Welcome to the first Naturopathic News of 2003. It’s my goal to help you find natural solutions to health problems. This newsletter is one way to do that. The more educated you are about your health options the better able you will be to take control of your health. Any feedback in the form of comments, letters to the editor, success stories, etc., is appreciated.
Prevention is a key aspect of my work as a naturopath. For this issue we will be discussing some important factors of cardiovascular health. Heart disease is the #1 killer of Americans, followed by cancer, stroke, emphysema, and accidents.
We all know someone with heart disease, or we have it ourselves. If you're interested in avoiding this disease you will be pleased to know that the majority of the causes of cardiovascular disease are in our control.
Most of us have had our blood drawn to determine our cholesterol level. That number alone, however, is actually quite useless.
There is a huge amount of misinformation about cholesterol that it is something bad to have. The truth is cholesterol is vital for health and we'd all be dead without it. Disease can come from cholesterol that is too high or too low. But in the broad range of cholesterol levels from 180 to 240 there is no correlation with heart disease. Below 180 there is increased risk of hemorrhagic stroke, depression, and suicide. Above 240 there is increased risk of cardiovascular disease and ischemic stroke. Over age 70, elevated cholesterol and cardiovascular events no longer correlate. All told, total serum cholesterol alone is a poor indicator of cardiovascular disease. Half of all heart attack patients have normal total cholesterol levels.
WHY ARE MDs RECOMMENDING STATIN DRUGS FOR CHOLESTEROL LEVELS ABOVE 200?
Ask the pharmaceutical companies who sponsor the drug studies and also help determine what normal cholesterol levels are. The upper limit of normal total cholesterol recently went down from 220 to 200, creating "disease" in additional millions of Americans. Of course, there happens to be a drug treatment for this ‘disease’—the stain category of drugs.
The statin drugs' potential side effects are significant. In some they deplete coenzyme Q 10 within the liver enough to cause liver enzyme elevations and within the muscles (including the heart muscle) to cause myopathy (muscle disease).
There are safer ways to decrease cardiac deaths and treat abnormal cholesterol levels without risking drug side effects.
As noted above, total serum cholesterol doesn't correlate with cardiovascular disease in the range of 180 to 240 but certain fractions of that total cholesterol do correlate. These fractions are HDL and LDL cholesterol. This is why you need a Lipid Profile (also called a Lipid Panel) and not just total cholesterol when you get your blood drawn.
Below are two tables listing the components of cholesterol (ie the Lipid Profile) as well as listing several other markers for cardiovascular health and disease. The first table has the usually quoted normal levels and the second table has ideal levels. Normal levels can change depending upon the levels found in the majority of the population as well as upon what health officials decide is normal. Ideal levels are those that reflect health. We want the ideal levels for optimal wellness not just normal.
CARDIOVASCULAR DISEASE MARKERS:
These are the declared "normal" levels that your MD will use to tell you whether your various serum/blood levels are "normal".
(NOTE: These levels do NOT necessarily mean healthy levels, rather these will include healthy and unhealthy patients):
Total Cholesterol Normal range: Changes with age: (mg/dL)
Upper level is 230 + age, Max 300
Lower level is 115 + age.
Recently cardiologists are recommending everyone’s level should be below 200 at all ages.
HDL Cholesterol Normal range: Males 30-70, Females 35-80 (mg/dL)
LDL Cholesterol Normal range: (mg/dL) 60-150 below age 20 70-180 age 30-50 80-210 above age 50
Triglycerides(TG) Normal range: Changes with age: (mg/dL)
Males lower level is 130 + age, Max 200;
Females lower level is 80 + age, Max 165
C-Reactive Protein(CRP) Normal range: Below 10 mg/L (1 mg/dL)
Homocysteine Normal range: Below 17 micromoles/L
Lipoprotein a (Lp a) Normal range: Below 25 mg/dL
The following serum levels are the most IDEAL (ie. beneficial) levels for cardiovascular (CV) health. These ideal or healthy levels are much tighter than the often quoted "normal" levels referred to by your MD. Remember "normal" does NOT necessarily mean "healthy". We want healthy, not just normal:
Total Cholesterol* Ideal Range: 180 to 200 mg/dL if less than age 70 Ideal Range: Up to 300 if older than age 70
HDL Cholesterol Ideal level: Above 50 mg/dL
LDL Cholesterol Ideal level: Below 100 mg/dL
Triglycerides(TG) Ideal level: Below 100 mg/dL
C-Reactive Protein(CRP) Ideal level: Below 1 mg/L (0.1 mg/dL)
Homocysteine Ideal level: Below 8.0 micromoles/L
Lipoprotein(a)ieLp(a)** Ideal level: Below 10 mg/dL
* Cholesterol: It is not advisable to have total cholesterol below 150 at any age due to increased risk for internal hemorrhage, depression, and suicide.
** Lp(a): LDL + APO(a) = Lp(a). Artery blockage (plaque) is composed of 90-100% Lp(a) NOT of ordinary cholesterol. Lp(a) is a substitute for ascorbate (Vitamin C). If you are not getting enough Vitamin C to produce collagen for tissue repair, when your arteries become injured they cannot heal properly. If there is inadequate Vitamin C, the next best way to repair your arterial injuries is make a Lp(a) plaque to cover the injury. Unfortunately the plaques tend to continue to grow. Simply removing plaque without restoring the artery to health is like tearing a scab off a wound. You do not want to remove the scab until after the tissue underneath has started healing. Your body needs sufficient Vitamin C so your arteries can heal. Elevated homocysteine can also play a role here and is detrimental because it causes the binding of Lp(a) to fibrin in very low concentrations thereby encouraging plaque formation in the vessel walls.
Besides obtaining blood work, your MD has other tests he can order to determine your cardiovascular state including resting EKG, treadmill stress test, echocardiogram, and coronary angiography. These are useful if you have known or suspected disease; however, as you advance from non-invasive to invasive studies there are increased risks for the tests themselves. There is a 1:1000 chance of dying from a coronary angiogram.
Next issue we will finish up with a discussion of some very useful self evaluations you can do on your own which can help determine your cardiovascular risk.
SUPPLEMENTS AND HERBS
Many of you have been ordering you supplements and herbs through Emerson Ecologics. So you already know that this is a great way to get the highest quality products at reasonable prices. Reference my name when you establish your account and receive a 10% discount on every order. Their customer service is excellent and they usually ship to our area in 2 days. If you would like more information on how to have the natural medicines you need delivered to your door, call or email me for further details.
Gregory Pais, ND, DHANP