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Cardiac Risk & Inflammation Factors
Homocysteine, lipoprotein (a), cholesterol, and C-reactive protein are all cardiovascular risk factors and inflammation markers – some actually cause cardiovascular disease, others are just indicators or the result of cardiovascular disease. This is important because if you do not address the factors that actually cause the disease, then, you cannot get rid of the disease. You end up controlling the symptoms and indicators, but the disease is still in the body doing more harm as time progresses.

Homocysteine (discovered by Dr. Kilmer McCully, 1969) is a toxic amino acid that is produced normally as a byproduct of protein synthesis when protein foods are metabolized; and, is converted to another amino acid, methionine, unless it’s blocked due to high insulin levels or low consumption of vegetables and beans. Poor nutrition (consisting of too much animal meat and not enough vegetables and beans containing folic acid, Vitamins B6 and B12) impairs the metabolism and breakdown of homocysteine. Refined sugar, flour, processed foods and a sedentary lifestyle lead to high insulin and homocysteine levels, which combine with LDL cholesterol to promote oxidation. This irritates and cuts the blood vessels causing inflammation, fatty plaque formation and gradually, as the plaque accumulates in the arterial walls, leads to atherosclerosis.

Elevated homocysteine may also make blood more likely to clot, raising fibrinogen levels and increasing the stickiness of blood platelets, which may precipitate a heart attack or a stroke. Elevated homocysteine may reduce brain function, increasing memory loss and triggering the development of Alzheimer’s. In addition, high homocysteine accelerates telomere (“genetic clock”) shortening of vascular lining cells and impairs endothelial nitric oxide production, preventing blood vessels from relaxing and restricting blood flow to tissues.

To prevent high homocysteine levels, there are three principal pathways through which the body breaks down homocysteine. The first of these pathways uses Vitamin B6 (pyridoxine) and zinc to convert homocysteine to the beneficial sulfur amino acid cysteine. The cysteine may then be used to synthesize glutathione, one of the body’s most powerful antioxidants. The second pathway requires folic acid and vitamin B12 and converts homocysteine to the beneficial and lipotropic amino acid methionine. The third and most potent pathway uses a nutrient (from beets) known as trimethylglycine, or TMG, to break down homocysteine and produce methionine and boost the generation of SAMe, or S-adenosyl-methionine, which can help with our mood (depression).

In addition to heart disease, high homocysteine levels may also be a risk factor for the development of other conditions, including osteoporosis, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), death from diabetes, miscarriage, other complications of pregnancy, and hypothyroidism.

Lipoprotein (a) is a protein with sticky, adhesive properties that is produced by the liver to repair the endothelium of the artery walls when there is insufficient Vitamin C to produce the collagen and elastin to repair the walls of the (damaged) blood vessels. In addition, the liver produces fibrinogen to develop fibrin, which is deposited in the form of a mesh; and, dries and hardens so that any bleeding stops. Lipoprotein (a) bonds with fibrin to complete the repair of the damaged walls.

Triglycerides, which are produced by the liver to provide a major source of energy to the body tissues, are chains of high-energy fatty acids that circulate in the bloodstream and provide much of the energy needed for cells to function. Triglycerides are also the chemical form of most fats in the food we eat. The liver takes up dietary cholesterol and triglycerides from the bloodstream and packages the cholesterol and triglycerides, along with special proteins, into tiny spheres called lipoproteins. The lipoproteins are released into the circulation, and are delivered to the cells of the body. When the body needs energy, the cells release the triglycerides, which are burned as fuel to meet our energy needs. If we eat too many refined sugar foods and do not exercise, the high insulin level triggers the liver to produce more Very Low Density Lipoproteins (VLDL), which is a main carrier of triglyceride. And, the excess triglycerides will build up in the blood and be stored in the body as adipose (fat) tissue. Consequently, many diabetics who have a high total cholesterol, may have high triglycerides, since the same foods that cause the blood glucose level to rise are the same foods that cause triglycerides to rise. A high triglyceride level is also a risk factor for stroke.

If you have a high cholesterol level because of high triglycerides, then, a statin drug like Lipitor will not help because the drug is not designed to reduce the triglycerides. This is why it is important that you get a complete lipid profile, a blood test that will provide a reading for each of the cholesterol components: total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), lipoprotein(a), and triglycerides (TG). Refer to Chapter 11 for more details about blood tests.

Cholesterol, a waxy, fatty substance, 80% of which is produced by the liver and the cells, is a very important nutrient that is used to build cell membranes and hormones. It is packaged in a fat-protein package called a lipoprotein so that it can be transported throughout the body. There are four types of fat-protein lipoproteins: chylomicrons, very low density lipoproteins (VLDL), low density lipoproteins (LDL), and high density lipoproteins (HDL). Lipoproteins are differentiated by how much triglyceride they contain such that the more triglyceride that is in these particles, the less dense they are and the more they “float”. Chylomicron contains the most triglyceride, followed by VLDL, LDL, and HDL.

If one’s total cholesterol level is too high, this may be an indication that the body has constant high insulin levels (hyperinsulinemia) triggering the liver to produce more triglycerides and cholesterol; or, that the liver is clogged with too much fat and cannot effectively filter the cholesterol out of the blood; or, that the cardiovascular system may be in a repair mode due to damaged blood vessel walls. Conventional medicine’s use of statin drugs has proven to effectively lower the cholesterol level by inhibiting the liver’s production of the enzyme HMG-CoA reductase. But, this lowers CoQ10 levels predisposing the patient to muscle deterioration (rhabdomyolysis) and heart disease, the very condition that these drugs are intended to prevent! In addition extra cholesterol continues to be produced until the root cause of why the liver is producing the extra cholesterol is addressed (e.g. high insulin levels, damage to the artery walls, a clogged liver,  insufficient nutrients).

High levels of LDL (“bad”) cholesterol result because of interference with the body’s utilization of cholesterol due to the suppression of thyroid function and the lack of sunlight. Suppression of thyroid function is caused by trans fats (partially hydrogenated oil in processed foods, margarine, shortening) and clear vegetable oils (corn, soybean). Under normal conditions, sunlight converts the cholesterol on the skin to hormone precursors, including Vitamin D. Then, cholesterol in the bloodstream migrates to the surface of the skin, to replace the cholesterol that was converted. But, if you do not obtain at least one hour’s worth of sunlight every day, this process of producing Vitamin D (to fight cancer) and naturally lowering your cholesterol does not occur.

A sedentary lifestyle and a poor nutritional profile of excess refined carbohydrates, insufficient soluble fiber, and excess saturated fat may also contribute to higher cholesterol levels. In addition, if the LDL particles are small-sized and dense, recent studies have shown that these particles become trapped in the inner lining of the artery walls, and, after being attacked by the immune cells, are highly inflammatory and toxic to the lining of the arterial walls. Consequently, someone with a normal cholesterol level could have a high cardiovascular risk or a sudden heart attack if the LDL particles are small and dense.

C-reactive protein (CRP) is a reactant released by the body in response to acute injury, infection, fever, or other inflammatory stimuli, indicating a heightened state of inflammation in the body. CRP measures inflammation, part of the immune reaction that protects you from infection when you injure yourself. It causes redness, pain and swelling, and can damage the inner lining of arteries, and break off clots from arteries to block the flow of blood triggering strokes and heart attacks.

C-reactive protein levels fluctuate from day to day, and levels increase with aging, high blood pressure, alcohol use, smoking, low levels of physical activity, chronic fatigue, coffee consumption, elevated triglycerides, insulin resistance or diabetes, taking estrogen, eating a high protein diet, suffering sleep disturbances, or depression.

Note: In addition to CRP, possible inflammation markers for Type 2 diabetes include tumor necrosis factor (TNF) and interleudin-6 (IL-6).
 
Fibrinogen is a protein that plays a critical role in normal and abnormal clot formation, a mechanism referred to as coagulation. An interaction between clotting factors and naturally-occurring anticoagulants normally results in healthy levels of fibrinogen and normal coagulation. If fibrinogen levels increase above normal, however, a blood clot becomes a threat; if fibrinogen levels decrease below normal, a hemorrhage can result.
Excess fibrinogen is produced by the liver due to inflammation, high homocysteine levels, and an immune response that releases a specific cytokine (interleukin-620) into the bloodstream. Platelets release the enzyme thrombin when they come into contact with damaged tissue, triggering the release of this cytokine, which leads to the formation of the soluble protein, fibrinogen. Fibrinogen is then converted to fibrin, an insoluble protein that is deposited around a wound in the form of a mesh to dry and harden, so that bleeding stops as the final stage in blood clotting. In addition, fibrinogen increases the viscosity of the blood, making it thicker and slow moving.

Key point: High C-reactive protein, high homocysteine and small, dense LDL particles are indicators of high inflammation, and may be reasons why more than 60% of heart attack victims actually have normal cholesterol levels.

As a result of the high inflammation, the blood vessels become damaged and the body goes into a repair mode that is indicated by high levels of these specific cardiovascular risk factors and inflammation markers.

In order to reduce these levels of internal inflammation and reverse its effects, utilize a consistent exercise program and a nutritional program that includes fiber-rich anti-inflammatory foods and Omega-3 fatty acids such as broccoli, spinach, beans, blueberries, avocados, flaxseed, and wild salmon. In addition, utilize other wellness principles such as cleansing/ detoxification and spiritual health. Refer to the wellness protocol section in Chapter 15 for more details.

Prescription Drugs -- The Answer?
Prescription drugs help to lower your blood pressure, blood glucose, and cholesterol -- but, are they really the answer to you improving your health? Go to the following web pages for more information about the danger of prescription drugs:

• Drugs for high blood pressure
• Drugs for high cholesterol
• Drugs for high blood sugar (diabetes)
• Drug companies
• Drugs (general information)