Every once in a while a great new book comes along that claims to have found the secret key to understanding most chronic disease conditions that the human organism is prone to, and not too long ago, in the book section of Natural Grocers, I bought a book that made that claim. As Archimedes exclaimed, “Eureka – I’ve found it!” And as the famous Rosetta Stone, which unlocked the secrets of ancient Egyptian hieroglyphics, did, this book claims to have found the key to understanding the genesis and development of most chronic disease processes occurring in the human body. Entitled simply, “Why We Get Sick,” written by Benjamin Bikman, PhD, this book makes the case that Insulin Resistance is the hidden epidemic that drives many, if not most, of the major chronic degenerative diseases that claim the lives of so many in our modern world. And the author goes on to explain exactly how this hidden epidemic is behind so many of the chronic health disorders we suffer from.
Insulin Resistance? Isn’t that just a problem with Type Two Diabetes? That’s the only chronic disease that most people think of in connection with Insulin Resistance. Although the author opens his book with an introductory explanation of exactly what Insulin Resistance is and how it is involved in the pathogenesis of Type Two Diabetes, the dirty work that this hidden epidemic does in undermining our health doesn’t stop there, claims Dr. Bikman. In fact, the very next chapter goes on to describe how Insulin Resistance is an important driver in the development of heart and cardiovascular disease – disorders like hypertension, atherosclerosis and arterial plaque, and cardiomyopathy. Yikes! Most people would never dream that Insulin Resistance has anything to do with heart and cardiovascular disorders! When it comes to heart disease, most people think of risk factors like excessive salt use, smoking, excessive animal fat intake and various other factors – but not Insulin Resistance. Although many who suffer from Type Two Diabetes also suffer from high cholesterol, arterial hypertension, and so on, most people would never think that Insulin Resistance was behind heart and circulatory system disorders if there was not also high blood sugar as well.
Unfortunately, explains the author, chronically high blood sugar, or Type Two Diabetes, became indelibly – and perhaps exclusively – linked to Insulin Resistance, while the other dirty work that Insulin Resistance, and consequently high insulin levels, was doing in the background, tended to go unnoticed. But as the author points out in the beginning of his book, Insulin is undoubtedly one of the most important, if not the most important, hormone in the body. Let’s face it – all of our cells burn glucose, or blood sugar, for energy, so every cell in the body has insulin receptors so that they can welcome glucose, the universal energy currency of the human body, inside. But the sum total of insulin’s various effects on the body goes way beyond the whole glucose thing, points out Dr. Bikman, and these other varied effects of insulin on the body need to be better known and appreciated. For example, Dr. Bikman classifies insulin as an anabolic hormone, since it promotes the growth and development of many different bodily organs and tissues – betcha didn’t know that! In so many ways, both obvious and subtle, the body’s different cells, organs and tissues respond to insulin and its presence. For example, many holistic health and integrative medicine authorities, such as Dr. Andrew Weil, have written about the insidious and often unseen role that chronic inflammation plays in the pathogenesis and development of many degenerative diseases that are so common today. But did you know that Insulin Resistance, and consequently high insulin levels in the bloodstream, can turn certain chronic inflammatory processes on, whereas healthy insulin sensitivity, and consequently normal insulin levels, can turn those same inflammatory processes off? It’s almost like the chicken and the egg, or pulling back the curtains to reveal another unsuspected culprit in the development of chronic degenerative diseases. Culprits behind other culprits, like hidden puppet masters pulling the strings.
So – how exactly does Insulin Resistance, and consequently high insulin levels in the bloodstream, cause high blood pressure? Through a number of different mechanisms, explains Dr. Bikman: First of all, high insulin levels stimulate the adrenal glands to produce more aldosterone, a hormone that causes the body to retain more sodium chloride and fluids – and this increase in blood and total fluid volume in the body drives up blood pressure. But it doesn’t stop there. The anabolic influence of the increased insulin, which promotes the increased size and growth of cells and tissues, causes a growth in the thickness of blood vessel walls, thereby decreasing vascular elasticity and driving up blood pressure. In addition, less effective or resistant insulin is less able to stimulate the production of NO, or Nitrous Oxide, one of the most powerful blood vessel dilators in the body, leading to tighter and more constricted blood vessels, thus driving up blood pressure. To make matters worse, Insulin Resistance also overstimulates the fight-or-flight sympathetic nervous system, which constricts the blood vessels, and drives up blood pressure, even further. Where high blood pressure, a key driver of heart disease, is concerned, it seems like multiple non-glucose related aspects of excessive and malfunctioning insulin gang up together to produce a combined pathogenic effect or result. This has led me to contemplate on a certain herb, Hibiscus flowers: I had long known that it had the effect of helping to lower mild to moderately high blood pressure, but I recently learned that it was also useful in lowering high glucose, or blood sugar, in Type Two Diabetes. Could it possibly be that Hibiscus flowers have a beneficial effect on both chronic health conditions by simply reducing Insulin Resistance and improving insulin sensitivity?
One of the great things about this book is that it really educates you on everything you didn’t know about the many functions of insulin in the human body, and how Insulin Resistance can drive, or even switch on, many pathogenic processes in the body that were previously dormant. Some of these are things you never even stopped to consider. For example, Insulin, with its overall anabolic emphasis and character, has a lot in common with the female reproductive system which, in growing the foetus during pregnancy and gestation, also has a strong or major anabolic character and emphasis. And so, Insulin plays a major role in the conversion of androgen hormones like testosterone into estrogen, which has a decided anabolic character and influence in growing the uterine lining, the placenta, and so on. The author goes on to explain how Insulin Resistance is involved in PCOS (Poly-Cystic Ovarian Syndrome) and the generation of ovarian cysts. Lest you think that females alone suffer reproductively from Insulin Resistance and hyperinsulinism, men’s reproductive health suffers as well: Dr. Bikman also links low testosterone levels in men to Insulin Resistance; it’s a well known fact that excessive fat or adipose tissue is also a condition driving Type Two Diabetes, which is closely linked to Insulin Resistance. It seems as if Insulin and Testosterone are adversely linked to one another: The higher the insulin, the lower the testosterone. And while we’re on the subject of fat and adipose tissue, did you know that smaller fat cells are healthier for you metabolically, and that larger fat cells are more linked to Insulin Resistance? But the fat or lipid connection doesn’t stop there: Lower density lipoproteins, or those protein / fat molecules with a larger fat component, are more likely to float in the bloodstream and attach themselves to blood vessel walls in the form of arterial plaque? And yes – higher concentrations of this LDL, or Low Density Lipoproteins, are more linked to Insulin Resistance.
Above all, this book is well organized and structured, and as it unfolds, Dr. Bikman presents, explains and develops his Insulin Resistance thesis step by step, like a master teacher or professor. The first section of the book concerns the initial presentation of the problem – in other words, the often hidden and insidious involvement of Insulin Resistance in the pathogenesis and development of many, if not most, of the chronic degenerative diseases that are so prevalent today. Then, after he has thoroughly presented and explained the problem, he then launches into a presentation and explanation of the causes of Insulin Resistance. These include age and genetics; interaction with, and the influence of, other hormones in the body; the widespread problem of weight gain and obesity; inflammation and oxidative stress; and lifestyle factors. The author wisely opens this section of the book with a discussion of age and genetics, or the influence of factors beyond our direct personal control, on Insulin Resistance in hopes that this opening will motivate his readers to be more serious and persistent in doing something about the subsequent factors that he discusses, which are subject to one’s personal control. And finally, there lingers the question, “Then what the heck can we do about it?” This is the therapeutic section of the book, in which Dr. Bikman lays out his program for combatting, controlling and managing the pesky problem of Insulin Resistance, which is at the root of so many of our modern health woes. The initial chapter of this third and final section of the book is entitled, “Get Moving: The Importance of Physical Activity”; that’s right – get off your duffs and start working out! This initial chapter is followed by the longest chapter of the book, which is about eating smart, or what we can do to bring down Insulin Resistance through dietary changes and modifications.
And naturally, since it’s a well known fact that eating a lot of sweets and carbohydrates is one of the surest ways to spike your insulin levels, the mainstay of the dietary remedies the author explores in this chapter involve various low carb diets; another principal remedy he explores in this chapter involves intermittent fasting – which, interestingly enough for this website, goes all the way back to Hippocrates. In other words, when you feel too jaded or satiated by food in general, skip a meal or two until your appetite naturally returns of its own accord. Don’t eat if you’re not hungry. It’s hard to escape the obvious conclusion that high carbohydrate foods like bread, potatoes, pasta, and chips are some of the most frequently abused foods there are today. I remember back when my mother, and subsequently my sister, were followers of the Atkins Diet, which was one of the first low-carb diets out there. Because I, as a young man, was not so concerned about losing weight, and didn’t have any serious weight problem until past middle age, I just pooh-poohed it and looked upon Dr. Atkins and his diet as just another fad diet. Dr. Atkins was on a crusade against carbs, but on the other hand, he was pretty darn friendly towards fats, recommending various treats like full-fat cream and the like, not to mention juicy, fatty steaks. Now, didn’t Dr. Atkins die of a big, fat heart attack? Like Dr. Atkins, Dr. Bikman, while being down on carbs, is also friendly towards fat, as well as meat and other high protein foods. The Keto Diet is another popular diet that the author explores in this chapter – a diet that is also fat-friendly, which exhorts us to “love the fat bomb”. If natural healing is basically a back to Nature movement, then that’s funny – I don’t see many, if any, fat-laden “fat bombs” in Nature – especially not any that are regularly eaten by our Nature-loving animal brethren.
Drawbacks and Shortcomings of This Book
Dr. Bikman is, above all, a science expert and writer, and is therefore thoroughly grounded and rooted in modern “evidence-based medicine”. And so, he takes care that all of the conclusions that he comes to, and which are duly presented in his book, meets his qualifications of being “evidence-based” – which means that which is supported by scientific studies – or at least the ones he considers to have been conducted by reputable doctors and research institutions. But what exactly is “evidence based”, and who decides which articles of evidence are valid and admissible or not? The answer is probably Dr. Bikman himself, as well as his scholarly associates, colleagues and peers – which probably means others who are of like-minded persuasion – in other words, a modern, biomedical, reductionist viewpoint. I mentioned earlier in this article the possibility that Hibiscus flowers and their beneficial effect in lowering both high blood sugar as well as high blood pressure might be due to the herb’s having the beneficial effect of lowering Insulin Resistance and boosting insulin sensitivity. Now let’s see – I imagine that a brief google search on the internet would tell me whether or not this little hypothesis of mine is true. Here’s a brief AI overview of the findings and data:
“Yes, scientific evidence suggests that Hibiscus flowers (specifically Hibiscus sabdariffa) can help lower insulin resistance and boost insulin sensitivity. Research indicates that Hibiscus extracts act as a natural agent for managing metabolic syndrome by regulating glucose metabolism, reducing inflammation and protecting pancreatic function.”
Amazing! Right off the bat, I’ve managed to zero in on scientific evidence that, somehow, Dr. Bikman managed to overlook! The AI overview then goes on to describe more specifically the various mechanisms responsible for the insulin-sensitizing effect of Hibiscus flowers:
“Reduced Insulin Resistance: Studies on diabetic and obese rats have shown that Hibiscus extracts significantly reduce Insulin Resistance and lower HOMA-IR (Homeostatic Model of Insulin Resistance) indices.
Improved Insulin Sensitivity: Hibiscus enhances glucose uptake in skeletal muscle and fat tissues. It also boosts insulin sensitivity, often in a dose-related manner.
Improved Glucose Control: Hibiscus can lower fasting glucose and lower post-meal (postprandial) glucose spikes.
Pancreatic Protection: It protects pancreatic beta cells from oxidative stress damage, promoting better insulin signaling and regulation.
That’s funny – throughout the whole text of his book, I don’t remember Dr. Bikman mentioning a single herb even once! So already, I’ve uncovered a gaping hole in Dr. Bikman’s therapeutic program or regimen for reducing Insulin Resistance and promoting increased insulin sensitivity. Without the medicinal herbs that Mother Nature, in Her healing care and compassion, has so generously bestowed upon suffering mankind, Dr. Bikman’s therapeutic regimen for combatting Insulin Resistance and promoting increased insulin sensitivity seems very rigid and spartan indeed – and above all, incomplete. And as a practicing herbalist. I would wager – heck, I know – that there are many other natural herbs and supplements out there that also reduce Insulin Resistance and improve insulin sensitivity. Among these are Milk Thistle Seed Extract and Vitamin K2, as well as a whole host of anti-diabetic herbs, for sure. With my Sun in Taurus, the Nature sign of the zodiac, I can well appreciate the fact that man is basically lost without the helping hand of Mother Nature.
Tracking the Root Cause of Human Pathology and Disease Back to Its Lair
As I mentioned in the beginning of this book review, the author, Dr. Ben Bikman, claims to have uncovered the hidden epidemic that lies at the root of most of the leading chronic degenerative diseases that modern man suffers from. But indeed, how truthful and accurate is this claim? Many authors of health-related books state their claims in the boldest way possible on the covers of their books, and then tone things down when they get to discussing the details inside. It’s all a matter of selling more books, I suppose. Here again, let me do a little google searching. Dr. Bikman claims that about 80 percent of Americans suffer from Insulin Resistance; is that really true, or are these numbers inflated? Well, here goes:
The AI overview of the results starts out making a more cautious and reserved estimate when it puts the basic percentage at around 40 percent. But then, it goes on to say that the figure may be as high as 70 percent among individuals who are overweight or obese. It then goes on to say that as much as 88 percent of Americans may be “metabolically unhealthy” to some degree, which usually involves some degree of Insulin Resistance. OK, Dr. Bikman – I remember reading that 88 percent figure in the beginning of your book, so your estimates aren’t really that overblown – especially when you say that most people don’t even know that they are insulin resistant. And Insulin Resistance, as a precursor to conditions like Type Two Diabetes, usually precedes its onset by years, if not decades. And the same “don’t know you have it” phenomenon might also apply to the development of all the other chronic diseases that Dr. Bikman discusses as being connected to Insulin Resistance.
And to be fair to Dr. Bikman, when you really get into the “meat” of his book, I don’t think that he is claiming to have found the single, universal cause of all human disease and pathology in Insulin Resistance. I think it would be fair to say that the many other functions of insulin besides the whole glucose thing are vastly unknown and underappreciated, and for this reason, the hidden damage that Insulin Resistance and hyper-insulinism do to the body and its complex physiological and metabolic processes is also vastly underappreciated. And if the truth about Insulin Resistance and all the damage it can do to the body was better known, people would not snack on cakes, cookies and chips, and would not indulge in sweets or junk food so casually. Come to think of it, this kind of “food” doesn’t do anybody any good, whether or not they have Type Two Diabetes or Insulin Resistance.
So although I don’t believe that we can yet make the claim to have found the universal root cause for all human disease and pathology, I also doubt that we will ever get to such a point. And if you encounter someone who is making this claim, chances are that it is probably way exaggerated or overblown. But all things considered, when it comes to being a driver or causative factor in the many chronic degenerative diseases that modern man suffers from, Insulin Resistance seems to be pretty darn important – and if you are interested in investigating it further, a great start would be to read Dr. Bikman’s book. When it comes to the root causes of human pathology and disease, I personally believe that Chinese Medicine basically got it right when it saw things in terms of roots and branches. In other words, there will always be many more surface disease manifestations (branches) than there are root causes of disease (roots) So many different diseases boil down to a single pathological process, like chronic inflammation, simply occurring or manifesting in different parts of the body, for example. And after reading Dr. Bikman’s book, you will see many different chronic and degenerative diseases as involving the hidden dirty work of Insulin Resistance.
Conclusion: Introducing Dr. Benjamin Bikman – And His Introducer
As a short exercise in the clinical assessment of one’s temperament via a cursory visual impression, I will present below two short videos, with the first one being of Dr. Benjamin Bikman, the author of Why We Get Sick and his introducer, Dr. Jason Fung, MD, who wrote The Obesity Code, and who also wrote the Foreword to Dr. Bikman’s book. I will write a short paragraph describing my impressions of each doctor, which will be followed by a short video of each person, so you can get a visual impression of each of them in action.
First, let’s take a look at Dr. Benjamin Bikman, the author of Why We Get Sick. My basic impression of Dr. Bikman’s constitutional makeup is that he seems to be of a Nervous or Melancholic Temperament, with the Dry quality predominant. Then why the pale complexion? Either Dr. Bikman has a tendency towards anemia, which is a deficiency of Blood, or the Sanguine Humor, which is the humor that is opposite yet complementary to that of Melancholy, or Black Bile, or Dr. Bikman is an albino individual.
Next, let’s take a look at Dr. Jason Fung, MD, the author of The Obesity Code and the writer of the Foreword to Dr. Bikman’s book. Although he is of a different race, and therefore has a different complexion or skin color, his overall constitutional makeup of humor and temperament appears to be much more balanced.