Arteriosclerosis - what causes it and how to prevent it
Arteriosclerosis is the result of the healing process as a result of the lining of arteries being damaged. The result is a scar over the site of the damage which could cause:
- Narrowing of the artery (and so impaired blood supply distally). Possible symptoms include angina (heart), intermittent claudication (legs), dementia (brain).
- Scar rupture with a clot forming on the surfaces which embolises to cause acute blockage downstream (myocardial infarction), acute gangrene (legs), stroke (brain).
- Weakening of the artery wall - aneurysm
- Breakage of the arterial wall - stroke
Arteriosclerosis - checking for risk factors
From the patient's medical history (in order of importance)
- Age - with age one can stay just as fit and well, but one has to work harder at it!
- Smoking is obviously a major risk factor.
- Industrial pollution - this is now a major cause of arteriosclerosis. See the work of Dr Dick Van Steenis and Michael Ryan at Country Doctor.
- Western diet - high in refined carbohydrates, high in dairy products, micronutrient-deficient and polluted by food additives and pesticides. The Stone Age Diet is highly protective against arterial disease. Western diets result in diabetes and high blood-pressure, both of which are major risk factors for arteriosclerosis. In fact, more often I now prescribe the ketogenic diet - please see Ketogenic diet - the practical details and My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
- Addictions in diet - to sugar, coca cola, caffeine etc.
- Lack of sunshine - vitamin D is highly protective against arterial disease.
- The Pill and HRT.
- High-stress living.
- Addictive drugs.
- Alcohol consumption of more that 2 units a day for men, fewer for women.
- Not sleeping well.
- Not exercising.
- Not taking nutritional supplements.
- Being apple-shaped (as opposed to pear-shaped). This is symptomatic of immune activity in the gut (food allergy or fermenting gut) resulting in low-grade inflammation, often followed by damage to blood vessels.
- Dental amalgam fillings. see Mercury - Toxicity of Dental Amalgam - Why you should have your dental amalgams removed
- Family history of arterial disease - if positive then you need to work hard to find and reduce risk factors.
- High levels of "bad" cholesterol (LDL) compared to "good" cholesterol. (HDL)
- Conditions associated with inflammation.
To diagnose arteriosclerosis
- Do not wait for the consequences! Do not wait until you have a heart attack or stroke!
- Can you get fit? If not, this may be because of poor blood supply secondary to arteriosclerosis.
- Are you at risk? See above factors.
- Look at the flow in arteries using Doppler techniques.
- Look at how much calcium is present in arteries - coronary calcium score. See LIFESCAN. This is non-invasive.
- Radiographic techniques (invasive) such as angiograms
- Blood pressure - most people get "white coat hypertension". If this is suspected, buy yourself an idiot-proof home measurement cuff. See Blood pressure
- Body mass index - a high BMI is often a symptom of carbohydrate addiction, but could be caused by underactive thyroid. See Hypothyroidism - A Common Hormonal Problem in CFS
Try increasing your exercise. If you are unable to do so, then this could point to arterial disease.
- Sugar and protein - ask for multistix urinalysis.
- ESR, creatinine protein or plasma viscosity - these indicate inflammation in the blood which may damage arteries.
- TFTs - hypothyroidism or hyperthyroidism are both risk factors for arterial disease.
- Homocysteine - raised levels are a potent risk factor.
- Magnesium deficiency - a good indirect test of mitochondrial function.
- Chromium deficiency.
- Increased clotting tendency - anticardiolipin antibodies.
- Serum B12 levels.
- Antioxidant status - GSHPx (Se), SODase (Cn, Mn, Zn), CoQ10.
- High uric acid and high gamma GT are both symptoms of poor antioxidant status.
- Cholesterol and triglycerides - blood should be taken with the patient fasting (no food for 12 hours previously). Raised cholesterol may be a sign of heart disease, not a cause. See Cholesterol - the common causes of raised levels.
I would test for these things routinely. The homocysteine test (see Homocysteine - the biochemistry of - not essential reading but interesting!) is a bit awkward because the blood has to be centrifuged immediately after it's been taken; otherwise the result is invalidated. Therefore, special arrangements need to be made. I.e. you need to go to a hospital or laboratory where this can be done.
Infections - if the history suggested, I would do breath testing for helicobacter pylori (see Helicobacter Pylori breath test), ELIZA antibodies for chlamydia.
Magnesium, B vitamins, antioxidant status, EFAs
- Magnesium deficiency is a common cause of arterial disease. Treatment of such with intravenous magnesium is a very powerful treatment. See the science in Dr Browne's paper on i.v.i. magnesium in the Journal of Nutritional Medicine
- B vitamin deficiency (especially thiamine). Thiamine deficiency alone can cause heart failure, common in heavy drinkers.
- Antioxidant deficiency (vitamins A, E, C and selenium)
- Essential fatty acid deficiency.
These things can all be tested for, but I would not do the tests routinely as long as my patient was taking nutritional supplements regularly - ie a multivitamin, multimineral, vitamin C and essential fatty acids. If you won't take the supplements, do the tests to convince yourself that you should take the supplements! See Nutritional Supplements To my mind, this is a far better way of spending your money than on medical insurance!
Apolipoprotein A - this is known to be a risk factor, but no-one is very sure how to treat it; so there's not much point in measuring it.
Pollution either from toxins such as:
- Pesticides - measure fat pesticide levels. This will pick up a range of POPs (persistent organic pollutants) such as organophosphates, organochlorines, fire retardants etc. OR DNA adducts.
- Heavy metals - no simple test because these are often sequestered away in tissues. Hair sample, blood sample, sweat or Kelmer test. See Hair Mineral Analysis and Mercury - Kelmer test and Toxic Elements screen - urine sample.
- Fine dusts (PM2.5 and under) from polluting industry such as power stations, manufacturing industry - indeed, anything with a chimney is a potential risk. At present, it would be expensive for industry to clean up its act; so the facts are either fudged or covered up. There are no tests for dusts.
- Hair Mineral Analysis
- Mercury - Kelmer test
- Toxic Elements screen (Biolab) – urine sample
- Toxic Elements screen (Genova) – urine sample
- Helicobacter Pylori breath test
- Heart disease
- Stone Age Diet
- Blood pressure
- Cholesterol - the common causes of raised levels
- Nutritional Supplements
- Mercury - Toxicity of Dental Amalgam - Why you should have your dental amalgams removed
- Hypothyroidism - A Common Hormonal Problem in CFS
- Homocysteine - the biochemistry of - not essential reading but interesting!
- Helicobacter Pylori breath test
- Ketogenic diet - the practical details
- My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
- Country Doctor
- Dr Browne's paper on i.v.i. magnesium in the Journal of Nutritional Medicine
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