cholesterol-particlesHow did we arrive at the conclusion that LDL cholesterol is the villain in heart disease?

Well…once again we see the mistakes made by researchers that lead us to think of LDL as the culprit.

A little history…

It had to do with a machine used in the laboratory, called an analytical centrifuge that created evidence that ultimately mislead researchers and clouded the issue of cholesterol sub-particles.

Invented in 1949 and used until 2004, this device was used to spin blood plasma samples at 40,000 rpm to separate out the cholesterol fractions such as HDL and LDL.

However this spinning process cannot separate the particles with the precision required to identify all of the sub-fractions of cholesterol that are present in the blood. It may have been state of the art when it was first used, but still fell far short in the accuracy required to actually identify all the sub-fractions of cholesterol.

This started the characterization of cholesterol particles as either good or bad cholesterol, depending on the particle density. This was a gross oversimplification that stuck in the minds of the public.

For many years this simplified version of a person’s risk of heart disease based on their ratio of good and bad cholesterol stood as the cutting edge of cholesterol testing and heart disease prevention.

This was accompanied by the now debunked view that saturated fats caused heart disease because of their association with cholesterol. People avoided saturated fats out of a fear that was not founded in good science.

They also consumed statins, the most prescribed class of drugs on Earth due to the same fear of cholesterol and it’s supposed relationship to heart attacks.

Americans have consumed some 14 billion dollars in cholesterol lowering drugs, which some health experts have advocated be given to people of all ages including children allegedly to prevent heart disease.

John Abramson argues in his book Overdosed America that lowering LDL cholesterol has inadvertently become the main focus of preventative medical care in the United States.

Cutting edge thinking about LDL cholesterol

Yet a more recent breakthrough utilizing a new technology called ion mobility analysis has shaken the traditional concept of cholesterol’s role in heart disease to the core, and called the entire LDL cholesterol theory into question.

Ronald M. Krauss, of the Children’s Hospital Oakland Research Institute, is using ion mobility analysis to count cholesterol particles such as LDL and HDL down to the smallest sub particle types using principles of physics.

Even though it’s extremely expensive and not widely available, this technology has helped to rewrite the rules on how we think about cholesterol and heart disease.

Rather than continuing to believe that LDL cholesterol is the bad cholesterol here, we now know that there are four types of LDL particles that factor into the risk of heart disease.

Some LDL particles are benign and others more dangerous. Thus it makes no sense to continue to base diet and drug recommendations on an outdated theory when the science regarding cholesterol particle types is far more precise now.

We could be using drugs that target the wrong particles, and making dietary recommendations that are doing more harm than good at this point, all while dramatically escalating health care costs and actually making treatment less effective!

Low Density Lipoproteins

LDL comes in four sizes:

  • Large (big fluffy particles)
  • Medium
  • Small
  • Very Small

As the LDL particle size decreases the particles become more dense, (and more dangerous). This is because the large fluffy particles can’t lodge in your artery walls as plaque, while smaller dense LDLs CAN!

High fat diets tend to increase the large fluffy LDL particles, while low-fat high carbohydrate diets increase the smaller more dense particles.

From this you can see why the standard medical advice about how we should eat to avoid heart disease is seriously flawed! It was all based on an oversimplified and outmoded concept of the nature of cholesterol particles.

Typical cholesterol tests can’t differentiate between large and small LDL particles. There are also genetic, environmental, and lifestyle factors that affect LDL particle size.

Enter “Ion Mobility Analysis”

Using ion mobility analysis, Dr. Krauss and his colleagues determined that there are some 11 different particles. This was done using a sample of 4,600 healthy men and women volunteers.

Eight percent of the test subjects went on to develop heart disease, and using statistical algorithms the researchers developed a series of three very accurate predictors for who would go on to develop heart disease.

Here are the correlations that Dr. Kraus’s team found:

    1. High levels of small and medium LDL particles with low HDL (called atherogenic lipoprotein phenotype) Also known as pattern B
    2. Low HDL levels
    3. High total LDL cholesterol

So as it turns out LDL cholesterol and the risk of heart disease is a complex relationship that standard cholesterol tests are almost useless to predict.

The PLAC Test

There is one test however that can give you a better idea of what your risk is. You can read about it in my article called “The PLAC Test.” This is the latest test that really utilizes our new knowledge of LDL to make more accurate predictions about what your real risk for heart disease is.

Using this test you can make better choices about lifestyle and diet, because they are based upon a more complete understanding of the science of cholesterol particles.

The MTHFR gene is a hidden culprit in heart disease and explains much in the reasons why cholesterol numbers don’t tell you what your real risk for heart disease is. Understanding how this gene defect affects your good cholesterol levels and how to treat it is essential to protecting yourself from heart attacks.

MTHFR geneWhat is the MTHFR Gene?

This gene is responsible for operating what are called “methylation pathways” that involve your body’s ability to convert certain substances into their reduced or active form. If this gene is defective in your body, these vitally important methylation processes cannot be completed properly, and certain substances (vitamins and amino acids) can’t be absorbed by your body and you develop deficiencies.

Some of these substances are:

  • vitamin b-12
  • folic acid
  • cystiene

In the case of b-12 and folic acid, these substances are converted to their active forms of methylfolate and methylcobalamin. These active forms are what your body can actually use, and so if you can’t convert them properly, you end up with a deficiency.

Cystiene is converted to the toxic amino acid homocysteine and then to methionine. If your methylation pathways are not working properly due to the MTHFR gene defect, then you end up with an accumulation of homocystiene which is highly inflammatory and causes damage to your arteries.

How is Your Good Cholesterol Level Affected?

HDL-C also called the “good cholesterol,” can be effectively lowered by a certain type of MTHFR gene defect called: C677T polymorphism.  Since HDL is protective and lowers your risk of heart disease, this gene defect can raise your risk by lowering your good cholesterol level.

There are several variants of this gene defect, and they affect cardiovascular risk in different ways, but it’s important to be aware of their impact so that you can protect yourself. Remember that 50% of heart attacks occur in people who have what’s considered normal cholesterol levels.

The affect of the MTHFR gene is seen by many researchers as the missing piece of the puzzle in trying to determine why this is so. With this information you can go about protecting yourself by applying this new knowledge and lowering your risk not only for heart disease, but also for other chronic diseases that are caused by inflammation.

What Other Problems Can This Lead To?

A defect in the MTHFR gene can also result in increase risk for the following diseases:

  • Cancer
  • Stroke
  • Fibromyalgia
  • Polyneuropathy

How Do You Know if You Have it?

This is a very important question, because once you detect this, then you can guard against it’s effects. The most simple test you can do is to eat asparagus and note if your urine has a strong odor in the hours following your meal.

If this odor is present when you urinate, (you can’t miss it), then you can be sure that you do in fact have a defect (called a polymorphism) in the way your MTHFR gene operates. There are also lab tests that your doctor can do to detect this problem.
It may be necessary to have formal lab tests done so that this problem can be medically verified. It’s also important because your doctor has to order it for your insurance to cover it. The best and most responsible advice I can give you is to go through your doctor and get tested for this.

Fortunately there are ways to treat this problem, that will work and help to protect your health, but of course the first step is to determine whether you have it or not, and your doctor can order the tests to confirm it.

What Can I Do?

A defect in the MTHFR gene results in failure to operate certain methylation pathways and convert amino acids properly. However, forms of critical b-vitamins, vitamin B-12, and Folic acid, in their “active” forms, which means they do not have to be converted or methylated, CAN be absorbed by your body and help ensure these critical chemical reactions happen as they are supposed to.

Thus instead of taking folic acid, you would take “methyl-folate.” Instead of taking vitamin B-12 (cyanocobalamin) you would take “methylcobalamin.”

There are other substances that can help. They are called “methyl donors” because they donate or provide what’s called a “methyl group” to help the chemical reaction complete properly. There are foods that contain “methyl donors,” such as garlic, onions, avocadoes, ect.

There are also nutritional supplements such as trimethylglycine, and SAMe, as well as special formulations that contain combinations of these methyl donors to help provide what your body needs to do these conversions properly.

None of these substances are drugs, nor are they prohibitively expensive. However, most mainstream doctors do not know about them, nor about defects in the MTHFR gene, and so you may have to search for a physician that is up on the latest genetic research, that can help you safely manage this problem.

The website I recommend is:

http://mthfr.net/

which is a website run by Dr. Benjamin Lynch. There is a wealth of information on this website regarding methylation issues and the MTHFR gene. If you have this gene defect, I would highly recommend that you visit this website and educate yourself.

You can also click on this video:

to learn more about this topic, and start arming yourself with powerful information that will allow you to protect yourself against heart disease, cancer, strokes, Alzheimers, and other effects of methylation problems.

My reasons for delving into this topic is that it fills in the missing information that cholesterol numbers leave out. The effects of this gene defect on your good cholesterol level is probably one of the main reasons for the increased risk of heart disease.

Defects in the MTHFR gene are one of the most significant drivers of chronic disease, and by knowing if you carry this defect, you can takes very strong steps to protect your health and to live better and longer.

references:

Cardiovasc Diabetol. 2012 Oct 8;11:123. doi: 10.1186/1475-2840-11-123.
Several genetic polymorphisms interact with overweight/obesity to influence serum lipid levels.

J Atheroscler Thromb. 2009;16(6):815-20. Epub 2010 Jan 9.
Association of C677T polymorphism in MTHFR gene, high homocysteine and low HDL cholesterol plasma values in heterozygous familial hypercholesterolemia.

J Hum Genet. 2001;46(9):506-10.
An association of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and common carotid atherosclerosis.

 

A home cholesterol test is one way that you can begin taking more responsibility for your health, and understanding just how your diet and lifestyle affect your cholesterol values. A cholesterol blood test will determine if you have normal cholesterol levels, and if not, the cholesterol test results can be read and further interpreted by your doctor.

Testing in a home environment is just not as accurate as the tests performed in your doctor’s office. Home test kits are just not engineered to replace a full diagnostic lab, but they don’t have to. These tests are meant to help you keep track of your cholesterol values, and make adjustments to your diet and lifestyle when you need to.

Caution: Never substitute a home cholesterol test, or home testing (of any kind) for proper diagnosis and treatment from your doctor. Your physician can measure cholesterol levels much more precisely using lab tests that you can with a home test, so the lab work your doctor orders on your blood samples is the most accurate and best way to establish what your levels really are.

Home tests help you keep track of markers like cholesterol or blood sugar, but they are not meant to be substitutes for a proper medical test or diagnosis!

You need to be tested by your doctor to establish what is called a “baseline,” and once you know what this is, then home testing can tell you whether your levels are going up or down. These measurements are “relative” and their real value is helping you to track how your cholesterol levels are responding to diet and exercise.

Although the home cholesterol test is fairly accurate, it should be calibrated with the cholesterol blood test that you have in your doctor’s office. Take your home test kit with you and test yourself at the same time your doctor draws your blood for the full laboratory test.

That way you can see how the results of the two tests differ, and will be able to get an idea of just how far off the cholesterol test results are between the cholesterol blood test you get in the doctor’s office and the home cholesterol test.

When you buy online, read reviews carefully, do a little research into the product you are buying. Some of these cholesterol testing systems are expensive (over $100.00) dollars, require you to buy a testing unit, and additional test strips for it. This can run well over $100.00 for both.

Obviously you would not use a home cholesterol test as often as you would use a glucose monitor for instance. You are merely trying to track your normal cholesterol levels, and see how they respond to changes you make in your diet and lifestyle.

Here are some brands:

  •     CholesTrak, Home Access Instant Cholesterol Test
  •     Cardio Check (gives you both HDL and LDL level)
  •     Lifestream Personal Cholesterol Monitor (give you both HDL and LDL)

“Cardio Check” seemed to have by far the highest customer satisfaction ratings online.

A home cholesterol test should can run between $10.00 and $150.00 depending on how comprehensive the test is. Some tests only give you total cholesterol, which is not a very useful indicator. It may tell you how your total cholesterol levels is responding to diet or exercise, but it does not indicate real risk factors.

For that you need to know your HDL level, and a test that gives you both LDL and HDL levels will give you the information to assess risk factors more clearly. When you know both your LDL and HDL levels, you can calculate total cholesterol, as well as HDL/LDL ratio which is the best cholesterol values which indicate your heart disease risk.

The home cholesterol test to look for is one that at least gives you both HDL and LDL levels. These should run you about $30-$50 and are available online. Again you will have to check it for accuracy against the cholesterol blood test from your doctor, but if it gives you a somewhat reliable indicator of your cholesterol values, then it’s doing it’s job.