Thursday, March 04, 2010

LDL Cholesterol- Is it truly a villain?

Institute For Medical Wellness Healthy Living Report

LDL Cholesterol- Is it truly a villain?

In my previous newsletter, I discussed the meaning of a Total Cholesterol reading as it relates to your risk of vascular disease. If you missed that newsletter, I'll update you.
Total Cholesterol is meaningless.

I'll say that again.

Total Cholesterol is meaningless!!

You see, total cholesterol is made up of many subfractions.

There are two common subfractions we usually hear about.

One that we measure is called LDL, otherwise known as low density cholesterol or BAD cholesterol. A simple way to remember LDL is bad is that L is lousy or bad.

A second that we measure is called HDL, otherwise known as high density cholesterol, or GOOD cholesterol. A simple way to remember that HDL is good is that H is happy or good.

So while two individuals may have the same Total Cholesterol, the amounts of the HDL and LDL may differ.

Today I will focus on LDL which has long been blamed for heart and vascular disease. What you may not know is that just as Total Cholesterol has subfractions that are both good and bad, LDL cholesterol also has subfractions. These subfractions are not all bad for you. Unfortunately, a routine cholesterol or lipid panel does not break down LDL into its subfractions. That is why at the Institute For Medical Wellness, we order a more detailed lipid panel to include these measurements. These added LDL subfractions enable us to better stratify your risk for heart and vascular disease and guide you towards a healthier diet and lifestyle to match your levels.

The first LDL subfraction I will call Type B LDL, otherwise known as small and dense. The small dense Type B LDL's tend to be more problematic. A simple way to understand this is to imagine a cholesterol doorway that is only 25 nanometers wide. Only LDL cholesterol particles smaller than 25 nanometers can fit through the doorway. Type B LDL tends to be 25 nanometers or less and can fit easily through the doorway. Unfortunately this doorway leads the cholesterol towards increased plaque formation and a higher risk of heart disease.

The second LDL subfraction I will call Type A LDL, otherwise known as large buoyant or big and fluffy. These big fluffy Type A LDL's tend to be much less problematic, as they tend to be larger than 25 nanometers in size, and do not fit easily through the cholseterol doorway. This makes the Type A LDL's not as dangerous.

OK. Now let me put this all together for you. Just as measuring a Total Cholesterol level by itself tends to be meaningless, measuring a total LDL is not very helpful without the subfractions we now call big fluffy and small dense.

So, I know people do not like to be call big and fluffy. But when we are talking about LDL cholesterol, big and fluffy is what you want to be.

For more information about this type of cholesterol testing, please visit the following website.

Unfortunately, there is a caveat. One insurance company, Aetna, is way behind the eight ball when it comes to lipid measurements, and refuses to allow payment for this testing. But I am always looking for a way to guide you through or around the health insurance quagmire. Presently I am in discussion to get this special testing at a reduced price for Aetna patients.

Stay tuned.

Next in the cholesterol series, in an upcoming newsletter, will be HDL.

Healthcare Reform Update:

Yes, here we go again!

First let me say that my views on healthcare reform are not meant to be political, as healthcare should never be held hostage to politics. Your healthcare and the decisions you make about your health should be yours to make, and yours alone. Unfortunately too many outside interests (insurers and politicians) have gotten in the way. It was not always like this.

My whole life has been centered around healthcare. I started my medical education in 1988, but I grew up in my father's medical office. My father was an independent family doctor who practiced for 25 years, before the insurance companies or the government took over control of the system. Insurance premiums were much more affordable during that period. The doctor-patient relationship was paramount when I would visit my father's office and see the interaction between him and his patient's. There was no concern for what insurance a patient had. So the problem, as I see it now, is not that there is not enough government and third party control of your healthcare, but too much. Way, way too much!!

So when I discuss the healthcare reform debate, it is personal. Healthcare costs, as I see it, have skyrocketed due to government and insurance control, so how will giving them more control of the system lower costs?

I am not part of any political party. I am not a republican or democrat, and I do not belong to a tea party. I am proud to be just as independent politically as I am independent in my practice of medicine. My views on this healthcare reform issue gravitate towards what I personally feel gives the most control of healthcare decisions to patient's and their physicians. Any reforms that try to intrude on the doctor-patient relationship, I will oppose, and oppose strongly.


Institute For Medical Wellness Planning Stages or what we hope to offer in the near future.

•Healthy Weight Program- Lite edition- pun intended!
•New Heart and Vascular Wellness to focus even more on prevention of heart disease.
•More In-Depth Nutritional Testing

If you have any ideas for future newsletters please let me know!

To Good Health!

Steven Horvitz, D.O,
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

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