The leading metabolic syndromes are a cluster of conditions which can present individually or in combination, increasing the risk of heart disease, diabetes, and stroke. The leading metabolic conditions which can increase risk include abnormal cholesterol or triglyceride levels, elevated blood sugars, increased blood pressure, and excess body fat around the waist.
Baseline labs we run on new patients and as part of an annual review may include: CBC, CMP, HgA1c, Lipids, CRPhs, Insulin
- CBC– A complete blood count observes healthy red and white blood cell counts
- CMP– A comprehensive metabolic panel describes our fasting glucose, kidney function, liver function, and electrolytes. Elevated liver enzymes may be an indicator of nonalcoholic fatty liver disease and often a good indicator of possible pre-diabetes. Elevated glucose is a warning of diabetes and insulin resistance.
- HgA1c– This blood marker represents the average blood sugar over a 3 month period. This marker elevates late in the disease process of diabetes and is thus a marker for a prolonged history of insulin resistance. Intermittent fasting over a 3 month period is likely to positively improve this lab.
- Lipids– A lipid panel provides evidence that triglycerides and LDL cholesterol(bad guys), both of which are found to increase diabetes, stroke, and heart disease risk, can reduce in time with intermittent fasting.
- CRPhs– C-reactive protein high sensitivity measures non-specific inflammation that is present in the body. Any weight loss as a result of fasting will reduce inflammation generally and can be tracked over the following weeks and months.
- Insulin– Insulin should be very low on a fasting blood test. An elevated insulin level on blood tests is a sure sign of insulin resistance, which appears many years before diabetes is ever diagnosed. This is the most important lab to run as chronic elevation leads to increased risk and progress of many serious diseases. Fasting can greatly improve insulin in a short few weeks.
Heart Disease and Stroke Risk
Heart attack and stroke combined are the leading cause of death in the United States. Standard labs and tests do not give enough warning to the potential occurrence of such attacks. It becomes imperative for every patient to utilize specialty labs and advanced tests to determine risk, in order to decrease risk of such attacks.
Cardiovascular facts and figures:
- Cardiovascular Disease is the number one killer in the U.S. for both men and women.
- One in 2.6 female deaths are from Cardiovascular Disease, while one in 30 are from breast cancer.
- Cardiovascular Diseases are directly or indirectly responsible for approximately 1,000,000 deaths in the U.S. each year.
- Nearly 2,500 Americans die of Cardiovascular Disease each day, one death every 35 seconds, more than the deaths caused by all forms of cancer.
- Cardiovascular Disease claims more lives each year than the next four leading causes of death combined.
- 1,300,000 Americans are expected to have a new or recurrent heart attack this year.
- Heart Disease and stroke account for almost six million hospitalizations each year.
- 333,000 coronary heart disease deaths occur out-of-hospital or in-hospital emergency departments annually.
- 50 percent of men and 64 percent of women who died suddenly of CHD had no previous symptoms of this disease.
- Each year over 400,000 people die of heart disease before reaching a hospital.
- 40 to 50 percent of all heart attack patients have a “normal” cholesterol or lipid profile.
- 71,300,000 American adults have one or more types of cardiovascular disease.
- Most heart attacks and strokes are preventable.
The following specialty labs and advanced tests will help your physician at East Valley Naturopathic Doctors determine your true risk and diminish the likelihood of experiencing a heart attack or stroke. Once both test results are received in the office, your doctor will recommend a follow up visit to discuss the findings and your individual treatment plan to decrease your risk for potential and sudden vascular attacks
The first step is to measure the values and ratios for cholesterol including LDL or “bad” cholesterol, HDL or ”good” cholesterol, total cholesterol, and triglycerides. Younger patients with good genetics can have a normal cholesterol or lipid panel. Lifestyle habits such as avoiding processed or animal based fats, regular exercise, fasting, and low carbohydrate diets can also contribute to positive lab values. Poor genetics, inactivity, processed or fried fats, high carbohydrate diet, and animal sourced proteins, will poorly contribute to elevations in LDL cholesterol and triglycerides. These lab values are collected as part of a fasting lab set annually and for all new patients. If these lab values are not favorable, then dietary and lifestyle recommendations will be attempted to modify individual risk factors.
After attempting to modify your individual lipid profile without sufficient success, the second step is to draw blood for an advanced cholesterol profile. An advanced cholesterol profile is an even more comprehensive blood lipid profile that determines the size and presence of the various lipoproteins that make up the total LDL and HDL cholesterol. The size or variations of the LDL and HDL particles are more valuable measures of risk than the total number measured. As an example, the smaller the LDL, the more likely it will invade the arterial wall and increase plaque formation increasing heart disease and stroke risk. More specifically, the advanced lipid panel evaluates the presence of LDL type III and LDL type IV, the smallest LDL particles, to determine if they are contributing to atherosclerosis(plaque build up). Another marker often measured in advanced lipid panels includes Lipoprotein(a), a direct cause of plaque growth and plaque rupture that can cause heart attacks. Other tests included in the panel or in addition, which are helpful to evaluate risk and determine best treatments, include C-reactive protein(inflammation marker), homocysteine(methylation marker), and insulin(diabetes marker). These are not accounted for on the standard cholesterol panels or most annual lab sets.
The benefits of the advanced lipid profile help us evaluate the evidence of positive ratios even in the presence of elevated “bad” cholesterol. If this is the case no treatment or medication is required. If upon finding abnormal values that are known to contribute risk, a natural approach toward heart disease can be considered to improve the cholesterol ratios and be both easily and accurately monitored over time.
Treatment for cardiovascular prevention can often be best done naturally. The current use of Statin drugs have been linked to both cancer and dementia. Studies being done at the University of Southern California have shown an association to the onset of dementia and statin use. The support increases in this theory, as patients with dementia stop statins, the dementia improves. In addition, studies over a 30 year period with patients using statin prescriptions, show only a negligible benefit. Not enough to outway the potential negative outcomes or the lifetime expense.
Naturopathic medicine goes to the root of the problem with natural alternatives to modulate cholesterol without the risk. If plaque is already present, therapies are able to stop and even reduce the presence of plaque. The use of chelation IV therapy is gaining popularity and research is starting to show it’s amazing benefits for the reversal and treatment of cardiovascular disease and soon diabetes.
Diabetes and Pre-diabetes
Diabetes is on the rise in the United States. Prevalence: In 2018, 34.2 million Americans(up from 24 million in 2008), or 10.5% of the population, had diabetes. Even more alarming is that of the 34.2 million adults with diabetes, 26.8 million were diagnosed, and 7.3 million were undiagnosed.
In addition to the number of people diagnosed with diabetes, there are approximately 57 million people in the United States with pre-diabetes. This condition causes an increased risk for developing diabetes, and often these people do not even know about their risk. Pre-diabetes involves difficulty regulating blood sugar, with mild glucose elevations beyond the normal levels, but not at diabetic ranges. For people with pre-diabetes, the hormones that control blood sugar will often be out of balance. Insulin is one of these hormones; it helps to bring glucose out of the blood and into the cells to be used for energy. In people with pre-diabetes, insulin often has difficulty driving blood sugar into the cells, a condition called insulin resistance. This will then lead to elevations of blood glucose, which can develop into diabetes.
Warning signs of diabetes include fatigue, increased thirst, increased hunger, tingling or numbness of hands or feet, and blurry vision. People with type I diabetes have insufficient insulin production; this type of diabetes usually begins in childhood, and will typically cause sudden weight loss over a few weeks. Type II diabetics will have weight gain due to increased fat conversion from the rising and circulating blood sugar, and a decrease in fat breakdown as a result of the elevated insulin.
Because of the increase in diabetes prevalence, the American Diabetes Association (ADA) has recently released new recommendations for the prevention of diabetes. The ADA now advises that all overweight people over the age of 45 should be screened for diabetes. People with two or more risk factors for diabetes should be tested for this disease, regardless of whether the person has symptoms of diabetes. The American Academy of Family Physicians recommends that people with high cholesterol and high blood pressure are screened for type 2 diabetes as well.
Diabetes risk factors include obesity, high cholesterol, high blood pressure, a sedentary lifestyle, and a family history of diabetes. Obesity centralized around the abdomen is associated with elevated risk of diabetes. Women who have had gestational diabetes have about a 40% chance of developing diabetes after the pregnancy. There also is a genetic association with diabetes for people of Native American, Hispanic, or African American descent. People also have greater risk as they age, with increased occurrence of diabetes after the age of 60.
For people with multiple risk factors, including obesity, metformin may be considered in addition to diet and exercise. Metformin is a medication which helps to decrease glucose production by the liver, and also may improve insulin sensitivity. With proper dietary changes and consistent exercise, medications are often not necessary to reverse the risk of developing diabetes. A few lifestyle changes can significantly impact your diabetes risk. In a study by the National Institutes of Health, 3,234 people with pre-diabetes were given either metformin, or specific dietary and exercise recommendations. The people in the diet and exercise group lost an average of 15 pounds, and reduced their risk of diabetes by 58%. The metformin group had a reduced risk of 31%. Diet and lifestyle always trump prescription medications.
You can reduce your risk of diabetes by following these guidelines:
- Begin a program of intermittent or regular multi-day fasting
- Limit dietary consumption of refined sugar, white flour, pasta, and processed foods to less than 100gm/day
- Exercise regularly, for at least 30 minutes per day, with walking being sufficient.
- Get a diabetes screen from your doctor including cholesterol testing and a blood pressure check; if you are overweight but have not had high blood sugar on previous tests, ask for a pre-diabetes screen of insulin resistance and glucose tolerance.
If these recommendations for reducing your risk of diabetes seem overwhelming, start with one change at a time and commit to that change until it becomes a normal part of your lifestyle. Work with your doctor to determine the most effective way to reduce your risk and improve your overall health. Your doctor can be an advocate and a coach in helping you to achieve your health goals.