Heart Disease With Normal Cholesterol? ApoB, Lp(a), and the Heart Labs Most Patients Never Hear About

Yep. >> Do you see that we are live? >> Yeah. Yeah. >> Awesome. All right. So, let's wait a little bit. We'll wait for people to join in. I see that there's a few people waiting. Um I'm going to go live on Instagram. Let's see. Do you see the little number of people watching? >> Uh I don't. I see private chat. I see comments. >> But right next to the live. Hi guys. is we're just going to wait a little bit for people to start rolling in to the room. Thank you all for showing up. Okay, and I think we are ready to get started. Okay. Hello everybody. Welcome to the MedMatrix Method podcast. Um, today we have a very exciting episode. It's Gab's first live episode and I am very thrilled to be here with him. So, first thing I'm going to do is I'm going to go into our episode introduction and then I'll go kind of into um how the structure of the podcast is going to work. All right. If you don't know me, my name is Leah Safy. I am the media director here at MedMatrix. You don't usually see me besides recently because I'm on the back end. I'm I'm monitoring the podcast. So, we're we're trying something new here. I don't know how it's going. [laughter] Um, but let's go right into the episode introduction. And this episode is called Cholesterol Isn't the Full Story: Heart Labs, Blood Pressure, and a Breakdown. What if the number your doctor keeps focusing on is not the number that tells the whole story? cholesterol gets blamed for heart disease all the time, but plenty of people have normal cholesterol and still end up with serious cardiovascular risk. Others are told one elevated number means that they need medication immediately without anyone asking what is actually driving the problem underneath. In this episode of the MedMatrix Method podcast, we're breaking down why cholesterol is only one piece of the heart health picture. We'll talk about the deeper labs most patients never hear about, including Apo B, lipoprotein, A, insulin resistance, inflammation, and thyroid markers. We'll also get into blood pressure, stress, sleep, body composition, and why a functional medicine approach looks beyond the standard panel to understand what is really happening before risk turns into disease. That was long-winded. Thanks for bearing with me, everyone. And now, let's go into the introduction. Welcome to the Men Matrix Method podcast where we talk about everything functional medicine. Today's episode is called Cholesterol Isn't the Full Story: Heart Labs, Blood Pressure, and a Breakdown. And we've been looking forward to talking about this because it's something we see all the time. Patients who are either scared by one cholesterol number or reassured by basic labs without really understanding the full cardiovascular picture. I'm really excited today to be joined by one of our functional medicine providers, Gabriel Rocha, who is going to break down what patients should actually understand about cholesterol, blood pressure, deeper heart labs, and how functional medicine takes a look at cardiovascular risk differently. Here's how today's episode is going to work. We're going to start with a discussion, and as we go, if you have any questions, be sure to drop them into the comments. After the discussion, we'll walk through a case study. not in this not in this episode about what a real patient scenario would be. And after that case study, we'll answer your questions during a live Q&A. Just a reminder before we get started, this episode is for educational purposes only. It is not meant to be personal medical advice and should not replace the care from your own medical provider. If you are interested in receiving personalized medical guidance from one of our providers, we would be happy to help. You can go to our website, book a discovery call, and start the process to becoming a patient there. Let's get started. Gabe, why don't you introduce yourself? >> Thank you so much, Leah. I really appreciate that um warm introduction and and the um the amazing intro that you did. And um and so folks, um my name is Gabriel Rochacha. I'm a PA. I've been practicing medicine for about 15 plus years now. Um, prior to that I was I was actually a army medic and so got to do that for many years jumping out of airplanes and and crazy stuff like that. And so um have a um a a wide range of different experience um from sports medicine to functional medicine, integrative medicine, uh lifestyle medicine, um certified in both lifestyle medicine and functional medicine. And so lots of exciting stuff in in in my uh in my career and just super excited to be here um on this Med Matrix podcast. Um thank you so much for the invitation and and I'm excited I'm excited to get to talk about cholesterol. I think that this is such an important topic. U you know it's uh it's one that that a lot of patients have questions about and and it can be a little complex. And so what we do really well here at MedMatrix is is break down these different concepts and easy bite-sized ways to to help our our good folks um better understand what it is that we're working through. And so that's that's what we're here to do today and I'm excited for it. >> That was awesome, Gabe. All right, let's get started with that first question. What is this? All right. Why are we talking about this? When a patient is told their cholesterol is high, what is usually missing from that conversation? >> Such a great question and and you know, it's these important details that are often missing in that conversation about cholesterol that helps to fill in the gaps that many times is missing. And so, um, a lot of patients are told that one number is too high without being shown the full cardiovascular picture. And so in addition to cholesterol mattering uh it should be interpreted along many other uh markers. So blood pressure, blood sugar, inflammation, insulin resistance. Um I like to focus on when when reviewing um a lab panel with a patient, I really like to focus on three critical areas. There's so many other ones, but the three critical areas in my opinion are cholesterol and and what is cholesterol doing and what are those those nuances, those those details of those cholesterol numbers. and we'll talk about that today. Uh but then also really important is inflammation. And we we um in the lab panels that we get, we get some great inflammatory markers. And so it's not only important like what is the cholesterol, but what's the the environment around the cholesterol? So inflammation is the second piece. And then and then the third component uh uh metabolic health or blood sugar regulation. Um and we'll talk about a little bit about that. But so so those are the three major areas that I like to talk about in addition to so many of the other things that we'll kind of delve into. >> Awesome. So what are those heart labs that people should know? >> Great question. Great question. And I I can we can literally spend an hour talking about what those other labs um are. Um, and so, uh, the the the the main ones that we're going to continue to circle back around through to today to kind of tie it all together, um, are, um, things like like LDL, right? Like that's your your your quote bad cholesterol. We we'll dive into more depth about that. Um, apole lipoprotein B. Um this is u the cholesterol that encompasses all the the bad uh inflammatory proteins that surround these cholesterol molecules. Uh lipoprotein A is your genetically driven uh u bad cholesterol. Um and and so so these are just a couple of of of the different markers that we'll be thinking about. Um, I'm going to take a step back and just kind of give you an analogy um so that we can better start to conceptualize and think about these different um terms and these different um concepts. And so uh think of your bloodstream as like as a highway, right? So so in your arteries, in your veins, um you know, they're all a a set of highways running together. Um cholesterol and triglycerides are important cargo that the body needs for energy, hormones, uh cell membranes, so like the integrity of you know the wall around your cell membranes, which is really important. Um and and it also the the body uses cholesterol for repairing too. And so um because fats can't travel freely in the blood um they have to be transported inside of little vehicles called lipoproteins. And so when you when when I say LDL lipo uh I'm sorry low density lipoprotein LDL um the word lipoprotein at the end of that LDL um just think of that as a vehicle um it's a cargo ship um and so inside of those cargo ships is where the cholesterol actually lives and so u so so that's that's the concept that I want you to to start with um and and and heart risk isn't determined only by how much cargo is being transported. We also need to know um how many vehicles are on the highway, what type of vehicles are they? Are they more likely to enter and damage the artery wall? Is the highway already inflamed or damaged? Um are traffic pressures and metabolic conditions making accidents more likely? Um uh metabolic is is a fancy term uh for blood sugar regulation and how the body uses um different nutrients for energy. So whenever I say metabolism, it's how is the body using that for energy. But okay, so that's a little bit of a of insight into, you know, the the analogy that I'll continue to use during during our time together. >> That was awesome. I've never thought about it that way, but it puts a very good visual on on what it is. >> And it's a lot of fun to think about, right? Like little little vehicles running through throughout the body. >> Yeah. So where does blood pressure fit into this heart health conversation? Yeah, such a great question. Uh um and so so blood pressure fits into the conversation because it's an incredibly important uh variable in what kind of damage is happening in in in that highway. Um and so the faster that vehicles have to travel. Um so so think about your blood pressure. The higher the blood pressure goes, the faster your vehicles have to travel. Um and and so the faster our vehicles travel now there's opportunity for more car accidents and more impactful accidents, right? The faster they're traveling, the higher the the the destructive capacity. Um and so um the interesting thing about blood pressure that that may not be so well known is that blood pressure is actually this the same underlying root cause that increases your blood pressure is the same thing that leads to things like diabetes, high cholesterol, um obesity and and then high blood pressure. It's that's a metabolic syndrome is is um the term to think about there. And so metabolic syndrome is is actually insulin resistance. Um and let me break that down really quick is that um when we over consume carbohydrates or sugar um uh then uh our body has to use more and more insulin, the hormone that unlocks the cell. So um so uh each cell um has a little key hole and that's insulin that opens up the door so that sugar can go inside be used for energy. But when we over consume sugar, insulin has to go higher and higher. The cell stops listening to insulin. Um and so you get insulin resistance and then you get high blood pressure, high cholesterol, diabetes, um high uh obesity, th those four components that all rise together. Uh so yeah so so um to summarize what I just said um the more carbohydrates we consume, the more sugar specifically um the higher our blood pressure goes, the more opportunity there is for accidents to happen on that freeway. >> Wow. So let's kind of dive into why this matters. Why is it risky? I know you talked a lot about cholesterol and all the different parts of it, but can you kind of reiterate why is it risky to only focus on lowering cholesterol without asking what the pattern is there? >> Yeah. So, such a great um question and and I love that you're framing it that way, Leah, because um it's risky to only focus on lowering cholesterol without asking the why the pattern is there because if we don't address the underlying root cause, we're really missing the big picture. um uh you know to you know you walk into and and I'm never going to uh poo poo um the u our our our conventional medicine friends. I I think there's a great role for them. I think they do a great job of you know when when you have to go to the emergency department and get your leg fixed. That's you know you want conventional medicine. If you have to have a surgery done to you know um to fix a broken arm they're they're amazing. Um uh but what we um do really well at MedMatrix is address the underlying root cause of why you're having high cholesterol. But um our our good friends um a lot of times in conventional medicine world they'll just get you started on a statin medication and say okay start taking this medicine your cholesterol is going to come down and and we'll keep it moving. However, uh what we know is that the most important thing to do is to address like what are the reasons that you have the high cholesterol? Why does it matter? Um and and what are we going to do about it? And so when we focus on that big picture, we can really start addressing the root cause of the insulin resistance, the thyroid dysfunction, the inflammation, the stress, the poor sleep, uh the metabolic dysfunction, all those, you know, fancy words that we're talking about now. again. Um, and and I'm very happy to go in to each one of those and discuss and explain how each one of those areas impact that cholesterol number that we're looking at. Um, and what what what what the pattern is and what it's telling us about where we need to go digging. >> Wow. So, can somebody have normal cholesterol and still be at risk for cardiovascular complications? >> Yeah, great question. Great question. And so yes, uh someone can have normal cholesterol and still have cardiovascular risks and that's because of those different components that we're thinking about. And so for example, um let's say somebody has great looking cholesterol markers. However, they are either pre-diabetic or diabetic. Um they're obese. Um uh u we we use a great tool in Med Matrix um called the InBody scan. We can talk much more about that later, but um this inbody scan will measure your visceral fat. That's the fat around your organs. These are all um uh additional risk factors that would contribute to uh cardiovascular risk. Um heart attack and stroke and and things of that nature. Um and and so so yes, uh somebody can have perfect cholesterol, all these additional markers and be a smoker and you know um um uh have high stress and poor sleep. Maybe they have sleep apnnea and and of course those are all very important areas to address. >> Okay. So let's opposite side of the spectrum. Why can somebody have high cholesterol but need a more nuanced conversation than this is bad? I know we talked a lot about the things that go behind, you know, what's more than just having lowering cholesterol or what's what heart health means more than cholesterol. So, I guess we're just swinging right back to there. >> Yeah, great question. And and so, you know, someone could have high cholesterol um but need that more nuanced conversation than this is bad. And and the reason why is because uh risk patterns exist. um whether plaque is present and and what other markers are abnormal and and what's driving that change is really going to be the the the key to better understanding what it is that is needs to be addressed in the individual. Um uh for example uh uh uh uh for example if when we look at the cholesterol pattern um for example um LDL is elevated um for a particular set of reasons uh often driven uh in part by a combination of things both genetic and um and nutritional. But if I see triglycerides are elevated. Remember that triglycerides are um the energy producing molecule. Um think of that as like an energy reserve that's throughout the your your highway. Um triglycerides are very much nutritionally uh directed. And so once I see that triglycerides are elevated, I'm like, okay, we need to focus on nutrition. um if I see uh LPA lipoprotein A elevated um and we'll talk a little bit more about that maybe actually now maybe a perfect time to start talking about those in more depth um but then I know that that's genetically driven lipoprotein A is genetically driven and so uh what can we do about that there are some different things that we can do it's it's a little bit harder to address but things like repatha PCSK9 inhibitors these are pharmaceuticals that um that aren't our first tool that we grab for but it gets a um a little more advanced. And so we start with the lifestyle stuff, but then if we see these different markers elevated, we know that we need to start expanding our toolbox. Um and so so that's why it's so much more nuanced than this is bad. Um we got to get into the weeds. We got to get into the details a little bit. [snorts] >> Interesting. Okay. And let's talk specifically about blood pressure. Why does blood pressure deserve as much attention as cholesterol? >> Oh, yeah. Yeah. Yeah. Blood pressure is the the speed of those little cars driving on the freeway. Um, you know, so blood pressure deserves as much attention as cholesterol because when that speed starts to pick up, we're getting things crashing into each other and um and that can be bad. Um, and the cool thing is um I think it's cool, but it's it's a simple formula. If blood pressure is high, we know that we got to work on a few things. We got to optimize your sleep. We got to optimize reduce stress. Um, and maybe I shouldn't say the reduce stress because life is life is stressful, right? Like that that there's no sugar coating that. Um, >> there I know we've talked about that um ourselves in the past, Leah. But um but all in good ways, of course. Um but we what we do know is that stress management is possible and stress management is a um a strategy. It's a tool. It's it's a skill that we learn and and um I I pride myself on on being able to to uh talk about it practically because it's such an important thing that it's such an important skill that goes un um unspoken about. Um you know, we we feel like as a society it's it you know, it's not okay to talk about stress or to be stressed. Um but if we don't talk about it, then we can't find the right tools to address the stress. And that's what that's I I do think that as a as a general population, as society, we are getting better at it, but we got a long way to go. So, back let's circle back around to the uh the idea of blood pressure. So, so sleep optimization, stress management, um sometimes there might be an underlying sleep disorder that we need to uncover. We can talk much more about that. There's also um you know um other things like your your thyroid health. um uh so many things that can contribute to high blood pressure and as we talked about before insulin resistance is one of those major uh drivers of high blood pressure and so what do we need to do often is improve our nutrition decrease carbohydrate intake and or at least improve the quality of those carbohydrates. Um so whole foods um you know u when I when I say whole foods we're talking about nonprocessed foods. So if it comes from a bush, a tree, the ground, um animal protein I think is another excellent source. Of course, um uh unprocessed animal proteins. Um so so yeah, so in their natural form, but yeah, that's a a little bit of long-winded answer of saying, you know, all the different ways that we can improve blood pressure. So if anybody ever has high blood pressure, I want to encourage you um don't feel that you have to be on a blood pressure medicine for the rest of your life. We have the tools at MedMatrix to help you better identify what is the root cause of your high blood pressure. And and the cool thing is is when we start working with folks, many folks are able to come off of their uh their blood pressure medicines, their diabetes medications, um their cholesterol medications. And so that's the beautiful thing is when you address the root cause. >> That's awesome. All right, so let's we talked a lot about root causes. Let's kind of reverse and go into symptoms. What are some symptoms or patterns that might suggest that somebody needs a deeper health workup? >> Yeah, great question. Great question. And so the different symptoms or patterns that tell us, hey, let's dive deeper. Um, and and start looking into this heart health workup are um so high blood pressure is an excellent indicator, right? So if you have high blood pressure, we know that there's something going on. um elevated cholesterol. If you have high cholesterol, if those numbers start to show up, hey, we need to start digging a little bit deeper. Um uh high triglycerides. Um so, uh I mentioned a little bit earlier about, you know, the the difference between um the LDL and HDL particles, right? That last word in those um those terms um high density lipoprotein, low density lipoprotein. When you think of lipoprotein, think of the vehicles on that highway. triglycerides. However, let's talk about that because if your triglycerides are high, this is the energy cargo that's being transported after the body um so that it has more fuel than it it it immediately needs. Um and what do I mean by that is is that it's an energy reserve and so the body can use those triglycerides for energy. Um, and that's how the body takes sugar, um, carbohydrates, and converts them and and stores them into triglycerides to use for later. Um, if you have high triglycerides, it's probably because you're over consuming carbs. A lot of times, you'd be amazed to to know that um, uh, when somebody is um, drinking lots of soda, they have very high triglycerides, um, high fructose corn syrup, the worst thing that you can put in your body. [laughter] And so that gets converted into triglycerides. And so people that are drinking two, three plus sodas a day just doing not doing themselves any favor. And so anyways, I'm going to get off my high horse now. So So uh uh to to finish the uh the thought though and come back to, you know, some of the other patterns that we see. So high blood pressure, elevated cholesterol, high triglycerides, belly fat. um if you have belly fat, that's another um pattern that we see that um tells us that, hey, there's some insulin resistance here that we need to do a deeper dive into heart health and do that work. Um insulin resistance, so hemoglobin A1C, a 90-day average of your blood sugars, that can also start to tell us, hey, there's there's something we need to dig into here. Uh fatigue with exertion. Um, and so when when you're you're more fatiguable and or you know, let's say you go up the stairs and you're you're wiped, you're you're you're you're um you're in a you know, you're really tired after bringing in the groceries. Um walking from the parking lot into, you know, the the store, um these are all indications that we should do a little bit of a deeper dive. If you have a hard time recovering after um exercise, um if you um have a family history of heart disease, um if you have um poor sleep or uh you're just feeling metabolically stuck, you know, uh you're looking at your patterns and you're like, man, I can't I can't get these cholesterol levels down. I'm having a hard time, you know, getting my blood sugars better. These are all great indicators that we need to do a deeper uh heart health workup. >> Oh, all right. So, we talked a lot about, you know, the root causes. So, I'm kind of going to skip through some of the, you know, repetitive questions that we've already asked. Um, but I do want to talk a little bit about thyroid function and how thyroid function can affect cholesterol and cardiovascular markers. >> Love that question because this really starts to get into the crux of the matter. Um, how thyroid function can affect cholesterol and cardiovascular markers. I love threes, right? Like you heard me talk about, you know, the three major things that I think about when we're reviewing labs together, you know, we talk about that. Um, whenever I'm thinking about how to optimize for weight loss, I think about three factors and and I'll tell you how thyroid fits into that pattern. Um, you know, when we're thinking about weight loss, we think about calories in and calories out, nutrition, exercise, that that that's the easy stuff, right? When we think about um hormones, we want to think about the thyroid because hormones will impact your ability to lose weight or not lose weight. Um and then finally, inflammation is another thing that often gets people stuck when we're trying to lose weight. So, but let me go back to that middle column of of hormones and specifically the thyroid. And so, when I when I say hormones, I'm thinking about estrogen and progesterone, your female hormones. I'm talking about testosterone, the the what's considered to be the male hormone, but also [clears throat] very important for women, too. By the way, um we're talking about um uh cortisol, the stress hormone. We're talking about insulin, the hormone that helps to um regulate your blood sugars. Um and now let's talk about thyroid and and why how does thyroid fit into this picture? Um when you think of the thyroid hormone, think about the thyroid is what controls the furnace in your body, your metabolism. It's it's going to regulate how your thyroid uses nutrients for energy. Um it regulates things like body temperature, um the furnace, right? Um your body temperature. It regulates um how um triglycerides, the fattorring pro molecule, um how that triglyceride is used for energy. It regulates um how the body grows. It regulates how the body heals. So, there's lots and lots of um things that the body does. And so, now let's tie thyroid directly to cholesterol um because suboptimal thyroid function will affect your LDL, uh your lowdensity lipoprotein, those little vehicles running through the highway, right? Um it impacts metabolism, impacts, uh energy, weight, um how your body loses weight, it impacts uh circulation. And so if you feel cold, if you have cold intolerance, um that can be low thyroid. Um it it impacts how your body processes those uh lipids, those um uh little cholesterol molecules. And so if the thyroid is not evaluated, a patient could be treated um for cholesterol without anyone asking why it changed or what's the underlying root cause, which is the beautiful thing at MedMatrix is we do that full panel. We're going to look at, you know, not only, you know, what are your cholesterol levels, but is it possible that your thyroid might be impacting those cholesterol levels? >> Awesome. All right. So, we talked a little bit, I mean, you just mentioned briefly what we do at MedMatrix, which is functional medicine. Let's talk slightly about conventional medicine and how conventional care often maybe falls short while evaluating cholesterol and blood pressure. Yeah, such a great question. Such a good question because and again I'll just I'll just say how much we love our conventional medicine colleagues. Um I was I was trained in conventional medicine. Um I I actually uh trained at Yale University and so you know the mecca of conventional medicine, right? And so um so I I I I think the world of them. However, when you walk into your primary care doctor's office, um you're probably going to be waiting around in the office for, you know, 30 plus minutes. You know, you get checked in. Um uh you you um walk into the office, you wait for another maybe 10 plus minutes. Uh the doctor walks in, they have about seven minutes to to spend to spend with you. Um and and having worked in the world of internal medicine in the past, I totally get it. Um that's that's why I left that world because I didn't feel like I was serving our patients. And so they have seven minutes. They're going through a list of mandatory questions that they have to ask you um to fill all the insurance model paperwork. Um and then um they um fill out a quick prescription and say, "All right, take this." Um no conversation really about what it is or what why you're taking it. Um sometimes if if you have a few extra minutes, um you might get that conversation, but but a lot of times you don't. and um and no discussion about the root cause of of it all. And so um so what they're missing often is that big picture unfortunately. Um uh and and that's what we do so well. Uh we are able to take the time that you deserve um that our patients deserve and make sure that we're covering all the um important details because it's not only you know the labs that are in front of us. It's the person that's in front of us. It's the person's family that um is a big part of the picture. It's, you know, your your partner, your spouse, your children that fall in into that picture. It's how is your sleep? What kind of stress are we under? You know, what what does your nutrition look like? Um and and and so as you can see, you know, uh uh at least a 30 60 minute appointment, uh which is what we do uh at Med Matrix. So when you sit down with us, you're going to feel heard. You're going to make sure that um uh we get the full big picture and that we come up with a a comprehensive game plan. Uh and and that's priceless. >> It really is. So let's kind of go deeper into conventional medicine having a very medicationdriven approach. Um, we talked a little bit about how they miss kind of the labs that we go in depth about the family history, things like that. But their approach specifically being medication only, how can that miss a bigger cardiovascular picture? >> Yeah. Yeah. Absolutely. Great question. Great question. And so going the route of medication only can really miss the big picture. Um, and I'll use um the thyroid um as a as a good example um because um if if we're only going for the cholesterol-lowering medication, uh we might have we might have missed completely the fact that the thyroid was actually the underlying root cause of the high cholesterol. Um but often in a standard um panel um you know you go you'll go to your primary care doctor they'll get these are the standard labs and and you folks have probably seen them there's about 10 of them um it's your metabolic panel your your CMP sometimes um which has liver function kidney function maybe some electrolytes um uh it does a blood glucose um and then your blood count um red blood cells white blood cells platelets that's if you're lucky maybe a vitamin D. Um, but that's not not the um the most common thing. Okay. So, that's what you'll probably get. Um, and and many of us come to the the doctor's office with what we would call non-specific symptoms. And so to to really get to the bottom of those non-specific symptoms, things like fatigue, you know, um uh you know, low motivation, trouble sleeping, aches and pains, you know, those aren't necessarily going to be uncovered um not very often by those 10 lab markers that we're looking at. And so, so again, um, uh, so when when they're looking at your cholesterol panel, they completely miss the possibility that it's really related to the thyroid being underactive. And so, so, so if we go for the statin before doing a full assessment, we're completely missing the boat and missing an opportunity to help all the things that are going to be going um, wrong when your your your thyroid is also underactive. And so what are those? Um low thyroid symptoms, low energy, trouble losing weight, dry hair, dry skin, um constipation, you know, the list goes on. But so so again, these are pretty non-specific symptoms as I I mentioned before. Um but yeah, we'd be completely missing the bow. >> Um so why is your labs normal? We hear that a lot. patients come in, they say, you know, my primary care said my labs are normal. Why is that not always enough for prevention? >> Great question. Great question. And so your labs are normal, not always great for prevention because uh really at MedMatrix, we're more concerned about optimal and and and and we want you to be in an optimal range. Um, and so whenever we're coming up with these uh ranges, uh, when I say we, I mean the lab companies, you know, the lab companies come up with these lab ranges. They're really just assessing what's the average of the population and where where do they land? Um, and as you might be able to know, um, uh, you as in the the general population, um, out there, when you walk outside your door, you know, you're seeing a generally, unfortunately, more and more unhealthy population. Uh, we're not getting more healthy, we're getting less healthy, I'm afraid, um, because we've gotten away from lifestyle as the key driver of health. And so we know that for example nowadays about twothirds of our general population in the United States has some sort of metabolically unhealthy pattern. Um and that number is probably somewhere between 2/3 to like 80 90% even depending on the different variables we're looking at. And so so our general population is unhealthy. And because of that we can't use averages to determine what is healthy or unhealthy. we really need to focus on what's optimal and and so um those those risk patterns are best identified by looking at through through that lens um so that we can prevent disease so that we can prevent um illnesses and so that we can optimize individuals health but also how you're feeling and improve your quality of life. Um, and we do that through a variety of of testing. Um, vitamins, minerals, nutrients, uh, assessments, hormone levels, inflammatory markers, the list goes on. And so, so yeah, so that's really what we need to focus on so that we can prevent these warning signs, uh, before the disease becomes obvious. >> That was a great segue into my next section, which is how does functional medicine approach heart health differently? >> Yeah, great question. Great question. And so so this I'm I'm really passionate about this part because uh functional medicine uh approaches heart health differently because again we're looking at the full cardiovascular and metabolic picture. How does um how do we improve and decrease the risk of ever developing these conditions and diseases? Um you know how do we improve the environment on that highway? Right? The if we go back to the analogy of um your cholesterol levels um being a good indicator of how things are set up on a highway um those cars with those cargo loads being carried the cholesterol molecules um and the speed at which they're traveling um is a really a great thing to focus on when we're trying to un u understand and address the underlying root causes of everything. Um and then how to improve that metabolic picture? How do we uh improve insulin sensitivity uh through nutrition, lifestyle, stress management? Uh how do we improve those cholesterol patterns? How do we improve uh the different markers that we've been talking about today? Uh blood pressure, blood sugar, thyroid function, uh um nutrition, body composition, family history, all those things really need to be taken into consideration. Awesome. And what what are those deeper labs that can help clarify risk when cholesterol alone does not explain the full the full picture? I know we keep roping back to this, but they are so important. So, could you answer again? >> Yeah. Yeah. Thank you so much for asking that because uh let me pull up a couple of notes that I actually had um uh written here um as I was preparing for our our our session today. Um, and some of the some of the I want to make sure and tackle each one of those really important um uh um factors that that we dig into at MedMatrix. And so so let's talk about some of those uh deeper labs that can help clarify risk when cholesterol alone doesn't explain the full picture. April lipoprotein beat for example. It's um it's something that um a lot of folks may have started hearing about out there but it's a marker that uh that's not often checked enough um but think of of it this way. APO APO is the number of plaque capable vehicles on the highway. Um it's counting the actual number of potentially dangerous vehicles on on the road. And so each major um fancy word here aogenic particle athogenic means it has the potential to um uh produce atherosclerosis or plaque. Um, so each one of those vehicles that has the capacity to build plaque um carries this Apo B particle and and that's included on things like LDL, VLDL, um, low density lipoprotein, very low density lipoprotein. Um, uh, it it's also carried on LPA, which I'm actually going to talk about here in a moment. Um, LPA is that genetically driven cholesterol. Um and so it typically carries each one of those things typically carries one apo molecule and so it that apb number provides the total number of plaque capable particles. Um and so uh let me uh move on to another really helpful one. Um but before I do that actually one more thing I want to say about apo B. uh April B can be uh really helpful when triglycerides are elevated or when an individual has diabetes, insulin resistance or metabolic syndrome. And so, so if you have one of those conditions, you definitely want to know what your Apo is. Okay, lipoprotein A. Uh I mentioned it before, but lipoprotein A is another advanced marker that we really like. Um and this is um the inherited hazardous vehicles on the road. Uh, and so what's passed on to you from mom and dad. Um, and so it's a genetically manufactured LDL like lipo, uh, lowdensity lipoprotein like vehicle that carries extra equipment that can promote plaque, inflammation, and clotting. And so, um, LPA, think about it, it's less about what you ate last week. It's more about the genetic hand that you were dealt. And so, uh, it's, um, yeah, not something that can be changed easily, but if if you do have that elevated, uh, we can talk about some more advanced therapies. Again, not the things that we typically jump to first, but, um, some, uh, pretty potent medicines that can be really helpful for preventing um, cardiovascular risk. And um and so uh some of the other things that are more advanced cardiovascular markers like high sensitivity CRP and and thank you for bearing with me here Leah because this getting along with it and and it is a little bit more technical part of of what we're talking about today. But these are the advanced markers that we think about and so high sensitivity CRP is like the smoke detector. Um, it's a smoke detector that indicates that there's inflammation somewhere in the building. Um, uh, high sensitivity CRP doesn't tell us exactly where the fire is, but it does tell us that there's inflammation and smoke present. Um, and so high sensitivity CRP can temporarily arise from things like infection, injury, dental inflammation actually. Um, you know, so sometimes when you come in and speak with us as functional medicine providers, uh, we're going to talk about dental health and, um, and and so not just at it doesn't just happen at your dental office. Um, but, uh, we want to be super thoughtful about, you know, what's going on in your mouth, which is also an extension of what's going on in in your GI tract, the microbiome, right? So the oral microbiome significantly impacts your GI microbiome. And so so if you have a dental infection, it can it can elevate your high sensitivity CRP. Um something simple like intense exercise can you know um if you overdo it it your high sensitivity CRP can temporarily go up. Uh autoimmune activity is another thing that can drive that. And so the the range that we're usually shooting for less than one optimally. Uh but normal is like one to three. Three and above we start to get concerned and be like okay what's going on here? Uh so yeah. So um so I'll probably leave it at that. I could probably go in a few more different markers, but for for the sake of time, I'll uh I'll pass it back to you. >> Oh, it sounds incredibly comprehensive. It sounds like very well-rounded. Like there is a lot of tests that you guys can do. Um so let's go specifically into more of a med matrix approach, right? When somebody comes to Med Matrix with high cholesterol, high blood pressure, or confusing heart labs, where does that process begin? >> Yeah, great question. And and so when somebody comes in to see us here at MedMatrix, uh with high cholesterol, high blood pressure, those those confusing heart labs that, you know, as we've been digging into today, can get uh complex. And so, um so what's the key is simplicity and a standardized approach that you know that when you're walking in through the doors, you know that you're speaking with somebody that has experience, that has a system in place, that has the answers that you're looking for. And so what what's what's different in here and what you're going to experience is that we get that full health history. We get your family history. We're going to talk about medications, the current medications that you're on. Um we're going to talk about your symptoms, nutritional assessment. We're going to talk about stress and sleep evaluation. Uh we'll talk about movement history, so physical activity, exercise, you know, what does your day-to-day look like. Uh we'll talk about body composition. um will actually use a very special tool that I love, the inbody scan, uh which is going to tell us about what does your body composition look like from a number standpoint. Um not only do we do that initially, but we also use that to track things over time. Uh we use a we we look at your blood pressure, your vital signs, the comprehensive lab test that we've been talking about today. So all those different things. >> That's awesome. All right. And what would you say the biggest takeaway for somebody who's been told their cholesterol or high blood pressure is high? What would you say they should take away from this episode? >> Great question. Great question. And so the biggest takeaway uh for somebody who's been told that they have high cholesterol, high blood pressure, uh do not stop at one number. Um you you have the one number, but don't stop there. Cholesterol and blood pressure matter uh but they're just one part of the big picture uh of your bigger cardiovascular health. The goal is to understand the root causes. Look at the right labs, track meaningful changes, and build a personalized plan that's going to support long-term heart health. And so that's the key. Uh and and and when you come to Med Matrix, we're going to better understand those root causes, better understand how we can um optimize your health and and and support you long term. >> Incredible. Well, Gabe, that kind of wraps up my questions for you, our discussion. Um I don't really see any Q&A questions that we can go through in the comments. um just a joke or two. So, which we really appreciate everybody's engagement. We appreciate everybody joining. We appreciate you all wanting to learn more about your health and better your wellness and better yourselves. Um if you are interested in becoming a patient, remember you can visit our website and uh book a discovery call, then go through that process and we can give you personalized advice from there. So, Gabe, thank you again. This is incredible. I am incredibly lucky to have been on this podcast with you. Um especially for your first one. >> Thank you. >> You've been too kind for me, Leah. And and I really appreciate you um you being such a great host and the great questions that you had. And I'm looking forward to our next one. >> All right. Well, don't flatter me, Gabe. All right. Have a great night. Thank you all again, Gabe. Thank you again. Talk to you next time. >> Bye, everybody.