Metabolic syndrome
Metabolic syndrome is not a disease in itself but a cluster of abnormalities that tend to occur together and, together, sharply increase the risk of type 2…
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Medicines commonly prescribed for Metabolic syndrome
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 10 mgActive substance: ramiprilManufacturer: Teva Pharma S.L.U.Prescription requiredDosage form: TABLET, 40 mgActive substance: atorvastatinManufacturer: Towa Pharmaceutical S.A.Prescription requiredDosage form: TABLET, 20 mgActive substance: atorvastatinManufacturer: Laboratorio Stada S.L.Prescription required
Metabolic syndrome is not a disease in itself but a cluster of abnormalities that tend to occur together and, together, sharply increase the risk of type 2 diabetes, heart attack and stroke. The practical point is simple: each component on its own can look "almost normal", yet combined they produce a risk far greater than the sum of the parts. And almost everything here can be changed.
What it consists of
The diagnosis is made when three or more of these five criteria are present:
- increased waist circumference — from 94 cm in men and 80 cm in women of European descent; thresholds are lower for some ethnic groups;
- raised triglycerides — 1.7 mmol/L or above;
- low HDL cholesterol — below 1.0 mmol/L in men and 1.3 mmol/L in women;
- raised blood pressure — 130/85 mmHg or above, or you are already on treatment for it;
- raised fasting glucose — 5.6 mmol/L or above, or diabetes already diagnosed.
Waist circumference is more informative than weight or BMI: what matters is the fat around the internal organs. Someone with a normal weight and a large waist is also at risk.
How to spot it
It produces almost no symptoms of its own, and that is the main difficulty. Sometimes there are:
- tiredness and sleepiness after meals;
- intense thirst and passing urine often — by which point glucose is already high;
- headaches and breathlessness on exertion;
- dark, velvety patches in the folds of the neck, armpits or groin — a sign of insulin resistance;
- in women, irregular periods or signs of polycystic ovary syndrome;
- snoring with pauses in breathing during sleep.
Who is at risk
- a sedentary lifestyle;
- a diet heavy in sugary drinks, refined flour and ultra-processed food;
- excess weight, particularly abdominal fat;
- age over 45;
- family history of type 2 diabetes or cardiovascular disease;
- previous gestational diabetes;
- polycystic ovary syndrome;
- sleep apnoea;
- fatty liver disease;
- smoking;
- treatment with corticosteroids or certain antipsychotics.
When to see a doctor
- your waist exceeds the thresholds above;
- your blood pressure has repeatedly been 130/85 or higher;
- tests have shown raised glucose, raised triglycerides or low HDL;
- you have close relatives with type 2 diabetes or early heart attacks;
- dark patches have appeared in your skin folds;
- you snore with pauses in breathing;
- you are over 40 and have never had these values checked.
What gets checked
The assessment is simple and inexpensive: waist circumference with a tape measure, weight and height, blood pressure (ideally with home readings over several days), fasting glucose and HbA1c, lipid profile, liver enzymes and creatinine. Where indicated: liver ultrasound, an ECG and an overall cardiovascular risk score. If sleep apnoea is suspected, a sleep study.
What works
Here lifestyle change has an effect comparable to medication, and it acts on all the components at once.
- losing 5–10% of body weight — enough to visibly improve blood pressure, glucose and lipids;
- 150 minutes a week of moderate activity: brisk walking, cycling, swimming. Plus two strength sessions a week;
- sit less — get up every 30–60 minutes; this matters separately from formal exercise;
- cut sugary drinks — the simplest and most effective single step;
- more vegetables, pulses, wholegrains, fish and olive oil; less ultra-processed food and white flour;
- reduce salt to under 5 g a day;
- limit alcohol: it directly raises triglycerides;
- stop smoking;
- sleep 7–9 hours: poor sleep worsens insulin sensitivity;
- treat sleep apnoea if present.
Medication
Medicines do not replace lifestyle change; they are added for specific reasons. Antihypertensives, statins where the risk justifies them, metformin in prediabetes, weight-loss medication where appropriate and treatment for polycystic ovary syndrome. Each decision is made by a doctor assessing your overall risk, not an isolated number.
Why it matters
Metabolic syndrome roughly doubles the risk of heart attack and stroke and multiplies the risk of developing type 2 diabetes several times over. It is also associated with fatty liver disease, chronic kidney disease, polycystic ovary syndrome and an increased risk of some cancers.
Common questions
Is it a diagnosis or not? It is a set of risk factors rather than a disease. But it predicts future problems well, which is why it has a name.
Can it occur at a normal weight? Yes, if the fat accumulates around the abdomen. That is why waist is measured.
Can it be reversed? Yes. It is one of the few conditions that genuinely turns around with lifestyle change and moderate weight loss.
Where do I start if there is a lot to change? With one step: drop sugary drinks and add a daily walk. The rest follows more easily.
Online consultation
In an online consultation the doctor adds your numbers together and assesses your overall cardiovascular risk rather than isolated values, advises which tests to have, reviews your medication and helps you put together a realistic three-month plan with an interim check.
This material is for information only and does not replace a medical consultation.
Consult with a doctor about Metabolic syndrome
Discuss your symptoms and possible next steps with a doctor online.
Medically reviewed by
Reviewed on Jul 21, 2026
Online doctors for Metabolic syndrome
Discuss your symptoms and possible next steps for Metabolic syndrome with a doctor online.
