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Metabolic Syndrome: What Is It and How Do You Know If You Have It?

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Hey, everybody! It’s Dr. Trish Murray – physician, best-selling author, and the Health Catalyst Speaker. Today’s podcast is entitled “Metabolic Syndrome: What Is It and How Do You Know If You Have It?”

If you go back in time, folks, the first name that was ever given to this condition, metabolic syndrome…we didn’t call it that in the beginning. The first name it was ever given was actually called Syndrome X because traditional medicine and doctors didn’t really know what caused it. You will see the diagnosis in a minute of all the things you must have in order to be diagnosed with metabolic syndrome, but, again, it was originally called Syndrome X because actually we didn’t know what exactly it was, but it was leading down a path of a lot of chronic diseases like high blood pressure and heart disease and diabetes.

It then took on the name insulin resistance syndrome or pre-diabetes, and that’s because during metabolic syndrome a huge part of the physiology of it is that a person is putting out a ton of insulin, but the insulin isn’t working properly. It is entitled insulin resistance or pre-diabetes, meaning people’s sugars are rising and rising not diagnostic yet of diabetes but they’re greater than 100 and abnormal. This, again, is developing insulin resistance which leads down the path to, in many people, most people, the eventual diagnosis of Type 2 adult-onset diabetes.

Now, over the years we’ve really come to realize that this condition, this syndrome, is a metabolic problem. Meaning someone’s metabolism is so out of balance that they develop chronic conditions and insulin resistance and eventually diabetes. So, when you say, “metabolic syndrome,” that word metabolism…what is someone’s metabolism? We all may have heard that word metabolic or metabolism, but what does it mean?

Well, the definition of metabolism is the chemical process occurring within a living organism that are necessary to support life. So, actually not just one process, as I said, but I mean the chemical processes, all of the chemical processes, occurring within any living organism that are necessary to support life, to keep you alive. If these internal chemical processes are all out of whack and out of balance, then you’re not going to be able to support life optimally. That’s what metabolic syndrome is, folks. It’s a complete imbalance of the chemical processes that should be going on in your body optimally. They’re not happening optimally, and they’re leading you down a path of metabolic syndrome.

So, what’s the diagnosis of metabolic syndrome? How do you know if you have it, and what are the things that are out of balance? Well, in order to diagnose anyone with metabolic syndrome, you have to have three out of five things going on within your metabolism. The list is here:

First of all, number one, a fasting blood sugar greater than 100. In the traditional medical model, normal blood sugar fasting blood sugar, meaning you don’t eat anything after midnight the night before, you can drink water the morning you get your blood drawn, but you shouldn’t eat any foods of any kind. A fasting blood sugar of greater than 100 is abnormal. It should be less than 99. Actually, folks, in an optimal functional medicine world and opinion, an optimal fasting blood sugar would be less than 90. But, in the traditional medical model a normal blood sugar fasting blood sugar would be less than 99, and an abnormal one is greater than a hundred.

Now, to be diagnosed with diabetes, Type 2 diabetes or any form of diabetes for that matter, a blood a fasting blood sugar needs to be higher than 126. So, you notice a fasting blood sugar greater than 100 but lower than 126 is diagnostic of metabolic syndrome or insulin resistance or pre-diabetes but not yet Type 2 diabetes. That’s number one.

Number two, the second factor that might be a sign or is a sign of metabolic syndrome if you have it is a high-density lipoprotein, an HDL, the good cholesterol, being less than 40 in a man or less than 50 in a woman. So, you need to get your lipids checked or you need to look at a lab test that you last had done of your HDL, your good cholesterol. If you are male and it is less than 40 that’s concerning. It’s not high enough. If you are a woman and it’s less than 50 that’s concerning. Women usually have higher HDL than men do. So, that’s number two.

The third factor in determining whether a person has metabolic syndrome is waist circumference. Now, as we know, we all would love to have the pear-shaped body…you know the waist that comes in and then the hips go out wider…the hourglass shape. The waist would be pear-shaped and smaller and the bottom where the hips are would be wider. Well, that’s the optimal, but as we age and if we put on too much body fat and especially abdominal body fat and visceral, meaning fat around the organs of the abdomen such as a pot belly or an apple-shaped body, big wasted but small hips.

A waist circumference greater than 40 inches in men and greater than 35 inches in women is the next factor that’s a sign of having metabolic syndrome. Now, if you have a measuring tape that looks like this one where you can pull it out or you have a fabric one if you do sewing or if you even have a metal one but it’s flexible, you can wrap it around your waist right at your belly button. You can check your own waist circumference and see what it is. Again, a waist circumference greater than 40 inches in a man and greater than 35 inches in a woman would put you at risk. It’s one of the five factors that that would put you at risk for metabolic syndrome.

The fourth factor is your blood pressure. A blood pressure greater than 135/85 is one of the factors of having metabolic syndrome. Again, blood pressure greater than 135/85.

The fifth factor that can be looked at to determine if someone has metabolic syndrome is triglycerides. Triglycerides are pure fat in the bloodstream. If your triglycerides are greater than 150 then you are at risk and you have one of the factors of the five.

If you have three or more of the five factors that are positive, meaning they’re found to be positive for you, then you have metabolic syndrome. Again, one more time:

  1. fasting blood sugar > 100
  2. HDL < 40 in men and < 50 in women
  3. waist circumference > 40 inches in men and > 35 inches in women
  4. blood pressure > 135/85
  5. triglycerides > 150

Now, folks, a study that was done out in this metabolic scientific world called the Interheart Study analyzed greater than 1,000 people who had a myocardial infarction, basically had a heart attack. What they found was these risk factors accounted for greater than 80 percent of the risk of why they had a myocardial infarction, a heart attack.

There are eight risk factors here, but you’ll notice every single one of the ones that we just talked about for metabolic syndrome are listed here:

  1. abnormal lipids (abnormal cholesterol, abnormal fats, the HDL, the triglycerides)
  2. smoking
  3. high blood pressure
  4. having diabetes
  5. abdominal obesity, meaning an increased abdominal waist circumference
  6. inactivity
  7. lack of consumption of fruits and vegetables
  8. alcohol an increased or elevated level of alcohol intake

Folks, the point here is that if you have metabolic syndrome, three out of the five factors or more that I just listed off before then this is why you have chronic disease. This is why you don’t feel well, and it is putting you at risk of heart disease and heart attacks. It’s putting you at risk for diabetes, and it’s causing you to have to be on many, many different prescription medicines to try and treat it.

Now, the other problem is that many of you out there, many of us Americans, do not know that we even have metabolic syndrome! Stats on patient awareness and control of chronic diseases is really poor in the United States. Look at these facts:

  • Fewer than half of women are aware of the risk factors for heart disease, cardiovascular disease. Actually one of the top killers of women even though we think men are more at risk of heart disease is guess what? Heart disease, women! We need to realize whether we have these metabolic imbalances.
  • Nearly one in three people with high blood pressure that are hypertensive or have high blood pressure are completely unaware of it. Two in five are not actively being treated for their high blood pressure, and nearly two in three are not adequately controlled, meaning you know you have high blood pressure, you go to the doctor, and you get it checked, but two out of every three are not adequately controlled meaning the blood pressure is not less than 135/80.
  • Less than half who should be treated for high LDL cholesterol (low density lipoprotein, the bad cholesterol) are being treated, meaning less than 50 percent, folks, who should be treated for high LDL cholesterol levels (the bad cholesterol) are being treated. Only one out of three are actually reaching the goal of being treated even if they are being treated.
  • Pre-diabetes or metabolic syndrome is seldom identified. Listen to this stat: only one in 100 people in our general population have been told that they have metabolic syndrome even though they have three out of those five factors that I listed off before. If you want to do yourself a favor, go back and listen to that list again and check yourself. Go to your doctor and ask them to look at these things and determine if you have metabolic syndrome so you’re not in that 99 out of 100 people that might have metabolic syndrome that don’t even know it.
  • Less than half that are diagnosed with Type 2 diabetes and know they have diabetes are actually adequately controlled.

Another study that was done, called the United States Diabetes Prevention Program, folks, evaluated a lifestyle approach because what’s the answer? Okay, let’s say you did test yourself and you look up your labs and you test your waist circumference, and you realize, Wow! I have three of those five factors that Dr. Murray listed off a minute ago. Or, I have four of them. Oh my God! I have five of them.

Folks, what do you do about it? Well, you can run to the doctor and get prescription medicines, yes. At first that’s really important to keep things under control, but how do you really reverse it? Lifestyle is your answer! You’ve got to change your lifestyle, you’ve got to change what you’re eating, you’ve got to change your activity level, you’ve got to decrease your stress, you’ve got to avoid toxins in your world. These things are how you reverse it. So, how do we know that this works?

Well, the United States Diabetes Prevention Program evaluated a lifestyle approach to prevent Type 2 diabetes in obese people. The whole study had to be stopped early because the results were indisputable that lifestyle, changing one’s diet, exercising, decreasing stress, and avoiding toxins reduced diabetes by 50 percent versus comparing that to the just pharmaceutical prescription drug interventions only decreased the diabetes by 30 percent. Lifestyle had a much better effect, indisputable effect, and therefore the study was stopped, and it was just determined that lifestyle is the way to go.

Looking here at some more statistics from that study on metabolic syndrome. Lifestyle interventions for pre-diabetes or metabolic syndrome delayed the onset or the diagnosis of Type 2 diabetes by eleven years versus prescription medicines alone. No lifestyle changes just prescription pharmacotherapy only delayed the onset of diabetes by three years. Would you rather push off and avoid diabetes altogether by eleven years or more or would you prefer to just take pills and have diabetes in the next three years or four years? The decision is yours.

Next, lifestyle interventions decrease the cases of Type 2 diabetes by 20 percent versus pharmacotherapy or prescription medicines alone only decrease the cases of Type 2 diabetes by 8 percent. Would you rather a rate of decrease in the cases of diabetes and the reversal of diabetes as 20 percent or would you prefer 8 percent? Hey, I’d vote for twenty and be on the medicines only if I need to.

Now, what are some tips that I could end with to give you that if you did them today – boom – you make the decision to do them today you will improve your health and you will reduce the three factors or any of those five factors of possibly having metabolic syndrome? The very first thing I would say is sugary drinks. Folks, you’ve got stop drinking soda. Do not drink soda. Period. By middle age, soft drink consumption is associated with a higher prevalence in incidence of multiple metabolic risk factors. Consumption of only one soft drink a day will increase your risk by one and a half times of developing metabolic syndrome. If you did nothing else for yourself, stop drinking soda!

Another thing is related to heart disease. The atherosclerosis risk in Community Study, another study, found that long-term consumption of the western pattern diet – lots of red meat, fried foods, and again sugary drinks like soda – increase the risk of developing metabolic syndrome. If you stop drinking soda, only eat fried foods maybe once a week if that or ever or eliminate it, and you stop eating so much red meat and just switch to fish for at least one night a week and more chicken or even a night of no meat per week you will absolutely decrease your risk and reverse your metabolic syndrome and avoid ever developing Type 2 diabetes. If you do have Type 2 diabetes you may be able to reverse that as well with some of these tips.


So, finally how to improve, how to reverse metabolic syndrome, how to even reverse and get on the bandwagon and on your journey to reverse Type 2 diabetes, adult-onset diabetes if you already have it.

  1. Eat the rainbow, and I don’t mean M&M’s and Skittles. I mean eat red, yellow, orange, green, blue, purple foods that are real whole foods. What does that mean? Vegetables and fruits.
  2. Stop all sugary drinks. Don’t drink another soda other than maybe once a year if that.
  3. Learn about what’s called the Glycemic Index. Google it and learn about it and read about the glycemic index. Maybe I’ll do another podcast on that coming up soon. The glycemic index, folks, has to do with any food has been measured in how much that food increases your blood sugar right after you eat it. Every food has a different glycemic index, and they rate it against a tablespoon of pure white cane sugar. You ingest white cane sugar and – boom – your blood sugar goes right up immediately and then insulin has to come and decrease it. All foods are rated against that as to what its glycemic index is. How much does it – boom – increase your blood sugar right away? Things like pasta, rice, and grains have an extremely high glycemic index, but fibrous foods such as beans or vegetables and even fruits…some fruits will have a higher glycemic index than others.

Another tip with fruit and, again, eating the rainbow. If you eat a piece of fruit that is colored on the outside but white on the inside, such as apples or bananas, they have a higher glycemic index than fruits that are colored on the outside and colored all the way inside like a peach or a strawberry or a blueberry would have a much lower glycemic index for example than an apple or a banana that’s colored on the outside but white on the inside.

Folks, eat the rainbow, stop all soda or even fruit juice, folks, because high concentrated fruit juice has actually more sugar per can or per serving than even a soda does, so stop all sugary drinks, Google and learn the glycemic index and learn what that’s about, and choose foods that emphasize a low glycemic index in your diet.

So, I’m Dr. Trish Murray – physician, best-selling author, and the Health Catalyst Speaker – signing off. I sure hope this has helped you learn what metabolic syndrome is. Look back at the five factors and notice if you have three or more you do have metabolic syndrome and don’t be one of the 99 people out there out of 100 that have no idea that they have metabolic syndrome even though they do.

Take care everybody!


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