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FEATURED SUPPLEMENT
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 | Endothelial Defense
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Endothelial Defense contains standardized pomegranate extract, which is excellent for blood vessel health. One of the many vascular health-promoting effects of pomegranate is to help keep HDL cholesterol functioning properly.
Call my office if you would like pricing on Endothelial Defense.
(516) 829-1515
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FEATURED LAB TEST
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Myeloperoxidase
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Myeloperoxidase (abbreviated MPO) is a blood test performed by just a couple of labs. It is an enzyme produced by white blood cells and increases with inflammation. It is currently the best marker for HDL cholesterol dysfunction. MPO is a brand new test for New York State residents. High MPO is associated with a 1600% increased risk of heart disease!
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"DR. DEBÉ'S UPCOMING LECTURE"
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"What's Going On In Your Belly?"
at Wild By Nature Market
2709 W. Long Beach Road
Oceanside, N.Y.
Tuesday April 2nd
at 7:00 pm
Please reserve a seat:
(516) 764-3580
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"DR. DEBÉ'S UPCOMING LECTURE"
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"A Functional Medicine Approach to Treating Depression"
at Wild By Nature Market
369 West Main Street Huntington, N.Y.
Thursday April 18th
at 7:00 pm
Please reserve a seat:
(631) 424-6480
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Greetings!
Welcome to the March, 2013 issue (I know it's late-What can I say? I tried!) of NUTRITIOUS BYTES where we ask, "Is Your HDL (good) Cholesterol Too High?" |
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HDL - Your Blood Value Does Not Tell the Whole Story
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Are you getting the necessary tests done?
If you know a little about cholesterol and cardiovascular disease risk, you know that LDL is the "bad" cholesterol and HDL is the "good" cholesterol. Actually, there are other types of bad cholesterol but let's just start with the acknowledgement that HDL cholesterol is good.
HDL cholesterol contains over 40 different proteins with different functions. The best known function of HDL is that it is involved in removing cholesterol from the artery wall and transporting to the liver for removal. This is one of the ways HDL cholesterol is good for blood vessels: it inhibits the build-up of cholesterol plaque within the arteries. Therefore, it is desirable to have higher levels of HDL cholesterol in the bloodstream. Studies have found higher HDL cholesterol is associated with less vascular disease. The higher the better, right? Not necessarily.
There is now evidence that once your serum (blood) HDL cholesterol climbs beyond 70-85 mg/dl all bets are off. Why is this the case?
Blood measures for HDL cholesterol levels are measuring weight per volume of blood. This is the result of the number of particles and the size of the particles. It is healthier to have large HDL particles. Both the number and size of the particles can be tested. It is better to have higher levels of the larger HDL2b. It is also good to have a greater number of HDL particles. If you only get a measure of total HDL, you are not getting the whole story.
HDL cholesterol particle number and particle size are both important. It is helpful to think of HDL cholesterol particles as garbage trucks removing bad LDL cholesterol from artery walls. The more garbage trucks you have the better. Large particles are like large garbage trucks that are transporting more "bad" cholesterol.
The reason that having a high blood cholesterol value may not be good is this: the garbage trucks may not be able to unload their "garbage". That's right. The HDL cholesterol can be dysfunctional; like a garbage truck with a broken motor.
When HDL cholesterol levels are above 70, it is likely dysfunctional and unable to perform its protective functions. The HDL may not only fail to be protective but can actually become damaging! Things are not as simple as they used to be. Actually, they were always this way; only our knowledge was simple.
Having a low, normal, or high HDL cholesterol level does not guarantee any particular health outcome or physiologic function for that matter. A small group of Italian villagers with low HDL cholesterol levels have been found to have very little heart disease. Additional studies found that these individuals had very capable HDL particles; they may not have had a lot of "garbage trucks" but those they did have were very efficient.
To further put this into perspective, there was a drug that was developed to boost HDL cholesterol levels. This drug, called Torcetrapib, caused huge increases in HDL. Just one little problem... It also caused increased deaths. More important than the HDL cholesterol number is how well the HDL works. This drug caused the production of a lot of dysfunctional HDL.
As a rule, you don't want to have low HDL cholesterol levels. These can also be dysfunctional. Now, just because your HDL cholesterol is high does not guarantee it is dysfunctional. This is a statistical association. It is the rule. But it doesn't apply in every case.
The most important thing is function. How does HDL cholesterol become dysfunctional? There are many possible contributing factors. Inflammation is a major contributor. Inflammation in turn is caused by many possible things, including chronic infections. For more on this subject see my newsletters on Inflammaging and Elevated Cholesterol: Flat Earth Theory of Heart Disease? Heavy metals and other toxins may damage HDL and cause it to malfunction and even become damaging. High blood sugar, and poor diet contribute to HDL dysfunction as well. See my newsletter on sugar-induced damage known as glycation: #1 Under-Appreciated Factor in Health & Aging.
So, how do you know how well your HDL cholesterol is working. In the future, there will likely be tests to directly measure how well the HDL is removing cholesterol from artery walls. For now, we have to rely on indirect indicators. The best available test is Myeloperoxidase. (See panel on left)
If you do have an elevated Myeloperoxidase level, and therefore dysfunctional HDL, what do you do about it? You look for the underlying cause and take some supplements that help improve HDL function and protect it from damage. (See left panel for one)
When it comes to evaluating your HDL cholesterol, you should be getting the following tests: total HDL, HDL particle number, and fractionation into particle size. Apolipoprotein A-1 is the carrier protein for HDL cholesterol and should also be measured. Lastly, and very importantly, get a measure of Myeloperoxidase. |
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Sincerely,
Joseph Debé, DC, DACBN, CDN
Board Certified Nutritionist
38 Great Neck Road
Great Neck, N.Y. 11021
(516) 829-1515
www.drdebe.com
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