Episode 73 – Cholesterol & Lipid Labs

Speaker 1: 00:00 This is Dr Chad Edwards and you’re listening to, you’re not going to believe this number, 73 of against the grain podcast.

Speaker 2: 00:07 Welcome to against the grain podcast with Dr Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready because we’re about to go. Go against the grain. Hello. Hello everybody. We are cardiovascular and spectacular here today with Dr. Chad Edwards. How are you? Doing Great. I didn’t know. I do a little intro thing. I was like, oh, we got to break. This episode is getting boring. So we’re here. Dr Chad Edwards. He is the founder of Revolution Health Dot Org. That’s the website. That’s a website. And uh, he also, uh, he, he’s written a book, revolutionize your health with customized supplements. Andy served in the US army. He’s a man of many traits and he is just really a beautiful man to be honest. But I pay you to say no. A weird goggles. So we, we are here on the podcast today, we talk about against the grain topics, if you will, um, things that really showcase why Dr Edwards believes that 80 percent of medical recommendations are crap. Okay.

Speaker 1: 01:27 Essentially pure, pure crap. Yeah. And that’s a technical measurement of pure crap. Um, but, uh, what are we talking about today, Dr Edwards in terms of this subject? Yeah. So we obviously, uh, you know, a few podcasts ago we had one on, we did it kind of an intro on cholesterol in my opinions about cholesterol and in our clinic we do a lot of lab work to help us understand our patients underlying physiology and I get the, the, I’m making a change in, in labs, but the, the current lab that I use has these colors for green, yellow, and red on each one of your lab results. So for example, your total cholesterol, if it’s below a certain number it’ll be green. And if it’s, you know, so like let’s say ldl low density lipoproteins, so that if it’s less than 100, it’s green. If it’s 100 to 1:30 gets yellow, if it’s above 1:30, it’s considered red.

Speaker 1: 02:26 Now, when you look at the, the cholesterol, um, you know, the national cholesterol education panel, there were recommendations on the management of cholesterol and these have been updated, but a atp three is the, is the one that I used for so many years and not everyone with a cholesterol of 1:31 needs treatment even by those guidelines. Now I would argue that most of them don’t need specific treatment, uh, to lower their regardless, but it’s, so it’s divided up into the categories. And so these patients will come in and they’ll say, oh, that’s red. We got to fix that. And, uh, I got to kind of calm, you know, talk them off the ledge a little bit and say, you know what, you’re not going to die. It’s just because this one lab is not as red, doesn’t mean you’re going to die. I’m not that concerned about it.

Speaker 1: 03:23 Uh, but here’s what it means. And all of those parameters are important factors. But many of them just tell me about the patient and we don’t treat numbers, we treat patients and it’s one of the ways that we’re different. And more importantly, you don’t just treat one number. Exactly, exactly. So what I wanted to do today is just kind of give a rundown on some of the, a lipid particles, the cholesterol particles, the light bulb protein particles and how we measure them and what they mean, and maybe a little bit about, not necessarily how we’re going to treat them because that’s a very, very individual individual issue. And one of my good friends is one of my patients. And um, he, uh, he, he came in this week and I, he, he listens to most of the podcast, so I think it was one of two listeners.

Speaker 1: 04:17 So he listened to most of the podcast. So if you’re listening to this, uh, you know who you are. My mom was, the other one is she, but you pay. We pay her. Jason, what are you gonna do with it? Uh, so you know, my, my good friend that’s worried about your cholesterol, you know, who you are. This is for you. So, um, you know, he, uh, he came in and was worried about it, so I figured, Hey, let’s, let’s talk about this and let’s, uh, you know, for, for patients that get your labs and whether it’s in revolution health and wellness clinic, or you go to your other doctors in what, what are we really assessing with your cholesterol? Okay. So, so let’s, let’s start first and foremost, what is the standard cholesterol and lipid a lab. So you go to your regular primary doctor, internist, whomever, and they said we’re going to check your cholesterol and you can get that done for very cheap.

Speaker 1: 05:11 If you’re paying more than $15 for that test, you’re getting ripped off and there are some labs that will really bend you over and rip you off a true story. Um, uh, so the, uh, the standard lipid profile consists of a basically five labs and the first one is your total cholesterol. Total cholesterol is directly measured, so they will measure your total cholesterol and give you a number, you know, 200 or whatever it is. Uh, the second one is ldl. Let me back up a second. One is HDL, which is high density Lipoprotein and manufactured in your body and it carries certain things around and uh, and we believe that there are some correlations with your overall lipid health metabolism, health, liver health based on hdl levels. And Lower HDL is thought to be a bad, not a sideline for one second. I had a patient that came in that had been using anabolic steroids, so got them out of his gym and, you know, he’s not legal, not healthy, uh, but was doing some bodybuilding competitions and he came to me because he wanted help in getting off of them and he wanted to do that in a healthy way.

Speaker 1: 06:28 So how do, how do we do that and all those kinds of things. So his initial labs is hdl was 18, incredibly low. Now we got him off of his steroids and um, I mean his, everything looks fantastic. I was so proud. His testosterone level was great. 1,300 naturally. Uh, so it hadn’t been on any, uh, any testosterone, no supplements, no nothing. Excuse me for over two months. And his testosterone levels look amazing, so I was very happy. Good grief, got the hiccups, very happy with that. I remember when I got back from Iraq, you know, we do these predeployment physical as post-deployment physicals and you have to have this periodic health assessment and all these different things that you’ve got to do. And one of my guys, you know, I worked with special operations and so one of my guys, when we were deployed, uh, had, had been using some performance enhancing substances and he came back, we came back and I got his cholesterol and I was like, dude, your hdl is 10.

Speaker 1: 07:30 How much. I mean, he’s a pretty muscular guy, pretty fit guy. And I was like, okay, how much were you juicing? And it just kind of ducked his head a little bit and because that’s jacked up, I mean, that’s really low. And so inappropriate use of hormones and specifically anabolic hormones. Testosterone is half Androgenic, half anabolic. So the anabolic hormones are, are more so have an effect on that, but they can be extremely detrimental to your overall health. Uh, I don’t recommend those. They’re, you know, of course they’re illegal, but I just see problems with them. You get bigger, thicker muscles and all that stuff, but it is not healthy to do that period. So you get the HDL low. HDL levels generally would say are unhealthy and we measure those directly as well. Most labs will directly measure those triglycerides and so we’re directly measuring these, these triglycerides and your blood.

Speaker 1: 08:29 Um, and you know, we want them know lower is generally a better and I like a fasting triglyceride level of less than 100. If you’re non fasting, I like them less than 1:50. And then we will most labs, many labs I should say now we’ll calculate your ldl and they will use what’s called the free world equation and they’re determining what your ldl is based on your total cholesterol, your hdl in your triglycerides, your ldl and your hdl and your total cholesterol are really unimpacted by what you ate that day. Your triglycerides on the other hand are not. So most of the time when you’re getting your cholesterol tested, they’ll say, we need you to be fasting. And that’s because triglycerides changed based on what you ate that day and since you’re calculating your ldl, it’s going to change your ldl result on your lab. It doesn’t actually change it, it changes the equation with the labs that I use. We directly measure ldl so it doesn’t impact in the same way. And for some patients we may even want to get a non fasting triglyceride to see, you know, how do they look, how are they handling their food and those kinds of things. But I can still get an accurate representation of their ldl is not calculated.

Speaker 2: 09:42 And that’s been my biggest hurdle in getting my limpid profile, um, is, is fasting before going in and getting it right. So if you came to revolution, it wouldn’t matter. It wouldn’t matter. Not for that, I think. I think all the, all the listeners, including my mom, uh, just hurt me become a patient of revolution health. There you go. Alright. So, so who, who does this affect and who should be getting, uh, the, the slab done?

Speaker 1: 10:16 Uh, you know, they would argue there’s, um, there are some recommendations for who needs to get cholesterol tested and you know, your average 20 year old does not need to go just get their cholesterol test. I, I just don’t see any evidence to substantiate that. Now, with that being said, patients come to see us because they feel bad. They want to perform better, they want to do better, they want to sleep better, those kinds of things. And I think cholesterol, even though I don’t believe cholesterol causes heart disease, it doesn’t, even though it doesn’t cause heart disease, it does give me an idea about their metabolism and what’s going on with their physiology. You know, cholesterol, you know, when their cholesterol or I’m sorry, when their triglycerides are 300, then the first thing I’m going to look at his blood sugar. How are they handling their blood sugar?

Speaker 1: 11:00 What are their instant little, what’s their hemoglobin a one c? Because your body processes, you know, what you eat and it has to do with the uptake and the processing and the metabolism, all of those things. So to me it’s an incredibly valuable marker, but not in the way that I was traditionally trained. I want to understand that patient’s biochemistry, how are they performing? So it’s a part of the picture now in our lab that. So you’d ask what’s the traditional cholesterol? So that’s the traditional cholesterol panel, but I think we need more information than that. And so we’ll go into lipid particles and so we want to break down. We want is that good healthy ldl, is it good healthy hdl and those kinds of things. And there are all different types and now we won’t go into detail. We couldn’t, we can on another podcast.

Speaker 1: 11:47 But uh, I will measure things like a small dense ldl. So the Ldl we want at large and fluffy, we don’t want it small and dense, has to do with how your body is processing that Ldl, how long it staying in the circulation, how long it, or is it being taken up by the ldl receptor and incorporated into the liver and tissues and those kinds of things. How long is it circulating? So how susceptible has it been to oxidative damage? Inflammation? And glycation, which I would argue are the biggest contributors to cardiovascular disease, uh, and we can actually measure oxidized Ldl, which is a great marker for a risk for cardiovascular disease. And there’s a lot of information about that as well. So we can measure those things. And then we can measure a, your ldl particle number, how many of them, you know, you’re cholesterol is a measurement of weight, so it’s milligrams per deciliter kind of thing. Uh, so you know, you want to know, uh, I have a ton of bricks.

Speaker 1: 12:45 Well do you have 2001 pound bricks or do you have to 1000 pound bricks? You know, you don’t know. It’s just, that’s what it is. So when your cholesterol, that’s what you’re measuring. So many times you want to know the number of particles, then you want to know where they are. Large and fluffy, are they small and dense, are you know, those kinds of things. So we can get a breakdown, a much better assessment of what does this look like. And again, that’s an indicator of their underlying physiology. It kind of makes you wonder what weighs more a ton of LDL or a ton of HDL.

Speaker 1: 13:19 It makes you a ton of feathers or a ton of uh, okay. Um, so, so, so you get this, you get this profile. Okay. And you said there’s a, are they more advanced profiles or is the lab that your clinic particularly uses a little bit more advanced and you get those additional markers? You can get them from a number of different labs. There’s different technologies through which they, you can use a, they use ultracentrifugation, they use Nmr, there’s all different testing modalities and none of them have a, to this point have shown to be clearly the best. And this is advanced testing. Uh, not everyone needs to do this. You don’t need to do this for your annual physical. I use it because I am looking at that patient’s overall health and it’s telling me much more than just your cholesterol level. Okay. And so you get this lab back.

Speaker 1: 14:13 And what as a physician, what are you commonly doing or recommending? Well, I’ve, I’ve got a full lab panel that I go through and so my buddy that came in the other day, and he’s, he now, he does have a well, so he was saying, I am so concerned about my Ldl, I’m just worried about my ldl. Now you look at the guy who’s got a great bmi is very lean, a muscular, he’s in right about 50 years of age. He doesn’t smoke, doesn’t drink an excessive amount of alcohol, he’s very fit and active. All of other markers look good is inflammation, looks good. His blood sugar handling and Luke’s good. Uh, all of those things. And when we look at cardiovascular disease, we’re talking about inflammation, oxidation, glycation. So those three things, which interestingly, many of the problems that we see, the aging of skin tagging onto the last podcast that we did, um, those are some of the major players in, in the, uh, destruction of skinner, the aging of skin.

Speaker 1: 15:22 Same thing happens on the inside inflammation, oxidation, glycation, the only difference in the skin is sun exposure where you can’t get a sun exposure on the inside of your arteries. So these processes are detrimental to our health and increase our aging. So his, his hemoglobin a, one c looks great, he handles his blood sugar very well as insulin levels are low, his inflammation markers are very low. We do a specific test called phospholipid a two, which is a blood vessel specific inflammatory marker only test, FDA approved, looking at risk for stroke. Uh, so we can measure all of those things and there are things that we can do to mitigate risks if they’re, if they’re elevated. But so for him everything looks fantastic, but as ldl is high. Now the other piece of that is he does have a strong family history of cardiovascular disease and we have to be careful with that as well.

Speaker 1: 16:16 So you can’t just ignore everything else. Looks Great. Family history sucks. Everything else looks great, so don’t worry about it. But, um, you know, I’m like, okay, well, so what are we going to do about this? We want to lower your overall risk. But you know, and we’ve talked about this a little bit before, understand that cholesterol doesn’t cause heart disease. When we have done studies looking at lowering cholesterol, patients who have elevated cholesterol, we give them some kind of medication, not a Staton, so it could have been Niacin, the ferric acid derivatives, any of those other studies. Zeniah was one that was a, or is that, uh, my, uh, those were all studied. None of them showed reduction in events. Nobody. You didn’t save any lives by lowering cholesterol and those things do lower cholesterol, but you didn’t save any lives, didn’t present any heart attacks by used by lowering cholesterol with those medicines.

Speaker 1: 17:13 And I think time and time and time again, it’s shown the cholesterol doesn’t cause heart disease. In fact, if you look at the Framingham data longest running cardiovascular disease risk, and we may have talked about this in our last cholesterol podcast, um, the patients that live the longest had a high co, had an elevated ldl. It’s not cholesterol, it’s not cholesterol. It’s not cholesterol. It’s the impact of inflammation. Oxidation, glycation on cholesterol. If think about your house, you can have a house. Fire. Is that, is the problem the house? No, the problem is the fire we can make. We can make it where you cannot have a house fire by removing the house, but you don’t have a house we can prevent or we can lower the risk, I should say, of cardiovascular disease by dramatically lowering your cholesterol, but then you won’t be able to make appropriate amounts of vitamin D, bile acids, testosterone, sex hormones, uh, you know, all of your, um, you know, pregnant alone and, and all of these other adrenal hormones as well.

Speaker 1: 18:21 So there are negatives not to mention the impact on your brain and all of those things. So there are multiple reasons you need that cholesterol problem is not cholesterol. The problem is the cholesterol composition, which is impacted by inflammation, oxidation, glycation, that your underlying physiology. That is where the focus needs to be. So when a patient comes in and like, like my buddy the other day and his ldl is up, I may not do anything specifically about that. The only other option for him is to put him on a Staton, which has never been shown to be effective for a guy like him. They’ve been shown to be effective for middle aged man with a previous event. He’s never had an event, so there are no studies or there is not. The preponderance of evidence does not support the use of statins even though that’s what we’ve been led to believe in, in that patient just hasn’t been shown.

Speaker 1: 19:18 And so in terms of preventative, preventative, because we want to take action before an event happens. Absolutely. What would you recommend optimizing overall health is specifically in regards to inflammation, oxidation, glycation, lower those three things. Make sure that your overall health is good. Exercise is good. Stress Reduction is good. You know, your, um, your nutritional levels are good. Homocysteine levels are low, you’re methylating well, you’ve got good amounts of b vitamins. Nitric oxide is optimized, endothelial function is optimized and all of those things can be done. And we evaluate and manage our patients based on all of those labs. Okay. And so the, the lipid profile or the cholesterol panel, the lab that you’re running, that is just one of the many labs that you might use to evaluate a patient’s overall health? Absolutely. Okay. Yeah, I would strongly discourage anyone from just looking at their cholesterol and saying, I’m going to die because I have x.

Speaker 1: 20:25 There is so much more to that picture and that’s why the data gets fuzzy. All of the data that supports the use of we got to give you these meds to lower your cholesterol and I would argue that statens are beneficial for some patients, but the data to support using it across the board is so freaking skewed by the pharmaceutical industry that I don’t believe it applies across the board like they want to. They’ve, we’ve been led to believe. So if there are listeners out there that want to learn more about the panels that you can offer them yet or a what panels they should be getting a, where would you suggest they do and go? Well, obviously I would recommend they come to see us in our clinic because we want to establish where we want to evaluate your overall health. Uh, certainly you can call our clinic at nine.

Speaker 1: 21:15 One, eight, nine, three, five, three, six, three, six. On our website@revolutionhealth.org. I’ve got a pretty comprehensive discussion of the the labs that we will often focus on now, each patient, we have to evaluate them individually and we’re going to order our labs individually based on their problem, their issue, their concern. Okay. Well Dr Edwards, thank you so much for talking to us today about cholesterol and more importantly the testing of cholesterol. That’s right, and there is so much more to come on this. We got a lot to talk about. We got to cholesterol series coming up and so you’ll hear more episodes in this cluster also, you’ll series and we’ll sprinkle through some other topics and subjects along the way, but Dr. Edwards. Thank you again. Thank you. Have a great weekend. Talk to you next time. Bye. Thanks for listening to this week’s podcast with Dr Chad in tune in next week where we’ll be going against the grain. Are you tired and fatigued? Are you frustrated with doctors because they just don’t seem to listen? Do you want to fix your pain without surgery? If you answered yes to any of these questions than we are the clinic for you, we offer prolotherapy, PRP or platelet rich plasma therapy and stem cell injections, ivy nutritional therapies, bioidentical hormone replacement therapy, and functional medicine to get you back on track to optimal health, call our clinic at nine one, eight, nine, three, five, three, six, three, six. Or visit our website@wwwdotrevolutionhealth.org. To schedule your appointment today.

Podcast: Play in new window | Download