Metabolic syndrome: what it is, symptoms, causes and treatment

Metabolic syndrome is not a single disease. The NHS describes it as a group of health problems that put you at risk of type 2 diabetes or of conditions that affect your heart or blood vessels. The problems that make up the group tend to cluster in the same person, which is why the label is useful: it flags that your overall risk is higher than any single result would suggest.

The NHS stresses that it is different from metabolic disorders, which are rare genetic conditions. If you have been told you have metabolic syndrome, it does not mean you have one of those inherited conditions.

The NHS says you may not have any symptoms of metabolic syndrome, and that you usually find out you have it after a blood test or check-up. That is the main practical point: because it is silent, it is found by measuring things rather than by noticing something wrong.

The NHS also says to see a GP if you think you are at risk of metabolic syndrome. What GPs look at are the individual measurements described below, rather than a symptom.

The NHS says it is not known what causes metabolic syndrome. It is linked to insulin resistance, which is when your body does not respond to the hormone insulin properly, and it may also be linked to having too much fat around your tummy. It also lists factors that make it more likely.

• Living with obesity.

• Eating a high-saturated-fat diet.

• Not doing much exercise.

• Having a Hispanic or South Asian background.

• Smoking.

• Drinking a lot of alcohol.

• Getting older, as risk increases with age.

The NHS says that if your GP or hospital specialist thinks you have metabolic syndrome, they will ask about medical conditions you or family members have, check your body mass index (BMI) and waist measurement, check your blood pressure and ask about any symptoms.

They will usually arrange blood tests to check your blood glucose and the fats in your blood, such as cholesterol. The NHS says you may be told not to eat or drink anything apart from water for up to 12 hours before the test.

The NHS says treatment usually involves making changes to your lifestyle. You may also be offered medicines to help you lose weight, improve your insulin resistance and blood glucose levels, improve your cholesterol and lower your blood pressure. In other words, each part of the cluster is treated, and lifestyle change underpins all of it.

The NHS says the best way to prevent metabolic syndrome, to treat it and to prevent complications is through a healthy lifestyle. The advice it gives is below. Another NHS page on overweight and obesity says that losing just a small amount of weight (5 to 10% of your body weight) can improve your health.

• Try to lose weight if you are overweight.

• Eat less saturated fat and meat and dairy products, and have more fruit, vegetables and whole grains.

• Do at least 150 minutes of moderate to intense exercise a week, spread over at least 4 or 5 days.

• Try to cut down or quit smoking if you smoke.

• Do not sit for long periods of time.

The NHS says metabolic syndrome increases your chances of having cardiovascular disease and type 2 diabetes. It may also increase your chances of non-alcoholic fatty liver disease, osteoarthritis, gout and some cancers, and it can sometimes affect fertility.

These are increased chances, not certainties. Managing weight, activity, blood pressure and cholesterol reduces them.

See a GP if you think you are at risk of metabolic syndrome, as the NHS advises. Because it has no symptoms of its own, it is also worth going to NHS health checks and routine blood pressure and cholesterol checks when you are offered them.

The conditions it raises the risk of, such as heart disease, stroke and diabetes, can produce symptoms that need urgent help. See the linked pages for the specific warning signs, and use NHS 111 or 999 as those pages advise.

On the NHS, metabolic syndrome is usually picked up by a GP or practice nurse through blood pressure, BMI, waist measurement and blood tests, sometimes through a routine health check. Lifestyle support, weight management programmes and medicines for blood pressure or cholesterol are available through the GP. The NHS overweight and obesity page says you may be able to self-refer to some weight management programmes.

Some people choose private health screening or a private GP for these tests. The measurements and the lifestyle advice are the same, and it helps to share the results with your NHS GP so that follow-up and any prescriptions are coordinated.