“Key tests can reveal problems with a person’s
blood sugar and insulin, inflammation level, level of folic acid, clotting
factors, hormones and other bodily systems that affect your risk of cardiovascular
disease,” says Mark Hyman, MD, the Lennox, MA, practitioner and author, on an old
May 2010 blog post. This last-of-three
columns on that post will discuss some of these tests and zero in on these
prime markers for cardiovascular disease.
“There’s no doubt about it,” Dr. Hyman says. “Inflammation
is a key contributor to heart disease. A major study done at Harvard found that
people with high levels of a marker called C-Reactive Protein (hs-CRP) had
higher risks of heart disease than people with high cholesterol. Normal
cholesterol levels were NOT protective to those with high CRP. The risks were
greatest for those with high levels of both CRP and cholesterol.”
“Another predisposing factor to heart disease,
Dr. Hyman says, is insulin resistance or metabolic syndrome, which leads to an
imbalance in the blood sugar and high levels of insulin. This may affect as
many as half of Americans over age 65. Many younger people also have this
condition, which is sometimes called pre-diabetes.”
“Although modern medicine sometimes loses sight
of the interconnectedness of all our bodily systems, blood sugar imbalances
like these impact your cholesterol levels too. They will cause your good
cholesterol [HDL] to go down, while your triglycerides rise, which further
increases inflammation and oxidative stress. All of these fluctuations
contribute to blood thickening, clotting, and other malfunctions – leading to
cardiovascular disease,” he says.
“What’s more, elevated levels of a substance
called homocysteine (related to our body’s levels of folic acid and vitamins B6
and B12) appear to correlate to cardiovascular illness. Where problematic
levels occur, they can be easily addressed by adequate folic acid intake, along
with vitamins B6 and B12.” My own internist, who is also a board-certified
cardiologist, put me on a supplement called Homocysteine Modulators (Solgar),
as well as CoQ10.
“Heart disease is not only about cholesterol. It
is important to look at many factors that contribute to overall risk.” Dr.
Hyman notes, “It seems that insulin and blood sugar imbalances and inflammation
are proving to be more of a risk than cholesterol.” If you want to test your
risk, Dr Hyman says, ask your doctor to perform the following tests:
·
Cardio C-Reactive
Protein (hs-CRP): There can be many causes of inflammation in the body, but this marker
of inflammation is essential to understand in the context of overall risk. Your
CRP should be <1.0.
·
Standard Lipid
Panel: Total
cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Pay particular
attention to your HDL and triglycerides and the TC/HDL and TG/HDL ratios and
work to improve them. Pay less attention
to lowering Total Cholesterol by lowering LDL, an outcome shown to be of
dubious value alone. Your doctor can’t
write a script for raising HDL and lowering triglycerides. You have to do it
yourself by the food choices you make at each and every meal.
·
VAP cholesterol
test: directly
measures LDL (vs. calculated as in the standard lipid test above), also VLDL,
LP(a), and LDL particle size and characteristics (small dense vs. large
fluffy).
·
Hemoglobin (Hb) A1c: This measures
your average blood sugar over the last 6 weeks to 3 months. Anything over 5.5%
is high. Dr. Richard K. Bernstein, the glucose self-testing guru and leading
diabetes expert, considers 5.7% to be full-blown diabetes. Alas, the ADA now considers
5.7% to be pre-diabetes and 6.5% to be type 2 diabetes. Studies show that CVD
risk doubles from an A1c of 5.5% to 6.0%.
·
Glucose Insulin
Tolerance Test (OGTT + Insulin): Measurements of fasting and 1 and 2 hr. levels
of glucose AND insulin helps identify pre-diabetes and high levels of insulin.
Most doctors just check blood sugar and NOT insulin, the first thing to go up.
By the time your blood sugar goes up, “the train has left the station.”
·
Homocysteine: Your homocysteine
measures your folate status and should be between 6 and 8.
·
Fibrinogen: Looks at clotting
factors in the blood. It should be less than 300.
And, most
importantly, know your test results. Take charge of your health. It’s your life. Make the most of it.
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