101: A Functional Approach to Understanding Key Cardio Lab Markers
It’s February and the month we focus on heart health. Ironically, I got my blood lab results and I am a prime candidate for a statin by conventional standards. My total cholesterol is high, my LDL is high, my homocysteine (an inflammatory marker is high) and, yet, I’m not worried. I know not to take these numbers at face value without applying context.
In this week’s podcast we’re talking about using a functional approach to understanding key cardio lab markers. Listen in as we discuss optimal ranges for heart health and all of the things to consider before jumping to a prescription.
EPISODE 101: A Functional Approach to Understanding Key Cardio Lab Markers
SHOW NOTES
(0:00) Intro
Happy Valentine’s Day - I hope your home is full of love today and that you remember that we love because God first loved us.
Heart Health Month
Nutritional Blood Chemistry
A reminder that there is still a lot of misinformation out there.
Ran a blood panel on myself:
I had what would be considered high cholesterol (216), high LDL (138) and high homocysteine - in conventional terms - this would look like a big ol mess to my regular doctor and probably make me a candidate for a statin.
Now luckily, I understand context around these markers and that’s what I hope to offer you today. So we can use me as an example as we walk through some of these numbers.
(6:59) Understanding lab ranges:
Lab ranges vary from lab to lab, region to region and are typically based on the average health of the region’s population.
Lab ranges aren’t necessarily based on optimal health, they are based on the statistical average or norm of where most people fall.
Most people are eating a Standard American Diet full of processed foods, sugar and inflammatory oils, and are not living in optimal health yet they fall within a “normal” range because, sadly, suboptimal health has become the norm.
A Functional Lab range is different and that’s what I am learning to use.
Functional ranges are based on a combination of current research, what reflects truly optimal health and normal ranges from 30-40 years ago when people were healthier than they are today.
(10:53) Waist to Height Ratio: below .5
First thing I want to start with is not actually a lab marker but a free, external measurement that you can do at home and that can tell you a lot about your health risk. And that is waist to height ratio.
Divide the number of inches of your waist by the number of inches of your height.
You want that number to be below .5
If it is more than half, you are at a greater risk for insulin resistance, obesity and cardiovascular disease.
Several studies have found that waist to height ratio is a more valid measurement than BMI.
BMI overestimates fat in muscular people and cannot give information about fat distribution.
Whereas WHtR is a better assessment for central fat, around your middle, which has greater associated health risks than fat stored in other parts of the body.
(13:05) Hemoglobin A1c: Functional Range: 4.1% - 5.4%
Why? What does that have to do with heart health?
Research shows that higher HbA1c levels are linked with a higher risk of heart disease. It gives a good picture of the way your body handles or doesn’t handle sugar.
Fasting glucose is often a marker we see on labs, but that is more of a snapshot of your glucose levels at the time of the blood draw whereas your HbA1c provides more of an average over the previous few months. Together they complement each other for a better bigger picture but you want to really watch that the HbA1c is kept in an optimal range of 4.1% - 5.4%.
An elevated HbA1c can be an indicator of insulin resistance or diabetes.
(17:02) CHOL/HDL Ratio: Less than 3
The Truth About Cholesterol with Carly Stagg
My total cholesterol is 217 which is considered a little high by conventional standards. A few years ago my total cholesterol was 250 something - definitely way high by conventional standards - which considers anything over 200 to be high.
A functional total cholesterol range for anyone under 60 would be 120-240. But a functional range for a woman over 60 would be 200-300. Interesting right?
Put Your Heart in Your Mouth by Dr Natasha Campbell McBride
Cholesterol is protective as we age and one major thing it’s important for is our brain health.
Dr Campbell McBride describes our brains as cholesterol hungry as it uses about 25% of our body’s cholesterol. Now what happens to a brain when there is not enough cholesterol - memory loss, degenerative disease and Alzheimers. There’s also a link between low cholesterol and Parkinson’s disease. The goal is not to get your cholesterol as low as you can.
Low cholesterol l is dangerous to the body - it contributes to MS, aggressive behavior, poor hormonal function - we need cholesterol to make hormones. Also we need cholesterol to make our stress hormones. We need cholesterol.
Most of our cholesterol is made by our bodies in the liver, the intestines, as well as the ovaries, the muscles, the adrenals, and skin.
Every single cell in the body is able to produce cholesterol and we make 60-80% of our own cholesterol. The rest comes from diet and intestinal absorption.
(21:46) Triglycerides: 50-100
90% of triglycerides are taken from the diet.
Excess triglycerides that are not used as energy - and two big users of this energy are the heart and skeletal muscle - but the excess not used as energy is stored in the adipose tissue (your fat tissue).
When it comes to triglycerides you want, again, keep those carbs in check and avoid the inflammatory oils.
From a functional standpoint we want to keep Triglycerides between 50-100. A standard range allows it to go up to 150 but we want to keep that a little tighter for optimal health.
Nutritional Considerations:
Refined/processed carbohydrates
Vegetable/seed oils
Poor metabolism of fats
Biliary Stasis: cholesterol may not be eliminating well due to poor bile flow.
(23:25) LDL & HDL:
Now let’s talk about LDL and HDL the “bad and good” cholesterol.
LDL is the protein carrier that moves cholesterol and triglycerides from the liver to the cells - the triglycerides are used for fuel, the cholesterol is used as repair material.
It’s not the LDL itself that is the problem. The question is why is the LDL being mobilized?
If you’re on a ketogenic diet you may have higher LDLs because the body is mobilizing more fat to be used as fuel.
If you have inflammation in your arterial walls, cholesterol may be mobilized to help soothe and patch them up.
When cells are damaged, they require cholesterol and fats to repair themselves.
HDL has the opposite job of LDL - it takes cholesterol from your tissues back to the liver - kind of back to home base.
The reason it’s considered the “good” one is because cholesterol is not going TO your cells it’s leaving your cells and traveling back to the liver.
LDL and HDL are not in and of themselves good or bad.
A person with active inflammation is likely going to have higher levels of LDL because the body is taking cholesterol there to repair it.
Things that can be causing this fire in the body are:
A diet high in refined carbs or vegetable oils, liver dysfunction, hypothyroidism, oxidative stress, gut dysbiosis or a gut infection, environmental toxins and chemicals, to name a few.
(27:31) Statins:
Unfortunately, a statin is often prescribed where there is a high LDL number but a statin is not addressing the fire.
Why would we use a statin as a first line of defense without addressing the things that could be driving up the LDL?
Reducing the body’s ability to get cholesterol to the cells generally limits the amount of helpful cholesterol that our body needs to optimally function.
Statins deplete the body of C0Q10 which is an important antioxidant that actually helps maintain the normal oxidative state of LDLs and is a super important to the heart muscle.
CoQ10 and other antioxidants help protect us from these free radicals that cause oxidative stress but statins deplete that which is not helpful and doesn’t make a lot of sense.
LDL-P (particle number) measures how many particles are floating around in your bloodstream and studies have shown that LDL-P more accurately predicts risk of cardiovascular disease than LDL-C.
Functional ranges for:
LDL: 40 - 120 (mine came in at a lovely 138)
Over age 60: 120 - 170
HDL: Female: 65 - 85 Male: 55 - 75
As I said earlier, total cholesterol is not all that helpful. But some lab panels will assess your total CHOL/HDL The higher the ratio the greater the risk of Coronary Heart Disease.
Functional Ratio: Less than 3. The standard ratio is less than <4.4.
(33:45) High Sensitivity C-Reactive Protein (CRP): <1
This is an inflammation marker that will help determine if inflammation is putting you at a higher cardiovascular risk. C Reactive Protein is synthesized in the liver and elevates in response to infections, inflammatory conditions and trauma.
<1 = very low risk
1-3 = increased risk
3-10 = advanced risk
(36:28) Homocysteine: 4-7 (mine was 9)
Homocysteine is an amino acid normally present in very small amounts in the blood. When it’s elevated, it leads to inflammation in the blood vessels.
Certain B vitamins help break down homocysteine and if there is a deficiency in these vitamins (namely B6, B12, and folate) or if the body can’t effectively utilize those B vitamins, homocysteine will remain in the blood and serum levels will be elevated.
(38:39) MTHFR gene mutation:
MTHFR is an enzyme that we need in this process to convert folate from food into methyl-folate which is the active form our body needs.
Methyl-folate is critical to methylation, which helps to optimize a huge number of processes in the body including the production of DNA, metabolism of hormones, and proper detoxification.
30-60% percent of all people carry an MTHFR gene variant which may lead to low levels of folate and b vitamins and high levels of homocysteine in the blood. Over time, these downstream effects of mutations in the MTHFR gene can put people at higher risk for many common health problems such as preventable heart disease, colon cancer, stroke, Alzheimer’s disease, and more.
If you have an MTHFR gene variant it is recommended to use methylated B vitamins. Before I do that, I’m going to experiment with taking liver capsules and see if that moves the needle at all. That’s what I’ve been using as our family’s main vitamin source.
(44:12) Vitamin D, 25-OH: 50-90 (mine 26)
You want to keep your Vitamin D 25-OH level in a functional range of about 50-90. Interestingly, you need cholesterol to be able to synthesize the Vitamin D you get from the sun. And Vit D helps keep the arteries flexible and healthy and helps prevent the stiffening associated with atherosclerosis.
(46:29) BUN: 10-16 (mine 19)
Blood Urea Nitrogen and is a marker to screen for kidney health. When it is high, it is often a sign of dehydration.
Water is the #1 nutritional deficiency in the US and that water is critical to the very foundational functioning of our bodies.
(47:49) Closing thoughts:
The way that you eat and the way that you drink are always going to have an impact, the biggest impact on your health and we know that we have so much power to change our health and its trajectory with food.
I invite you to join us for Feast 2 Fast® where we really dial this in and learn to eat in a way where real food meets real life.
I’m so excited for this next round because we do it for the entire season of Lent - it’s the only round of Feast 2 Fast that is 6.5 weeks instead of 4. We step it up a little and so extra sugar detoxing and more superfasts, but it’s still the same wonderful real life approach that shows you how to make room for the Heck Yeahs in your life.
(50:46) Outro & Disclaimer
Thanks for listening! Have a healthy and blessed week!