Volume 2 * Number 2

Your Heart: A Very Demanding Organ

When you think about it, your heart is a very demanding organ. It’s also a very essential organ. Your heart beats 60 to 100 times per minute, day after day, decade after decade. It’s incredibly strong and it needs a massive supply of blood on a continuous basis, delivering nutrients including oxygen. When it doesn’t get what it needs, you might experience a form of chest pain called angina. However, while angina is certainly a common symptom of heart disease, it is not the most common first indication that a person has heart trouble.

The most common first indication of heart disease is, well…sudden death.

Many people who develop heart disease never get a chance to complain to their doctor about symptoms like angina. Instead, they present their condition to the coroner. You probably know at least one family that lost a member to a sudden, massive heart attack, sometimes referred to as a "widow maker". Losing a loved one is tragic enough, but somehow the shock of a sudden and unexpected death is often even more difficult for a family to endure.

The Clogging of an Artery

Each year, twelve million people die from vascular disease. That includes vascular blockages to their hearts, their brains, their kidneys, and other vital organs, but it’s all basically the same disease — clogging of the arteries. It’s a common problem and the leading cause of death in America.

Arteries get clogged by a process called atherosclerosis, in which cholesterol plaques build up on the inside linings of the arteries. As the cholesterol plaques grow, the blood flow thru an artery gets restricted. The gradual restriction of blood flow to the heart leads to angina. However, it’s interesting that gradually decreasing blood flow to an area is not what causes the acute event of a heart attack or a stroke. In fact, I’ve seen many patients with a complete blockage of a coronary artery in the heart or a carotid artery in the neck that still had normal function because the body developed alternative pathways for delivering blood flow, called "collateral circulation".

Therefore, the gradual clogging of the arteries certainly causes problems like angina and claudication (pain in the legs with walking), but it does not cause sudden death or acute heart attacks and strokes. Instead, these are from a sudden loss of blood flow caused by a blood clot called a "thrombus", which is usually created at the site of a ruptured cholesterol plaque.

A cholesterol plaque is somewhat like a scab on your skin. Some of them are dry and scaly, while others get a soft tender center that will release gooey stuff if you pick at it. Many cholesterol plaques also have a soft center, so they are now referred to as "vulnerable plaques". When the crusty top of a vulnerable plaque ruptures, it exposes the gooey center, which contains inflammatory compounds which cause the blood to clot, so a thrombus forms. If the thrombus is large enough to block the artery, the tissue supplied by that artery goes into shock . If that artery is feeding a section of heart muscle or brain tissue that does not have collateral flow, the result is a heart attack or stroke.

Because plaques are made of cholesterol, the medical establishment has spent decades blaming cholesterol for vascular disease. However, many victims of vascular disease actually have normal cholesterol. Although high cholesterol certainly is one cause of atherosclerosis, many other factors also contribute to plaque formation, including vulnerable plaque rupture and thrombus formation.

Risk Factors for Vascular Disease

If you want to bring on a heart attack in the most efficient way, you should smoke tobacco. Smoking is far and away the biggest risk factor in heart disease. Number two is probably heredity. If you picked the wrong parents and they both had heart disease, it might be wise to track down that inherited trait and define exactly what it is.

Other well-known risk factors include high cholesterol, diabetes, obesity, high blood pressure, a sedentary lifestyle (i.e. lack of exercise), and stress. However important these are, my goal is to inform you about other risk factors that you may not learn about from mainstream physicians.

Most interesting to me is happiness. I’m serious. Happiness is a major factor in all sorts of health issues. Two of the strongest predictive questions you can ask somebody are: "Are you happy?" and "Do you like your job?"

For example, there are more heart attacks at 9 a.m. on Monday morning than at any other time of the week. Does that mean that the human heart has a little internal clock that tells you when it’s time to have a heart attack? No, of course not. It means that your brain and your thought patterns will resist good health if your life is not arranged in a way that makes you look forward to living. Happiness is extremely important.

Avoid Rust in Your Pipes

I think the most under-tested risk factor for vascular disease iron overload. Unless you are a menstruating female, one of the worst things you can do is take extra iron. No postmenopausal woman - and no men at all - should take iron unless there is clear proof of a deficiency. In fact, if your blood tests show low levels of iron and you’re over 50, you probably should have a colonoscopy to make sure you are not losing blood through your digestive tract.

It is widely recognized that premenopausal, menstruating women have a lower risk of heart disease than either men or postmenopausal women. Many people assume that this is because they are protected by estrogen, but a series of 3 studies from Finland refute this assumption. The first simply showed correlation between ferritin levels (a measure of iron status) and heart disease. Those with the highest ferritins had the most heart disease. The next tracked women who had a partial hysterectomy, which removes the uterus but leaves the ovaries, so these patients should still have estrogen but they no longer dispose of excess iron by bleeding each month, and their risk of heart attack goes up to that of men. The third study showed that if men donate blood three times a year, their risk drops to the level of menstruating females. The fact is, getting rid of excess iron by losing blood every month, not estrogen, is why women have less heart disease than men.

Here’s the ironic (yes, pun intended) part of the whole scenario: A ferritin level costs less than $20 and it costs nothing to treat a mild high-iron condition. Just donate blood. You’ll lose the iron, some trauma patient will be able to live thanks to your donation, and they might even give you cookies and a glass of orange juice. The problem is that few physicians test for high iron levels. I’ve had patients come into my office who have been to several cardiologists, even at famous heart centers, and had untested ferritin levels 3 times the level shown to increase heart risk.

A Classic Case of Resistance

Another cardiac villain is called homocysteine. This is an amino acid that is normal to have in low levels, but can cause heart disease at higher levels. Basically, I think of homocysteine as a little scrub brush that roughs up the inside of the artery, causing plaque to stick there. Dr. Kilmer McCully discovered the damaging potential of homocysteine while investigating the cases of rare children who had died of atherosclerosis before puberty. He discovered a genetic disorder that allowed extremely high levels of homocysteine to accumulate in their blood, and was associated with massive plaque build up.

When Dr. McCully published his findings in 1969, he received a typical reaction from the establishment…he lost his job for refusing to jump on "the cholesterol bandwagon". Mind you, he wasn’t saying that homocysteine was the only cause of heart disease. He was merely saying (and has continued saying for 30 years) that cholesterol by itself is not the only cause of heart problems. His information was finally published in JAMA in 1998 and now he has a best-selling book, but only after 3 decades of toiling away in obscurity due to irrational resistance to his new concept. As with most breakthrough medical discoveries, Dr. McCully’s findings were first ignored, then ridiculed, then persecuted, and finally accepted as the establishment’s own. Think of the amount of medical knowledge that has been smothered over the years by this "status quo" approach. More to the point, think of the people who died needlessly from heart disease simply because physicians did not have the latest information on homocysteine and other risk factors.

One last thing about excess homocysteine: You can either inherit it or you can develop the condition from a deficiency of folate, B6, and B12. One theory is that increased use of multivitamins that contain these B vitamins is one of the main reasons that heart disease has been decreasing in this country for the last 20 years.

A Stealth Bomb in Your Arteries

The next risk factor is an evil cousin of the LDL "bad" cholesterol. It goes by the name of Lipoprotein-a or Lp(a). It seems to have a bad influence on LDL cholesterol, sticking to it and causing it to create plaques more easily. When you hear of a person who has a strong family history of heart disease, even though their cholesterol is normal, Lp(a) is often the culprit.

The are several problems in dealing with Lp(a). The first is that the lab testing has not been completely standardized yet, so many physicians are reluctant to even test for it. The next problem is that there are no prescription drugs out there that can treat Lp(a), so the pharmaceutical companies are not interested in educating physicians about it. The last problem is that the only proven remedies are all natural compounds, including CoQ-10, Niacin, Vitamin C, and two amino acids called L-Lysine and L-Proline, but all of these combined will usually only drop the levels of Lp(a) by 25-40%. Unfortunately, there is a lack of well-funded research on this particular risk factor.

I tested a patient not long ago who had an extremely high level of Lp(a)…about four times the normal level. She had some vague chest pains, so I sent her (with her lab value) to a local cardiologist to be evaluated. He sent me back a letter saying that this patient had "no known risk factors for heart disease"…even though Lp(a) has been widely recognized for 10 years as a major risk factor and has been on the front page of 4 medical journals in the last year. I sent the good doctor copies of the journal articles and never heard back from him.

A Commonly Overlooked, but Deadly Risk Factor

There is another sneaky risk factor that is commonly overlooked: Chronic infection and inflammation. It has been well documented that the inflammation that often accompanies chronic infection is a contributing factor in causing heart attacks. You see, when the inflammatory proteins in your bloodstream increase, so does the stickiness of the cholesterol that is trying to attach itself to your arterial walls, increasing the tendency to form a thrombus.

A couple of chronic infections have been definitely linked to this, including gingivitis (gum infection), H. pylori infection in the stomach, and Mycoplasma infection, which causes "walking pneumonia", chronic bronchitis, and chronic sinusitis.

To understand how this works, we must first ask why cholesterol sticks to the walls of blood vessels in the first place. The cholesterol plaque may be initiated by a small spot of inflammation, by infection, by turbulence, by homocysteine, or by other factors not yet known. It’s not just the cholesterol causing the heart disease. Cholesterol may be more like a rescue squad that comes in and tries to patch up the problem. One initiating factor is inflammation, which attracts the cholesterol to stick to the blood vessel wall, much like a "band aid" covers a wound.

We measure the degree of inflammation in the bloodstream with a simple blood test called a "C-Reactive Protein". If the CRP is elevated, we then investigate the possible sources of inflammation.

How to Create a Diabetic

Insulin resistance is one risk factor that is near and dear to my heart, because it’s one that you can do something about yourself. Basically, if you look at somebody and their waist is bigger than their hips, it’s very likely that they have insulin resistance. This condition, which is a precursor for type-II or adult-onset diabetes, is appallingly common in the United States.

Let me explain how to create an adult-onset diabetic. For our purposes here, we’ll call this person "Johnny." Unless Johnny has a very obese or sugar-addicted mother, he will probably be born normal in terms of insulin function. Over the years, though, Johnny and his family eat cereal for breakfast every morning and pack a sandwich, chips, and cupcake for lunch. For dinner they may get a cheeseburger, fries, and a fried apple pie. On some days they’ll make that pizza with a big dish of ice cream for dessert.

All of those foods, in addition to containing very unhealthy fats, have a lot of sugar and starch. Starch turns into sugar in the belly. All that sugar causes the blood sugar to rise dramatically. This is dangerous because sugar hooks onto proteins throughout the body and gums them up, similar to the way we make caramel. This eventually kills small capillaries and nerves, which affects just about everything. Untreated diabetics often have eye problems, impotency, amputations, and kidney problems, as well as increased rates of heart attacks and strokes.

So, if Johnny is healthy, his body will control blood sugar levels very strictly. How does it do that? By releasing insulin. Insulin is a hormone released from the pancreas into the bloodstream to bring sugar levels down. But what happens to the sugar? Well, if Johnny is an active lad and spends his time running around and playing hard, he can burn the sugar up as energy. If he is idle–perhaps he prefers to sit in front of his video game for a few hours after eating–that sugar is going to be stored as fat, because one of insulin’s jobs is to convert sugar into fat. Changing sugar into fat is how insulin controls our sugar levels.

What do you suppose is going to happen to Johnny if he keeps eating in a manner that causes huge insulin surges, three to five times a day, day after day, decade after decade? In addition to storing lots of fat, his cells will become desensitized and then resistant to the message of insulin, just as your nose does to a strong scent if you stay in a room long enough. Then, his insulin level will have to go up in order to continue to control his blood sugar level. That’s the essence of insulin resistance. Eventually, his pancreas will fatigue, his blood sugar will rise, and he will get labeled a diabetic.

Would You Believe a 100% Cure?

How fast this happens to one’s cells is somewhat dependent upon family history, but is much more influenced by diet and exercise habits. Diabetes in this country has risen 300% in just fifteen years, but our genetics haven’t changed…at least not nearly to that degree. Diabetes is definitely a dietary disease. Native people–Southwestern Native Americans, Australian Aborigines, and Eskimos–who are put on a typical American high-carbohydrate diet develop diabetes at the rate of up to 80%. However, when put back on their native diet, they have had up to a 100% cure rate. That alone should tell us something important about the way to treat adult onset diabetes.

To check for insulin resistance, we measure a simple fasting insulin level. Treatment is based upon an exercise program combined with an adequate-protein, high-fiber, low-sugar, and healthy-fat nutritional program. I’ve seen at least 50% of Type-II diabetics get off of either their insulin shots or their diabetic medications if they’re willing to do the program.

Conclusion

Vascular disease odes not always give us the luxury of a warning. The first hint can often be a disaster. Many risk factors are not only identifiable, but also treatable. Please don’t wait for symptoms. Instead, consider having your risk factors measured and then take preventative steps to modify them, including a rational and appropriate nutritional and exercise program. And perhaps most importantly, be sure to enjoy the life you choose.