By Dr Sharief Ibrahim
It happened almost 25 years ago, at the turn of the century, yet I remember it as if it were yesterday.
One moment, I was reviewing critically ill patients as they came through the hospital corridor. Next, I collapsed and became the most serious patient in my own hospital. A bleeding thyroid cyst had compromised my airway. An anaesthetist intubated me right there on the corridor floor before colleagues rushed me into theatre.
I underwent an emergency operation to stop the bleeding. Hours later, the haemorrhage reoccurred, and I required a second surgery. By the end, I had lost three-quarters of my thyroid. I spent a week comatose on a ventilator in intensive care before I slowly began to recover.
For decades, I had been the consultant physician caring for patients in crisis. In that moment, I was the patient. The experience not only transformed how I viewed my own health, but also how I approached medicine itself.
Childhood Clues
In truth, the warning signs had been present long before my thyroid crisis. As a child, I often experienced sudden dizziness, shakiness, and fatigue between meals. At the time, no one labelled these episodes, but I now recognise them as severe hypoglycaemic events caused by fluctuations in blood sugar.
Alongside these symptoms, I carried a small but persistent amount of belly fat. It may have seemed trivial at the time, but it was an early sign of metabolic imbalance. These subtle clues foreshadowed what was to come: metabolic syndrome.
By my fifties, I had developed prediabetes, raised blood pressure, and high cholesterol, the very conditions I had been treating in my patients for decades.
Lessons From the Front Line
Over the course of 45 years as a doctor, more than 30 of which were spent in the NHS, I have cared for countless patients with the same constellation of problems. Diabetes, hypertension, obesity, and eventually dementia appeared again and again in my clinics and wards.
Our standard approach was to prescribe medications, but over time, I came to realise that medication alone was rarely enough. While prescribing is essential, particularly in acute and advanced disease, it cannot be the whole story. We must also address the underlying processes that drive these conditions if we are to change their long-term course.
The Root Cause
For many of my patients and for myself, the common denominator was insulin resistance. It is, in many ways, the metabolic “root” that gives rise to a whole cluster of chronic conditions.
Managing each disease in isolation is necessary, but it risks missing this shared pathway. By addressing insulin resistance through a combination of nutrition, physical activity, restorative sleep, and stress management, we can often improve multiple conditions simultaneously.
This does not mean abandoning conventional treatment, far from it. Rather, it means combining the best of both worlds: evidence-based medication when needed, and lifestyle interventions that enhance and, in some cases, reduce dependence on those medications.
My Own Journey
After my thyroid crisis, I began applying these lessons to my own life. Initially, the challenge seemed overwhelming. I could not even walk half a mile to the train station. So, I started slowly walking once around the block, then gradually increasing my distance.
The results, over time, were transformative. I lost a significant amount of weight and reduced my waist size by eight inches, from 40 inches to 32 inches. As my fitness improved, I moved from walking to running. To my own surprise, what began as short steps eventually led me to complete more than 120 marathons, most of them in my 60s.
I don’t share this to suggest that every patient should run marathons, but to highlight what is possible when lifestyle changes are sustained and built gradually. The same principles that supported my recovery — food, movement, sleep, and stress management — are accessible to anyone. For me, the journey brought not just improved numbers on a chart, but also energy, resilience, and an enhanced quality of life.
A Broader Perspective
I have seen patients with multiple chronic conditions reduce their medication burden, regain independence, and enjoy better physical and cognitive health, not by rejecting medicine, but by complementing it with lifestyle strategies.
This is particularly important as we grow older. Frailty, multimorbidity, and polypharmacy are defining challenges in geriatrics. By targeting underlying metabolic health, we can alleviate these burdens and enable people to live not only longer, but also better.
A Personal and Professional Reflection
The journey that began with my collapse in a hospital corridor has taken me through personal illness, professional re-examination, and ultimately authorship. Over the last six months, I have distilled these lessons into a new book, Your Metabolic Shift.
The book reflects both my personal journey with metabolic syndrome and my 45 years of experience caring for patients. It includes a series of case studies that explain how lifestyle modification, through real food, simple routines, and an understanding of biology, can help people address insulin resistance and the consequent metabolic diseases.
It is not an argument against medication, but a call for balance. If we can combine medical treatments with strategies that address the root causes, we will be better equipped to face the metabolic health crisis that is overwhelming healthcare systems worldwide.
Your Metabolic Shift will be published on 25th October 2025 in plenty of time for Christmas, it’s a valuable present for loved ones, particularly those over 50. I hope that it will stimulate discussion among colleagues, inspire reflection among practitioners, and provide patients and the broader public with a practical approach.
Closing Thought
When I look back, I see a sense of continuity. The child with hypoglycaemia. The front-line consultant physician, the patient lying comatose on a ventilator and the marathon runner. All were different stages of the same journey.
That journey taught me a profound lesson: that while medicine is powerful, the body itself still possesses remarkable healing power, if we address its needs at their root.
Your Body Knows How To Heal. Download my free guide here: