Men and Andropause: Part 1

Men and Andropause: Part 1

By Mike Clark, Education Director and CEO of NBH Lifetime Health

In a recent article regarding andropause, the author stated that “any man that is feeling the signs of andropause, should definitely see a doctor and get help.”

The author further states: “Although with age, a decline in testosterone levels will occur in virtually all men, there is no way of predicting who will experience andropause symptoms of sufficient severity to seek medical help. Neither is it predictable at what age symptoms will occur in a particular individual. The author does not identify the “signs of andropause” nor does he explain when the symptoms are severe enough to seek medical help.

The purpose of this article is to define andropause and to identify the symptoms of andropause. It will also be recommended that all men, whatever their age, should have lab tests done by a competent physician trained in bioidentical hormones if they have any signs of testosterone deficiency. Further, this article will explain why all men who have “suboptimal levels of free testosterone” should consider restoring these levels to more optimal levels for prevention reasons and for quality of life reasons.

Andropause-the Male Menopause

Menopause, the time in a woman’s life of distinct hormonal changes, can be very stressful to women, both on an emotional and physical level. During this time, many women suffer from mood swings, hot flashes, body aches and other effects of declining estrogen and progesterone levels. All women endure changes caused by declining hormone levels.

However, just because a man may not feel the dramatic changes a woman often undergoes doesn’t mean that he does not experience hormonal changes. As men reach their 40s (and sometimes much earlier), most will start noticing physical and emotional changes. Abdominal fat often takes the place of formally hard muscle, even with regular physical exercise. Eight hours of uninterrupted sleep are less frequent as nocturnal visits to the bathroom to urinate increase in frequency. The thick head of hair that once covered the head becomes gray and thinner. Every night sex may turn into once a week to every-other-week sex as both interest and ability to perform decrease. Drive and ambition may also begin to fade along with libido and lean muscle mass and strength.

Many physicians state that these changes in men are an inevitable part of “normal” aging. The idea that there is such a thing as andropause is still thought of as a myth by most mainstream medical doctors. They state that since men don’t have a physical signpost (such as the cessation of menstruation seen in women), andropause does not exist. However, even though women have a clear-cut physical demarcation in their lives, other changes of menopause take place over several years. In the case of andropause, it is thought that the majority of physical, mental and emotional changes take place over 10-to-15 years.

These changes, which include declines in libido, sexual function, muscle mass and strength, increase in prostate size leading to benign prostatic hypertrophy, along with fatigue and depression, begin around age 40 for most men. It has been estimated by some researchers that today as many as 25 million American men between 40 and 55 are experiencing signs and symptoms of andropause. It has been our experience that most men over the age of 40, and many men younger than the age of 40, have low levels of free testosterone.

…read Part 2 for “Testosterone: The Key to Andropause”

January 26, 2010 | truthabouthormones | No Comments »

Adrenal Fatigue

Do You Suffer From Adrenal Fatigue?

Are you:

  • Tired for no reason?
  • Have trouble getting up in the morning?
  • Need coffee, colas, salty or sweet snacks to keep going?
  • Feeling rundown or overwhelmed?
  • Can’t bounce back from stress or illness?
  • Crave salty and/or sweet snacks?
  • Feeling best only after 6 PM?
  • General feeling of “malaise?”

If you answered yes to one or more of these questions you may be suffering from Adrenal Fatigue.

Adrenal Fatigue is a collection of signs and symptoms, known as a “syndrome,” that results when the adrenal glands function below the necessary level. As the name suggests, its paramount symptom is fatigue that is not relieved by sleep but it is not a readily identifiable entity like measles or a growth on the end of your finger. You may look and act relatively normal with Adrenal Fatigue and may not have any obvious signs of physical illness, yet you live with a general sense of un-wellness, tiredness or “gray” feelings.

Who gets Adrenal Fatigue?

Anyone can suffer from Adrenal Fatigue at some time in his or her life. An illness, a life crisis, or a continuing difficult situation can drain the adrenal resources of even the healthiest person. Poor or irregular eating habits, lack of “downtime”, consistent or unrelieved stress (now or in the recent past), too little sleep or poor quality of sleep, sub-optimal hormone levels, all make a person more prone to Adrenal Fatigue.

Adrenal Fatigue affects an estimated 80% of people living in industrialized countries at one time or another in their lives, yet it has been ignored and largely untreated by the medical community. Conventional medicine only recognizes it in its most severe forms of Addison’s Disease or Cushing Disease.

Unless you suffer from one of these extreme forms of adrenal fatigue, you are considered to be within the “NORMAL” lab range. You are then told (1) you are depressed so take an anti-depressant or seek counseling and/or (2) it is all in your head, and/or (3) you are getting old.

People suffering from Adrenal Fatigue often have to use coffee, colas and other stimulants to get going in the morning and to prop themselves up during the day.

NBH Lifetime Health Hormones & Weight Loss Centers are pleased to announce a comprehensive program for assessing and treating adrenal stress. We offer a complete program that uses saliva and blood testing and patient education combined with therapeutic and lifestyle products to achieve maximum effectiveness. Call for an evaluation today and start your recovery program.

Adrenal Fatigue Burnout Questionnaire

The following questionnaire will help you determine if you have symptoms of a syndrome popularly known as “burnout”. Burnout refers specifically to a type of Adrenal Fatigue brought about by lifestyle factors such as working too hard, deaths in the family, divorce, job loss, juggling too many activities, etc.

Give each question a value ranging from 0-5 with “0″ representing not being true for you and “5″ describing you very well. The more high numbers you have, the more likely you have some degree of adrenal fatigue.

Do you tire more easily? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Do you feel fatigued rather than energetic? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are people annoying you by telling you “you don’t look so good lately”?
___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you working harder & harder but accomplishing less? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you increasingly cynical and disenchanted? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Do you often experience unexplained sadness? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you forgetting appointments, deadlines or personal possessions more frequently?
___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Have you become more irritable? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you more short-tempered? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you more disappointed with people around you? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you seeing family members and close friends less frequently?
___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you too busy to do even routine things like make phone calls or read reports or send cards to friends? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you experiencing increased physical complaints (aches, pains, headaches, lingering colds)? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Do you feel disoriented when the activity of the day comes to a halt?
___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Do you feel disoriented when the activity of the day comes to a halt?
___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Is joy elusive? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Are you unable to laugh at a joke about yourself? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Does sex seem like more trouble than it’s worth? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5
Do you have very little to say to people? ___0 ___ 1 ___ 2 ___ 3 ___ 4 ___ 5

January 11, 2010 | truthabouthormones | No Comments »

Male Andropause

Male Andropause.

By Mike Clark, Clinic Director of NBH Lifetime Health

Low testosterone levels for men can mean high health risks. After decades of research and hype surrounding female menopause and hormone replacement therapy, men have recently started receiving some attention about their own age-related hormonal decline, known as andropause.

At NBH Lifetime Health, we have been treating men of all ages for testosterone deficiencies for more than ten years. A simple lab test for free and total testosterone will determine if the male is deficient in this primary male hormone. We also test the estradiol level to determine if testosterone is converting to estradiol. Another important test is DHEA. This hormone is often called the body’s repair hormone and master hormone.

For males in the 40’s and above, we offer tests for the major heart factors including cholesterol, homocysteine, fibrinogen, and CRP. Testosterone is of  course a major heart factor in that low levels  are associated with heart disease. We have found that most men over 40 have less than optimal levels of free testosterone. More and more, we are finding the younger males can  also  have these difficulties.

Declining testosterone levels

Declining testosterone levels can lead to the development of numerous symptoms such as a decrease in virility, libido and sexual activity, general sense of well-being, as well as fatigue, depression and sleep disturbances. In addition to problems such as sexual dysfunction or general malaise, low testosterone also translates into decreased muscle mass and strength, as well as a decrease in bone mass and an increase in abdominal fat. Studies show that the latter two pay a role in degenerative diseases such as osteoporosis, cardiovascular disease and diabetes. Moreover, depleted testosterone levels are being linked to the incidence of various lipid disorders and heart disease.

Less bone, more fat

While osteoporosis hasn’t always been considered a disease that afflicts males, the rising incidence of bone mass degeneration among aging men points a finger to some age-related cause. As androgen receptors are expressed in osteoblasts (bone-forming cells) researchers now believe that androgens have some direct effect on bone formation and resorption.

Declining Testosterone, Fat Mass and Heart Risk

A growing body of research now suggests that an age-related increase in fat mass, or obesity, can be attributed to a fall in free testosterone and growth hormone levels. Moreover, studies report a connection between abdominal obesity and increased cardiovascular mortality and Type II diabetes mellitus. Recent findings from the University Hospital in Ghent, Belgium illustrate that age is related to a drop in free testosterone levels and free insulin-like growth factor-1, while contributing to an increase in body mass index and fat mass.

One recent study consisting of 372 males aged >20-85, revealed that body mass index and age were independent factors in determining testosterone levels. These decreased by about one quarter when researchers compared the young controls to men in the elderly group, while free testosterone levels fell by almost half with age. Likewise, fat-free mass decreased by 18.9%. In a subgroup of 57 men aged 70-80 years, the lower that testosterone levels dropped, the higher the percentage of body and abdominal fat, as well as plasma insulin levels.

Low Testosterone and Increased Risk of Diabetes and Adipose Fat.

Other findings indicate that low testosterone levels predisposed men to adipose fat which, in turn, seemed to raise their risk of diabetes mellitus. Researchers at the University of Washington’s Department of Medicine set out to examine the effects of age-related decreasing serum testosterone levels on intra-abdominal fat in a group of 110 second-generation healthy Japanese-American men. Measurements were taken first to establish baseline levels of glucose, body mass index, visceral adiposity, subcutaneous fat, fasting insulin and C-peptide levels, and overall testosterone levels (which were within the normal range relative to the men’s age).

When the researchers performed follow-up measurements 7.5 years later, their results indicated that intra-abdominal fat had increased by an average of 8.0 centimeters squared. More importantly, though, they found that the change in intra-abdominal fat correlated to baseline total testosterone levels, but they were not significantly related to other measurements such as body mass index, total fat or subcutaneous fat. The study authors concluded that, in their sample, “lower baseline total testosterone independently predicts an increase in intra-abdominal fat. This would suggest that by predisposing to an increase in visceral adiposity, low levels of testosterone may increase the risk of type II diabetes mellitus.”

Low testosterone Levels, Excess Abdominal Fat and Heart Disease

Similarly, another study that analyzed some of the health effects of excess abdominal fat, also referred to as android obesity, reported that individuals exhibiting upper body excess fat distribution tend to have lower levels of plasma testosterone and growth hormone levels, suggesting what the authors describe as “complex hormonal abnormalities”.

Abdominal obesity lends itself to an apple-shaped figure and has been related to a heightened risk of conditions such as cancer, diabetes and heart disease. These researchers believe that, “Visceral fat tissue, through its portal drainage, could be an important source for free fatty acids that may exert complex metabolic effects: involvement in hepatic lipogenesis, increase in hepatic neoglucogenic flux, reduction in insulin metabolic clearance and involvement in peripheral insulin resistance through a competition mechanism described by Randle.”

They conclude that abdominal obesity may be related to diabetes by means of an enhanced fatty acid made available from fat tissues (visceral and subcutaneous) in individuals who are genetically predisposed to type II diabetes. Research has also pointed to the possibility of a link between abdominal obesity and hypercorticism, or elevated cortisol levels. A reason for this, suggest scientists, might be that excess cortisol opposes testosterone and growth hormone production, both of which are regulators of body fat. Moreover, low testosterone levels also seem to encourage cortisol levels to rise and elicit their many aging effects, including immune dysfunction, brain cell injury, arterial wall damage and other assaults.

Hypogonadism (low testosterone) and Heart Trouble

Low testosterone levels have also been implicated in playing a role in the development of chronic diseases such as atherosclerosis and cardiovascular heart disease. One study found that, in assessing a group of men and postmenopausal women over 50 years of age for levels of various hormones as they might relate to health conditions, plasma estradiol levels were highest in hypertensive men and testosterone levels were lowest in men with coronary heart disease. The researchers conclude that perhaps, “Decreased testosterone and/or increased estradiol may have an adverse effect on lipid profile in elderly men.”

Another study conducted among a male population likewise reported that low testosterone may be a risk factor for coronary heart disease, which may relate to lipoprotein metabolism by endogenous testosterone. Results showed that mean plasma testosterone levels among patients with coronary heart disease were significantly—about 40%—lower than in healthy subjects. Moreover, there was a negative association between plasma testosterone levels and plasma triglyceride levels and lipoprotein (a), which translated into higher blood lipid levels relative to lower testosterone levels. Contrarily, a positive association between plasma testosterone levels and high-density lipoprotein cholesterol and high-density lipoprotein 3 cholesterol meant that higher testosterone levels equaled higher “good” cholesterol levels.

The Natural Aging Factor

It is well documented in research that sex hormones such as testosterone are vital components in the sexual development of pubescent males, as well as contributing to the increase of their muscle and bone mass as they transform from boys into men. Meanwhile, dwindling testosterone levels as a result of metabolic aging trigger the opposite kind of effects, including the loss of body hair and progression of male pattern baldness, loss of muscle and bone mass, and increased fat.

Low testosterone levels aren’t just the prospect of a small segment of the male population but rather, they tend to affect the male population as a whole. Natural aging causes a gradual decline in male hormones, so that by age 70, men have less than a quarter of their optimal testosterone levels. Some figures reveal that free testosterone levels start to fall at the age of 25. While men with normal testosterone levels sometimes exhibit some of the symptoms, which may very well stem from other causes besides hypogonadism, the fact that androgen therapy usually alleviates these symptoms suggests a hormonal deficiency as the root cause of such deterioration in health.

January 6, 2010 | truthabouthormones | Tags: , , | No Comments »

Your Choice for the Future: Prevention or Treatment

Your Choice for the Future / Prevention or Treatment

Options:

  • Seek long term health insurance
  • Seek medical assistance to TREAT the sickness
  • Prevent the Condition through Preventive Medicine.

By Mike Clark

The companies that sell long term health insurance have some important information regarding future health and future insurability. As you will note below, the conditions that they say will prevent you from obtaining insurance — or at least insurance at a reasonable cost — ARE THE VERY CONDITIONS WE WORK TO PREVENT.

Our philosophy at NBH Lifetime Health is that it is better to prevent diseases and disabilities than to seek help for them at some future time.

The following is excerpted from a Long Term Insurance Company:

“Health Risks That Cost Women Their Good Health Discounts.”

Here are some health conditions that insurers look for in women (and men).  They may not limit you now – but they potentially pose a greater risk you’ll need long-term care in the future.  A long-term care insurance professional can best tell you if you’ll be eligible for “good health’ discounts.”

-       Breast Cancer

-       Osteoporosis (Lower Bone Mass)

-       Overweight (compared to Recommended Height-Weight Tables)

-       Arthritis (Affected Joints, Taking Steroids, Limitations)

-       Adult Onset Diabetes

-       High Blood Pressure (Under Treatment)

-       Schleroderma

-       Taking Medications for Depression or Anxiety

-       History of Alcohol or Drug Dependency

-       Tobacco Use

THESE ARE ALL CONDITIONS THAT WE CAN HELP PREVENT/TREAT!

“Health Risks That Cost Men Their Good Health Discounts”

Here are some health conditions that insurers look for in men (and women).  They may not limit you now – but they potentially pose a greater risk you’ll need long-term care in the future.  A long-term care insurance professional can best tell you if you’ll be eligible for “good health’ discounts.

-       Prostate Cancer

-       Heart-Related Health / High Blood Pressure

-       Overweight (compared to Recommended Height-Weight Tables)

-       Tobacco Use

-       Arthritis (Affected Joints, Taking Steroids, Limitations)

-       Adult Onset Diabetes

-       Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease)

-       Taking Medications for Depression or Anxiety

-       History of Alcohol or Drug Dependence

THESE ARE ALL CONDITIONS THAT WE CAN HELP PREVENT/TREAT!

TODAY YOU ARE HEALTHY, BUT 24-HOURS FROM NOW, THINGS CAN CHANGE

Here are some of the life-altering changes that can unexpectedly happen at any age.  They can cause the need for long-term care.  They can make it impossible for you to qualify for long-term care insurance protection.

  • Coronary Heart Disease (CHD) Every 26 seconds an American suffers a coronary event and each year about 700,000 will have a first attack.  CHD is the leading cause of permanent disability in the U.S. labor force.  About 22% of men and 49% of women will be disabled with hart failure.

Source:  American Heart Association, 2009 update.

  • Stroke. Each year, about 500,000 Americans suffer their first stroke. 28% are under age 65.  Stroke is the leading cause of serious, long-term disability and institutional care is (still) required by 20% at three months after onset.  Source:  American Heart Association:  2009 Fact Book
  • Osteoporosis. Often called a “silent disease” because bone loss occurs without symptoms, some 10 million Americans already have the disease and 34 million have low bone mass.  Eighty percent of those affected are women.  One in two women are one in four men over age 50 will have an osteoporosis-related fracture in their lifetime.  Six months after a hip fracture, only 15 of patients can walk across a room unaided.
    Source:  National Osteoporosis Foundation, January 2009
  • Diabetes. There are 20.8 million people in the U.S> who have diabetes and over 1.3 million new cases are diagnosed every year.  Over 500,000 of new causes are people age 40-to-59.  The risk of stroke is 2 to 4 times higher for people with diabetes.  Source;  American Diabetes Association, Statistical Update 2009
  • Parkinson’s Disease. One million Americans suffer from Parkinson’s Disease and each year 40,000 new cases are diagnosed.  It usually develops after the age of 65 but 15 percent of those diagnosed are under age 50.  Source;  Parkinson’s Disease Foundation, June 2009
  • Alzheimer’s Disease (AD). Every 72 seconds someone in America develops Alzheimer’s disease (AD); by mid-century someone will develop Alzheimer’s every 33 seconds.  An estimated 5.1 million American’s have Alzheimer’s with at least 200,000 younger than 65 with early-onset AD.  Nearly 500,000 new cases are diagnosed every year.  A person with AD will live an average of eight years and up to as many as 20 years from the onset of symptoms.  Source; Alzheimer’s Association Fact Sheet, 2009

THESE ARE ALL CONDITIONS THAT WE CAN HELP PREVENT/TREAT!

Mike Clark, Clinic Director

December 23, 2009 | truthabouthormones | No Comments »

Need Energy? Magnesium Might Be Your Answer.

Are you feeling tired? Stressed out? You are not alone!

It is the holiday season and we are all supposed to be happy and full of energy. After all, we have a million things that we just must get done. We have shopping to do, gifts to buy, rooms to clean, parties to attend, trees to decorate and more and more.  During all of this we are supposed to smile, make sure everyone else is happy and be ready to do it all again the next day.

One way to boost your energy is to increase your intake of magnesium.  Unfortunately, eating a balanced diet doesn’t always provide the extra energy you need to counteract a slight deficiency of magnesium.

Magnesium is a mineral that is integral in more than 300 biochemical body reactions.  It even helps in breaking down glucose into energy, so your energy can fall if your magnesium level is low.

Magnesium deficiencies can cause the body to work harder because the heart rate is higher, requiring more oxygen to accomplish physical tasks than if the magnesium levels are sufficient. The recommended daily requirement of magnesium is about 300 milligrams for women and 350 milligrams for men.

An ample amount of this mineral combats stress and hypertension (high blood pressure) and boosts energy levels.

Magnesium also relieves muscle cramps, and helps prevent arrhythmia.

Everyone loses magnesium in the course of daily life, and everyone should supplement with magnesium.

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Heart Health & Diagnostic Testing

Standard testing does not protect you against heart disease. Why should we be concerned about conventional testing and about our heart? How can we protect ourselves?

WARNING: THE FOLLOWING INFORMATION IS SCARY BUT ACCURATE.

Feel free to share this information with your family and friends to scare them and perhaps save their lives.

Heart Facts: Cardiovascular disease, or CVD, kills more than 16 million people worldwide each year and accounts for 30% of the total number of deaths. In the U.S., where more than 61 million people live with CVD, one American dies of CVD every 33 seconds – and more than half of those who die suddenly of CVD had no previous symptoms.

Heart disease and stroke, the main components of cardiovascular disease, account for nearly 40% of all deaths in the nation.

ABC News: Dec. 29, 2006. “It should come as no surprise that nearly every one of us knows someone who died of heart disease; it remains the No. 1 killer in the United States, according to a year-end update on heart disease and stroke statistics from the American Heart Association. In fact, cardiovascular disease accounted for more than one-third of all deaths in the United States in 2004, according to the update. Further, stroke is the no. 3 killer after heart disease and cancer. The update found about 700,000 people experience new or recurrent strokes each year.”

Women. Your heart & menopause. The risk of heart attacks and strokes increases in women after menopause. According to the Centers for Disease Control and Prevention (CDC), one in 10 women between the ages of 45 and 64 has some form of cardiovascular disease (CVD); by age 65, however, the rate is one in every four. As hormonal levels decline with the onset of menopause, women’s heart and arteries are inexorably affected.  “Estrogen helps keep the arteries free from the buildup of fatty substances, cholesterol, cellular waste, and other contaminants.” It is known that estrogen keeps arteries supple. See the UPCOMING   Newsletter to learn more about how bio identical hormones can protect your heart.

Many women simply don’t recognize the warning signs of coronary heart disease until such time as their health is already deteriorating. According to the American Heart Association (AHA), more than half a million (500,000) women die of heart disease each year. Since 1984, heart disease has claimed the lives of more women than men, making it the #1 KILLER OF AMERICAN WOMEN. While men do have more heart attacks than women, women are less likely to survive, and more likely to have a second attack.

Women (and men) with high blood pressure also have an elevated risk for heart disease because hypertension hardens the arteries, which forces the heart to work harder. Roughly one third of people with hypertension do not know that they have high blood pressure.

It’s common to think breast cancer is the No. 1 threat to women’s health when, in fact, heart disease is responsible for more deaths in women than all forms of cancer combined. Heart disease is the most significant health concern for women in the United States today.

The common belief that heart disease affects mostly men is a dangerous myth. In reality, more women than men die of heart disease in the United States each year. But according to the American Heart Association, only 13 percent of women know that heart disease is a major threat to their health.

Men & Declining Testosterone. Studies have shown that adequate levels of testosterone are important for maintaining cardiac health and preventing age-related senility. Reports from the oft-cited Rotterdam Study, where researchers examined the association between testosterone levels and cardiac health in 504 men aged 67-to-75, showed that men with higher levels of testosterone had lower levels of coronary artery disease. As the authors of the study stated, “we found an independent, inverse association between levels of endogenous testosterone and severe aortic atherosclerosis and progression of aortic atherosclerosis in men.” MANY studies show that testosterone also helps protect the hearts of women.

Standard testing does not protect you against heart disease.

Limitations of Standard Lipid Testing. “For years, physicians have relied on the standard lipid panel—including total cholesterol, LDL, HDL, and triglycerides—to assess their patients’ cardiovascular disease risk. It is increasingly apparent that this approach fails to detect many individuals at risk for heart disease.”

This focus on standard lipid testing causes individuals and doctors to neglect all the other causes of heart disease, some of which are more important than cholesterol. “Can you have a heart attack if you have low cholesterol? You sure can. Can you survive to the age of 95, outlive all your neighbors, and never have a heart attack despite high cholesterol? Absolutely. Can you suffer a debilitating or fatal heart attack with “normal” cholesterol? It happens every day—1,152 times a day nationwide, to be exact, according to a 2004 report by the American Heart Association.”

By way of example, former President Clinton had received frequent assurances from his physicians that he was in “good health.” He had passed an annual thallium stress test for the preceding five years. His cholesterol was reported in the press as excellent at 179 mg/dl, and doctors monitored his cholesterol values frequently. Mr. Clinton jogged and complained of no symptoms with vigorous exercise. Yet, shortly after the release of his autobiography, he developed unstable symptoms that warned of impending heart attack. Extensive blockages of all three coronary arteries (greater than 90%) were diagnosed through heart catheterization and Mr. Clinton underwent a quadruple coronary bypass operation. He had a massive heart attack and heart surgery.

Many patients are told that they are in a low risk group due to their “normal’ cholesterol levels. They either died shortly thereafter from heart attacks or were “saved” on the operating table after suffering a heart attack.

Patients have died from heart attacks despite having an LDL level of 95 mg/dL. Is this unusual? The average LDL level in heart attack survivors is 140 mg/dL. Compare this to the average LDL for all Americans, which is 134 mg/dL. These values are so close; it is no wonder that predicting heart attack risk based on LDL values is an imprecise science at best.

This does not mean that you can ignore cholesterol. Several large studies have demonstrated that cholesterol levels are related statistically to the risk of heart disease. The higher your cholesterol levels (total and LDL), the greater the likelihood of heart disease. The Multiple Risk Factor Intervention Trial, or MR FIT, showed that the likelihood of heart attack in the people with cholesterol levels in the highest 20% was three times that of people whose levels were in the lowest 20%. The well-known Framingham trial also illustrated this phenomenon.

In both studies, however, a significant number of heart attacks still occurred in people with low or “normal” cholesterol values. In the Framingham study, four of five people fell into a large middle range of cholesterol levels, whether or not they developed heart disease. Those with extremely low total cholesterol (less than 150 mg/dL) had low (though not zero) risk for heart attack; those with extremely high cholesterol (greater than 300 mg/dL) had high risk for heart attack (threefold higher). But the great majority of people fell in between these extremes, and the greatest number of heart attacks developed in people with cholesterol levels in this middle range.

Look for “Testing for a healthy heart” in an upcoming Blog or go  to www.nbhlifetimehealth.com to order the “Healthy Heart” lab tests.”

Mike Clark, Clinic Director

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