Stopping Heart Disease: Seven Lifesaving Blood Tests Your Doctor Doesn’t Order!

By Steven V. Joyal, MD

Stopping  Heart Disease Consider a beautiful Sunday afternoon in springtime, the smell of flowers, trees, and grass emerging from a long winter.

Now, imagine the sudden onset of crushing pain across your rib cage, shortness of breath, and a cold sweat across your face and back. A beautiful spring day, interrupted by the classic symptoms of a heart attack!

If you don’t want this to happen to you, prevention is critical, and an important part of an over-all prevention strategy is to detect risk factors for heart disease early in the course of the disease. Although the symptoms of an acute heart attack may appear suddenly, the underlying disease (called coronary atherosclerosis) that ultimately results in a heart attack occurs over many years.

Heart disease is the leading cause of death in the United States, and about every 25 seconds one of us will suffer a heart attack.  Annual blood testing plays an important role in helping to identify risk factors early in the course of vascular disease. Regrettably, many doctors are not aware of several blood tests that offer great benefit at detecting cardiac risk factors beyond those detected with typical, routine testing. At your next physical, be sure to take this list of seven lifesaving blood tests with you so that you and your doctor can help identify heart disease risk factors early, rather than too late. 

1. HbA1c

Elevated blood sugar is a significant risk factor for heart disease, even if you don’t have diabetes. Routine testing usually includes a fasting blood sugar level, but a far more accurate measurement of your blood sugar control over a three-month period of time is the hemoglobin A1c (HbA1c) test. This test is usually given only to diabetics, yet all of us need to fully understand the risks associated with high blood sugar.  If your HbA1c level is not optimal (over 5.7), you need to achieve better control over your blood sugar levels. Weight loss, exercise, and diet are three time-proven strategies of achieving better blood sugar control. Nutrients like cinnamon, soluble fiber, and the exotic-sounding Indian Ayurvedic herbal medicine Gymnema sylvestre can help, too.

2. Fibrinogen

Increasingly, scientists have discovered that inflammation plays a deadly role in most degenerative diseases.  Fibrinogen levels increase in response to inflammation in our body.  Recent studies suggest that elevated fibrinogen levels are an independent risk factor for heart disease and stroke in patients with decreased vascular circulation (peripheral artery disease).  If your fibrinogen levels are elevated, weight loss and physical activity can help. Also, consider fish oil, niacin, and folic acid, in addition to vitamins A and C, to support healthy fibrinogen levels.

3. Homocysteine

Elevated levels of homocysteine are associated with an increased risk of heart attack, stroke, bone fracture risk, and cognitive function including depression.  If your blood tests reveal elevated homocysteine levels, B-vitamins like folic acid, B12, and B6 can help support healthy homocysteine metabolism.

4. C-reactive protein

Elevated levels of C-reactive protein indicate your body is under assault from inflammation. This important test can help you ward off some of the most lethal diseases before they begin.  Studies suggest that C-reactive protein is a risk factor for a host of diseases including cardiac disease, macular degeneration and arthritic conditions.  For those with elevated CRP, a low dose of daily aspirin can be helpful.  Also, natural therapies like fish oil, L-carnitine, and soluble fiber can help support healthy levels of C-reactive protein.

5. TSH

Our thyroid gland is the master metabolic regulator of our key body functions.  Signs and symptoms of a significantly overactive or underactive thyroid are easy to recognize for most physicians. Studies show that mild thyroid disease can increase the levels of cholesterol in the blood, contribute to weight gain, and increase the risk of heart rhythm disturbances.  A screening test for thyroid stimulating hormone (TSH) starting at age 35, and every five years thereafter, is a good strategy to identify subtle thyroid malfunction early.

6. 25-hydroxy vitamin D

The remarkable benefits of vitamin D extend across the entire health spectrum. Produced in the skin during exposure to sunlight in the ultraviolet-B spectrum, vitamin D is also available as a low-cost dietary supplement (vitamin D3, cholecalciferol). Over thirty different cell types, including bone, vascular, brain, muscle, and immune system cells contain receptors for activated vitamin D. Recent scientific studies show that low levels of vitamin D are associated with an increased risk of certain types of cancer (e.g. breast, prostate), cardiovascular disease, and even the flu. Despite the enormous health benefits associated with optimal vitamin D status, the vast majority of us are insufficient, with some research suggesting as much as 80% of the population may not have optimal blood serum levels. A simple blood test can detect your vitamin D status. If you avoid sun exposure out of concern over skin cancer and premature skin aging, the latest research suggests that you will need somewhere between 2,000-8,000 IU of supplemental vitamin D3 daily to achieve optimal serum levels.

7. Advanced lipoprotein profiling

The information you obtain with advanced lipoprotein testing provides a wealth of detail on important parameters of heart disease risk, much more than the standard cholesterol profile.  For example, we know that small, dense LDL-cholesterol particles are far more plaque-producing than large, fluffy LDL-cholesterol particles. A standard cholesterol test does not differentiate between small, dense LDL and fluffy, buoyant LDL. Another example is the so-called “good” cholesterol, HDL. Standard cholesterol tests do not tell us if you have more of the favorable HDL2 subclass of particles or the less favorable HDL3, while advanced lipoprotein tests evaluate for HDL2 and HDL3 cholesterol. Several different types of advanced lipoprotein tests are available based upon your individual needs.

Statin Drugs May Increase Diabetes Risk

Statin Drugs May Increase Diabetes Risk

New data from a large review (meta-analysis) of major statin trials suggests that the cholesterol lowering drugs (statins) slightly increase the risk of developing diabetes. The results of the study were published online February 17, 2010 in The Lancet.

“We found that there was indeed a risk of diabetes, about 9%, but it isn’t a worrying increase as had been suggested by other studies,” said lead investigator Dr David Preiss (University of Glasgow, Scotland). “Then again, it wasn’t a completely flat result. We did see [risk].”

Investigators stress that clinical practice should remain unchanged in patients with moderate or high cardiovascular risk, given the benefits of statins seen in these populations.

However, statin medications are increasingly prescribed for low risk patients. The risk for developing diabetes is greater than the benefits of statin drugs in the low risk group.

Bottom line … protect yourself against diabetes if you’re taking a statin drug. The following nutrients help to maintain healthy blood sugar levels and may provide the protection you need:

1. Soluble Fiber

Soluble fibers, such as apple pectin and glucomannan, help control blood sugar spikes after eating a meal. Nutritionists suggest supplementing with five grams 20 minutes before each meal.

2. Chromium

Chromium is a trace mineral critical for maintaining healthy blood sugar levels. It helps the transport of blood sugar (glucose) into cells, and thereby supports already-normal insulin action. Foods rich in chromium include eggs, lean beef, spinach, and apples.

3. Cinnamon

Cinnamon supports healthy glucose metabolism. It’s believed that a water-soluble cinnamon extract is the most effective form for daily supplementation. Additionally, cinnamon has been shown to support levels of triglycerides and cholesterol that are already within normal ranges.

4. Lipoic Acid

Lipoic acid helps protect against oxidative stress generated by high glucose levels. Foods rich in lipoic acid include dark green leafy vegetables, broccoli, and organ meat. If you decide to supplement, take the active form of lipoic acid. It’s known as the “R” form and is responsible for lipoic acid’s benefits.

Natural Support for Diabetic Nerves that Hurt

Natural Support for Diabetic Nerves that Hurt
Millions of people suffer needlessly from diabetic neuropathy because conventional medicine has nothing to offer but toxic medications that don’t work.

Fortunately, natural nerve support is available for nerve damage caused by high blood sugar. You can stop the pain and improve your quality of life by supplementing with specific nutrients proven to support healthy nerves.

1. Acetyl-L-carnitine

Acetyl-L-carnitine has been shown to limit the neuropathy associated with diabetes. In two randomized, placebo-controlled clinical trials, acetyl-L-carnitine, in daily doses of 500 mg and 1000 mg, was shown to yield significant reductions in pain.

2. Lipoic Acid

As a powerful antioxidant, lipoic acid positively affects important aspects of diabetes, including prevention, blood sugar control, and the development of long-term complications such as disease of the heart, kidneys, and small blood vessels.

It has also been shown to reduce the pain associated with diabetic neuropathy.

Clinical trials of people with diabetes who had symptoms caused by nerve damage affecting the heart showed significant improvement taking 800 mg of oral alpha-lipoic acid daily without significant side effects.

3. Curcumin

Researchers are continually discovering more benefits from curcumin, which is the yellow pigment that gives turmeric its distinctive golden hue.

In a study of inherited peripheral neuropathies, curcumin was shown to relieve neuropathy by causing the release of disease-associated proteins that are produced by a mutated gene.

4. Omega-6 Fats

Diabetics are not able to make the omega-6 fat, GLA, and it must be supplemented. GLA improves diabetic neuropathy if given long enough to work.

In one double-blind, placebo-controlled study, 111 people with mild diabetic neuropathy received either 480 mg GLA daily or a placebo.

After 12 months, the group taking GLA was doing significantly better than the placebo group. Good results were seen in two smaller studies as well.

5. Omega-3 Fats

The omega-3s are found in high quantities in coldwater fish such as salmon and are widely consumed for their anti-inflammatory powers.

Omega-3s are essential fatty acids and are important components of cell membranes, including the delicate myelin sheath that protects nerves.

Studies have shown that omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are able to reduce demyelination in the nerves of diabetic animals, which reduces neuropathic pain.

For more information on diabetic neuropathy, visit our protocol at http://www.lef.org/protocols/neurological/neuropathy_01.htm.

Stop Smoking! But Watch Out for Diabetes…

Stop Smoking! But Watch Out for Diabetes Smoking cessation predicts higher short-term risk for the development of type 2 diabetes, according to the results of a prospective cohort study reported in the January 5, 2010, issue of the Annals of Internal Medicine.

“Cigarette smoking is an established predictor of incident type 2 diabetes mellitus, but the effects of smoking cessation on diabetes risk are unknown,” writes Hsin-Chieh Yeh, Ph.D., from Johns Hopkins University in Baltimore, Maryland, and colleagues from the Atherosclerosis Risk in Communities (ARIC) Study.

The goal of this study was to test the hypothesis that smoking cessation would increase diabetes risk in the short term, possibly caused by weight gain related to quitting smoking.

The study cohort consisted of 10,892 middle-aged adults free of diabetes at study enrollment from 1987 to 1989.

Interview at baseline and at subsequent follow-up determined smoking status. Incident diabetes was identified by fasting glucose assays through 1998 and by self-report of physician diagnosis or use of diabetes medications through 2004.

In the first three years of follow-up, 380 participants quit smoking. Compared with adults who never smoked, the incident of diabetes among former smokers was two times higher. The authors concluded, “Smoking cessation leads to higher short-term risk.”

For smokers at risk for diabetes, smoking cessation should be coupled with strategies for diabetes prevention and early detection.

What You Should Do

You should protect against diabetes after you quit smoking. Here are two strategies to consider…

1. Start a Borderline Diabetic Diet

A borderline diabetic diet reverses prediabetes. Preventing full-blown diabetes is ONLY possible with early dietary intervention. Start this diet before you quit smoking.

The diet consists of avoiding anything “white” and focusing on a higher protein based-diet.  Eating whole grains is allowed to a lesser extent.

2. Stop Blood Sugar Spikes

The diabetic diet guidelines begin with minimizing sugar spikes after meals. Carbohydrates result in a sharp rise in blood sugar levels. This is quickly followed by a rise in insulin levels.

The more insulin that’s released the greater the chance for developing insulin resistance … the hallmark of type 2 diabetes.

Eat 10-15 grams of soluble fiber and try supplementing with 1 ounce of apple cider vinegar 10 minutes before each meal.

Preventing Sugar Spikes After Meals

Preventing sugar spikes and restoring insulin sensitivity is the first step in preventing diabetes.  If you’re at risk for diabetes (middle age, family history, overweight, inactive) follow these suggestions:

1. Eat Soluble Fiber

Soluble fiber interferes with carbohydrate absorption from the intestines into your bloodstream.  By limiting absorption, less sugar enters the blood and prevents spikes.

I suggest supplementing with psyllium husk or beta-glucan 10 to 20 minutes before each major meal.  Both of these soluble fibers come in powder form and mix well with water.

2. Take Chromium Polynicotinate

Chromium polynicotinate is a trace mineral that enhances the effect of insulin.  With chromium, cells don’t needs as much insulin to uptake glucose.  The more sensitive the cells are to insulin, the less is released into the blood.

Take 500 mcg of chromium polynicotinate with each major meal.

3. Try Coffee Berry & Cinnamon

Cinnamon is well known by naturopathic doctors for its positive effects on blood sugar.  The problem is that whole cinnamon contains oils that prevent it from working.  The best suggestion is to take 200 mg with each meal of a water-based cinnamon extract free from the oils.

Cinnamon works better with the herb coffee berry.  Coffee berry inhibits the conversion of glycogen (stored sugar) to blood glucose, thus helping to minimize spikes and the amount of insulin released.  About 50 mg of coffee berry with each meal should do the trick.

4. Take Lipoic Acid

Glucose (blood sugar) destroys the insulin receptors sticking out from the cell’s membrane. Without these receptors, insulin won’t work.  Lipoic acid is a naturally occurring antioxidant that protects insulin receptors.  I suggest taking 200 to 300 mg/day of R-lipoic acid (the “R” form is more potent).

5. Eat Complex Carbohydrates

Complex carbs have less effect on blood sugar spikes.  Foods like oatmeal, bran, wheatgerm, and whole grain breads take longer to breakdown to glucose.  The long it takes to breakdown carbs to glucose, the less insulin is released.

A word of warning: all carbohydrates, complex or not, eventually become glucose.  I suggest cutting the servings breads and cereals in half.

Summary

Preventing sugar spikes after meals restores insulin sensitivity and is the first step in diabetes prevention. To learn more, read the Life Extension Foundation’s diabetes protocol at http://www.lef.org and use the search term “diabetes.”

Supplemental vitamins C and E reduce post-heart attack deaths in diabetics

Supplemental vitamins C and E reduce post-heart attack deaths in diabetics

In a communication published online on August 12, 2008 in the journal Cardiology, researchers at Grochowski Hospital and the Polish Academy of Sciences in Warsaw report the results of a preliminary study which found that supplementing diabetic patients with vitamins C and E significantly reduced mortality over a thirty day period following acute myocardial infarction (heart attack). The presence of diabetes is known to adversely affect heart attack outcome.

The study included 800 participants in the Myocardial Infarction and Vitamins (MIVIT) study, a placebo-controlled clinical trial designed to assess the safety and outcome of the antioxidant vitamins C and E in heart attack patients. Subjects were randomized to receive a 12 hour intravenous infusion of one gram vitamin C followed by 400 milligrams vitamin C plus 200 milligrams vitamin E administered orally three times per day, or a placebo regimen.

The researchers compared 30-day cardiac mortality among those who received the vitamins with that of subjects who received the placebo. Although deaths were the same for the treatment and placebo groups in nondiabetic subjects, among the 122 diabetics, mortality was 68 percent lower in those who received the antioxidant vitamins.

The authors remark that the vitamins have synergistic activity, resulting in a reduction in reactive oxygen species formation in heart attack patients. In diabetics, elevated blood sugar significantly increases reactive oxygen species, leading to increased endothelial damage and endothelium-derived nitric oxide inactivation. Additionally, these free radicals play a role in the development of diabetes.

“Early administration of appropriate doses of antioxidant vitamins C and E in diabetic patients with AMI seems to be particularly reasonable in view of increased reactive oxygen species formation in these patients,” the authors conclude. “This may explain the beneficial effects of antioxidant vitamins observed in our study.”