S7E14: Insulin and Hypertension

Do you wonder if you're the best version of yourself? This is a question we seek to answer in this podcast. We reveal information that helps you recover your health and become resilient. Modern life makes us fragile. Our diet, lifestyle, environment set us up for failure. We do not accept this. We seek optimization. We strive to become dynamic. Hey, what's going on? Dr. Chris here. So this past weekend, I went to donate blood, and I got rejected because my blood pressure was too high. My my diastolic, which is the bottom number, was just a little too far out of the range. So which was a bummer. I I know pretty much why, and one of the reasons I donate blood is because of this. You know, the main thing is that I have hemochromatosis, which is a difficulty in excreting iron. So which means I build up too many red blood cells, which thickens my blood. It's a pretty common. disorder, uh, happens to European men a lot. Women are somewhat protected of it because of menstruation, but that can be a big deal. These iron overload, which can be pretty damaging to your organs and actually fatal at a certain point. So it'd been a while, so I knew it was time for me to dump some blood, and I was bummed that I was not able to. And there's some other factors too, you know. I have a Fair amount of stress in my life, or I have in the past. It's gotten better. Plus school starts back up. I have 2 kids, which means getting up earlier, schedules a little disrupted from the summer schedules. My sleep's a little more fragmented. My wife works nights. Sometimes she comes home at 1 o'clock in the morning, wakes me up. Well, she doesn't mean to. And then I have to get up early for the kids. So all these little things, you know, also haven't been working out as much and exercising as much, a little more sedentary. So all these things accumulate and will raise your blood pressure. But I want to talk about an ebook I put together. But before I even get there, I want to talk about the correlation between insulin resistance and hypertension, because it's so important. It's super common. It's probably, I'm guessing, the number one reason blood pressure rises. Here goes Dr. Chris talking about insulin resistance again. I just have to reiterate it from time to time because I'm passionate about the subject, and because I don't think people You realize just how big of a deal it is. You know, just about every— not every, but most cells of the body have insulin receptors. So, when they stop responding, bad things happen. So, it can literally affect probably every system of the body. It doesn't affect all at once. It can sort of selectively affect systems, and in this case, the cardiovascular system. I also want to talk about it because I feel like a lot of practitioners don't fully understand the mechanism. We learn, you know, in PT school, we definitely learn that diabetes and insulin resistance increase the risk for Hypertension and, and stroke and heart attack, but we weren't really taught the actual mechanism. Just, you kind of learn correlation is not causation, but there is a correlation there. But in this case, there definitely is a direct mechanism. So I kind of also want to educate at least the other physical therapists out there. And also, I've certainly had my blood sugar issues in the past, which I've pretty much got under control, uh, for the most part. But that's just another variable in my whole picture of some elevated blood pressure. But before we even go down that pathway, I do want to talk about taking your blood pressure because I think a lot of people just go see the doc, they get their blood pressure taken, blood pressure is elevated, and now it's time for medicine. And I just think there's— it's too fast, too soon. They need more information. Blood pressure is super finicky, right? And there's something called white coat syndrome. If you haven't heard of that, that just means your blood pressure may be artificially elevated when you go see a doctor in the white coat. Maybe it's the presence of someone that's authoritative, or maybe you've waited for several hours in the waiting room, you're frustrated, and maybe the staff's been rude. Or maybe you're just worried that something is wrong. You're at the doctor's office for a reason. You're worried about some bad news, right? Let's face it, going to the doctor's office is never really fun and relaxing. So that's what white coat syndrome is. And I have that. I've confirmed this myself. And, you know, I'm not in the healthcare field. So this can happen to anybody. Um, well, you know, the first time I had my blood pressure taken, uh, for a checkup, it was high and they're talking about medicine. But then I got home and I had a blood pressure cuff. I checked it several times throughout the week and it was pretty much normal, slightly elevated, but definitely not hypertension. I was like, oh, I have— I've got white coat syndrome. So definitely check it on your own or even go to like the grocery store, like Publix down here. They have free— those free blood pressure checks over by the pharmacy. Just stick your arm in the thing. And take it. And, um, you know, if you are on the high side, I would probably take it consistently for a few weeks to make sure you have an accurate idea of what your blood pressure actually looks like. Because at any given time, it's just a snapshot. I mean, you could just— literally just talking will increase your blood pressure. Um, crossing your legs while taking your blood pressure will elevate it. Uh, getting stuck in traffic on the way to take it, well, you know, whatever stresses you out will definitely elevate it. How you breathe affects it. So, if you're more of a chest breather, you're going to have higher blood pressure. If you're breathing through your mouth, it's going to be a higher blood pressure. So, breathing through your nose and belly breathing is going to lower it. Several poor nights of sleep will artificially elevate it. So, there's a lot to it. So, definitely make sure that you know what's going on with your blood pressure before you just jump onto a medicine. Alright, so let's move on to the topic at hand, insulin and high blood pressure. So, as a reminder, insulin is secreted by the pancreas when you eat carbohydrates. So foods that are high in carbohydrates, it's going to elevate your insulin because your body tightly regulates how much sugar is in the bloodstream. Too much, you die. Too little, you die. So the pancreas's role is to secrete the insulin to get the sugar out of— some degree of sugar out of the blood. You always want some in there. And it pushes it into the muscle cells in the form of glycogen and into the liver. So that's where it's stored normally. By the way, it's mostly stored in muscle. You have way more of a storage tank in muscle versus the liver. Once you run out of space in the muscle, it gets stored more in the liver, and that's how fatty liver develops. And so, to that point, the more skeletal muscle you have, the more of a storage unit you have, and that makes you more insulin sensitive. So, as we age, the cells tend to not respond as well, particularly in the 4th decade of life and on. And particularly if you've had a diet that's been high in carbohydrates, particularly high fructose corn syrup, sugars, all the garbage we're not supposed to be eating, the cells just stop responding to it. And then, the pancreas has to secrete more and more. And, I've mentioned this on podcasts before, the first shoe to fall is elevated insulin. So, you might have normal A1C and glucose, Because the pancreas is working overtime, insulin's climbing, but your blood sugars are staying relatively stable. So, you know, when you get a blood draw, definitely get your insulin checked. That's not routinely checked. All right, so if your insulin's creeping up, blood sugars are normal, that does not mean that you're in an optimal space. You need to get your blood sugars under better control. So, you know, what happens when your cardiovascular system stops responding To insulin is not good because under normal circumstances, insulin is a vasodilator. It makes the arteries wider. It does that by stimulating a pathway that stimulates nitric oxide, which is the vasodilator. By the way, breathing through your nose also stimulates nitric oxide production. So, that's one of the reasons it reduces your blood pressure. Nitroglycerin, if you've heard of it, that is an angina medicine that is used to also Open up the arteries. And yes, I said nitroglycerin, as in dynamite. So Alfred Nobel back in the 1800s figured out that if you mix nitroglycerin with rock, you get dynamite. And there's kind of this like fascinating story. I can't remember all the details, but there was something called Monday disease amongst miners. So they would get these headaches when they returned to the factory on Monday mornings, like pretty reliably, and they would get this flushing, right? And on the weekends, these miners were getting angina pectoris or chest pain. So what they figured out is that the nitroglycerin was releasing nitric oxide and being absorbed into these miners. And so by like midweek to the end of the week, their, their blood vessels are like constantly wide open. And so all their chest pain and headaches went away. And then they would turn home for the weekend. They'd be essentially in withdrawal and it would snap back and then everything would go into constriction. They would get chest pain again. And then the story gets even more interesting. So then Pfizer developed a drug called sildenafil, aka Viagra, which was meant to treat chest pain by breaking down the enzyme that breaks down nitric oxide. So they're trying to hope— they're hoping to get this like prolonged effect of nitric oxide. And so they gave it to, I think it was Welsh miners for some reason. And, you know, they did this clinical trial with them. And by the end of the trial, you know, they said, did anybody have reduced chest pain? And it turns out it didn't really relax the vessels in the chest, but it did relax the vessels in the penis. And so everyone said, no, it didn't really do anything for my chest pain. And then the researcher said, did it do anything else? And one brave soldier raised his hand and said, I've been having incredible erections. And then everyone sort of chimed in, yeah, me too. And so that's how Viagra was actually developed. So a multimillion-dollar industry was born out of essentially just a fluke, which brings up a different point. I'm kind of getting off topic, but it's important to mention that you should never mix Viagra with any sort of vasodilator. I think people think that's a vasoconstrictor, Viagra. It's not. It relaxes the arteries for more blood flow. So if you're taking something else, like there's even like workout drinks that contain nitric oxide, In conjunction with Viagra, you'll get a massive dilation of the arteries and a massive drop in your blood pressure, and then the heart will respond by going the other direction and increasing heart rate and blood pressure. That's where the difficulty is, is the combination of 2 muscle— or sorry, vasodilators. So anyway, insulin is normally a vasodilator. When you stop responding to it, now you get constriction of the arteries. Just like putting your thumb over a hose increases the pressure. And then you've got the kidneys and the whole sodium thing. So sodium is often blamed for high blood pressure. And, you know, when I was back, I was a personal trainer, I just thought salt bad, don't use salt. I would never salt my food. I lived off of tasteless chicken for years. It's more complicated than that. So salt can be an issue in the presence of insulin resistance. So in other words, Salt— well, water chases salt. So, if you are heavily salted and you drink water, you will retain a lot of that water, which is a trick to staying hydrated, by the way. And, that's how electrolytes work, which is always funny to me because you'll hear a lot of people say, well, salt's bad for you, but electrolytes are good. Well, the main electrolyte is salt, so it doesn't really add up. But, what happens is insulin, when you become insulin resistant, kind of affects aldosterone, which is another hormone that controls the salt and water balance. So basically, once that— in the kidneys, and once that is off, now your kidneys will sort of hold on to too much salt where normally it does a good job of balancing salt and water. Now you're going to hold on to too much salt, and now that means you're going to have a lot of fluid retention, and just the volume of fluid in your body will increase the blood pressure as well. So that's where salt becomes a problem. It's in the presence of diabetes or insulin resistance. So there's, there's more to it than that. This is sort of the beginning of the cascade of metabolic dysfunction. That's what insulin really is. is, is a metabolic dysfunction. Metabolism is simply the process of your body turning food into energy. And, what type of energy do you burn? How efficient are you at it? You should be able to burn fats and carbs for energy. There's more to it than that. There's amino acids, but generally, it's fats and carbs are the main energy sources. So, I put together this guide. It talks about a whole bunch of other things that are involved in blood pressure elevation like alcohol, lack of sleep, lifestyle things. Yeah. Then I have recommendations that you can do to help naturally reduce it. That's the whole guide is, you know, before going on medicine. And this is not meant to be medical advice, by the way, but there are some things you can do to naturally reduce your blood pressure. Exercise is very powerful. Interestingly enough, grip strength training— I did a whole podcast on that— is very effective at reducing blood pressure. There's a really interesting story about the Air Force with that. Where the pilots were passing out with these high G-force turns. And they figured out that the ones that were gripping the— I don't know what you call it— controller, steering wheel, were not passing out and had to do with isometric grip holds and how it reduced or normalized their blood pressure. So I put together this guide. It's got some general recommendations on it. Talk about supplements too. But remember, supplements are just that. They're only supplements. Yeah. They're only a piece, a small piece of the bigger puzzle. So you can't just rely on supplements. And it has a kind of like a mini worksheet that you can work through, like a 30-day reset plan that's all free. I'll put that in the show notes. A ship in harbor is safe, but that's not what ships are meant to do. What does this mean? It means exposing yourself to difficult situations so you become resilient. If you need help building resilience, check out our flagship program called Physiologic Flexibility. This is a 3-month do-it-yourself program that teaches you how to maximize your homeostatic regulators such as your pH, blood glucose, O2 and CO2 tolerance, and temperature. We give you specific action items through the program with the goal of becoming antifragile. If you want to become the inspiration for your friends and family, this is the program for you.