Tuesday, April 7, 2009

Lp(a) and Women's Heart Risks

For women with high Lp(a) and high CAC scores, estrogen (including natural, fake and the horsey-hormones) has been shown to in fact be beneficial in controlling CAD risk, events and reduction in Lp(a). Does this translate to men... *ha* I believe it may -- that is why alcohol-extracted soy protein, phytoestrogens and even... BEER help men with Lp(a) and reduce CAD.

With that said, controlling Lp(a) in post-menopausal women has enormous benefits for heart disease. HRT (hormone replacement therapy) is safe, convenient and promotes longevity and optimal heart health. Plus people report better well-being, sharper minds and unrelenting energy. (They say sex is better too.)

Bioidentical HRT and monitoring via salivary/blood testing is the ONLY way to go, according to my personal research.

Uzzi Reiss MD, Michael Colgan PhD, Suzanne Somers, Cheryle Hart MD (hormonesbyhart.com) are all excellent resources.

Each one of the above authors stress an insulin-controlled diet in conjunction with optimizing all 10 hormones (they forgot vit D -- but one of my pts sees Dr. Hart and she normalizes vitamin D [25-hydroxy-D] now).

1. Melatonin


3. Pregnenolone

4. Estrogen (we have 3 types floating around -- E3 is the best and shown to be cancer protective; avoid E1, higher cancer rates)

5. Progesterone (Dr. John Lee MD obgyn is a good read esp for insulin, promotes avoidance of plastic/pesticides/poisons, etc)

6. Testosterone (yes for women this is very VERY good too -- and reduces Lp(a))

7. Insulin

8. Cortisol

9. Vitamin D

10. Thyroid

Control of Lp(a) is reviewed in great detail in our Part 3 TYP Diet, TYP Lp(a) reports 1 and 2.

Critical components of a successful Lp(a) reduction program at TYP are:

--control of all the above hormones -- ALL TEN

--good adequate sleep (for cortisol reduction and immune system optimization), rest, relaxation, recovery, etc

--exercise -- to reduce belly fat -- including resistance training which grows lean body mass, muscles

--low carb diet -- no wheat or gluten or grains or legumes; minimal fruit

--moderate diversely-colored nonstarchy veggies

--adequate high quality protein (including organic organ meats)

--avoidance of things which set off the immune system -- excessive cardio, excessive endurance training, infections, excessive mental or physical stress, sleep deprivation, etc

--antioxidants: astaxanthin, krill oil, carotenoids, coenzyme Q10, curcumin, alpha-lipoic acid, carnitine, NAC, flavonoids, pycnogenol, mushroom extracts, et cetera -- they are all EXCELLENT

--saturated fatty acids: unrefined coconut oil, MCT oil, fat on grassfed meat/wild game/free range fowl/wild seafood, egg yolks, butter oil (greenpasture.org), (if not casein-sensitive) raw fermented dairy, high-quality 70+% chocolate, organic lard, etc

--ultra high dose EPA DHA fish oil 6-8.5 grams daily (higher quantity, if inflammation is present)

--avoidance of all omega-6 refined veggie oils: sunflower, safflower, peanut, soybean, canola, etc

--intermittent fasting (this replicates the effects of NIACIN combined with all the above strategies)

--niacin 1-2 grams daily

--avoidance of low-fat diets (eg, the AHA low-fat-diabetogenic-kill-ya diet)

If elevated Homocysteine (greater than 8.0) occurs despite all the above strategies, consider adding high doses of B-vitamins
--Folic acid, 1 - 5 mg daily
--Vitamin B12, 1000 mcg daily (adenosyl- and/or methylated cobalamin) sublingual is the best absorbed form
--Vitamin B6, 50 mg daily
--Trimethylglycine (Betaine) 1.5 - 3 mg daily

Sure sounds like... the optimal Paleo warrior diet/lifestyle, right?

And... not unlike a diet/lifestyle of wolves...?


Jake said...

Two fat questions:

Beef contains more monounsaturated fats than saturated fats. Are these monounsaturated fats as good for you as olive oil?

Are the Omega 6 fats in almonds as bad for you as the Omega 6 fats in vegetable oils.

Anonymous said...


You mentioned avoiding "omega-6 refined oils" like Canola oil. I know Canola oil is highly refined, but according to Wikipedia, Canola oil has an approximate a 2:1 ratio of Omega 6 to Omega 3 oils so wouldn't this be a near ideal ratio?

According to Wikipedia, Canola oil is 61% Omega 9, 21% Omega 6, 11% Omega 3 & 7% Saturated.

Dr. B G said...

Hi Jake :)

In the petri dish, there is no differentiation. Synergistically, I think when consumed with some veggies, wine and other foods, I believe digestion provides even better substrates than just monounsaturated fatty acids alone.

I've wondered about the omega-6s in almonds (esp if they are RANCID). Shelf veggie oils are rancid the second they are extracted (due to heat, processing, hexanes, etc). Almonds at least are a little more stable. I guess nature gave them better shelf lives in the package the originally came in!

Almonds v. almond oils provided benefits for cardiovasculature health in one trial -- incr HDL, larger particles, lower CRP.
I think almonds despite the little omega-6 they have are great foods. Soaked almonds are probably even better -- less chance any phytic acid from the exterior of the nut to bind and prevent absorption of Mg, Fe, and other nutrients. Many cultures (like Indian, Punjabi, Persian, etc) soaked their nuts overnight before eating. I don't have time to do it -- but should...


Dr. B G said...

Dear Anonymous,

Omega-6s in generally should be limited due to their pro-inflammatory effects on our hormones and eicosanoids. Though canola may appear to have 'favorable' ratios, the oil is highly refined, heated and extracted using a variety of chemical processing which leads to an oxidized product. Even topical use of canola, safflower, sunflower or soybean oil leads to the incorporation of these highly-reactive oils into our cell membranes which can be easily oxidized (and thus cause cellular damage).

Not good if excessive. Then you'll need more good fats to counter and try to neutralize (omega-3, saturated fats like coconut and grassfed meat/wild fowl, some GLA omega-6).

Hope that helps!