Cholesterol and the Heart
by Daved Rosensweet M.D.

Question 1

Dear Dr Rosensweet:
I am 62 and have an elevated cholesterol of 255. I am, of course, concerned about this, though I feel great. What would you recommend? R. M., Naples

Dear R.M:
When you mention an elevated cholesterol, you open the door to an extensive subject about the risks of coronary artery disease. Here follows a brief introduction! There are a series of tests to determine your risk for arteriosclerosis and there are many measures that can be taken to reduce that risk.

There is a relationship between elevated cholesterol levels in your blood and a risk of arteriosclerosis, however the correlation is not absolute nor specific. There are other tests that are more predictive. Assessing cholesterol and these other factors can lead to programs that address risk and improve your arterial health.

When we look at the population of the United States as a whole, we know that the risk, in general, for coronary artery disease is higher for those people with an elevated cholesterol. Yet, there are many exceptions to this.

Numerous people, for instance, have had heart attacks when their cholesterol levels were normal, while others have had elevated cholesterol but no coronary artery disease.

The connection between artery problems and high cholesterol was found many years ago. Subsequently, medical researchers have found that there are different types of cholesterol, "good" (HDL), and "bad" (LDL). We know that one cause of damage to arteries can occur from a reactive substance in the blood known as a Œfree radical¹. This type of damage is called Œoxidation¹. The trouble with LDL is actually with oxidized LDL. Oxidation is one of the reasons why antioxidants such as vitamin C, vitamin E and others are so valuable.

Fundamentally, arteries harden in a process that begins with micro-injury to the arterial wall. The injury provokes and inflammatory response. During the repair of the inflammation, cholesterol, calcium and scar tissue are deposited. These block the artery. There is a new test called the "sensitive C-reactive protein (CRP) that reflects injury and inflammation. It is a more effective predictor of possible coronary artery jeopardy than cholesterol levels alone.

Over 30 years ago a Harvard researcher named Dr Kilmer McCully proposed that coronary atherosclerosis begins with an injury to the artery. He stated that this damage resulted from the failure of proper chemical processing of a reactive substance called "homocysteine". Homocysteine levels can also be measured in the blood and relate to coronary risk.

Homocysteine is properly handled if it undergoes a biochemical process known as "methylation". Methylation is highly dependent on generous levels of the cofactors Vitamin B6, Vitamin B12 and folic acid. I highly recommend these vitamins for everyone because of the prevalence of arterial injury. B12 is difficult to assimilate. Because of this, I suggest the sublingual, "hydroxycobalamin" form of it.

The topic of coronary arteries and cholesterol does not stop here! Diet, fiber, antioxidants, red yeast, thyroid hormone, stress, and other subjects are important as well.

When we have even a hint of possible coronary artery problems (such as your elevated cholesterol level) it is important to investigate. Ultimately we want to know if the coronary arteries are actually having a problem.

Standard medical evaluation can be exceedingly valuable. This includes stress’ (treadmill) EKG, ultrasound, and other non-invasive basics. There are more extensive blood tests for oxidant damage and other lipids. Newer, lesser invasive technology such as an "ultrafast CAT scan" can also be valuable to show calcification of the arteries. If need be, more precise delineation is available through angiography.

There is a purpose and a goal to this discovery: in so many incidences, coronary artery disease, even with blockage to the point of symptoms, can be reversible! Think of that.

Coronary artery disease, like any serious illness, is complex and profound. I can in no way do full justice to it in this article. This is but a bare beginning. Whether you are ultimately at greater risk for this problem or not, elevated cholesterol warrants a thorough exploration of your heart.


Question 2

Dear Dr Rosensweet:
I had chest pains recently, and sure enough, my doctor found blockage in my coronary arteries. I had an angioplasty and a stent [a tube designed to keep a partially blocked artery open] was placed in one of my arteries. It worked for a while but the chest pain has recurred. Is their any option to further surgery? E.H., Fort Myers.

Dear E.H:
There are options. Success will rely on more than one factor or treatment. Because significant disease of this nature is complex and multidimensional, healing can have more elements to it than initially meet the eye’. Let me zero in on one possible treatment: chelation.

In World War II, British factory workers in the munitions industry were being diagnosed with lead poisoning. Scientists, utilizing a principle that binds one chemical to another (chelation), successfully removed lead from these workers¹ bodies. After this treatment, many of these people began showing up at their doctors¹ offices, delighted because their unrelated chest pains had disappeared. Doctors postulated that the EDTA chelating agent was binding and removing calcium along with the lead and thus helping to clear their blocked coronary arteries.

Chelation is unproven. There simply have not been adequate scientific studies to confirm or refute its effectiveness. It has been hard to inspire these studies. Medical research of this magnitude and expense is most commonly underwritten by pharmaceutical companies seeking to market a new drug. EDTA has been around for so long a time that no effective patent, and thus exclusive rights to it, can be obtained. It is also a very inexpensive substance. Low profit expectations have kept this a non-priority for drug companies.

Interestingly enough there are 3 new develpments in chelation. One is that there is a large scientific study that is recently being undertaken. A second is that there is a new-to-USA intravenous chelation method requiring just minutes rather than hours. The third is that much more is now understood regarding oral chelation methods, and there are excellent nutritional supplement products available to address this process. In practice, some people derive dramatic benefit from chelation, some have moderate or modest success, and some have no apparent success. Chelation, when done correctly, is safe.

I recommend that you consult with a doctor that has specific training in chelation by a doctor¹s organization known as the American College for the Advancement of Medicine (ACAM). Chelation is complex and needs to be performed according to basic but strict guidelines.

I recommend that anyone having coronary blockage consult with many doctors. Go to the best representatives of each approach, in person, to get opinions on the options available for treatment. Remember that each expert may be predisposed to the methods of his or her specialization. Choice of treatment for blocked coronary arteries is an important decision and is best discovered with great care and attention to detail. You and your family can then come up with the approach that feels the most right to you. Even though coronary artery disease has claimed many lives, thousands and thousands of others have been successfully treated. It can be done and you can do it.

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This article is from www.RosensweetMD.com and is Copyright 2003 Daved Rosensweet M.D.