Errant metabolism

Most metabolic imbalances can be corrected by lifestyle changes or surgery

Woman having bread with tea

Metabolic disorders occur when abnormal chemical reactions in the body lead to a disruption in the process of metabolism. This results in either an excess of some substances [leading to toxicity] or deficiency of others. However, most metabolic disorders are related to enzyme malfunctions.
There are different types of metabolic disorders. Let’s take a look at the most common ones.


This condition is caused by an overactive thyroid gland, which releases the hormone thyroxine. At normal levels, thyroxine helps the metabolism function properly. When too much thyroxine is released, however, our basal metabolic rate [BMR] increases. Symptoms include weight loss, increased heart rate and blood pressure, protruding eyes and swelling in the neck.


This condition is caused by an underactive thyroid gland, either due to a developmental problem, nutritional deficiency, thyroid disease or pituitary gland malfunction.
When too little thyroxine is released, our BMR reduces. Symptoms include fatigue, weight gain, slow heart rate and constipation.


Diabetes is a condition that occurs when the body cannot use glucose properly. Diabetes is of two types: type-1 and type-2.
Type-1 diabetes: In this, the pancreas produces little or no insulin, thus requiring external insulin. Symptoms include increased thirst and urination, extreme fatigue, constant hunger, weight loss, and blurred vision. If a person suffering from type-1 diabetes is not treated
with insulin, he may lapse into a life-threatening diabetic coma.
Type-2 diabetes: Also known as ‘insulin-resistant diabetes’, it is the most common form of diabetes. The pancreas usually produces enough insulin but the body is resistant to it and needs increasingly larger amounts of insulin to perform the same functions. Most people with type-2 diabetes are overweight. Symptoms include fatigue, increased thirst and hunger, frequent urination, weight loss, blurred vision, and slow healing of wounds. In some cases, symptoms may even be absent.

G6PD deficiency

G6PD [Glucose 6-phosphate dehydrogenase] is an enzyme produced by red blood cells that helps the body to metabolise carbohydrates. A G6PD deficiency can result in the damage and destruction of red blood cells known as haemolytic anaemia. Common symptoms of haemolytic anaemia include pale skin, dark coloured urine, jaundice, fever, weakness, dizziness and confusion.


Galactosaemia is a rare genetic disorder that is caused by a liver enzyme deficiency needed to digest galactose [breakdown product of lactose found in milk products]. Because galactose cannot be broken down, it builds up in the blood and causes serious problems. Symptoms usually occur in babies and include vomiting, swollen liver, and jaundice. If left untreated, it damages the eyes, brain, liver and kidneys.


Phenylketonuria [also referred to as PKU] is a genetic disorder that is caused by the inability of the body to break down the amino acid, phenylalanine—essential for normal growth in infants and children. It occurs predominantly in infants, and if left untreated, can lead to mental retardation and seizures.

Metabolic syndrome

The metabolic syndrome or Syndrome X is a cluster of diseases that significantly increases one’s mortality rate. It is characterised by high blood pressure, high blood sugar, raised triglycerides, low HDL [good cholesterol] and most importantly, Central Obesity/Abdominal Obesity—excessive fat tissue in and around the abdomen. If you are a man and your waist measures over 40 inches, or if you are a woman and your waist measures over 35 inches, you are at a risk of weight-related diseases [according to the World Health Organization].
It is well said, “He, who does not mind his belly, will hardly mind anything else.” It is a fact that 80 per cent of type-2 diabetics are overweight and over 40 per cent of obese are diabetics. Obesity also has a social stigma attached to it, which hampers the confidence of the affected.

How are metabolic disorders treated?

Treatment for metabolic disorders is individual-specific, and depends on numerous variables, including the type and severity of the metabolic disorder, the extent it has affected the patient’s brain and body functions and options for appropriate clinical trials. Although several therapies may be recommended, bariatric surgery is the only clinically-proven method for long term and sustained weight loss for morbidly-obese people.
Nutrition and vitamins: Patients benefit from a diet, which eliminates substances that trigger the metabolic disorder. However, some need to avoid fasting in order to control symptoms of their disorder or they may have seizures if they go too long without eating. Another treatment option is co-factor therapy, in which vitamins are used to reduce the impact of the disorder on the body. The response to this therapy varies among patients.
Physical therapy, medication and surgery: While certain metabolic disorders respond to medications, the ones that affect the nerves and muscles may benefit from physical therapy or surgery. Certain metabolic disorders require bone marrow transplant to help slow or halt the progression. However, it has only shown benefit for patients in the early stages, making early diagnosis critical.
Most of these disorders can be brought under control by dietary and lifestyle changes or surgery.

Things you should know

Lean muscle mass: Lean muscle mass burns more calories than any other part of your body, and a higher percentage of lean body weight results in a higher metabolic rate. That’s why building muscle is a good idea if you wish to shed a few kilos.
Age: When you become older, your metabolism slows down as you lose lean muscle mass. This usually starts from the age of 30.
Gender: Men generally have more lean muscle mass [because of the presence of testosterone], which results in a higher basal metabolic rate [BMR] than women.
Height: Tall people tend to have a more active metabolism and need more calories to stay energised because they have a larger surface area of their bodies to fuel.
Genetics: Family history also influences your metabolism. Some people are born with a slower metabolism causing them to gain weight more easily.
Eating patterns: When you eat at regular intervals, your metabolism becomes more active and burns off the calories. If you don’t—say if you have only lunch and dinner—your body goes into ‘starvation mode’ causing your metabolism to slow and your body to store excess energy as fat.
Sleep: Adequate and effective sleep is crucial to boost your metabolism. When you don’t get enough sleep, an increased amount of fat is stored as a result of the inability to metabolise carbohydrates. This leads to high blood sugar levels causing an increase in the levels of insulin produced and increasing the stores of unused fat. The outcome is weight gain or an inability to lose weight easily.

This was first published in the November 2010 issue of Complete Wellbeing.

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Muffazal Lakdawala
Dr Muffazal Lakdawala is an obesity expert and founder of Centre for Obesity & Diabetes Support [CODS].


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