Tag Archives: cholesterol testing

Protecting Yourself from Heart Disease – Video blog

Heart disease is the number one killer of Americans.  Find out how to properly assess your risk and what tests you should be having done.

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3 Medical Myths Debunked

Health care can be a confusing field.  There is so much information out there, much of it conflicting, that leaves consumers confused about their health.  Well, today I am here to sort some of them out for you.  Below are some common medical myths that people believe but are not necessarily true.

1. High Cholesterol Means a High Heart Attack Risk

This is perhaps the biggest one I see in practice.  Everyone thinks that having high cholesterol means they are at risk for having a heart attack.  They also think that having low cholesterol is protecting them from heart disease and heart attacks.  Neither is true!  As a matter of fact, 50% of the people who have heart attacks annually have high cholesterol and 50% have low cholesterol. To most people this is an astounding stat, but it’s true.  What has been shown in the research is that your total cholesterol is not actually a predictor of heart disease.  Looking at the break down of the HDL (the good) versus LDL (the bad) cholesterol is helpful but still is not the entire story.  What you should be looking at is the size of your cholesterol.  How do you do that?  It’s simple really.  It’s just a blood test.  It is how the lab analyzes your cholesterol that’s different.  Without getting to technical, small, dense particles of LDL cholesterol are bad because they can make their way into the lining of your blood vessels most easily.  Light, fluffy, large pieces of LDL are not problematic because they cannot readily get into the walls of your vessels and cause the atherosclerotic plaques that are so dangerous.  These are tests that several of the largest laboratories are performing now and give us better information about cardiovascular health.  I have begun measuring cholesterol in this fashion on all my high risk cardiovascular patients and the results have helped us tailor nutritional programs that will be most effective for them.

2. Bed Rest of Back Pain

I recently had someone visit my office on a Monday for an acute case of back pain.  She was in quite a bit of distress and discomfort.  So much so that she had been to the emergency room over the weekend.  There she was given test and test and finally told that her back pain was not life threatening and to go home, take some pain killers and get bed rest for 5 days.  The advice of bed rest is still being given out by many physicians around the country for back pain despite the evidence that overwhelmingly concludes that this only makes back pain worse. In fact, the research shows that if you do go with bed rest you are much more likely to develop a chronic back problem.  If you have an episode of back pain do not stay in bed.  Your best bet is to stay as active as possible.  Your goal should be to continue your normal activities, within reason, but modify these activities to fit your current limitations.  Now, if your normal activities include vigorous exercise you may want to hold off on that until your back is feeling better, but you should try to walk if you can.  Rest if you need to, but keeping the joints and muscles of the back active even when they are hurt is the best way for them to heal appropriately.  You should also see a chiropractor.  Chiropractors are trained extensively on the back and know how to provide nonsurgical relief for back pain.

3. Eating Fat Makes You Fat

This is a biggie.  People come into my office for a lot of reasons.  However, regardless of their initial reason I always ask about their diet.  Inevitably someone will tell me they eat a healthy diet because they eat low fat.  People assume that low fat is the best way to keep fat from accumulating around their midsection (and everywhere else!).  This simply is not true.  It seems intuitive that eating fat would make you fat just like saving money makes you rich.  However, things in the human body are hardly ever that linear.  The way the human body stores fat is by secreting a hormone called insulin.  Insulin is secreted when a person consumes carbohydrates (bread, pasta, sugar) and to some degree protein.  Insulin signals the body’s cells to take in the energy in the blood, in the form of sugar, and store it as fat or use it.  Notice that I did not say that fat causes insulin release?  That’s because it doesn’t!  If fat does not cause the body to secrete the hormone necessary for fat storage then how can fat make you fat?  It can’t!  This myth comes from the fact that fat is higher in calorie than other foods but somewhere along the line people made the leap that eating fat caused fat to accumulate in the body.  When fat is consumed it is actually slowly converted to sugar and burned, not stored.

There are many more to choose from, but these are some of the most common that I see in my office.  If you’d like to know more, let me know in the comments section and I’ll post about your questions.

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6 Blood Tests Everyone Should Ask Their Doctor For

At the Vreeland Clinic we use nutrition and diet to manipulate health.  Our main goal is to improve overall health and help people feel energetic and youthful.  To know if we’ve achieved our goal we rely, in part, on our patients to inform us on how they are feeling.  This is not, however, the only marker we use to “check up” on our patients.  We use a wide variety of blood work to make sure that along with feeling great, our patients are protected from the dangers of aspects of disease that do not always manifest in overt symptoms until it’s too late.

This blood work is a huge part of our practice and today I am going to share with you the blood work that you should be asking for when you go to your doctor.

1. Particle Size Cholesterol Test

Now, cholesterol is an interesting subject.  Knowing the total number is useless.  Knowing the breakdown of the “good” cholesterol (HDL) versus the “bad” (LDL) is a little more revealing but still is far from telling the whole story.  What you need is to find out the particle break down.

Cholesterol testing has historically been used as the standard indicator for cardiovascular disease classified as HDL (good) or LDL (bad). However, it is actually the lipoprotein particles that carry the cholesterol throughout the body, not necessarily the cholesterol within them, that are responsible for key steps in plaque production and the resulting development of cardiovascular disease.

It is the particle size that is important.  Small, dense and hard lipoproteins are dangerous while light and fluffy particles are not quite as worrisome.  We know that just as many people with low cholesterol have heart attacks as people with high cholesterol.  If total cholesterol was a good indicator of heart disease then why do people with “healthy” levels have heart attacks? It’s because your total cholesterol doesn’t tell the whole story.  You must know the particle breakdown to have any real idea about your cardiovascular risk.

Below is a schematic from SpectraCell Laboratories that illustrates why this type of test is important.  They are a national lab that runs these tests and their panel is called an LPP panel.  There are many other companies that can do these tests.  The other lab I am familiar with is Atherotech Diagnostics Lab.  They call their test the VAP panel.  Either test works.  Your doctor can order these tests easily. (Please click the picture to enlarge it).

2. Fibrinogen

Fibrinogen is an important factor in blood clotting and increases in response to tissue inflammation.  Fibrinogen can help predict the risk of heart disease and stroke.  Fibrinogen will not only be high in people with heart disease, but it’s also high in other inflammatory conditions such as rheumatoid arthritis.  High levels of fibrinogen also increase the risk of venous thrombosis (blood clots).  Blood clots are silent killers that are often discovered too late.  This is a simple test that almost all labs are capable of running.  If you take appropriate steps, lowering fibrinogen can lower your risk of many inflammatory diseases.

3. Hemoglobin A1C

Having your fasting blood sugar tested is very valuable, but it’s just a spot shot.  It only tells you what your blood sugar was at the moment your blood was drawn.  And if you followed the instructions, you fasted before that test so your blood sugar is likely as low as it’s going to get.  (Remember with blood sugar, lower is better than higher).  High blood sugar leads to diabetes.  A hemoglobin A1C (or HbA1c) checks your blood sugar control over the last 2-3 months.  A much better check!  High HbA1c is an independent risk factor for heart disease for people with or without diabetes.  Higher HbA1c leads to an increased risk of heart disease and vice versa.  HbA1c is another test that every lab can perform and is easily ordered by any physician.

4. DHEA

Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands and is a precursor to the sex hormones estrogen and testosterone.   Blood levels peak in one’s twenties and decline significantly as we age.  They reach a level of about 20%-30% of one’s youthful peak between the ages of 70 and 80.  Healthy levels of DHEA supports immune function, bone density, mood, libido and a healthy body composition.  This is another easy test to order and almost all labs can perform it.

5. Homocysteine

Homocysteine is formed in the body from the metabolism of the amino acid methionine.  It is inflammatory in nature.  High levels have been associated with an increased risk of heart attack, bone fracture and poor cognitive function.  Other studies have linked high homocysteine to macular degeneration and gall stones.  Some patients, because of a genetic defect in the way they metabolize folic acid, have very high homocysteine.  Lowering this is critical for long term health.  It is easily lowered with activated B12, activated B6 and activated folate.  Homocysteine is easily performed at any lab.

6. C-Reactive Protein

CRP, as it is abbreviated, is another inflammatory enzyme.  CRP is a powerful predictor of systemic inflammation and is a great indicator of risk for heart disease and stroke.  It may predict heart disease years before it becomes problematic.  It identifies at risk populations while they are still healthy.  This truly is a great tool.  A review of epidemiological data shows that CRP was able to predict heart attack, stroke, peripheral artery disease and sudden cardiac death in healthy individuals with no history of cardiovascular disease.  Again, this is a simple test and can easily be ordered by your doctor.

This list is by no means comprehensive, but it’s a good start.  Each individual person may require more testing depending on their specific condition.  These are, however, a great way to evaluate your overall health and predict disease that might await you years down the road.  Once you have found your specific risk factors appropriate steps can be taken to avoid the consequences in your later years.

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