Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Most traditional physicians almost always order a standard lipid panel which includes total cholesterol, triglycerides, LDL cholesterol and HDL cholesterol.

Unfortunately this standard lipid test will put most people at risk causing plaque to silently build up in there arterial walls if this one test is not ordered.

Most people I bet have not even heard of this life-saving test and even worse most people would believe if their total cholesterol and LDL cholesterol are within the optimal range they are free from a serious cardiac event.

WRONG!

The lab test I am referring to is called oxycholesterol, or oxidized LDL cholesterol (OxLDL).

Its role in cardiovascular disease has been well documented. (See references below)

The optimal value for OxLDL is less than 60 U/L.

Learning how to lower OxLDL levels (if elevated) is critical to preventing or reducing the plaque buildup in your arteries known as atherosclerosis.

When OxLDL increases in your bloodstream they cause massive inflammation and significantly decreases the elasticity of your arteries.

Even worse this ominous lipid (OxLDL) also increases blood clot formation in your arteries leading to atherosclerosis and sending your stroke risk skyrocketing.

Again mainstream medicine has unfortunately overlooked this test.

I see time and time again patients having a false sense of confidence taking statins to lower their total and LDL cholesterol only to see significantly elevated OxLDL. 

This is a recipe for disaster.

This article is not to deter anyone from addressing elevated LDL cholesterol with statins but to be certain that they are not going down the road toward a cardiac event with high levels of OxLDL.

Unfortunately statins will not lower OxLDL.:(

Fortunately, the technology to measure OxLDL levels is available.

Simply ask your doctor to order OxLDL from Labcorp or Quest. The code from Labcorp is: 123023. The code from Quest is: 92769

In the next 3-5 years, this type of testing will likely become much more mainstream. But why wait? Knowing your OxLDL levels and working on lowering them, and keeping them low, can mean the difference between no plaque buildup and severe plaque buildup in your arteries!.

The peer reviewed medical papers listed below clearly shows us that OxLDL levels are linked to heart disease.

In just one study published in Circulation the plasma OxLDL level in patients who had had heart attacks skyrocketed about 3.5-fold over control subjects.

Knowing if the amount of oxidative damage to your LDL cholesterol is elevated or not is critically important. That's why testing is essential.

But equally as important is to know why the oxidative damage is occurring in the first place so you can do something about it.

What do we know about the possible causes of elevated OxLDL?

While the experts aren't positive yet what triggers the oxidation of LDL molecules, it's likely that much of it is related to diet, stress, infections, thyroid issues and environmental toxin exposure.

What Steps Can One Take to Lower Elevated OxLDL?

1: Mediterranean-style diet, high in monounsaturated fats, reduces LDL oxidation. One study of 372 adults at high risk for heart disease found that diets rich in olive oil or nuts decreased OxLDL levels.

2: Eating a diet high in polyunsaturated fats—like the ones you'll find in fast foods, junk food, and baked goods increases OxLDL. In fact, corn oil, sunflower oil, safflower oil, cottonseed oil, canola oil and soy oil all seem to raise OxLDL levels.

3: Besides the Mediterranean diet there are a couple more dieting “secrets” that can drive down LDL oxidation. To no ones surprise gluten-free diets have been shown to reduce levels of OxLDL.

4: Pomegranate juice have been shown to ward off LDL oxidation.

5: Green tea also fights LDL oxidation as well.

6: Vitamin E is a powerful nutrient that prevents oxidation damage in the body. (Make sure you are taking all eight of the vitamin E family)-Naturally occurring vitamin E exists in eight chemical forms (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol

7: A heart supplement superstar Coenzyme Q10 because it targets and reduces the oxidation of LDL cholesterol molecules. I recommend 200 mg daily as a supplement.

8: Other natural solutions for fighting oxidation include garlic, resveratrol, and grape seed extract. 

Other Factors to Consider in Lowering OxLDL Include the following

1: Research has shown that either a low functioning or an over-functioning thyroid gland can drive up your OxLDL levels.

2: Chronic infections can increase levels of OxLDL. Studies show that bacterial lipopolysaccharide (LPS) commonly associated with increased intestinal permeability aka: Leaky Gut will negatively impact LDL particles leading to elevated OxLDL. (Good reason to go gluten-free). Covid has been found to associated with elevated OxLDL. In addition the following infections have also been associated with elevated OxLDL and should be ruled out and addressed: Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus

3: Rule out environmental toxins 

Be sure to get your OxLDL level tested and work with a functional practitioner to treat the root reasons if your level is elevated.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

Reference

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627698/
https://www.ahajournals.org/doi/10.1161/01.atv.21.5.844
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631666/
https://www.frontiersin.org/articles/10.3389/fphar.2020.613780/full
https://www.ahajournals.org/doi/10.1161/circulationaha.104.529297
//www.functionalmedicineuniversity.com/OxLDL.pdf
https://academic.oup.com/cardiovascres/article/68/3/353/309912
https://www.sciencedirect.com/science/article/pii/S0022316622147838?via%3Dihub
https://pubmed.ncbi.nlm.nih.gov/28371298/
https://pubmed.ncbi.nlm.nih.gov/16115546/
https://www.sciencedirect.com/science/article/abs/pii/S0955286305000586
https://pubmed.ncbi.nlm.nih.gov/18689551/
https://pubmed.ncbi.nlm.nih.gov/26773777/
https://pubmed.ncbi.nlm.nih.gov/23456579/
https://pubmed.ncbi.nlm.nih.gov/21812107/
https://www.sciencedirect.com/science/article/abs/pii/S0098299797000319
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063630/
https://www.sciencedirect.com/science/article/pii/S0022316622071711
https://www.liebertpub.com/doi/10.1089/jmf.2012.2408
https://pubmed.ncbi.nlm.nih.gov/17616006/
https://pubmed.ncbi.nlm.nih.gov/10845869/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214326/
https://www.sciencedirect.com/science/article/pii/S0735109706008515
https://academic.oup.com/jcem/article/83/5/1752/2865698

Compliments from Functional Medicine University www.FunctionalMedicineUniversity.com

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Cardiovascular disease remains the leading cause of death worldwide.

There are quite a number of cardiovascular lab markers I commonly check to determine the cardiovascular risk of my patients.

One in particular is Apolipoprotein B (ApoB).

The levels of ApoB are much too high. We want to optimally see the ApoB less than 70

Unfortunately, the  standard lipid panel generally includes four things: total cholesterol, high density lipoprotein (HDL) cholesterol, LDL cholesterol, and triglycerides. 

While LDL, the major cholesterol-carrying serum lipoprotein, is the primary therapeutic target for management and prevention of atherosclerotic cardiovascular disease, there is strong evidence that apoB is a more accurate indicator of cardiovascular risk than either total cholesterol or LDL cholesterol.

If your physician is not including ApoB, this is simply "unacceptable" if you are serious about determining your cardiovascular risk.

You may in fact have a normal lipid panel but an elevated ApoB and be at an elevated cardiovascular risk.

In 2019, the European Society of Cardiology/European Atherosclerosis Society stated that apolipoprotein B (apoB) was a more accurate indicator of cardiovascular risk than low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol.

The Basic Overview of Understanding ApoB

apoB is a major structural protein found in LDL, and it helps to transport fat and cholesterol throughout the body. Lipoproteins that contain apoB, such as bad cholesterol, are particularly dangerous because they can penetrate the walls of arteries.

apoB is emerging as the crucial lipoprotein trait for the role of lipoprotein lipids in the etiology of coronary heart disease. 

The protein apoB can help predict one's heart disease risk more accurately than a standard lipid panel, which measures cholesterols and triglycerides.

But emerging evidence suggests apolipoprotein b (apoB) is an even more accurate marker that can identify potential high-risk patients.

These apoB particles can lead to plaque buildup in the arteries, increasing the risk of heart disease and stroke,

“When we measure apoB, we're actually counting all of these particles that cause plaque buildup, and this is a much more accurate way of determining cardiovascular risk due to cholesterol

Higher apoB shortens lifespan, increases risks of heart disease and stroke, and in multivariable analyses that account for LDL cholesterol, increases risk of diabetes.

Effective Plan to Lower ApoB

1. Weight Loss
2. Switching from saturated fats to unsaturated Fats (Monounsaturated--avocado, walnuts, flaxseed, wild salmon, etc.)
3. Soluble Fibers: Apples, okra, eggplant, oats, berries and barley and psyllium husk
4. Phytosterols-- nuts and seeds
5. High fructose corn syrup will raise ApoB
6. Transfats will raise ApoB
7. Soy protein lowers ApoB
8. Dietary Patterns-- Mediterranean Diet with heavy focus on plant based foods
9. Omega 3

Dr. Grisanti's Comments:

According to prominent cardiologist, Dr. Mohammed S. Alo, Assistant Clinical Professor of Medicine at Midwestern University in Chicago, Illinois and Assistant Clinical Professor of Medicine at Ohio University in Athens, Ohio
he recommends that Apo B should be under 70. He further states if one is an overachiever and want to live the longest and not have atherosclerotic heart disease, he recommends having your apoB under 55. He states that most studies show that levels below 55 completely arrest and even may in fact reverse plaque and atherosclerosis.

References:

https://pubmed.ncbi.nlm.nih.gov/34677405/
https://pubmed.ncbi.nlm.nih.gov/19491209/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540246/
https://www.ahajournals.org/doi/10.1161/JAHA.122.025858
https://www.ahajournals.org/doi/10.1161/JAHA.122.025858
https://jamanetwork.com/journals/jamacardiology/article-abstract/2753612
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462411/
https://www.aafp.org/pubs/afp/issues/2014/0415/od2.html
//www.functionalmedicineuniversity.com/ApoBPaper.pdf

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University's Certification Program (CFMP) www.functionalmedicinedoctors.com. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Grisanti is required