Getting to the Heart of High Cholesterol and Cardiovascular Disease

During a recent visit to a conventional medicine doctor, I shared my Cardio IQ lipid test results from Quest Labs — a test I ordered on my own. As the doctor reviewed the data, he looked puzzled, eventually remarking, “Fancy tests, above my pay grade.”

Cardiovascular disease, as you may know, is a silent epidemic affecting nearly half of all U.S. adults and claiming more lives each year than any other health condition. Despite its prevalence, many doctors are unaware of next level tests like Cardio IQ, while their approach to care focuses primarily on short-term symptom relief, overlooking the deeper, underlying causes.

At PROVOKE Health, we’re committed to a different approach. Through advanced testing and a functional medicine approach to healthcare, we address cardiovascular disease at its roots, offering patients more than just a temporary fix and paving the way for optimal long-term health.

Cardiovascular disease (CVD) is a classification of illnesses that include arrhythmia (irregular heartbeat), atherosclerosis (buildup of plaque in the arteries), cardiac arrest (heart stops beating), heart attack (blockage stops blood flow to the heart), congenital heart disease (structural deformities present from birth), high blood pressure, cardiomyopathy (enlarged, thickened, or stiffened heart muscle), and stroke.

According to the most recent data from the American Heart Association (AHA), cardiovascular disease accounted for 931,578 deaths in the United States in 2021. That’s more than all forms of cancer and chronic lower respiratory disease combined. Between 2017 and 2020, 127.9 million U.S. adults (48.6 percent) had some form of cardiovascular disease. And between 2019 and 2020, direct and indirect costs of total cardiovascular disease were $422.3 billion ($254.3 billion in direct costs and $168.0 billion in lost productivity/mortality).

Despite these alarming statistics, many healthcare providers — especially those who are trained in conventional medicine — continue to offer only short-term solutions that often fail to address the root causes of cardiovascular disease, such as the following treatments:

• Medication to lower your blood pressure if it’s high, which is good for preventing stroke and organ damage.
• Medication to decrease the level of low-density lipoprotein (LDL) in your bloodstream. LDL is the so-called “bad cholesterol” that’s commonly implicated as the root cause of plaque buildup in the arteries.
• Surgery to clear any blockages, repair damage, or correct deformities in the cardiovascular system.

These conventional treatments can save lives and prevent damage to vital organs. However, they often fail to address a leading cause of many forms of cardiovascular disease — inflammation — and the root causes of the inflammation. These may include hidden infections, nutrient deficiencies, exposure to environmental toxins (including toxic mold), hormone imbalances, mental or emotional stress, poor sleep, and other factors or combinations of factors.

Taking a Functional Medicine Approach to Restoring Cardiovascular Health

Here at PROVOKE Health, we take a Functional Medicine approach to restoring cardiovascular health that focuses on the patient and whole health instead of illness and symptoms. We go beyond merely diagnosing and treating high blood pressure and “high cholesterol” to identify the root causes, and we work closely with each patient to develop a personalized plan of care to restore cardiovascular health.

The tests we offer in coordination with the Cleveland HeartLab can be broken down into two categories, each of which is covered in greater detail later in this post:

• Advanced lipid tests
• Inflammation tests

Results from these tests offer us data that helps our team understand the causes of inflammation in blood vessels and the heart. This in turn enables us to pursue a well-informed approach to addressing inflammation, which is known to contribute to many chronic health conditions, including cardiovascular disease .

Once we have a complete understanding of your genetic profile and cardiac markers, the team here at PROVOKE Health can create a personalized plan of care that reduces the risk of developing a serious cardiovascular disease and can often help reduce the need for prescription medications, which may cause or contribute to other health issues.

Advanced Lipid Testing

A conventional cholesterol test typically shows total cholesterol along with levels of Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL), and triglycerides. Elevated triglycerides are associated with increased risk of heart disease and may be associated with obesity and diabetes. Results from a conventional cholesterol test can be misleading and often result in patients being prescribed cholesterol-lowering medication that can negative impact their health in other ways.

When we have reason to suspect that cholesterol may be negatively impacting a patient’s health, we order a Nuclear Magnetic Resonance (NMR) lipid panel — a blood test that’s used to provide a detailed profile of lipids (fats) in the bloodstream, focusing on cholesterol carrying particles. The great thing about the NMR lipid panel is that is breaks down LDL and HDL particles by size and density, which offers insights into the number and type of particles that may contribute to a risk of heart disease.

Specifically, NMR lipid panels include:

• LDL-P (Low-Density Lipoprotein Particle Number): Measures the total number of LDL particles, which can be an indicator of heart disease risk, since higher numbers increase the likelihood of plaque formation.
• Small Dense LDL Particles: Identifies smaller, denser LDL particles that are more atherogenic, meaning they’re more likely to contribute to plaque buildup in arteries.
• HDL-P (High-Density Lipoprotein Particles): Measures the number of HDL particles, which helps in assessing “good” cholesterol levels and protective factors.
• LDL Size and HDL Size: Provides information on particle size, because larger particles are generally less harmful than smaller ones. (Imagine the walls of your arteries as netting — larger particles are less likely to get trapped in the net and start to accumulate.)
• Total Cholesterol, HDL-C, LDL-C, and Triglycerides: Includes standard lipid measurements as part of the profile.

The NMR lipid panel gives us more detailed information with which to work and may indicate that a patient with elevated LDL doesn’t really need to be on cholesterol-lowering medication.

Plaque X for Cholesterol Management

Once we understand a patient’s HDL and LDL levels, we may recommend a chelation therapy supplement named Plaque X (PX) for cholesterol management. (In the case of Plaque X it binds to fatty deposits of cholesterol, which is then eliminated by the body.) PX is used to support heart health by reducing arterial plaque and cholesterol. It contains a phospholipid named phosphatidylcholine that is believed to assist in dissolving fatty deposits in blood vessels, potentially improving blood flow and reducing cholesterol levels. PX may work by:

• Removing plaque:
• Supporting lipid metabolism
• Improving endothelial function

Some studies suggest that combining Nuclear Magnetic Resonance lipid panel testing with therapies like Plaque X may provide a targeted approach to improving cardiovascular health, especially for patients at risk for, or diagnosed with, heart disease.

Testing for Inflammation

Inflammation is an underlying cause of most chronic health conditions. I don’t say it’s the root cause, because many factors can cause inflammation. These include nutrient deficiencies, food sensitivities, smoking, alcohol consumption, hidden infections, stress, lack of sleep, autoimmune disorders, exposure to toxins, a sedentary lifestyle, hormone imbalances, and emotional stress.

The first step is to test for inflammation. Testing determines how serious the inflammation is and can help to determine its cause(s). Our objective is to catch inflammation as early as possible and start treating it before it becomes a bigger problem.

The inflammation tests we order help us evaluate the following biomarkers:

• F2-Isoprostanes: This is a “lifestyle marker” that measures the amount of oxidation in your body, which may damage your endothelium — the tissue that forms a single layer of cells lining your blood vessels, heart, and lymphatic vessels. Eating too much red meat, smoking, or not exercising enough can increase your F2-Isoprostanes levels and your risk for future heart disease.
• Oxidized LDL (OxLDL): OxLDL is a marker that measures the amount of LDL that has been damaged due to oxidation. Poor lifestyle habits can increase your OxLDL levels and increase your risk for prediabetes.
• High-sensitivity C-Reactive Protein (hsCRP): This is a general marker of inflammation, especially in the blood vessels. The presence of a cold may increase hsCRP levels over the short-term (days to weeks). However, the accumulation of cholesterol in the artery walls may result in long-term elevation of hsCRP (years to decades), so we monitor hsCRP levels over time.
• Lipoprotein-associated phospholipase-A2 (Lp-PLA2): Lp-PLA2 is an inflammatory enzyme bound mainly to LDL that indicates the active build-up of plaque inside the artery walls. LP-PLA2 activity is an independent predictor of coronary heart disease and stroke in the general population.

Identifying and Treating the Root Causes of Inflammation

The presence of inflammation is just another clue in the process of diagnosing the root cause of CVD. The next steps are to evaluate the patient’s diet and lifestyle and any pertinent environmental factors and then order additional tests to identify the root causes of the inflammation. Factors that contribute to inflammation include the following:

• Hidden food allergies or sensitivities
• Undiagnosed or lingering infections
• Small intestinal bacterial overgrowth (SIBO) or small intestinal fungal overgrowth (SIFO)
• Leaky gut, which is often the result of damage to the protective lining of the gut from SIBO or SIFO
• Unhealthy diet, often a diet that’s high in sugar or other simple carbohydrates and processed foods
• Sedentary lifestyle
• Exposure to environmental toxins and heavy metals
• Exposure to mold toxin
• Genetic susceptibilities
• Hormone imbalances
• Autoimmunity
• Fatty liver
• Psychological or emotional stress
• Poor sleep (insufficient or restless sleep)

See my previous post “Understanding and Managing Chronic Inflammation” for details on how we diagnose and treat chronic inflammation here at PROVOKE Health.

My Recent Experience with the Conventional Healthcare System

As I mentioned above, a conventional medicine doctor that I recently sought care from was unfamiliar with the Cardio IQ lipid test from Quest Labs. Yet the research clearly shows the benefit of understanding and addressing the root causes of cardiovascular disease and not merely treating symptoms such as high blood pressure and elevated levels of LDL (“badcholesterol”). Treatment decisions should be based on both short- and long-term needs and factors that are unique to each patient.

Using high blood pressure and cholesterol medications as a long-term solution to CVD is one of the greatest blunders of modern conventional medicine and the pharmaceutical industry. These are exceptional tools if the goal is to generate long-term profits for the medical and pharmaceutical industries, but they’re not so great for the long-term health of patients.

There is nothing fancy about preventing and reversing endothelial dysfunction (heart disease) and the subsequent disability and death we see in families across the United States. It’s complicated, but it’s logical — you keep asking questions and testing until you find the root cause(s) and then you address the factors that are causing the problem. That’s the Functional Medicine approach, and it’s the approach we take with each of our patients at PROVOKE Health.

Regardless of your age or how you feel, monitoring your cardiovascular health for early warning signs of trouble is always a good idea. Generally, the earlier you can intervene and change the course of a poor health issue, the better the outcome.

Don’t settle for the standard blood pressure and cholesterol testing, which are limited both in breadth and depth. Insist on a full workup, including the tests discussed in this post. For more information or to schedule testing in our Tampa functional medicine clinic, please contact us.

You can schedule a free 10-minute consultation to discuss your cholesterol or cardiovascular concerns with me, Dr. Matt Lewis, or our Medical Director, Dr.  Karalynne Blochberger, using the consultation button below.

If you’re ready to schedule your first appointment or a follow-up appointment to discuss your plan of care, please use the button below.

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Disclaimer: The information in this blog post about cardiovascular disease testing is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at PROVOKE Health, nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP^® specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing at PROVOKE Health in Tampa, Fla. Dr. Lewis has more than 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), Dr. Lewis has learned how to restore his own health and vigor to prevent the onset of these and other illnesses, and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa and elsewhere.