What’s the Problem, Dr. Korman?
by Dr. Laura Korman, DC
Q: My doctor told me that my cholesterol is high and wants me to take medication to lower it. Is there anything I can do naturally to reduce my risk for heart disease?
A: With heart disease being the number one killer of Americans, I am asked this question often. My first response is that cholesterol is not the enemy, and there are several factors that need to be addressed when considering the true risk for developing a cardiovascular event.
Cholesterol is a fatty substance found in the cell membrane of nearly every cell in the body. Without adequate levels we can't make our hormones, protect our brain and nerves, or make Vitamin D. Most of the cholesterol in the body is made by the liver, and only a small portion is determined by diet.
The question before considering a medication to drive cholesterol levels down should first be, “Why is my body producing excess cholesterol?” Perhaps the body is working to protect your nerves or brain from a toxic environment, and the answer to a healthier cholesterol level could simply be a detoxification program.
Other than some well-known ways to reduce heart disease, like avoiding fast food, quitting smoking, exercising, or even just sitting less often, I want to share three blood tests that are rarely used, but will provide vital information about your actual risk of developing a cardiovascular event. What is more important than the total cholesterol is the ratios of the particle sizes of cholesterol often referred to as “good” and “bad” cholesterol.
The HDL cholesterol are large fluffy fats that protect against arteriole plaguing. A ratio of HDL to total cholesterol (HDL/cholesterol) should be above 25% to be protective against heart disease. The LDL or “bad” cholesterol can be broken down and looked at more closely with a test called an NMR lipid profile. This test should be ordered to analyze the sizes of the LDL cholesterol, and it can tell if you have a true genetic risk for heart disease and produce excessive smaller particle sizes.
Again, the larger particles are protective, and the smaller, sticky particles are the true villains. They can become stuck in damaged blood vessel linings where they cause inflammation and plaque formation. You might have heard that omega-3 oils are important for overall wellness, and heart health is no exception. The average American diet, including vegans or those that follow a “heart healthy diet,” can be loaded with foods high in omega-6 oils like certain grains, nuts, seeds and vegetable oils.
A blood test to check for inflammation and a healthy ratio of these two poly unsaturated oils is an omega-6/omega-3 ratio. The ideal ratio should be between 1:1 and 4:1. Interestingly, people are often told to eliminate meat to lower their risk for heart disease, not knowing that pasture raised, grass fed animals, including cattle, provide us with meat that is nearly a 1:1 ratio of omega-6 to omega-3 fats.
Unfortunately, 97% of all beef consumed in this country comes from large commercial farms that feed their cows toxic grains which causes this meat to be inflammatory. Another important test is called a fasting insulin. This test measures the amount of insulin (a hormone produced by your pancreas) the body needs in order to help prevent serum blood sugar levels from escalating too high.
Doctors will often rely on a fasting glucose or even a HgA1c (average blood sugar over 90 days) to measure a person’s risk for diabetes, but they don’t often run an insulin test unless a patient already has diabetes. What doctors cannot understand without running a fasting insulin is a person’s development of early diabetes or insulin resistance. This is where the all the cells of the body become resistant or non-responsive to insulin’s attempt to lower blood sugar levels by driving glucose out of the serum and into the cells, so they can produce energy.
Optimally, fasting insulin levels should be less than five. When you start to see this level rise, despite a normal glucose or HgA1c test, it indicates you are becoming pre-diabetic which is a major contributor to heart disease and several other chronic illnesses including diabetes, obesity and Alzheimer's. But you are not powerless in this fight against heart disease. Lifestyle, and nutritional choices are both significant ways to lower this risk.
Ask your doctor to run all three tests: the NMR lipid profile, Omega-6/Omega-3 ratio and a fasting insulin—especially if you feel that you could be at a greater risk for heart disease—to check for true genetic association, inflammation and/or pre-diabetes, all of which can be positively changed with diet and nutrition.
If your doctor is not familiar with these tests, or does not see the need for them, please reach out to my office or another functional medicine practitioner to receive these tests. Then together, you can create a plan to address the root causes and treat them naturally.
For more information and to contact Dr. Korman’s office, please call 941-629-6700 or visit DrLauraKorman.com.