Advanced Cholesterol Testing

Cardiovascular disease remains the leading cause of death worldwide and yet we as consumers aren’t
taking advantage of the technology available with an advanced lipoprotein analysis. Insurance companies largely refuse to reimburse it and physicians consequently do not routinely order them for their patients. We are missing out.

Consider Mary,

who had completely normal routine labs but already had a heart attack and coronary artery
bypass at age 50. Mary was at her ideal body weight, ate great, slept well, never smoked and exercised
routinely. Interestingly, Mary had a family history that was concerning- she had a father who had a heart
attack at age 60. An advanced lipoprotein analysis would reveal that she had an elevated Lp(a) ten times
above normal, which is the most dangerous LDL-cholesterol (bad cholesterol) marker we can measure.
Lp(a) is genetic-variant and at high levels have been shown to accelerate vascular aging. This is important
because Mary has a good chance of passing this down to her children. Although the high Lp(a)
measurement does not lower with optimal nutrition, it can be lowered with a high dose B vitamin called
niacin. Other early interventions can be done for those people who know they have this inherited and not so
uncommon condition. Imagine Mary avoiding cardiac bypass surgery had we known and intervened in this
condition 20 years ago.

The advanced cholesterol testing can also reveal the type of bad cholesterol we carry. Is it the smaller,
denser type (called Pattern B), or is it the more favorable larger, buoyant LDL cholesterol (called Pattern
A)? Pattern B is almost found universally in people who have the sugar problems of prediabetes and
diabetes and this is part of the reason why people who have sugar problems have a much higher incident of
early strokes and heart attacks. This problem can be addressed through various treatment options, the
easiest of which is taking good doses of Omega 3 fish oil.

“Advanced cholesterol testing can also tell us about our good cholesterol and whether we truly have the best
subtypes of good cholesterol – the ones that are the most efficient at removing all the bad cholesterol in our
blood vessels. There are natural treatment strategies that will improve the subtypes of good cholesterol.”

The five things we can do now if we are concerned about our cholesterol:
1. Nutrition intervention. 70% of how much and the type of cholesterol we make is genetically
determined – that means we can lower our cholesterol by a significant amount by avoiding
processed foods and unhealthy fats – think French fries, chips, unhealthy snacks.
2. Fish oil – 2000-3000mg per day. Fish oil has been shown to decrease triglycerides, increase HDL
and help change people from a dangerous Pattern B to a Pattern A.
3. Exercise, particularly high intensity training will increase HDL (good cholesterol).
4. Lose weight and stop smoking! Smoking dramatically lowers good cholesterol while healthy
weight loss will increase HDL cholesterol.
5. Consider advanced lipoprotein analysis at least once in your life. You can measure your Lp(a) and
LDL Pattern type and type of HDL. You will gain a deeper understanding of the health of your
vascular system and be the best advocate for your health with your primary card physician. If you
have a family history of early stroke or heart attack, I feel it is a must. A resource for you to
directly access lab testing for the advanced lipoprotein analysis is on our site at Health and Bliss Lab Testing.

Yours in Health,

Alan Hopkins, M.D.

Metabolism and Weight Loss Expert, Clinical Assistant Professor of Surgery & Perioperative Care, Dell Medical School, University of Texas at Austin