Los Gatos Longevity Institute: Complex Lipid Disorders

Complex Lipid Disorder Management

Is Cholesterol the Culprit?

It started with cholesterol over 25-30 years ago. The ads have been relentless. Avoid eggs and butter. Eat margarine. You know the story.

In fact, recent studies are once again showing that eggs aren't so bad after all. (actually eggs provide a superb source of protein). And even more recently, we are seeing "super eggs" with increased amounts of Vitamin E and high dose DHA for enhanced brain and cardiac function.

So the theory was too simplistic and naive as we well know today: The figure below shows that there were an equal number of people who suffered a heart attack as those who did not suffer the same fate with the same cholesterol at all levels.

fig 1
Cholesterol does not predict Heart Attacks

Thus, the famous Framingham Study did not have the predictive value that we have been led to believe.

What’s going on here?

As with all models of this sort, it turned out to be an incomplete and oversimplified picture. It was also based on the notion that correlation equals causation. A risky assumption. More studies and many more risk factors have recently been identified.

The Latest Picture

We now look at a much more complex picture of cholesterol and lipids (fats or triglycerides), and newer risk factors, in the blood to give a more sophisticated and predictive picture of your cardiovascular health or risk:

Cholesterol- is a participant, not the cause of cardiovascular disease.
HDL - the good lipoprotein that carries cholesterol away from the heart back to the liver. The higher the more protective.
LDL - the bad lipoprotein that carries cholesterol to the heart from the liver. The lower the better.
Triglycerides - neutral fats, elevated by increased carbohydrate intake, which has its own risk consequence.
LDL particle sizing - small heavy dense vs large fluffy particles. This has lead to a new risk profile type called Pattern B or Pattern A. (see below)
LDL and HDL isoforms - both can be fractionated into five separate and more distinct components.

The New 21st Century Risk factor profile

Lp(a) - (lipoprotein a) - a degenerative form of the LDL that aggressively promotes atherosclerosis (hardening of the arteries).
Homocysteine - newer risk factor -- from incomplete conversion of the amino acid homocysteine to methionine that may be irritating to blood vessels. This inflammatory response is a risk for vascular disease.
hsCRP - high sensitivity C-Reactive Protein - a sensitive, but non-specific, measure of inflammation -- showing newer notions of cardiovascular disease as inflammatory in nature. This is much closer to revealing the cause of cardiovascular disease. Remember, cholesterol does not cause heart or vascular disease.
Fibrinogen Levels - as above, the higher the fibrinogen levels the greater likelihood of forming small blood clots that can lead to blocked arteries. Blocked arteries can eventually cause strokes and heart attacks. This may have the most prognostic significance (predictor) of any of above and is least likely to be tested by routine or even "advanced" workups
Lp-PLA₂- (lipoprotein-associated phospholipase A₂) - levels -- the newest and most sophisticated measurement of the effects of this enzyme on oxidized LDL causing the entire cascade that leads to atherosclerotic changes. This is reputed to be one of the first markers for cerebrovascular (stroke) risk and a surrogate for endothelial dysfunction, leading to heart disease.

Look above at LDL particle sizing. There is an increasingly recognized, but infrequently and poorly diagnosed syndrome of high triglycerides and low HDL which is a surrogate marker for these small dense LDL particles. Termed Pattern B or ALP (Atherogenic Lipoprotein). Look at the following illustration. See how these small dense particles "leak" into the vascular wall and the larger LDL particles don't?

This leak is the beginning of atherogenesis, or atherosclerosis -- hardening of the arteries. The end result: high blood pressure and blocked arteries eventually leading to strokes and heart attacks.

Illustration showing why this small dense LDL particle is of so much concern even if the blood level is reported as "normal"
fig 2
Atherogenic Lipoprotein Picture

Why is this important? Because routine testing will not measure any of this. A Normal LDL level might actually be quite dangerous. You need to go to more sophisticated testing and understanding.

This what we here at the Institute offer you -- a more complete look at these very complex issues. And better answers to why you may have problems with difficult to treat hypertension or heart disease.

Conclusion

So the story is a lot more than just Cholesterol. Cells need a certain amount of cholesterol as a lubricant for healthy cell membranes. It is also the biochemical source of all sex, stress and blood pressure regulating steroids --- so that it can’t be all bad.

In fact, some studies have suggested that very low cholesterol levels in men can increase risk of death.

Bottom line: you need the resources and expertise of physicians who fully understand the more complex story of lipids and who have access to more advanced testing methods.

We are now offering one of the most sophisticated, and non-invasive approaches to cardio-vascular problems available anywhere -- from the comprehensive testing as explained above to our unique 4-hour intensive CV Bundle:

Resting EKG -- basics
ECHOcardiogram for ejection fraction -- dynamics
Dual Isotope HeartScan -- regional flow
Treadmill Stress Testing with Met equivalent -- exercise tolerance
Carotid Ultrasound or IMT (intimal media thickness) scans
superfast CT (EBT) HeartScans for coronary artery calcifications

Our Association

We are most excited to serve as a regional lipid disorder center following many of the guidelines of the American Heart Association and in conjunction with one of the best and most accurate labs in the country - Berkeley HeartLabs directed by Dr. Robert Superko. They are clearly in the vanguard of lipid analysis and newer thinking. More recently, we have added the more automated, and cost effective, VAP testing which approximates the gold standard BHL testing. In this ever evolving field of study even SpectraCell Labs, is now planning yet another variant of these tests which looks highly promising.

Using our sophisticated nutritional approach, we at the Los Gatos Longevity Institute can take this to a new dimension of dietary modification along with intensive and targeted and known vitamin co-factors, selected minerals, vital anti-oxidants and phytonutrients.

That’s a lot of information.

So call us for an appointment and we can begin to explain this more thoroughly. It might save your life whether you have known cardiovascular disease, or want to prevent the consequences of this.

Call for a consultation today. It could be the most important thing you've ever done for yourself.