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Good afternoon, I'm Dr. Todd Binkley, practitioner of functional medicine and non-force doctor of chiropractic.

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I've been getting a lot of questions about the episodes I did a while back about heart disease,

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about how cholesterol doesn't cause heart disease.

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Well, if cholesterol doesn't cause heart disease, why do we hear about cholesterol-lowering drugs

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and why is everybody obsessed with their cholesterol levels all the time?

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Well, cholesterol is important, but it's associated with heart disease. It does not cause it.

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Inflammation causes heart disease and there are better ways to test your level of inflammation

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and better ways to test other factors in your bloodstream, in your blood vessels

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that increase your risk of having a heart attack or a stroke.

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So we're going to talk about that and a dramatic case of someone who I was able to help survive heart surgery

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and who was basically left for dead.

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I mean, I hate to say that, but it's the most accurate way I can describe it.

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We'll come back to that before that.

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In the news, I always like to present something from the most recent news and this is really interesting.

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Three in five physician practices are now owned by non-physicians.

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So people ask me all the time, functional medicine sounds great.

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Why don't all doctors do this?

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Well, several reasons. Number one, most people don't show up to see their doctor until they're in such a mess.

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They need standard medical care.

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So it's not necessarily your doctor's fault.

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It depends on how well you've taken care of yourself.

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But it is also sort of demoralizing to learn that three in five U.S. physicians are now owned by non-physicians.

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So most doctors work for corporations like health insurers, private equity firms,

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large pharmacy chains, and this reached 30 percent as of January for the first time,

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surpassing ownership by hospitals and health systems.

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So as a result, three in five physicians are now owned by non-physicians.

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So what does that mean?

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Your doctor, most likely the doctor that your insurance company is covering, UDC or doctors,

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are their medical decisions are governed by boards of directors of corporations that are mostly concerned

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about cutting costs and maintaining their bottom line and getting their profit margins up over your health.

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And that's just sad.

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In 2020, corporations owned about 17 percent of U.S. medical practices,

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while hospitals and health systems owned about 25 percent, according to a report released by the Physician Advocacy Institute.

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But corporate ownership of medical groups has surged.

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Well, it surged during the pandemic.

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And so these trends raise questions about how best to protect patients and physicians in a changing employment landscape,

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says Kelly Kenney, the Physicians Advocacy Institute chief executive officer.

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Quote, quote, corporate entities are assuming control of physician practices and changing the face of medicine in the United States

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with little to no scrutiny from regulators.

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And the CEO of the Physicians Advocacy Institute goes on to say, quote, physicians have an ethical responsibility to their patients' health.

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Corporate entities have a fiduciary responsibility to their shareholders and are motivated to put profits first.

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These interests can conflict with providing the best medical care to patients.

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You think? Well, you're not alone.

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Even the FTC now is saying, given recent trends,

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we are concerned that some transactions may generate profits for those firms at the expense of patients' health,

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workers' safety, quality of care, and affordable health care for patients and taxpayers,

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said the Federal Trade Commission and the Justice, the Department of Justice, and the Health and Human Services Department

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in a joint statement which appeared in those agencies' joint request for information, which was just announced in March.

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So a request for information is a tool that federal agencies can use to gauge the level of both support and opposition

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they would face if trying to change policies.

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So anyway, the government's working in the background.

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This is a big deal.

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And this is responsible for the reason we spend more money in the United States of America on health care,

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more than twice the amount of money of all the other industrialized nations.

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We spend more than twice what all the nations in Europe and Japan and Korea and all developed societies on health care.

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And we have crappier outcomes.

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We have sicker people.

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It's just not right.

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And this corporate pursuit of profits over actual health care is a big part of the problem.

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For this reason, I often recommend that everyone get a health savings account or a medical savings account

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connected to a high deductible, less expensive health insurance policy and spend your money on things that actually improve your health

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instead of just crossing your fingers and waiting till you need medical care to save your life.

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You need that backstop.

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Obviously, you want to have insurance to cover you in a crisis.

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But don't just wait until you're in the crisis.

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I mean, you know, I know listeners to this show are probably I'm preaching to the choir.

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That's why you're listening to this show.

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Functional medicine, restoring normal function before you become dependent on pharmaceuticals for the rest of your life

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is obviously a better way to go.

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And unfortunately, insurance doesn't cover that.

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You do have to pay a little bit out of pocket, but it's much less expensive than you might imagine,

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especially considering the consequences and expenses of waiting until you end up in the hospital and are out of work for several weeks or months

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and have to pay the deductibles and co-payments of even good insurance.

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So there are better options.

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So I've been getting a lot of questions about heart disease.

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I talk about how cholesterol doesn't cause heart disease.

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So and cholesterol, measuring your cholesterol isn't the best way to predict your risk of heart disease.

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There are so many other tests that do a better job of that.

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And I include several of them on the regular blood panel that I do on almost all of my patients.

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So tests like C, reactive protein, a measure of inflammation throughout your body.

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Tests like erythrocyte sedimentation rate.

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This just means as a measure of blood viscosity, how thick is your blood?

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They literally just set a timer and see how long it takes your red blood cells,

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erythrocytes, red blood cells to sink to the bottom of a test tube and measure that.

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That is a measure of how thick your blood is.

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And what causes your blood to become thicker is mostly inflammatory cytokines,

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inflammatory debris.

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Inflammation makes your blood thicker.

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So C, reactive protein and sed rate are both good markers for inflammation.

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I also test ferritin levels, iron storage throughout your body,

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which in addition to measuring iron overload and iron deficiency is also a marker of systemic inflammation.

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Uric acid is a marker of inflammation that mostly affects your joints when it's super elevated.

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That is the marker for diagnosis of gout.

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But it is also a marker of inflammation throughout your body, especially your joints.

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And as we talked about earlier,

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inflammation in your joints can affect your entire body, including your brain,

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and risk of cognitive decline.

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So here's another. So these things are included on my panel.

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I test them on everyone. They're better. I also check the cholesterol, of course.

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But these things are better markers, but even better than that.

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So the top of the line, if you want a full, really comprehensive measure of your cardiovascular health,

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do you have risk factors?

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Did your father or your uncle have a heart attack in their 30s or 40s or 50s?

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Do you have a loved one who is already on several medications for high blood pressure,

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for cholesterol, any heart medications?

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You're at high risk for cardiovascular disease. Otherwise, you wouldn't need those medications.

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So anyone who's at risk for cardiovascular disease should consider, number one,

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doing that basic panel that I talk about all the time.

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But if you want to be even more comprehensive, then the test I use for people at higher risk is by doctors' data.

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Doctors' data is not the only one that does a profile like this.

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The Cleveland Clinic first developed a similar list of criteria

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for a closer and more intensive look at your risks for cardiovascular disease several years ago.

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So LabCorp, lots of other labs offer a similar test.

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But I like the doctors' data test because it's very comprehensive.

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It's about a little less than $200, $195, I think, $199.

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It's right around $200. Maybe it went up a little bit.

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But anyway, it includes your standard lipid test, total cholesterol, triglycerides, good and bad cholesterol,

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but also things like oxidized LDL.

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So oxidized LDL is a much stronger risk factor than just LDL.

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So LDL is low-density lipoprotein.

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That's the quote-unquote bad cholesterol.

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But a high level of oxidized LDL is a much stronger predictor of risk for coronary artery disease, heart attacks, strokes, etc.

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And high levels of this also markedly increase your risk for developing metabolic syndrome within a decade.

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Next on the list is small-dense LDL.

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So these are what are called fractionations.

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These are subsets of the total bad cholesterol that you have.

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The small-dense LDL, low-density lipoprotein bad cholesterol, is extremely atherogenic subtype.

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So that means it's very much involved in the creation of plaque and damage on the linings of the blood vessels

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that end up causing arteries to become clogged and bits to break off and cause strokes.

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Three times greater risk for cardiovascular disease than normal-sized LDL bad cholesterol particles.

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These small-dense LDL bad cholesterol particles are also associated with elevated triglycerides,

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low-good cholesterol, obesity, metabolic syndrome, pre-diabetes, insulin resistance, renal or kidney dysfunction,

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hepatic steatosis, meaning fatty liver disease, and dietary trans fatty acids.

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These small-dense LDL particles more readily penetrate the arterial endothelial wall

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and are more prone to oxidation, which is the result of this inflammatory process.

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So the endothelial wall, just to review your blood vessel, is the pipes that carry nutrients and oxygen to every part of your body,

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starting with the big ones that exit the heart, and they're sort of a three-layered tube.

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So the outside of your blood vessels is made of connective tissue like many other parts of your body.

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It creates the strength and the integrity of the pipe itself, kind of like a garden hose, the outer part.

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And inside that is a muscular layer that allows the blood vessels to expand and contract on demand

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to control and regulate blood pressure throughout your body.

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Then inside this innermost layer in every blood vessel is called the endothelium.

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The endothelium is kind of like silky pantyhose liner that lines the blood vessels to keep the walls nice and smooth.

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So all of these red blood cells and white blood cells and nutrients that are hurtling through your blood vessels

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can get where they're going without becoming stuck to the walls.

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And so you can have high cholesterol and nice, slick, smooth endothelium and not get any plaques.

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The plaques start when you have micro tears in this endothelium that then must be bridged with a little scab,

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just like when you cut your skin. You heal the cut with a scab that forms, which is made up of scar tissue and some other things.

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And in the lining of your blood vessels, these little breaches in this inner lining of the blood vessels,

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little scabs form, which are made of fibrin, the scar tissue that heals every damaged part of your body.

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But then that scar tissue is a matrix that then becomes impregnated with calcium and cholesterol.

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So that is the connection between cholesterol and heart disease.

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If you get the tears, then you're going to have buildup of fibrin, buildup of calcium and cholesterol in those scabs.

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But if you keep inflammation under control and don't get all those micro tears in the first place,

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then it doesn't matter so much how high your cholesterol is because cholesterol will just keep moving through your body

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and eventually get filtered out or used to make cell membranes, steroid hormones, cholesterol, as an essential nutrient.

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It is the foundation block, building block nutrient for all of the sex hormones, estrogen, progesterone, testosterone, etc.

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And it's a key component of making cell membranes throughout your body.

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So if some doctor told you, you need to get your total cholesterol down to 100,

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I've heard this in the last week or two, three or two or three times from patients.

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All my doctor told me I need to get my total cholesterol down to 100. That's ridiculous.

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The total current total level of total cholesterol recommended is 200 and it used to be 240.

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This is only when they invented statin drugs that they lowered the quote-unquote normal total cholesterol to 200

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so they could put everybody on statin cholesterol lowering drugs.

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It used to be fine. Everyone was fine at 240 for decades.

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There's research that shows that the ideal range for total cholesterol is more around 225 for most people.

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But these are all averages. Everybody's situation is different.

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Which is why it's always so important to get tested.

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I am Dr. Todd Binkley. You're listening to Safe, Effective, Natural Solutions to Almost Any Health Challenge.

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Today, we're talking about more advanced tests to measure your true risk,

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to better measure your risk of cardiovascular disease, your risk of heart attack or stroke.

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If you or someone you love is on several medications for blood pressure, cholesterol, heart disease,

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who has had a previous cardiovascular event of any kind, then they are at high risk of cardiovascular disease.

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If someone in your family, your brother, your father, or mother, women, are at cardiovascular disease risk as well,

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if anybody close to you, a close family member, has had a cardiovascular event, way too young,

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in their 30s, 40s, 50s, then you're probably at risk of heart disease

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and might want to consider doing a little bit more advanced testing.

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And so the best advanced test, it's not the only one,

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but it's the one I like the best because for about $200 you get a tremendous amount of information

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that would otherwise cost several hundred dollars to do as individual tests.

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So we've talked about a few of those so far.

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The next on the list is the PLAC test.

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So high levels of lipoprotein phospholipase activity, the acronym is the PLAC test,

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PLAC, is strongly associated with increased risk of coronary artery disease, disease progression,

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PLAC instability, and cardiovascular events.

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So it's a very highly indicative test of significant hardening of the arteries,

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especially the coronary arteries, and risk for rupture of advanced plaque.

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So it's when you have a rupture of an advanced plaque that that little chunk travels further downstream

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and blocks an artery to your heart and causes a heart attack,

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or travels up to your brain and causes a stroke.

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So high levels of plaque, PLAC, are associated with double the risk of cardiovascular disease

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regardless of the level of your cholesterol levels.

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Next on the list of the doctor's data, cardio metabolic profile is homocysteine levels.

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Homocysteine levels have been tested for a long time and used to be considered a strong indicator,

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risk factor for cardiovascular disease, which has sort of since been disproven,

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but it is still a good measure of whether or not you're getting adequate B vitamins in your system.

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Which can be a factor. So that's included on the test.

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Elevated high sensitivity CRP. So I test CRP on everyone.

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High sensitivity, HSCRP is just a more sensitive as the name suggests,

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measure of a very narrow range of CRP that's strongly associated with heart disease.

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So that's included on the panel.

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And apolipoprotein B. This is a test that is not commonly done, not commonly ordered separately,

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not even commonly ordered by cardiologists, but a high level of apolipoprotein B,

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or just apob for short, is a strong risk factor for cardiovascular disease.

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And elevated levels of it increase risk of fatal heart attack,

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even when LDL bad cholesterol levels are normal.

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So elevated apob is a better indicator of risk of cardiovascular disease

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in either total cholesterol or the LDL bad cholesterol level.

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And there's abundant research to document this.

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And the nice thing about this doctor's data cardiometabolic profile is it explains all of this,

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right in the report, explains your levels and it explains what I'm reading to you now.

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All of the indicators, what these tests mean and the research to back it up.

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Next on the list, in addition to apob, is apoa.

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So apoa is another lipoprotein that is an excellent metric for your risk of cardiovascular disease.

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And they also include the ratio of apob to apoa.

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And apoa is a direct indication of anti-atherogenic HDL particles.

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So what does that mean?

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It's a measure of the good cholesterol and a small fraction of the best among beneficial lipids

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that are protective against cardiovascular disease.

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Lastly, and this is really important, especially for people who are overweight or who have diabetes,

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is the appetite suppressant hormones leptin and adenopectin are included.

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So high leptin to adenopectin ratios have been associated with obesity, type 2 diabetes,

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insulin resistance, inflammation, and of course cardiovascular disease.

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And the recent evidence indicates that a high ratio is more clinically sensitive to risks

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for metabolic syndrome, type 2 diabetes, and cardiovascular disease than other tests alone.

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So this is another really important indicator of your risk factors and it is also included

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on the doctor's data cardiometabolic profile.

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I'm Dr. Todd Binkley.

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You've been listening to Safe, Effective, Natural Solutions to almost any health challenge.

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We've been talking today about cardiovascular, the best ways to measure your risk.

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Someone you love's risk of cardiovascular disease before it's too late,

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not just checking cholesterol but doing a more sophisticated panel.

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It costs a couple hundred dollars and there are several out there,

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but the one I like the best is doctor's data cardiometabolic profile.

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You can Google that.

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You can go to doctorsdata.com and pull up, just type in cardiometabolic profile and pull up a sample report

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or you can email me and I will send you that report.

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So I had a patient who came to me who had open heart surgery.

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He had been coming to me for years because he had severe arthritis in his neck

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and he would just come a couple of times a month for me to keep his neck loose enough

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so that he could move and function properly and walk and he was pretty fit.

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He was in his late 70s, pretty fit guy, always wore shorts, had muscular calves.

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He looked really, really good for his age and he'd gone on vacation to visit his family in Minnesota

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and three or four months had gone by.

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I hadn't seen him and I knew he'd gone on vacation,

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but it was very unusual for him to not come in and get his regular adjustment for his neck.

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So I called him up and he said, oh, yeah, I've been meaning to get in.

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I had open heart surgery and my cardiologist followed up and he just says that, you know,

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it's just as good as it gets.

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What do you mean?

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Come get in here.

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Yeah, Adam came in and he brought his test and he looked like a ghost.

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He was hunched over.

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He was pale.

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He couldn't drive anymore.

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His wife had to bring him in and I asked him if he did his BNP test.

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I've talked about this before.

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This is another really important test for current stress on the heart.

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B type natrietic peptide.

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B as in boy and as in Nancy, P as in Paul.

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BNP.

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Well, upper limit of normal for BNP is 100 medically.

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The healthy range is below 40.

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His BNP test after his heart surgery was 1200.

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Well, a few days after heart surgery, that's pretty normal.

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But four or five months later, his BNP was still 400, four times the upper limit of normal.

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And his cardiologist told him, well, you're old.

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Get used to it.

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That's as good as it gets.

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I said, no, that's not acceptable.

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I put him on high doses of CoQ10 fish oil and some other nutrients.

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And within, oh, by the way, his ankles were swollen up to the size of his calves because his heart,

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he was having heart failure.

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Heart failure doesn't mean your heart stops.

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It just means it's failing to keep up with demand.

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The pump is getting weak.

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So his ankles are the size of his calves.

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He slumped over.

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He's struggling to breathe, shortness of breath, can't drive anymore.

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After three weeks on a high dose of CoQ10, his ankle swelling had gone down by half.

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He was standing up straight again and driving.

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We cut the dose down from there.

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Eventually got him after a little over a year to where his BNP level was back to near normal.

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And he was like a new person, totally back to normal, driving, fit, walking, doing all the things

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that he wanted to do.

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He was on his deathbed and his cardiologist had told him, you know, get used to it.

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This is as good as it gets after he had open heart surgery.

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And instead, he went on to live several more years in excellent health, walking, fit, doing all the things

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that he wanted to do.

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And his wife was obviously and his family were obviously very happy about that.

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So the point of all this is know your risk factors, get tested, do something to be healthier now

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than you were last week.

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And we're about out of time.

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But I just before we run out, I just wanted to say about one more thing.

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This is really exciting to me.

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You can get a defibrillator.

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You see these in the movies.

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Somebody's having a heart attack and you pull out the paddles and the instructions are all there.

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Anybody, almost anybody with just a little bit of reading the instructions can start somebody's heart.

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Somebody's having a heart attack by getting an automated external defibrillator, an AED.

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So you get these things used to cost thousands of dollars.

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You can get one for less than a thousand, like $800.

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So email me for more information about that.

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We're out of time.

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Have a fabulous weekend.

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See you next Friday right here at 4 p.m. on KDAR 98.3 FM.

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Have a fabulous weekend.