlying cause of various issues in autoimmune disease patients.
Many of those with autoimmune conditions may not realize that symptoms like low energy, muscle and joint aches, mood fluctuations, and gastrointestinal problems are directly associated with insulin resistance.
This condition disrupts the immune system's functioning and closely relates to increased inflammatory episodes and deteriorating health in autoimmune diseases.
Metabolic factors significantly influence autoimmune diseases. Issues like insulin resistance and micronutrient deficiencies, such as vitamins, minerals, amino acids, fatty acids, and others, further compromise the health of individuals with autoimmune conditions [1-4].
Insulin Resistance and Autoimmune Diseases: Three Common Problems Linked to This Metabolic Disorder
1. Energy Deficiency and Fatigue: One of the prevalent symptoms in autoimmune patients is a lack of energy and fatigue.
While fatigue is a natural signal that our body needs rest to recover and repair daily wear and tear, it typically manifests towards the end of the day or after intense physical or mental activity. It usually resolves with adequate sleep and rest.
However, in autoimmune patients, fatigue often appears progressively earlier in the day. Initially, they may feel fatigued in the afternoon, and then as the condition progresses, the tiredness can start to set in by midday, and, in some cases, patients may wake up feeling exhausted.
Fatigue and low energy levels are due to deficiencies in vitamins and other micronutrients and metabolic disorders that impact the body's energy production mechanisms.
Insulin resistance, along with micronutrient deficiencies, impedes the burning of fat and slows down metabolism. As a result, the body's efficiency decreases, leading the individual to experience extreme fatigue and reduced endurance for physical activities.
2. Chronic Pain: Chronic pain is a symptom characteristic of autoimmune diseases such as rheumatoid arthritis, Hashimoto's thyroiditis, systemic lupus erythematosus, Sjogren's syndrome, inflammatory bowel diseases, ankylosing spondylitis, psoriasis, scleroderma, and others. Patients often experience joint and muscle pain (myalgia), abdominal pain, discomfort in the fingers, and bladder pain. Simple actions like climbing stairs, opening a water bottle, eating, or urinating can become painful.
Insulin promotes inflammation and exacerbates pain. It acts as a growth factor, encouraging body cells to proliferate and aggravating inflammation. Insulin resistance suppresses healing mechanisms, accelerates tissue damage, and leads to chronic inflammation.
3. Gastrointestinal Dysfunction: Most patients with autoimmune diseases experience gastrointestinal issues. Common symptoms include constipation, diarrhea, bloody stools, difficulty swallowing, abdominal bloating, and pain.
These symptoms are due to gut microbiome alterations, digestive tract wall inflammation, and motility disorders. Changes in the gut microbiome are known to aggravate insulin resistance and disrupt the functioning of the immune system[5-7].
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Insulin Resistance
Produced by the pancreas, insulin is chiefly recognized for its role in lowering blood sugar levels.
Upon eating, the pancreas releases insulin. This hormone then attaches to cells, signaling them to take in glucose, thereby reducing the amount of glucose in the bloodstream.
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Image: After a meal, the pancreas secretes insulin. Different foods cause the secretion of varying amounts of insulin. Carbohydrates trigger a higher secretion, while fats require minimal to no insulin. Adapted from NEJM 2022.
Insulin resistance occurs when cells in the liver, fatty tissue, and muscles try to protect themselves from excess glucose availability and fail to respond to this hormone.
The body must secrete increasingly larger amounts of insulin to achieve the same biological effect.
Beyond its role in maintaining stable blood sugar levels, insulin regulates fat burning, energy production, and inflammatory processes affecting the body's overall function.
Elevated insulin levels intensify inflammation, exacerbate flare-ups in autoimmune diseases, contribute to the formation of atherosclerotic plaques in blood vessels, increase the risk of cancer development and the onset of diabetes.
Micronutrient Deficiencies & Insulin Resistance
Insulin resistance is a leading cause of disease today. Combined with marginal deficiencies in micronutrients, it plays a central role in developing and aggravating autoimmune diseases.
A sedentary lifestyle, combined with habitual consumption of processed foods that trigger increased insulin release, can lead to marginal deficiencies in vitamins and micronutrients. These nutrients are crucial for the proper functioning of insulin receptors. Over time, this progressively diminishes the cells' ability to respond effectively to insulin.
Micronutrients play a crucial role in the chemical reactions essential for sustaining life, collectively known as metabolism or metabolic processes. Insulin resistance, a key metabolic disorder, significantly influences various bodily functions. It affects energy production, the functioning of the immune and hormonal systems, fertility, mood regulation, body weight management, and numerous other processes within the human body.
These marginal nutrient deficiencies often go unnoticed for years until the onset of a disease. They are challenging to detect with ordinary laboratory tests and thus described as 'Hidden Hunger.'
For healthy metabolic functioning and the resolution of insulin resistance, an adequate supply of vitamins, minerals, and micronutrients is essential[11-16]:
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For normal insulin secretion and function: magnesium, chromium, B-complex vitamins, vitamin K2, vitamin D3, and probiotics.
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For proper completion of skin and tissue healing processes: vitamin C, zinc, vitamin E, amino acids, antioxidants, vitamin D3.
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In managing chronic inflammation: omega-3 fatty acids, vitamin C, vitamin D3.
- For healthy immune system function: vitamin D3, vitamin C, omega-3 fatty acids, probiotics, zinc.
Deficiencies in these specific micronutrients are directly linked to autoimmunity.
Deficiencies in micronutrients and vitamins, negatively impact health, facilitate the development of insulin resistance, hinder tissue healing, and promote chronic inflammation.
Specialized Tests in the Management of Autoimmune Diseases
It is encouraging that factors related to lifestyle, micronutrient deficiencies, and diet, which can be identified and corrected, improve the course of autoimmune diseases.
It is crucial for patients with autoimmune diseases having metabolic disorders to pinpoint the exact deficiencies impacting their health, as these are directly linked to insulin resistance.
Until a few years ago, precisely detecting deficiencies and the causing factors of metabolic disturbances like insulin resistance was challenging with ordinary tests. This led to reliance on general guidelines with limited efficacy.
Recent advancements in a new category of tests that detect small molecules in the body provide an accurate picture of deficiencies and metabolic disorders affecting an individual’s health status.
These tests, known as metabolomic analyses, are sensitive methods that record exact deficiencies, allowing for a comprehensive therapeutic plan to address insulin resistance and improve patient health [3,4,17,18].
They detect over 80 markers directly related to an individual’s health status.
The tests identify deficiencies in vitamins and other elements associated with:
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Insulin resistance
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Carbohydrate metabolism
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Lipid metabolism
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Inflammation management
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Energy production
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Gut microbiome condition
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Immune system function
- Hormonal system function
The results are accompanied by a tailored therapeutic plan for each patient, and consistent medical monitoring is essential.
Based on the test results, the treatment includes vitamins and micronutrients, dietary recommendations, and lifestyle modifications.
As marginal deficiencies in micronutrients accumulate over time and lead to diseases, time and effort are needed for their correction.
Conducting these tests is the first step. The physician then formulates a suitable therapeutic plan based on the results.
The patient implements the treatment to address their disease and improve their health. This process requires time, effort, and consistent monitoring by our team.
Even though improvements can often be observed from the start, it usually takes 6-8 months to achieve significant change and a year to stabilize the body at a better functional level.
Correcting insulin resistance through medical interventions in lifestyle, addressing bodily deficiencies, and diet changes the health trajectory:
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Reduces fatigue and enhances energy levels
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Improves metabolism, reduces body weight and visceral fat
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Significantly improves daily life for individuals with chronic inflammatory diseases like Hashimoto's disease, psoriasis, rheumatoid arthritis, ulcerative colitis
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Reduces the risk of cardiovascular disease and diabetes
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Improves sugar and lipid metabolism
- Reduces inflammatory flare-ups of the disease
Our clinical experience has shown that correcting deficiencies in vitamins and other elements, restoring metabolism, and regulating weight to normal levels radically changes the health course in individuals with insulin resistance for the better, improving their quality of life from a state of constant deterioration to one of consistent improvement [3,4,17-19].
Timely intervention to restore these aspects is crucial to halt the deterioration of health.
Bibliographic References
[1] Insulin Resistant Pathways are associated with Disease Activity in Rheumatoid Arthritis and are Subject to Disease Modification through Metabolic Reprogramming; A Potential Novel Therapeutic Approach," Lorna Gallagher Sian Cregan Monika Biniecka, et al. Arthritis and Rheumatolology. Dec. 16, 2019.
[2] Chronic Inflammation in the Context of Everyday Life: Dietary Changes as Mitigating Factors. Margină, D.; Ungurianu, A.; Purdel, C.; Tsoukalas, D.; Sarandi, E.; Thanasoula, M.; Tekos, F.; Mesnage, R.; Kouretas, D.; Tsatsakis, A. Int. J. Environ. Res. Public Health 2020, 17, 4135.
[3] Targeted Metabolomic Analysis of Serum Fatty Acids for the Prediction of Autoimmune Diseases. Dimitris Tsoukalas, Vassileios Fragoulakis, Evangelia Sarandi et. al. Frontiers in Molecular Biosciences, Metabolomics, 2019.
[4] Prediction of Autoimmune Diseases by Targeted Metabolomic Assay of Urinary Organic Acids. Dimitris Tsoukalas et al. Metabolites. 2020 Dec 8.
[5] Gut Microbiota as a Trigger for Metabolic Inflammation in Obesity and Type 2 Diabeteσ. Torsten P. M. Scheithauer et al. Front. Immunol., 16 October 2020.
[6] Insulin resistance per se drives early and reversible dysbiosis-mediated gut barrier impairment and bactericidal dysfunction Author links open overlay panelDalaleGueddouri et al. Molecular Metabolism, March 2022
[7] Metabolic syndrome, autoimmunity and rheumatic diseases Gabriela Medina et al. Pharmacol Res . 2018
[8] Hidden Hunger in the Developed World. Biesalski HK. The Road to Good Nutrition. Basel, Karger, 2013, pp 39–50 https://doi.org/10.1159/000355992
[9] Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. Bruce N. Ames. PNAS 2006. https://www.pnas.org/content/pnas/103/47/17589.full.pdf
[10] Prolonging healthy aging: Longevity vitamins and proteins Bruce N. Ames PNAS October 23, 2018. https://www.pnas.org/content/115/43/10836
[11] Dietary micronutrients in the wake of COVID-19: an appraisal of evidence with a focus on high-risk groups and preventative healthcare. McAuliffe S, Ray S, Fallon E, et al. BMJ Nutr Prev Heal 2020:bmjnph-2020-000100.
[12] Insulin Resistance and Vitamin D Deficiency: A Link Beyond the Appearances. Valentina Trimarco et al. Front. Cardiovasc. Med., 17 March 2022
[13] Role of Minerals and Trace Elements in Diabetes and Insulin Resistance Pallavi Dubey et al. Nutrients. 2020
[14] Effects of Magnesium Deficiency on Mechanisms of Insulin Resistance in Type 2 Diabetes: Focusing on the Processes of Insulin Secretion and Signaling Krasimir Kostov Int J Mol Sci. 2019
[15] Effect of supplementation with vitamins D3 and K2 on undercarboxylated osteocalcin and insulin serum levels in patients with type 2 diabetes mellitus: a randomized, double-blind, clinical trial J. I. Aguayo-Ruiz et al. Diabetology & Metabolic Syndrome August 2020
[17] Non-communicable Diseases in the Era of Precision Medicine: An Overview of the Causing Factors and Prospects. Dimitris Tsoukalas et al. Bio#Futures. Springer, Cham. May 2021.
[18] Micronutrient deficiencies in patients with COVID-19: how metabolomics can contribute to their prevention and replenishment. Dimitris Tsoukalas1,2 and Evangelia Sarandi2,3 BMJ Nutri Prev Heal. Nov. 2020; bmjnph-2020-000169
[19] Dietary factors in rheumatic autoimmune diseases: a recipe for therapy? Shani Dahan, Yahel Segal1 and Yehuda Shoenfeld. NATURE REVIEWS | RHEUMATOLOGY. 13 Apr 2017.
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