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When you’re insulin resistant, that is, you’ve got metabolic syndrome, pretty much every chemical in the body is NOT QUITE RIGHT. Some are up. Some are down. Few are actually at physiologically NORMAL levels.
Traditionally the focus is on the big guns.
- And cholesterol
In this series, we take a look at some of the other players.
Who they are, what they’re up to and how they’re part of the state of insulin resistance.
Salivary gland function in insulin resistance
When you’re insulin resistant – you typically, produce less saliva and the composition of the saliva, is altered.
It manifests as a dry mouth.
When it is bad enough, to notice, it is referred to as xerostomia. Most people notice it, when there is a 40 – 50 % loss of function of the salivary glands. But long before, this happens, you will be experiencing the consequences of salivary hypofunction, because saliva, is a magical elixir, which protects, lubricates and hydrates oral surfaces of the mouth.
You need it
- To swallow
- To talk
- To taste
- To chew
It influences who lives in your mouth. And, this determines, how healthy your gums and teeth are. And this in turn, impacts heart, brain and lung health.
So what is saliva ?
A spit-acular fluid
Well, it’s a very complex fluid, containing over 2000 different proteins, made by salivary glands.
A few are unique to saliva, most are not.
In fact, salivary glands are able to produce insulin !
Glands………..with an S
There are the BIG ones, these are referred to as the major salivary glands, these include the parotid, sublingal and submandibular.
And then there are the minor ones.
There are somewhere between 800 and 1000 of them, dotted throughout the oral cavity
In a single day, you will make and swallow, somewhere between 0.6 – 1.5 L of saliva. But at any given point in time, there is around 0.7 – 1 ml of saliva in mouth.
The life and times of a salivary gland
Eating, turns on the tap, but when you’re resting, saliva is still produced.
Saliva levels follow a circadian rhythm : levels are at their lowest, first thing in the morning (6 am) and reach their peak, 12 hours later, around 6 pm.
There actual production, is regulated by the autonomic nervous system, both, sides make a contribution…………
The parasympathetic nerves control the amount.
The sympathetic nerves, control the composition.
Why is there a trickle and not a torrent, when you’re insulin resistant ? No one knows for sure.
The empty spit-tootle
Saliva gland atrophy has been suggested.
This is thought to be sparked, by decreased nerve stimulation and/or poor microcirculation. In the case of insulin resistance, this is arising because of the hyperinsulinemia and it differs from the atrophy, that happens in Sjorgren’s syndrome. The atrophy in Sjorgren’s syndrome, an autoimmune disease, is brought on when the immune system, continuously takes pot shots, at the salivary glands.
The insulin effect..
The worse the body chemistry, the bigger the problem.
Initially the troubles are due to microcirculation problems, problem brought on by shortages of nitric oxide. These microcirculation problems, manifest relatively early…………..studies suggest, overweight kids, already have signs of salivary gland hypofunction.
Poor glycemic control, then takes things up a notch………..
As the excess sugar is cleared by the kidney, it takes body water with it, precipitating dehydration, not just neglect.
Dry mouth a health crisis
A dry mouth is not just a nuisance, it has serious health ramifications. It impacts teeth and gums, its hurts the mouth and leads to difficulties chewing, talking and swallowing.
So it is something that should be on your radar.
Addressing the bad body chemistry, is going to be the place to start, but it is a little unfair, to blame all salivary problems on insulin, there are a host of other things, that can put strain on salivary gland function.
Salivary gland abuse
Comes in many guises, fortunately many of the factors, negatively impacting salivary function can be managed / addressed.
- Alcohol, particularly alcohol based mouthwashes
- Caffeine consumption – it’s not just in coffee, it’s in many soft drinks
- Mouth breathing
- Upper respiratory infections
- Fear & anxiety
In terms of medications, over a 1000 drugs, have been shown to induce dry mouth, the categories of drugs which are known to be problematic, include :
NOTE : Anti-cholinergics, are a category of drugs, which have many indications, they’re used to treat asthma, COPD, overactive bladder, Parkinson’s disease, as well as Alzheimer’s disease.
If you’re taking a drug, which is having a negative impact on your salivary function, discuss whether it would be possible to substitute or discontinue the medication with your doctor. Don’t ever just STOP a medical treatment you’re on, it can have SERIOUS ramifications.
The reality……….. a lot of the time, you cannot PREVENT negatively impacting your salivary glands, so are there ways to help them out ?
A little spit fire
The strongest stimulant for saliva production, is chewing / mouth movement.
Unfortunately, eating/drinking all the time, has it’s own set of issues…. fortunately, there are other options, each with their own pros and cons.
A technique with lots of pros and only a one con, is tongue hoola.
The tongue hoola hoop
To do it, you rotate your tongue round the edge of your mouth slowly, a couple of times – alternating between circling clockwise then anti-clockwise. The technique costs NOTHING, and it works like gang busters, saliva levels increase by 25 % and they stay elevated for a little while.
The con of doing the tongue hoola hoop – you look a little STUPID !
So you might not want to do this one in PUBLIC.
But, to get the benefits, you MUST DO IT.
And you must do it, on a regular basis, throughout your day.
Remembering to do it
If you’re joined at the hip, to an electronic device, you might want to pair, your tongue hoola hooping, to the “loading wheel”. Every time the wheel spins, because your device is THINKING, give your tongue a whirl.
If your “computer” is anything like mine, this will ensure, your mouth is bathed in saliva, all day.
There are other things you can do, to mitigate the effects of salivary gland hypofunction.
Beyond tongue hoola hooping
- The obvious ones, staying adequately hydrated.
- If the atmosphere, where you live is particularly dry, using a humidifier, will moisten the air and can help stave off dehydration.
- A more medical approach, would be to use a sialogogue, this is a fancy name for a saliva substitute. These can be bought ready made, or you can make a homemade version.
- A more exotic option is electro-stimulating. Salivary pacemakers, haven’t gone main stream just yet, but they are coming.
The take home message – when you’re insulin resistant, you need to take care to keep the mouth juice FLOWING.
Salivary secretion and salivary stress hormone level changes induced by tongue rotation exercise. J Adv Prosthodont (2020) 12:204-9. Fumi Mizuhashi, Kaoru Koide.
Obesity, salivary glands and oral pathology. Colomb Med (Cali) (2018) 49(4):280-287. Ignacio Roa and Mariano del Sol.
A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Drugs R D (2017) 17:1–28. Andy Wolff, Revan Kumar Joshi, Jorgen Ekstrom, Doron Aframian, Anne Marie Lynge Pedersen, Gordon Proctor, Nagamani Narayana, Alessandro Villa, Ying Wai Sia, Ardita Aliko, Richard McGowan, Alexander Ross Kerr, Siri Beier Jensen, Arjan Vissink, Colin Dawes.
Is salivary gland function altered in noninsulin-dependent diabetes mellitus and obesity–insulin resistance? Archives of Oral Biology (2016) 64 : 61–71. Jitjiroj Ittichaicharoen, Nipon Chattipakorn, Siriporn C. Chattipakorn.
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