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.

Stress, Immortality, and the Hormesis Hypothesis

Stress, Immortality, and the Hormesis Hypothesis

By Steven V. Joyal, MD

Stress, Immortality, and the Hormesis HypothesisIs low-level stress the secret to immortality?

Longevity scientists have long been puzzled by the fact that stress, when carefully applied, very often results in prolongation of lifespan rather than causing premature death.

We need to be careful by the manner in which we characterize or define stress in the context of lifespan extension. Stress, as a critical causal factor in lifespan extension, is best defined by the term hormesis. When stress, either internal or external, is applied to a living system at a relatively low level so that a beneficial biological adaptation occurs, we define this as hormesis. The capacity of a biological system to adapt and thrive in response to stress is critical to survival. In fact, aging itself can be characterized as the inability to adapt and respond successfully to stress.

We must differentiate chronic stress that overwhelms a biological system and results in damage and decay from the type of low-level stress of hormesis that contributes to a beneficial biological response. For example, chronic stress that causes large bursts of the hormones cortisol and “fight or flight” catecholamines like adrenaline accelerates the aging process and reduces lifespan. In contrast, low-dose radiation with gamma rays and beta radiation has been shown in several studies to stimulate natural chemical and biological processes that are actually protective against cancer.1-4 This may seem surprising to some, but low-level gamma radiation, rather than causing cancer and premature death, has been shown to suppress cancer induction from chemical carcinogens, oncogenic retroviruses, and viral oncogenes like ras and src.5,6

Significant lifespan extension as a result of calorie restriction is probably the best evidence in support of the hormesis hypothesis as applied to longevity. Animals that are calorie restricted are able to significantly suppress chemical and radiation-induced cancers as opposed to peer controls fed ad libitum. Calorie restriction in animals results in an increase in resistance to oxidative stress and the negative effects of excess inflammation as well as the deleterious impact of exhaustive physical exercise.

The beneficial biological response to oxidative stress in calorie restriction is particularly impressive. Animals under calorie restriction have reduced levels of oxidatively damaged proteins, lipids, and DNA. Calorie restricted animals have an amazing capacity to beneficially modify gene expression involved in glucose metabolism, protein synthesis, and cellular energy capacity. Gene expression in calorie restricted animals shows adaptations involving enhancement of detoxification, anti-inflammatory pathways, and DNA repair enzymes.

Do the impressive adaptive benefits of calorie restriction share a common pathway?

The hormesis hypothesis helps provide an answer.

The mild stress of calorie restriction rapidly turns on a variety of gene pathways critical for essential defense and survival of the organism. Gene expression studies show that calorie restricted animals rapidly turn on genes related to stress response and energy metabolism. For example, Lee et al showed that of 6,437 genes activated by calorie restriction, nearly 30% were related to energy metabolism and stress response.7 Hormesis as an explanation for the biological benefits of calorie restriction implies an adaptive mechanism through evolutionary biology. In order to survive, living systems must adapt to an ever-changing barrage of internal and external insults. The low-level stress of calorie restriction produces gene expression changes that create a variety of positive adaptive responses for longevity.

In addition to calorie restriction, other strategies may help mimic the hormetic response. Consistent, mild-to-moderate (never exhaustive) exercise triggers a variety of adaptive mechanisms similar to calorie restriction. Exercise adaptation includes improvements in insulin signaling, mitochondrial energy metabolism, and resistance to oxidative stress, all of which are also known to occur with calorie restriction.

Nutrients, too, have hormetic properties. One example is vitamin D. The past decade has seen a veritable explosion of research supporting beneficial biological roles for vitamin D in the immune system, cardiovascular system, central nervous system, and endocrine system, in addition to control of the cell cycle and cancer pathogenesis.8 There is compelling evidence that vitamin D acts as a hormetic agent. Low doses of vitamin D exert stimulatory effects upon wound healing, while large doses may inhibit psoriatic plaque. A longitudinal, nested, case-control study of prostate cancer showed that both low (</=19 nmol/l) and high (>/=80 nmol/l) 25(OH)-vitamin D serum concentrations were associated with higher prostate cancer risk, while serum concentrations of 25(OH)-vitamin D within the 40-60 nmol/l range comprised the lowest risk of prostate cancer.9 A biphasic, U-shaped response curve is a characteristic of hormesis.

Clearly, more research is needed to understand how best to evaluate the hormesis hypothesis as applied to calorie restriction, physical exercise, and nutrients like vitamin D in the context of longevity science. In the interim, we are left with the intriguing possibility that stress, when applied carefully and strategically, may be the key to living healthier, longer.


  1. Mitchel REJ. Low doses of radiation are protective in vitro and in vivo: Evolutionary origins. Dose-response. 2006;4(2):75–90.
  2. Mitchel REJ. Low doses of radiation reduce risk in vivo. Dose-Response. 2007;5(1):1–10.
  3. Sakai K, Nomura T, Ina Y. Enhancement of bio-protective functions by low dose/dose-rate radiation. Dose-Response. 2006;4(4):327–332.
  4. Sakai K, Hoshi Y, Nomura T, Oda T, Iwasaki T, Fujita K, Yamada T, Tanooka H. Suppression of carcinogenic process in mice by chronic low dose rate gamma-irradiation. Int J Low Radiat. 2003;1(1):142–146.
  5. Bauer G. Low dose radiation and intercellular induction of apoptosis: potential implications for control of oncogenesis. Int J Radiat Biol. 2007;83(11–12):873–888.
  6. Jürgensmeier JM, Schmitt CP, Viesel E, Höfler P, Bauer G. Transforming growth factor beta treated normal fibroblast eliminate transformed fibroblasts by induction of apoptosis. Cancer Res. 1994;54(2):393–398.
  7. Lee CK, Klopp RG, Weindruch R, Prolla TA. Gene expression profile of aging and its retardation by caloric restriction. Science. 1999;285(5432):1390-3.
  8. Norman AW. From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr. 2008;88(2):491S-499S.
  9. Tuohimaa P, Tenkanen L, Ahonen M, Lumme S, Jellum E, Hallmans G, Stattin P, Harvei S, Hakulinen T, Luostarinen T, Dillner J, Lehtinen M, Hakama M. Both high and low levels of blood vitamin D are associated with a higher prostate cancer risk: a longitudinal, nested case-control study in the Nordic countries. Int J Cancer. 2004;108(1):104-8.

Swine Flu Fighters

Swine flu fighters are powerful nutrients known to lessen the severity of symptoms and limit the number of days you’re sick.  The secret to beating any strain of the flu virus is to start treatment fast, within 24 hours of feeling sick. 

If you develop a runny nose, sore throat, or dry cough at anytime during the next few months, begin supplementing with the swine flu fighters immediately. 

Don’t wait for a fever to develop…that’s a big mistake.  By that time it’s too late for any type of remedy to work.

The Swine Flu Fighters

#1: Cimetidine (Tagamet)

Cimetidine is an over-the-counter medication used to treat heart burn.  Amazingly, it also has direct viral-killing effects.  Take 800 mg/day until all symptoms disappear.

#2: Vitamin D

Low blood levels of vitamin D is one of the main reasons we have a flu season.  Taking vitamin D strengthens your immune system while controlling inflammation.  You can safely take up to 5000 IU/day if you feel sick.

#3: Vitamin C

Vitamin C is a potent antioxidant that increases the lifespan of your immune cells.  The longer that each immune cell can live the better the chance for stopping the flu virus from spreading.  Take 2000 mg/day.

#4: Zinc Lozenges

Zinc prevents the flu virus from attaching to the cells lining the respiratory tract.  Unable to “stick”, the virus is prevented from infecting your body. 

Take 24 mg of a zinc lozenge twice a day for 1-2 weeks.

#5: Garlic Extract

Garlic is not only toxic to the flu virus, but also increases the activity of immune cells.  Pungent oils, called allicins, have been shown to lessen flu symptoms by up to 50%. 

Take 9000 mg/day of a garlic extract standardized to 5% of allicins.

#6: DHEA

DHEA is the immune boosting hormone.  Higher blood levels of DHEA can enhance just about every function of the immune system.  Everyday dosing with DHEA is determined by a blood test. 

However, if you feel sick start taking 200 mg/day for 2 weeks.  At that point, you can stop taking it.

#7: Melatonin

Melatonin is a hormone secreted by the pineal gland that enhances the immune system’s production of key chemical messengers, called cytokines.

Cytokines are how immune cells communicate and coordinate the fight against the flu virus.  Take 10 mg at bedtime.

#8: Andrographis Paniculata

Cultivated in Southeast Asia, andrographis paniculata is an herb that has been used for thousands of years to fight infections.  It inhibits viral replication and strengthens several parts of your immune system.  Take up to 1500 mg/day.


The swine flu fighters are powerful nutrients that when taken with the first signs of infection (runny nose, sore throat, and dry cough) can help you feel better fast.  Don’t wait for the onset of a fever to begin a flu remedy…it’s too late. 

Read Life Extension’s influenza protocol which can be found at the following web address:

Nutritional Strategy for Preventing Colon Cancer

A nutritional strategy for preventing colon cancer is as easy as 1-2-3!


Polyphenols are plant-based nutrients loaded with powerful antioxidants. Toxins, like pesticides, enter our bodies from the foods we eat and damage the cells lining the colon wall. If the toxins damage the cells DNA this can lead to cancer.

A diet rich in plant-based polyphenols (antioxidants) prevents the cellular damage caused by food toxins. High concentrations of polyphenols are found in:

1. Red Grapes & Buckwheat

Red grapes and buckwheat are loaded with polyphenols. One in particular, called resveratrol, protects the colon by activating DNA-protection genes. Eat whole grain breads fortified with buckwheat. Freezing red grapes is a nice cold treat on hot summer days.

I also suggest supplementing with a whole grape extract containing 50-100 mg of resveratrol.

2. Green Tea

Drink green tea! It’s load with ECGC, another powerful polyphenol. Laboratory studies have shown that green tea may inhibit colonc cancer growth. The problem is that you would have to drink 15 to 20 glasses a day. Instead, take a supplement of green tea with high levels of ECGC.

#2–Herbs & Spices

Herbs and spices have been used for centuries to support digestive health. Colon cancer research has recently uncovered amazing protective effects with the turmeric spice and garlic:

1. Turmeric Spice

The active nutrient in turmeric is called curcumin. Add turmeric to soups, marinades, pastas, eggs, and meats. It has a subtle sweetness and nutty flavor.

If you have a family history of colon cancer, consider supplementing with a turmeric extract that contains 200-400 mg of curcumin.

2. Garlic

Cooking with garlic not only tastes good but also protects the cells lining the colon. I add garlic to just about everything I eat. But that’s probably not enough.

A high quality supplement containing 20-30 mg of allicin, the most important part, is the only way to fully benefit from garlic.

#3–Vitamins & Minerals

All the vitamins and minerals are important for disease prevention. However, the two big ones are listed below:

1. Vitamin D

In 1990, the peer-reviewed medical journal, Lancet, was the first to link vitamin D to the risk of developing colon cancer. They reported that you are 5 times less likely to develop colon cancer with high blood levels of vitamin D.

They also noted that relying on sunlight and dietary sources for vitamin D wasn’t enough.

The conclusion was to supplement with vitamin D. Most people will need to take around 2000 units/day. Check a blood level first and than talk to your doctor about the right dose for you.

2. Selenium

Selenium is a trace mineral found in legumes and nuts. In 2004, the University of Arizona found that people with high blood levels of selenium had a 34% less chance of developing colon cancer.

But it’s hard to get enough selenium from your diet. A supplement providing 200 mcg/day is suggested.


A nutritional strategy for preventing colorectal cancer includes plant-based polyphenols, herbs and spices, vitamin D, and selenium. I started my program with red grapes, garlic, and a vitamin D supplement.

For more information, read Life Extension’s colon cancer protocol.

Vitamin D deficiency: emerging cardiovascular disease risk factor

emerging cardiovascular disease risk factor

A review published in the December 9, 2008 issue of the Journal of the American College of Cardiology describes the involvement of deficient vitamin D levels in common risk factors for cardiovascular disease (including high blood pressure, diabetes, and obesity) and in cardiovascular events.

Vitamin D deficiency is estimated to affect up to half of all adults and 30 percent of children in the United States. While the vitamin’s role in bone health has long been known, a flurry of recent studies have uncovered associations between deficient levels of the vitamin and a number of diseases, including cardiovascular disease. In their review, Michael F. Holick, MD, PhD and colleagues note that insufficient levels of vitamin D activate the renin-angiotensin-aldosterone system, which can lead to hypertension and thickening of the heart and blood vessel walls. Altered hormone levels related to a deficiency of vitamin D (which is also a hormone) increase the risk of diabetes, which is a well known risk factor for the development of cardiovascular disease. In 15,088 subjects from the NHANES III national cohort registry, higher vitamin D levels were related to a lower risk of diabetes as well as hypertension, high triglycerides, and obesity. And among Framingham Heart Study participants who had levels of vitamin D of less than 15 nanograms per milliliter upon enrollment, the risk of subsequent cardiovascular events was twice as great as the risk experienced by those with higher levels of the vitamin.

Chronic vitamin D deficiency is associated with secondary hyperparathyroidism, which increases the risk of inflammation and cardiovascular events. Elevated parathyroid levels were associated with an increased risk of death among older individuals compared to those with normal levels over the course of follow-up in a recent observational study.

“We are outside less than we used to be, and older adults and people who are overweight or obese are less efficient at making vitamin D in response to sunlight,” stated review coauthor James H. O’Keefe, MD, who is a cardiologist and director of Preventive Cardiology at the Mid America Heart Institute in Kansas City, Missouri. The authors’ strategy for restoring vitamin D to optimal levels in cardiovascular disease patients includes initial treatment with 50,000 international units (IU) vitamin D2 or D3 weekly for 8 to 12 weeks followed by maintenance with 1,000 to 2,000 IU daily. They also suggest limited sun exposure as a means of increasing vitamin D. They observe that supplementation with vitamin D is safe and that such effects as elevated calcium levels and kidney stone development have only rarely been observed among individuals who consume 20,000 IU per day or more.

“Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated,” stated Dr O’Keefe. “Vitamin D is easy to assess, and supplementation is simple, safe and inexpensive.”

“Restoring vitamin D levels to normal is important in maintaining good musculoskeletal health, and it may also improve heart health and prognosis,” Dr. O’Keefe concluded. “We need large randomized controlled trials to determine whether or not vitamin D supplementation can actually reduce future heart disease and deaths.”

Clinical trials find calcium / vitamin D may reduce colon cancer risk

Clinical trials find calcium/vitamin D may reduce colon cancer risk

Research findings presented at the American Association for Cancer Research meeting, held this year in San Diego, suggest that supplementing with vitamin D and calcium may reduce colon cancer risk, while consuming too much iron might increase it.

Veronika Fedirko of Emory University presented her team’s discovery that supplementing colorectal adenoma (polyp) patients with 2 grams calcium, 800 international units of vitamin D, or a combination of the two for six months was associated with an increase of Bax, a protein that controls apoptosis (programmed cell death), compared with placebo group levels. By increasing Bax levels in the colon’s mucosa, a greater number of precancerous cells (such as those that are found in polyps) may self-destruct. The trial found that the greatest increase in the ratio of Bax to Bcl-2 (an apoptosis inhibitor) occurred in the group that received both calcium and vitamin D.

“We were pleased that the effects of calcium and vitamin D were visible enough in this small study to be significant and reportable,” Dr Fedirko stated. “We will have to fully evaluate each marker’s strength as we accumulate more data.”

In another study presented at the AACR meeting, Emory University Rollins School of Public Health professor of epidemiology Robert Bostick, MD, MPH and colleagues found that individuals who consume high amounts of vitamin D and calcium had increased expression of E-cadherin, a calcium-dependent glycoprotein that moderates the movement and proliferation of colon cells. Loss of E-cadherin expression has been associated with the progression of cancer. The study involved the comparison of biopsy samples from individuals with and without sporadic colorectal adenoma, and is part of a larger effort to identify biomarkers for the development of colon cancer. “We want to have the equivalent of measuring cholesterol or high blood pressure, but for colon cancer instead of heart disease,” Dr Bostick remarked. “These measurements will describe the climate of risk in the colon rather than spotting individual tumors or cells that may become tumors.”

An additional abstract coauthored by Dr Bostick reported the finding in the same study population that high levels of iron are associated with a reduction in a protein known as APC needed to control cell growth. “Clinical implications of these findings, if confirmed, could include lowering iron intakes in adenoma patients to prevent adenoma recurrence or colorectal cancer,” the authors conclude.

The current studies contribute more evidence for a protective role for calcium and vitamin D in colorectal cancer. Dr Bostick’s team is involved in a ten year study at several centers which will evaluate the effects of increased calcium and vitamin D as well as biomarker-guided treatment on the recurrence of colon cancer.