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Cholesterol it seems has been demonized and most of the times painted like a monster, but the truth is, it’s not as bad as you think it is. Today, we’re going to find out exactly when it’s good and when it’s bad for you.
Daniel Amen: Welcome back to the Brain Warrior's Way. Tana and I are here with Dr. Mark Houston. We are learning so much. Mark, we are just so grateful for your time and your knowledge, and sharing it with the Brain Warrior's Way community. Today we're going to talk about the most controversial thing we've talked about yet.
Tana Amen: Right.
Daniel Amen: Which is cholesterol. Cholesterol has been demonized, people are worried about it. They put it on health packages, "No cholesterol."
Tana Amen: I have to say, it was actually your module that really opened my eyes. Again, I mean, having you here, even today, I've learned more than I did even in your module. His module on cholesterol was fascinating. It was really ...
Daniel Amen: As a psychiatrist, one of the things I started paying attention to, 15, 20 years ago, was low cholesterol is associated with depression, suicide, homicide, and death from all causes. I'm like, "Uh oh." We have to talk about this.
Tana Amen: Doesn't a lot of it have to do with what kind of cholesterol you're making, right? As far as numbers, isn't the number not the only thing we're looking at these days?
Dr. Houston: The cholesterol myth is probably the worst myth that's out there. Most of the therapeutic regimens are cholesterol-centric, which meaning they get the cholesterol down, specifically the LDL cholesterol, everything's going to be okay. Here's the real story with cholesterol. The cholesterol, if it's in your body in a native form, is not atherogenic. It's only when the cholesterol is modified into an atherogenic form, which means oxidized or glycated, or some other form. It becomes a foreign protein. The foreign protein, which is the modified LDL is attacked by the immune system, because it's supposed to do that. The defensive mechanism that your body mounts against a foreign protein is correct, and it's usually acute, and it takes care of the problem. You get rid of whatever the insult is, in this case it maybe oxidized LDL cholesterol. When it becomes a chronic problem, the body continues to attack it. Then the blood vessel becomes the innocent bystander in the process.
Tana Amen: The collateral damage.
Dr. Houston: Yeah, so here's what I want your audience to understand. Cholesterol in the concept that it's promoted in public health has been like a public number enemy, when it really is not an enemy. You have to have cholesterol for function. I mean, it's your membranes, your vitamin B, your sex hormones. At some point, you get too low in the LDL cholesterol or total cholesterol, you're going to have some health detrimental effects that have to be balanced against the bad effects of a modified LDL. Here's the story, LDL cholesterol is not the enemy. It's the process by which LDL is attacked by your body, which is inflammation, oxidative stress, and vascular immune dysfunction that is the etiology of coronary heart disease. There's huge numbers of way to look at that. The other myth is this. How many of your patients, not your patients, but patients you are seeing go into their office, their doctor, and they say, "Well, your LDL cholesterol is elevated." Without even thinking about why it's elevated, they put them on a statin.
Now, the story needs to be a lot deeper. You need to ask three questions. What's your micronutrient and macronutrient intake? Look at your dietary stuff. Everybody gets that one. The two they never ask, are you toxic? Heavy metals or pesticides. Have you had some chronic, subclinical, or active infections? All three of those are the primary etiologies of dyslipidemia.
Tana Amen: How interesting.
Dr. Houston: In fact, 70% of dyslipidemia in this country is due to one of those three things. No one even asks the question and checks for it, so if you go back and remove those insults, a lot of people's cholesterol becomes normal without having to specifically treat them with either a drug or even a nutrient for that matter.
Daniel Amen: Diet, toxins, infections.
Tana Amen: I just want to recap really quickly. The cholesterol itself is not the problem. It's what your body is doing to change the cholesterol, or how the cholesterol is changed in your body that is the problem, which in some cases can be altered by your lifestyle. Maybe in some cases not. I know in my case with some thyroid issues I had, I struggled with my numbers being a little bit high. When I went in my doctor, I finally got this amazing doctor. He said, "You're always going to struggle with your cholesterol numbers, but what you do for it is really helpful, because you've got this thyroid issue and you've had your gallbladder removed." Sometimes our history, right? It's not just what we're eating, but sometimes your history fights against you a little bit, and you have to work a little harder. Is that true?
Dr. Houston: Yeah, so I mean obviously our genetics are important, but most of our diseases are environmental. 80% of our diseases are environmental. We talked about dyslipidemia, it's a rare patient that has a genetic disorder and lipids. It's usually an environmental story, and it's one of those three things we talked about that you need to measure, correct, and if you do that, sometimes the LDL will come down dramatically, and you don't even have to treat it. LDL cholesterol modified form through the three processes of inflammation, oxidative stress, and immune function is really the etiology of coronary heart disease. That's what we need to attack, the treatment.
Daniel Amen: What's the best way to look at cholesterol is ... Most people they get total cholesterol, HDL, which people think of as good, and LDL, which is bad.
Tana Amen: Triglycerides, and that's it.
Daniel Amen: Which is way too simple. Is it to get those numbers and then fractionate the LDL into big, fluffy A particles, versus little tiny demon B particles. If you have the big fluffy A ones, don't worry about it so much. What do you look at?
Dr. Houston: I'll give you dyslipidemia 101, nutrition course. What I think is the present state of the art. The old lipid panels, which you just mentioned, measuring total levels, are obsolete. You can't determine in an individual, anything related to those. As a population, yeah, you can get statistical analysis. You have to do advanced lipid testing. Now advanced lipid testing is basically measuring particle number, and particle size of everything. HDL, LDL, and BLDL, which is your carrier for triglycerides. Within that, the particle number of LDL, LDL-P, is the driving risk for coronary heart disease and myocardial infarction. It's very closely tied to apolipoprotein B, which is the carrier for LDL cholesterol.
That's the bad's half. The other half is the oxidized, or settelated, or glycated form of that particle. The protective side has always been said to be HDL. HDL total tells you nothing. You have to look at particle size and HDL particle number. Now it's even more complicated. It's whether it functions. That's called HDL functionality. If you measure even the advanced lipid, HDL, if you don't know that it's working, you still don't know the protective risk of their test we have available to measure HDL functionality. One of the best ones is myeloperoxidase, or MPO. Soon we'll be able to measure, actually, the ... What's called reverse cholesterol transport, that's the ability of HDL to take the bad stuff, the LDL, out of the cell. [inaudible 00:07:58] one of the new labs that's going to be doing that for clinical use. Advanced testing's important, particle size, particle number, and functionality of HDL. That's the key.
Daniel Amen: Based on what is available now to people, what do you think is the best test people should ask for or get?
Dr. Houston: Tell your doctor to order an advanced lipid test, and there's about six or eight labs across the country that do that. They're all very good, and you just get one that's cost effective in your area, that you can read.
Tana Amen: Are the words, extended profile or fractionated the same thing?
Dr. Houston: Yes, extended, fractionated, or advanced are all the similar terms.
Tana Amen: Okay, so again, we have many of our patients say that their doctors say that that's a waste of time, or they don't do that. I just want to make it very clear we are talking to one of the world's most renowned cardiologists right now, and he is suggesting that you get this done. We highly recommend it as well.
Daniel Amen: One more question. What about eggs?
Dr. Houston: Glad you asked that one. Another myth. Another myth. Just review that literature as well. There is no doubt that eating one egg a day increases serum cholesterol, that's number one. You could eat seven a week, no problem. Number two, there is no association between eggs, coronary heart disease, or myocardial infarction.
Tana Amen: Yes.
Dr. Houston: The reason is because eggs are mixed fats with protein. That does have cholesterol, obviously, but it's got a little saturated fat, it's got some monounsaturated fats, it's got some Omega-3s. It's one of the most balanced foods out there. The egg myth is really, an egg myth. You can have eggs. The only situation that is even questionable is in a Type II diabetic.
Tana Amen: Yeah, that's what I've heard, so there's like ...
Dr. Houston: A hand full of them.
Tana Amen: Isn't there like 25% of the population that does convert weird ...
Dr. Houston: Otherwise, not an issue.
Daniel Amen: For most people, they start the morning with scrambled eggs and spinach, with a cup of blueberries it'd be all right?
Dr. Houston: Yeah, just don't fry your eggs, poach them.
Tana Amen: Yeah, no right. We are so happy to hear that, because we like eggs for breakfast. We travel, it's one of the easiest foods when you travel.
Daniel Amen: Don't fry them.
Dr. Houston: Organic poached eggs.
Daniel Amen: All right, Dr. Mark Houston, author of What Your Doctor May Not Tell You About Heart Disease. His website is hypertensioninstitute.com. I just can't tell you how grateful we are ...
Tana Amen: Just fabulous.
Daniel Amen: For your friendship and for ...
Dr. Houston: Thank you. You guys are awesome.
Daniel Amen: Helping to educate our community. Thank you so much.
Tana Amen: Thank you.
Dr. Houston: It's been a pleasure. Thanks for having me on your show. It's been a pleasure.
Daniel Amen: Thanks Mark.