Are Cholesterol Tests Really Worth It?

Hello and welcome to can of worms Saturday!

Yes - I took a deep breath before popping this topic up today because I know it will create some interesting conversation around the dinner table tonight.  For those of you who know my approach to pulling apart test results and putting them back together into a program that works towards a healthy outcome for you, you will also know that I wouldn't put such a tricky topic forward, without a good reason to do so.

As you would have read in my last piece, I have some information from a recent conference that is going to turn the cardiovascular medicine world upside down and change the way we look at blood work, arterial blockage and heart health in a pretty big way.  The theme to the chorus change sounds a little like:  - take an actual look at the blood please lab technician - count the lipids (LDL and HDL cholesterol), measure their size and understand the integrity of the vessel they are carried in because this is what will determine a health risk in the cardiovascular system.  Gone are the days (long gone) where a lab person is checking what is going on under the microscope with your blood and what it contains.  It's not quite the catchy ditty we'd hope for.  The neat package that a straight cholesterol test done automatically did for you in the past to predict risk is no longer a tune we want to finish the show on. It simply is not enough information - just the first verse!

We now know that endothelial damage (lining of the artery) is the score on which the notes of distress and disease are written. This is the hot spot to watch, but the methods to do so are not yet available in Australia... yet (I'm working on it).  The damage at this important layer of blood work is so incredibly underestimated and overlooked in current diagnostic methods that it begs belief that we weren't looking here in the first place.  We would soon realize that statin drugs are not the answer to a cholesterol problem, that LDL cholesterol can actually be converted into good cholesterol and that HDL cholesterol previously thought to be protective can also be dysfunctional.

To answer the question in the title of this blog - our current cholesterol tests are now considered to be an outmoded form of testing to arrive at an educated assessment of cardiovascular risk and do not deliver enough data to make an educated decision on risk.  It is useful for part of the picture, just not the whole picture.  Other risk factors to consider are:

1. Nitric Oxide levels

2. Size and number of LDL particles

3. Number of HDL particles (if too high could herald dysfunction)

4. Omega 3 fatty acid levels

5. Homocysteine

6.  Apolipoprotein A and B count

7. Fibrinogen

8. High Sensitive C -Reactive Protein (normal levels not sensitive enough)

Yes there is a lot of information to digest.  Take your time, but at some point if you find yourself looking down the barrel of a statin prescription - maybe we should talk first... after all - who wants to increase their risk of developing diabetes from medication by 47%? (Proven on statin drugs - research available if required)


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