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glipizide and metformin (Metaglip has been discontinued in the US)

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To Hell In A Handbasket; Men Who Crash And Burn

 by: Dr. Gavin Lange

What's up with men? Why do we push our bodies to extremes? Why do we so often ignore our body's signals that we're doing too much, going too fast, trying too hard? Why do we indulge in excess, and constantly exceed our" envelope of tolerance"?

A lot of us, it seems, are just too tough for our own good. A neighbor I talked with recently expressed this attitude after telling me about his chronic pain, stomach symptoms, and sleeplessness, "I'm just gonna keep on truckin'," he huffed. He wasn't going to change anything about his life, his habits, or his health - not really. He was going to suck it up, maybe have a few drinks, take it on the chin, pop a few pills, and just "keep on truckin". That was his master plan.

Since losing my father, aged 55, to an accidental overdose of prescription drugs, I began to be more aware that most of us guys don't know the first thing about how to live. Don't get me wrong, we think we are bad to the fuckin' bone, just ask my dad. He was a bad-ass lawyer, never lost a case, he knew his shit, everybody loved him, or did nobody love him, whatever. The point is that most guys will tell you how fuckin' great they are at one thing or another, they might even pump iron just like my dad... real fuckin' cool, healthy as all shit... then we crash and burn. So when my neighbor recently told me about his butt-load of problems and that he was just gonna keep on truckin', I thought okay go for it, but I couldn't help but wonder where his truck was headed. Actually, to tell you the truth, I know where his truck is headed... he's headed straight to hell. I don't mean hell in a religious way. I mean there are two roads, literally. The road to health and the road to suffering and disease. My dad, my neighbor, and frankly most of us (nice biceps aside) are on the road to suffering and disease.

What I can tell you, for those of us who are interested in a better way, are that the road to disease is a well marked path and there are distinct signs and symptoms along the way. If we know a few things about the signs and symptoms, the early warning signs, and we practice staying in touch with our body, instead of ignoring it while we truck on, then we can stay off the road to disease and we can practice staying on the road to health. It's a matter of understanding that the road to disease is a three stage journey. In the beginning, it is easiest to ignore the signs and symptoms. As we progress further in this stressful and unhealthy direction however, our 'adaptive power' is increasingly depleted. Eventually we are faced with a full blown health crisis and we crash and burn. Why should we keep on truckin', all manly style, if we are simply headed toward a crash? How much better to understand the process of health and disease, the big picture, and take steps early on to prevent the otherwise inevitable crisis.

THE ROAD TO DISEASE: STAGE

When a man is young, he is generally full of "adaptive energy." This means that he has the energy he needs for coping with life, with stress, obstacles, setbacks, relationships, and just about whatever life throws at him. When we're younger, our adrenal glands are still strong and capable of pumping out loads of "cortisol" and other powerful anti-stress hormones. If we eat things we shouldn't, indulge in excesses we know are not healthy, it's pretty much okay, maybe not really, but it seems like it for the time being.

During stage I, stress hormones, like cortisol, can work wonders; they kill pain and neutralize inflammation, reinforce our personality, regulate glucose levels and energy production, and prevent dehydration. In short, our body produces anti-stress hormones to help us cope with any and all types of stress. As long as our adrenal glands can produce sufficient amounts (usually EXCESS amounts) of anti-stress hormones then we can "keep on truckin'" and faintly notice that anything is amiss. We're basically good to go, even when things are very wrong.

Did you know that most of us guys, yes, the vast majority of us, have a long history of blood sugar problems, chronic stress, sports injuries, nutritional deficiencies, chronic dehydration, sleep deprivation, accumulated toxins, even touch deprivation. Our nervous systems are shot, our muscles are too tight, our bones and joints are compressed and torqued, and most of us are holding huge amounts of tension and repressed pain from head to toe? We're so accustom to these things that we're actually IDENTIFIED with them, even defensive about letting it go. We've been this way so long, we don't know WHO we would be without it. This is how and who we are. Lucky for us the adrenal glands have always been there, pumping out (excess) cortisol, so in spite of our chronic problems, we can, like our neighbors and co-workers, keep on truckin.

THE ROAD TO DISEASE: STAGE II

Now for the bad news. The adrenal glands do get tired, and when they do, all hell breaks loose. If our life has been chronically stressful, and our body/mind has suffered a lot of neglect and abuse, our adrenals begin to falter. At this point, the tuff guy, who has always been, more or less "just fine," begins to experience symptoms he has never felt before. The neck and shoulder pain becomes worse, inflammations of all kinds (from the intestines to the skin) begin surfacing. We begin to lose energy and our personality weakens. The enthusiasm of youth that we remember having turns to depression, frustration, pain, violent and even suicidal thoughts. What happened to the guy who was once practically invulnerable? What happened to just enjoying life? We muster every ounce of energy we have left, but it's getting harder and harder to deny it - we're not what we used to be, we're crumbling and falling to pieces. We're more prone to infections. We feel old and tired and stiff. We throw our hands in the air, or pull the sheets over our head, or increase our self-medication. We wonder if anyone else can see through the remains of our persona.

A SINKING SHIP

When we were eighteen, if we hurt or stressed our body in one way or another, our adrenal glands would cover for us, recovery was quick, and we were back in the saddle again. This creates the impression that we are strong as an ox and pretty damn resilient. Pride enters the picture. Guys tell me that they used to be able to eat anything, a "cast iron stomach" or whatever. Now, one bite of the wrong thing and they have pain, indigestion, bloating and various reactions. There's a million variations on this theme. The common denominator though is that the adrenal glands and the body's adaptive reserves are becoming depleted. In the past, the same food, stress, or indulgence was definitely a problem, we just didn't feel the problem because all that wonderful cortisol would kill the pain, quall the inflammation, and life went on undisturbed. (Ah, the good ole' days.)

So why are millions of dudes going down the tubes? You might think that more of us would have wised-up by now, and some of us have. But, most of us are still pretty clueless, and our sad state of physical and mental health proves it. After too many years of unhealthy habits and chronic stress, our adrenals have been worked to the bone, and then, what seems like all of the sudden, they just can't cover our asses for us anymore with all that powerful anti-stress cortisol. Pretty soon it's the proverbial straw that breaks the camel's back, and down we go, a sinking ship. Just like the Titanic, preventable as it was, we didn't even see it coming.

HYPERCORTISOLEMIA: CHRONIC STRESS

Did you know that if you run your system chronically dehydrated, cortisol can save your life? That's it's job. When you are not drinking enough water, cortisol makes your body retain salt and fluid so you don't die. Thanks to cortisol, we

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