So, I mentioned last week that I was away at the annual conference for the Institute for Functional Medicine. What I didn’t say (other than the >100 degree heat!) was that the conference was all about cardiometabolic syndrome.
Dr Mark Houston, a functional medicine cardiologist from Vanderbilt, told us early in the course: “You’re going to love me and you’re going to hate me. You’ll love me cause I’ll show you how to help your patients. You’re going to hate me because I’m going to show you why everything you do for high cholesterol and hypertension is wrong”. I’m paraphrasing, but since he said it in a lovely Southern drawl that reminded me of home, I didn’t shutter. Not then.
Now, remember that this is a room full of docs and other care providers who think outside the conventional medicine box, basically. So, we’re already ahead of the game. Even so, I spent the weekend being amazed at the amount of research I was told (from conventional medical journals!) and how it guides us in using natural medicine to treat lipids and blood pressure in a whole new way.
So, the warning is this : I doubt I’ll ever get a “usual” lipid panel again. I had already started getting advanced lipid panels on many patients, but now I agree that the typical panel is pretty much worthless. Also, if your blood pressure is even a little bit high, I have a whole new list of things to evaluate that would get to the cause, not just try to drop the number. As Dr Houston said: Hypertension is an appropriate response to an inappropriate chronic condition. I’m ready to get to the source.
Worse: I’ve always been somewhat proud of my high HDL. Always attributed it to my paternal grandfather, who ate red meat and eggs and drank whole milk his entire life and hung around into his 90’s. Some of his side of the family lived into their 100’s, even way back when. So, Dr Houston tells us that if your HDL is over 80, you’re probably either infected or inflamed. Guess who is getting more bloodwork done soon?
I’m ready to deal with the fact that at least 1/3 of folks who have heart attacks have normal lipids. And that even if you correct lipids with statins, folks still have heart attacks. And the fact that there has never been a study that shows that statin use in women protects them from heart attacks. Not one study.
My friend, Mimi Guarneri, MD, who is the founder of the Scripps Center for Integrative Medicine, says this: yes, you need to know someone’s lipid panel and treat it. You also need to know what is damaging their heart, and sometimes it has nothing to do with drugs or medicine or something we can measure. To learn about her book, The Heart Speaks, go here.
So, at this point, can I become a cardiologist as well?????
A quick note: the staff has asked that I mention this. Please give yourself more time than usual to get to the office. Not only is Sesame Place open, which always adds at least 5-10 minutes on to your drive to the office, but they also have some lanes closed while they redo sidewalks. Be warned! And try to be early!