Hormone and Metabolism
Hormone
Hormone: A chemical substance produced in the body that controls and regulates the activity of certain cells or organs.
Hormones are chemical messengers that travel throughout the body coordinating many processes like growth, metabolism, and fertility.
Metabolism
Metabolism is the process by which your body converts what you eat and drink into energy. During this process, calories in food and drinks are combined with oxygen to release the energy for your body to function.
Carbohydrate metabolism is a biochemical process that ensures a constant supply of glucose energy to the cells.
Protein metabolism is a biochemical process responsible for the synthesis of proteins and amino acids.
Fat metabolism is a metabolic process that breaks down ingested fats/oils into fatty acids and glycerol that can be used by cells of the body.
Basal metabolic rate (BMR)
Basal metabolic rate (BMR) or resting metabolic rate (RMR) is a minimum number of calories required for basic functions at rest.
Your metabolic rate depends on age, gender, muscle-to-fat ratio, amount of physical activity and hormones.
Having a high BMR will help you in fat loss.
A slow metabolism is basically a low BMR.
Reasons/factors related to slower metabolism
Age, sex, less muscle mass, more body fat and insulin resistance.
How to improve BMR
Build muscle: weight training, strength and resistance training.
Get required sleep, Eating protein, fiber rich foods,
Adding vitamin B complex, C and D, minerals calcium, magnesium, potassium, iron, zinc, and selenium. Green tea, coffee.
Insulin and Role of Insulin, High blood insulin effects, Low blood insulin effects, Glucagon, Amylin, Incretins and Catecholamines
Insulin and Role of Insulin
Insulin is a hormone produced in the pancreas by beta cells, responsible for allowing glucose in the blood to enter cells, providing them with the energy to function and decreases blood glucose.
Insulin in muscles
Insulin is considered to be an anabolic (muscle building) hormone in that it promotes glucose uptake, synthesis of protein and glycogen and it inhibits the degradation of these compounds in muscle tissue.
Insulin in liver
During a meal, insulin stimulates glucose storage by the liver as glycogen. The insulin released from the liver acts on adipose and muscle tissue to stimulate glucose uptake.
Insulin in Adipose tissue
Insulin facilitates entry of glucose into those cells.
Insulin inhibits breakdown of fat(triglycerides) in adipose tissue.
High blood insulin effects
. Glucose uptake in muscle, liver, and adipose tissue
. Glycogen synthesis in muscle and liver. (glycogen is storable form of glucose)
. Anabolic / Anti-catabolic (protein/muscle building). Protein synthesis in muscles.
. Promotes Fat storage in adipose tissue
. Inhibition of stored fat release.
Low blood insulin effects
. Glucose release (breakdown of glycogen from liver)
. Catabolic (break down of triglycerides, protein, and glycogen)
. Muscle amino acids release (only when there is a shortage of carbohydrates and fats).
. Enable fat release.
. Regulation of fat release
Without low insulin levels, you cannot burn the stored body fat easily.
Having high insulin sensitivity and decrease in insulin levels may help you lose weight, lower your risk of disease and increase your quality of life.
For a diabetic, keeping the blood insulin level low is a tool in promoting the fat loss, calories restriction (CR) and exercise are the ones for the control and reversing of the type 2 diabetes.
Glucagon
Glucagon is a hormone, produced by alpha cells of the pancreas. It works to raise the concentration of glucose and fatty acids in the bloodstream, and is considered to be the main catabolic hormone of the body.
Glucagon works to counterbalance the actions of insulin.
About four to six hours after you eat, the glucose levels in your blood decrease, triggering your pancreas to produce glucagon. This hormone signals your liver and muscle cells to change the stored glycogen back into glucose.
Glucagon is released overnight and between meals and is important in maintaining the body’s sugar and fuel balance. It signals the liver to break down its starch or glycogen stores and helps to form new glucose units and ketone units from other substances. It also promotes the breakdown of fat in fat cells.
In individuals with diabetes, the opposite occurs. While eating, their glucagon levels rise, which causes blood sugar levels to rise after the meal.
With diabetes, glucagon levels are too high at mealtimes.
Amylin
Amylin is a hormone co-stored and co-secreted with insulin by pancreatic islet beta cells, in a 1:100 ratio. Amylin inhibits glucagon secretion and therefore helps lower blood glucose levels.
It also delays gastric emptying after a meal to decrease a sudden spike in plasma blood glucose levels, it increases brain satiety (satisfaction) to help someone feel full after a meal.
Incretins
Incretins are gut hormones that are secreted from enteroendocrine cells (in small intestine) into the blood within minutes after eating. Nutrients in the GI tract stimulate the secretion of incretins which amplify glucose-induced insulin release.
Functions,
Stimulate insulin secretion
Suppress glucagon secretion
Slow gastric emptying to prevent spike in blood glucose levels
Increase satiety after a meal to signal to the brain to stop eating
The two types of incretin hormones are GLP-1 (glucagon-like peptide) and GIP (gastric inhibitory polypeptide).
Gut
The gastrointestinal system, also referred to as the gastrointestinal tract, digestive system, digestive tract, or gut, is a group of organs that includes the mouth, esophagus, stomach, pancreas, liver, gallbladder, small intestine, colon, and rectum.
Catecholamines
Catecholamines are hormones made by the adrenal glands and brain.
The main types of catecholamines are dopamine, norepinephrine, and epinephrine.
Catecholamines help the body respond to stress or fright and prepare the body for “fight-or-flight” reactions.
They act both as neurotransmitters and hormones.
During periods of stress or fasting, catecholamines activate lipolysis.
Medical field significance
Unusually high or low levels of individual catecholamines can cause medical issues. High or low levels of multiple catecholamines can indicate a serious underlying medical issue.
Catecholamines are implicated in the pharmacologic treatment of a many of the diseases and disease processes.
Some Diabetic medications, very important guidelines and points to remember, Understand the effects on you by adding one by one, Typical guidance for different populations and Interlocks and complications in following the guidelines
Some Diabetic medications
Diabetic medication includes stimulation of insulin secretion (sulfonylureas, meglitinides, incretin mimetics) and increase insulin sensitivity (metformin, thiazolidinediones), and others.
Non-insulin medicines used to treat type 2 diabetes and mechanism of Action is that,
. Decreases liver glucose release and decreases insulin resistance (metformin)
. Stimulate insulin release from the pancreas
. Prolongs action of incretins to slow blood sugar absorption
. Similar to natural incretin. Increases insulin secretion, slow stomach emptying and reduces appetite.
. Promotes glucose excretion through urine
. Increase the insulin secretion from the pancreas
. Slows the absorption of carbohydrates from the intestines
. Decreases insulin resistance through improved muscle uptake of glucose.
And
Insulin injections.
High lights for Metformin, Secretagogues and insulin users
Metformin
Metformin decreases the amount of glucose you absorb from your food, the amount of glucose made by your liver and increases insulin sensitivity.
For some people, it may rarely cause a serious, life-threatening condition called lactic acidosis. Tell your doctor if you have kidney disease. Your doctor may tell you not to take metformin.
During a study in 2011, found that, metformin along with exercise increase heart rate, more concentration of metformin in plasma and showed no additional benefit on blood glucose control.
It suggested to lower the exercise workloads.
Study in 2013, taking metformin along with exercise for the people with impaired glucose tolerance (insulin resistance/ type 2 diabetes) did not have additional effects on cardio vascular disease.
In the study or 2019, they recommend to combine both metformin and exercise together to get the maximum benefits.
Conclusion. Exercise + metformin.
Although latest 2019 study recommends you can combine both together,
Don’t carry out heavy workload workouts.
Check that the heart rates are not too high.
Drink plenty of water.
Split the exercise in the morning and evening.
Metformin intake can cause vitamin B12 deficiency. Consider adding.
Metformin alone without other combination of drugs does not cause hypoglycaemia or low blood sugar. However, in rare cases, you may develop hypoglycaemia if you combine metformin with a poor diet or strenuous exercise.
Metformin leads to significant reduction in testosterone levels, sex drive and induction of low testosterone induced erectile dysfunction.
Secretagogues /Sulfonylureas
Sulfonylureas, work by stimulating the pancreas to produce more insulin. More insulin in your body means more storage of fat and more weight gain.
Sulfonylurea leads to significant elevation in testosterone levels, sex drive and erectile function.
Sulfonylureas along with exercise leads to more glucose uptake by muscles can result in hypoglycaemia or low blood sugar conditions.
Insulin users
Insulin plus exercise together can lead to even low blood sugar levels.
Very important guidelines and points to remember
Since you are already under medical conditions with or without different medications, you should consider some important factors.
You should able to judge and calculate your present health conditions/concerns, that is how long the condition was since it started, starting dosage, present dosage, how much under control with or without exercise, any other medical conditions existed or developed at a later stage including your heart related risks like high cholesterol and triglycerides levels.
You have to consider below key factors, regarding your dosage, CR and exercise.
Medication dosage, with calories restriction (eating less food than normal), exercise during a routine time, performing exercise when the blood insulin is low, and to be considered for any other heart related complications/ailments of yours also.
All the above 5 will have effects on your blood sugar levels and in exercise workouts.
Understand the effects on you by adding one by one,
1 Medication alone
2 Medication + calories restriction.
3 Medication + calories restriction and exercise together when the blood sugar/insulin is not that low.
4 Medication + calories restriction and exercise when the blood insulin is low, that is fat burning zone (in the morning before your first meal and before your last meal of the day).
The consistent way to fat loss is your medication plus calories restriction to start with. This is not external factors dependent. You can easily be consistent with.
When you are on calories restriction, adequate protein intake distributed throughout the day is mandatory. Better keep the protein powder in stock for any time easy use.
When you are on calories restriction, different medication will affect you depending on number of calories you restrict, your type of medicine, dosage and extent of exercise that may lead to low blood sugar levels(hypoglycaemia).
Consult your doctor regarding your plan, dosage, change of alternate medications.
You need to be very slow and confident in understanding the effects of the above combinations. Be patient and go slow. Once if you understand and confident you can proceed, you get the maximum benefits. Don’t risk your health. You may require additional 5 or 6 months to achieve your goal. There is no time limit set for your goal.
You are expected to burn on the average around only 300 calories per day by the way of exercise.
Continue with your medications, but check for reducing the dosage, check your blood sugar levels trend as frequently as possible or if possible, change to metformin.
Once again check with your doctor for advice.
Typical guidance for different populations
Case 1
People who are diagnosed with insulin resistance or prediabetes and advised exercise without medications.
Follow calories restriction, exercise in the morning and evening in the fat burning zone (in the morning before your first meal and before your last meal of the day). Monitor the trend, if found bad, increase exercise, more calories restriction if not already to your safe lower limit. Carry out blood tests. Monitor the trend and act.
Consult with your doctor.
Case 2
People who are already taking metformin.
Calories restriction, medium weight and medium heart rate exercise in the morning and evening in the fat burning zone. Drink plenty of water. Monitor for your blood sugar drop. It should be safe. Monitor for reducing or eliminating dosage over a period of time.
Consult with your doctor.
Case 3
People who take Insulin Secretagogues/ Sulfonylureas.
Sulfonylureas are prone to hypoglycaemia. Exercise with medication will be more prone to hypoglycaemia and during fat burning zone it can drop even more. Understand your health, reduce dosage, consult your doctor and monitor your blood glucose closely. Have a backup plan for low blood sugar. Keep some glucose, fruits handy.
Consult with your doctor and discuss your plan.
Case 4
Insulin users.
Same as 3, even more tight control. Consult your doctor. Reduce dosage. Be clear on, which one of the combinations for fat loss is to accept and to reject.
Sit with your doctor consult/discuss with him, how and what to follow and what is not suitable for you.
Case 5
Normal individuals, overweight or obese people, to get lean body mass.
Similar to case 1, but monitor the fat loss.
Case 6
Diabetes type 1.
Not applicable. Do not follow any of my advice.
Interlocks and complications in following the guidelines
. Diabetes type 2 cannot be controlled easily as you age and cannot be controlled and reversed without fat loss.
. Fat loss for a diabetic is difficult because some type of medicines as above may keep your insulin levels high and may promote fat gain
Such medicines can cause too low blood sugar under calories restrictions and/or with exercise on empty stomach or from over consumption of alcohol.
. Being with insulin resistance and with high insulin levels, fat loss is almost impossible. Possible only with low insulin levels.
Insulin is a fat storage hormone that will prevent fat loss, if the level is high.
. Low levels of insulin levels are required for fat loss.
. Normally, low level of insulin is not possible without low levels of blood glucose
(this is the case with most of the type 2 diabetics, still it is possible to have low insulin and high/low blood sugar called ketoacidosis, if you are insulin deficient that is a serious complication that needs urgent medical attention).
You must ensure blood glucose should not go below to dangerous levels due to your combination of medicines, calories cut and during/after exercise in low insulin levels time slot.
It means you have to be low in insulin but not too low in blood glucose. Your body should able to maintain this condition to be healthy without risks.
. Also, you can see that some restrictions with your combinations for the fat loss with metformin also.
. Burning 300 calories from your stored fat through exercise will make you to lose 1kg (300X30=9000cals and 9000/9=1000g) of fat per month. Whatever the amount of the calories you burn by the exercise may be, you will lose fat only when the blood insulin level is low. That is the interlock and complication.
. Exercise in such a time slot is only for additional fat burn. Any time of exercise helps, increase in insulin sensitivity, sleep and mood. With calories deficit any time of exercise may help in fat loss but may not be to a greater extent because your (type 2 diabetics) insulin levels are always high.
. Also remember that you can lose your stored fat by restricting your calories intake and when the blood insulin is low along with your medications. You should take care of your health by keeping your blood sugar levels not too low.
You need to sit with your doctor and find out a solution, for fat loss. You can use one of the above combinations suitable to you. Definitely this varies with almost every person.
Guidelines for CR without exercise.
Over a period of time with CR, your metabolism slows down that leads to Fat loss plateau.
Track your daily calories accurately.
Need to improve your BMR.
Adding vitamin B complex, C and D, minerals calcium, magnesium, potassium, iron, zinc, and selenium.
Green tea, coffee.
Diet should be with low carb, with good amount of protein, fiber and high amount of balanced fat to bring down the insulin levels low.
You should consider taking more balanced fat around 35% of your restricted calories and 1.7 grams of quality protein per kg of your weight (or 2 grams per kg with weight training) and the rest is carbohydrates for the day.
High amount of (balanced) fat will be required for insulin resistance/type 2 diabetes people to keep the blood insulin levels low for fat loss.
Fasting and eating window time should be something like 16/8 hours (also called intermittent fasting/time restricted eating). If suitable, you can skip breakfast, have only 2 meals a day with protein 2 or 3 times in the 8-hour window.
As you lose fat, protein intake is very important to minimise muscle loss.
If hunger cannot be controlled and when the body fat percentage is low, consider diet breaks /calories cycling to improve BMR.
(Eat normal maintenance calories for one week with good carbs then to CR for next 3 weeks to improve your metabolism and to control your hunger when you have already lost good percentage of your body fat).
It might take much long time to lose the required fat loss. No possibility of adding muscle and bone strength without weight/resistance/strength/HIIT training. Would not be much change in BMR.
Deplete and keep your glycogen stores to a minimum, before each meal for fat loss. Eat less carbs and more balanced fats.
You can’t spot reduce body fat.
But you can build/train each body muscle separately and try to cover the whole-body muscles if you can train.