Metabolic Derangement. Part 1: First sign of heart disease can be death.

Posted on October 21, 2018 by Dr. G

Do you have a medical history or family history of heart disease?

The first installment of what will be a several part series on metabolic derangement.

What is metabolic derangement?

As a chiropractor with advanced training in neurology and functional medicine, I help my patients remove all forms of interference with optimal nervous system function,  I have particular interest in metabolic derangement. Metabolic derangement is any condition of lifestyle, genetics or environment that will alter blood chemistry to the point that the nervous system is not able to function optimally.  Heart disease is just one form of metabolic derangement.  

If you’ve worked with me you may have heard me say, your brain is 2% of your body weight yet it uses nearly ⅓ of your fuel (oxygen, glucose, etc.).  Since the brain is the central processing unit of the nervous system, its blood delivery must be efficient and uninterrupted. Therefore cardiovascular health is of great importance.  How well the heart can deliver nutrition and oxygen to your brain which has the smallest blood vessels in the body that are most susceptible to the effects of blood vessel disease. I don’t know how many brain MRI’s I have seen over the years where the evidence of small vessel disease is right there on the images.  It’s so common that the readiologists often gloss over it as an incidental finding stated as ‘white matter changes’ in the body of the report.  

“The Nervous System is the master system, it control all other systems in the body”

Please be aware that I am NOT a cardiologist, nor do I play one on the internet.  Much of the information in this article is attributable to the education I have received from www.PeterAtillaMD.com .  Peter Atilla has been able to make much of this information explainable to patients and colleagues alike. My recent relatively deep dive into this subject in recent years has made me aware that just 5 or 10 years ago the handful of people who knew the most about this subject (lipidologists and many cardiologists) have dramatically altered what was thought to be true based on the research.  Physicians are often kept abreast of limited research that is presented to them by drug company representatives. Drug companies are likely to provide research most relevant to their type of intervention.

Yet my patients present to the office with recommendations and prescriptions for medications that are based on what was being said when I started studying this material in 1992.  A routine lipid panel, Total cholesterol, HDL (good), LDL (bad), and Triglycerides. And according to Dr. Peter Atilla, a routine lipid panel like that tells you as much about heart disease as your eye color.  

I also get a lot of patients who are attracted to alternative medicine who just refuse to “poison themselves with ‘these medications’ that cause more problems than they seem to solve”.  Yet they have had episodes of difficulty breathing climbing up stairs and or radiating symptoms down their arm after exertion.  Some have had a parent who had died of a sudden coronary heart attack. I feel it’s important that we begin this dialogue and I will share what I feel is important to me.

The Facts:

We see stories every day about the increase risk of muscle disease, diabetes and dementia associated with statin drugs.  We see reports that contradict dietary guidelines that we thought were written in stone. We hear that nearly 50% of all heart attacks, have “normal Cholesterol”.  Heart disease is far and away the number one killer of Americans, with Cancer and Neurodegeneration being a distant number 2 & 3.  These are the 3 conditions (and their treatment) that we are all dying of.

We can’t forget the fact that the proper use of medical care is considered one of the top 4 causes of death and we have to remember that the treatment is typically for effects of the 3 mentioned diseases.  So our purpose is to increase our ‘health span’ so that we reduce the need for any form of treatment for chronic disease and optimize our current state of health and performance.

Knowledge  inspires proper action and reduces the need to be fearful.  Hiding from your genetics, your personal & family health history is a form of fear manifesting as procrastination and willful ignorance.  Putting off doing something you know needs to be done, and that ‘something’ does NOT necessarily have to be prescription medication.  

Dispelling myths

Myth: HDL is “good cholesterol”, LDL is “bad cholesterol”.  I will not spend too much time here.  Most of you attracted to my site and office already have a sense of this nonsense.  The human body does not make things that are bad for you. There is ‘appropriate cholesterol’ and ‘appropriate cholesterol’

Myth: LDL cholesterol causes heart disease.  LDL no more causes heart disease than oxygen causes fire.  (I need to attribute this analogy to Peter Atilla MD). Oxygen must be present to have a fire, but oxygen does not cause fire.  LDL must be present to have heart disease but it does not cause heart disease.

Measuring what in the blood does not tell us what’s happening in the wall of the artery.  Looking at blood serum measurements we are inferring risk of what could be happening in the arteries.  Some markers are more telling than others. The least telling markers are the ones people present with when their MD prescribes medication, Total chol, LDL, HDL and triglycerides.

Myth:  Lower LDL is good for your health no matter how low it is.  That’s like saying really low or no oxygen is good for your home, because without oxygen you will not have fire, and your house not burning down is good.  But clearly your home needs oxygen for reasons other than avoiding fire. And the truth is there is very little to no evidence that if LDL was super low, let’s say 10 mg/dl, that this is in any way a problem for your health.  Sure some people will say otherwise but I believe the evidence is that they are wrong. 

Fact:  Dietary cholesterol contributes minimally to serum cholesterol.  Most of you are already aware of this and it’s the reason why eggs are okay to eat.  

Myth:  The liver produces all of our cholesterol.  Cholesterol is so important to every cell and tissue in the human body that each cell is capable to meet its own needs by producing its own cholesterol.  Cells and tissues produce enough on their own to meet their needs. The liver accounts for about 20% of cholesterol production in the body. The liver and GI tract actually account for the clearance of LDL cholesterol out of the circulatory system and into our stool.  

The exceptions to cells meeting their own cholesterol needs is interesting, the cells that need to use cholesterol to make steroid hormones like testosterone, estrogen, cortisol, etc do not necessarily make their own.  The gonads and adrenal cortex. This accounts for dramatic fluctuations in times of extreme stress as seen in injury and infection.

Low LDL can reduce the risk for events associated with coronary and cerebral artery occlusion, but is that the only measure of health?  Clearly cholesterol has other purposes. This is why we find that all cause mortality goes up with very low LDL cholesterol even though coronary events decrease.  

In order to have heart disease and arterial disease known as atherosclerosis you have to have sufficient amounts of the following 3:

1. LDL cholesterol.
2. Oxidation.
3. Inflammation/Immune response.

We need to discuss all three in this series.  

The background information in this article and  this series is important because by gaining knowledge and perspective you are more likely to make appropriate choices and knowing which of your numbers are important will help you track them over time helping you navigate risk.  

We don’t ask you to become a doctor, however we do ask that you become an expert in yourself and what your needs are to express health and optimal performance.  By now you should have far more questions than answers. Stay tuned to this unfolding story.

Please share this article with anyone you feel may want to know more, leave comments or ask questions.  Thank you.