Cholesterol, Just a Number?

By Dr. A. R. Scopelliti

Apr

30

This article is a great find by my office manager Debbie.  It concurs with what I have been saying all along.  If you have high cholesterol or are already on cholesterol lowering drugs, this should be cause for you to do your own research.  Similar information is available at Dr. Mercola’s website, which I have referenced many times in the past.  Readers may intuitively ask why I would be writing so many articles on cholesterol when my specialty is in neurology?  Well, quite honestly two reasons.  The main reason is that heart disease is the leading cause of death in this country.  The second?  Because I too have fallen victim to the “take these cholesterol meds or else…” story.  Cholesterol has become an incredibly hot topic in recent years as well as a financial gravy train for the pharmaceutical companies who manufacture the drugs.  Virtually no one who has been to see a doctor in the last 20 years cannot tell you their cholesterol number as quickly as how many children they have.  However, routine screening exams performed by the vast majority of primary care doctors, are next to useless with respect to predicting heart disease.  They are useful to give you a cholesterol number which will then be used to determine whether or not you will receive a prescription for cholesterol lowering drugs.  If having a low number is your goal, then this is appropriate.  However, if preventing heart disease is your goal, then this formula requires rethinking.  With the number of people taking these drugs, why has the rate of heart disease gone up? One of the main side effect of cholesterol lowering drugs is muscle fatigue and weakness.  Clinically, I hear this all of the time simply from the large number of people taking these drugs.  One must ask the question, isn’t the heart made of muscle?  Again, not sensible.  The first thing that needs to change is our screening process.  The focus of blood work needs to be on inflammatory markers rather than on total cholesterol.  There are several lab panels now available which are much more useful than simple total cholesterol screening.  If you are determined to be at elevated risk, this is most always correctable with diet and exercise.  You should be working with someone skilled specifically in this area, or, your doctor should be working directly with a lipidologist.  If you are currently taking cholesterol lowering drugs, you should not stop taking them without an alternative plan and you should always be working with a trained professional.  As always, there is a multitude of information available on my website fitness and healthy eating pages with respect to health, which is really what we all strive towards, rather than just boasting the lowest “number”.

More on the Metabolic Syndrome

By Dr. A. R. Scopelliti

Apr

3

Metabolic syndrome, (obesity, hypertension, dyslipidemia and hyperglycemia AKA diabetes), remains a concern in regards to increasing health risk within the United States population.  For the first time in recorded history, our current generation is projected to have a shorter life expectancy than the prior generation.  This is a projection from the New England Journal of Medicine in 2005 based on the current epidemic.  And things have only gotten worse since then.  Metabolic syndrome with its associated cardiovascular disease, stroke, blindness, amputations, etc., accounts for the majority of healthcare dollars currently being spent.  Still worse, current medical treatments focus only on symptoms, which actually make the syndrome worse.  Hyperinsulinemia causes the pancreas to secrete increased amounts of insulin in response to elevated blood glucose.  However, practitioners typically focus on glucose levels or hemoglobin A1c, and prescribe drugs which actually increase insulin levels even further.  In a typical case, a patient would present with obesity, hypertension, diabetes and elevated blood lipids.  The patient would be told to lose weight by eating more fruits and vegetables and to cut down on fats and cholesterol and to do some light exercise as a standard first-line therapy of lifestyle changes.  This certainly stands the test of reason.  The problem is that under this regimen, the syndrome actually worsens.  Eventually antihypertensive medication is prescribed as are drugs for diabetes.  Soon the patient finds themselves on 6 or more drugs with no improvement in their status.  The underlying problem is that nothing has been done to address their insulin resistance.  A more appropriate course of treatment in this scenario would be the use of a muscle sparing protein diet and more importantly carbohydrate restriction, consisting mainly of fiber and vegetables, keeping in mind that all carbohydrate, with the exception of fiber, will eventually be turned into blood glucose either quickly or slowly.  By restricted carbohydrate intake, insulin secretion can be reduced and thus reducing insulin sensitivity/resistance.  In doing this, weight loss can occur and the patient’s syndrome can actually reverse.  If you suffer from any of the symptoms associated with metabolic syndrome, you should consult with myself and/or your family physician before undertaking any therapeutic regimen as in extreme cases drug therapies may be appropriate to reduce risk of stroke and/or other consequential risks.