“Clinical Pearls” from Dr. Van on the Importance of Optimizing The Endothelium

* PATIENT INSPIRATION TO CHANGE FROM DRUGS TO NUTRIENTS: Patients inspired him by showing improvement in their health by taking supplements such as higher doses of vitamins C and D (5000 IU/d) and a broad spectrum high potency multivitamin/mineral (helped a patient dramatically with a neurologic condition) . This inspired him to look beyond drugs. Drugs give one possible benefit with the possibility of many side effects. Patients also inspired him to look at prevention.

* SELF -EDUCATED - Through patients, the internet and physicians such as neurosurgeon Russell Blaylock and hypertension specialist, internist at Vanderbilt University, Mark Houston, MD.

* ENDOTHELIUM - The endothelium is the pristine inner layer of the artery lined with a slimy hair-like substance called the glycocalyx that protects us from the atherosclerotic process. The endothelium is the critical inner boundary of the 3 layers of each artery. It is a single layer thick. The endothelium keeps blood flowing smoothly and releases nitric oxide to help dilate the arteries. It is a barrier that protects the artery. The endothelium is said to have a surface area as large as a tennis court. On the inner lining of the endothelium is the glycocalyx discovered 30 years ago which is very fragile, “slimmy” and can be damaged easily, like the endothelium. Things that can damage either are a sedentary lifestyle, smoking, excess sugar consumption, uncontrolled hypertension and seed oils.

* ATHEROSCLEROSIS: Oxidative stress from mitochondrial energy production can cause endothelial damage leading to atherosclerosis from inflammatory cytokines which attract white blood cells to attach to the endothelium. White blood cells can get through the endothelium into the middle layer and create plaque. Monocytes, a type of white blood cell, can get through the endothelium and become a macrophage which gobbles up damaged LDL cholesterol creating a foam cell causing inflammation, plaque and atherosclerosis. When LDL cholesterol becomes oxidized, it can become smaller and denser, forming small, dense LDL (sdLDL). This transformation is associated with increased atherosclerosis risk. Oxidized LDL (oxLDL) is more easily trapped in the artery walls, promoting inflammation and the formation of foam cells, which contribute to plaque buildup.

* MEASURING ENDOTHELIAL FUNCTION - Vascular elasticity testing measures large arteries (C1) and small arteries (C2) leading to the capillaries and end organs. C2 arteries are much more dependent on good endothelial function and health. The C2 arteries effect oxygen being delivered to the end organ via the capillaries. So having normal C2 function is more important for overall vascular risk than a C1 measurement and is more correlated with overall vascular health.

* LIPID PROFILE & CARDIOVASCULAR RISK: A Triglyceride/HDL ratio < 2.0 is optimal to maintain a healthy LDL cholesterol. The closer to one the better. When LDL cholesterol is not oxidized, large and “fluffy” is not a cardiovascular risk factor. This T/HDL ratio can be seen on any basic lipid profile by just dividing the total triglycerides by the HDL number.

* DIET: Mediterranean Diet with good fats, organic vegetables, fruits, nuts, low glycemic whole carbohydrates, free ranged meats, fish - olive oil, avocado and coconut oils are optimal. Avoid pastas, processed carbohydrates, high fructose corn syrup, sugars, sweets and seed oils.

* CHOLESTEROL: Dr. Van does not believe cholesterol is bad for heart disease. Sugar is the real enemy and high glycemic carbohydrates.

* SUPPLEMENTS: Arterosil derived from sea algae (rhamnan sulfate a marine polysaccharide) provides nutrition to the endothelium and glycocalyx. It has been shown to remove plaque in the carotid arteries. He recommends products that make nitric oxide from the endothelium that dilate arteries (beet root derivatives), age garlic extract, omega 3 fatty acids, curcumin, green tea extract, vitamin C, magnesium, N-acetylcysteine, etc. Chelation therapy can be of benefit by helping to reduce heavy metal burden.

* EXERCISE: Exercise 150 minutes per week of aerobic exercise - walking, biking, jogging, etc. is recommended for a healthy endothelium. Strength training also helps improve vascular flow to muscles during growth and stress.

* BIG PHARMA - Big Pharma owns many aspects of medicine. Drugs are not the answer to improving vascular disease. If you help the endothelium you pretty much helps every organ in the body.

Highlights…

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