Wednesday, August 4, 2010

How to Raise Your Good Cholesterol

If your doctor is still ordering the standard cholesterol test of total, LDL, HDL and triglycerides, you are in the dark ages. See, the problem is that 75% of the folks who have a heart attach have a normal LDL and HDL. Get your doc to order the most current tests: a VAP cholesterol or a Berkeley Heart Lab test so that you can check your subfractions; that is, check your good vs bad subfractions of LDL and good vs bad subfractions of HDL. And in women in particular, your Lipo(a) is crucial to know. We also like to measure the level of inflammation with both the cardio (or high-sensitivity) c-reactive protein (hscRP) and homocysteine.

Seventeen years ago I did a fellowship with the American Heart Association while at Harvard Medical School. To this day, one of my favorite aspects of preventive medicine, or as I call it aggressive preventive medicine, is to help my patients understand the importance of their markers of heart disease, particularly since this remains the most common cause of death among men and women. After menopause, women catch up to men by age 60 in terms of their risk of heart disease.

Cardiology has advanced hugely in the past 30 years, mostly because heart disease is the leading killer of productive white corporate men. Lots of research dollars = lots of research achievement and progress.

For women, it's all about the triglycerides (I recommend TRG < 100) and HDL > 50 (your "good cholesterol."

Here's the short version....

These lipid subfractions are all good: HDL2, HDL1, LDL2, LDL1, Large-HDL, Large-LDL

These lipid subfractions are all bad: sdLDL (small dense LDL), HDL3, Small-HDL, LDL3, Small-LDL
What lowers HDL2?
  • American Heart Association Low-Fat/Step 2 Diet - makes your particles dense
  • Lack of lean muscle tissue
  • High insulin (fasting insulin > 6)
  • Lack of exercise or overtraining 
  • Belly fat
  • Adrenal dysregulation
  • Too many carbs
  • Sugar, processed foods
  • Inadequate fish oil (omega 3s)
  • Smoking
  • Too much alcohol (Per day: 2-3 or more drinks for men; 2 or more for women)
What raises HDL2?
  • Paleo Diet
  • Estrogen
  • Andogens (taking DHEA, testosterone)
  • Niacin (see below)  
  • Vitamin D (Note that you need a higher dose if you have a problem with your vitamin D receptor)
  • Intermittent fasting  
  • Generation of ketone bodies (low carb, mod-high prot/fat)  
  • Exercise (avoid excessive endurance training)  
  • Strength/resistance training  
  • Reduction in belly/visceral fat  
  • Reduction in insulin (eliminating wheat, reducing carbs)  
  • Tobacco cessation  
  • Elimination/moderation of alcohol 
  • Eating protein, esp Leucine, Taurine, etc 
  • Carotenoids (astaxanthin, krill oil, seafood, grassfed meat, etc)  
  • Fish oil/EPA+DHA: supplemention, grassfed meat/dairy; fatty fish, mackerel, tuna, herring, hamachi, trout, cod liver oil, mollusks, krill, crustaceans, etc  
  • If high inflammatory state: Ultra high dose 8-10 g/day EPA DHA fish oil for 6-18mos (Goal: fatty acid profile test, omega-6 to omega-3 ratio = 1.5)]  
  • ALA, monounsat fats: flaxseed oil, olive oil, nuts/seeds, etc  
  • Plant sterols, grass-fed ghee  
  • Eating some saturated fats (not TRANSFATS which are toxic to HDL2)  
  • Eating some CHOLESTEROL (via omega-3 eggs, seafood, grassfed meat/dairy, etc)
Niacin & HDL2
Niacin raises HDL2 by 200-300% in 18-36 months.

Fish Oil Studies in Greater Detail
  • Take 4.5 g/d x 6wks EPA + DHA resulted inHDL2 increase of 74% with a concomitant 19% decrease of HDL3-C (Metabolism, 1991).

No comments:

Gottfried Center for Integrative Medicine's Fan Box

About Me

My photo
I'm an organic gynecologist, yoga teacher + writer. I earn a living partnering with women to get them vital and self-realized again. We're born that way, but often fall off the path. Let's take your lousy mood and fatigue, and transform it into something sacred and useful.