Treating The Lab Report And Not The Person

Interesting concept don’t you think? Perhaps a bit provocative, but it is something that I am becoming increasingly concerned with over time as I pour through more blood chemistry and patient histories. My hope for this article is that it leaves the reader a little uneasy about what they are being told is “normal” about their current state of health. The fact is that you should be uneasy. Don’t be afraid, but be interested in knowing more. Things are going unchecked and you are allowed to feel like you are getting the whole story and that everything is under control. I want to detail for you two different medical problems that I see quite often in my clinic and explain to you exactly what I mean by stating that in many cases people only end up successfully treating their lab report and not their actual medical concern.

Most of the time when I order blood tests for a patient the very first thing they ask about is their cholesterol. Perhaps that is the only part of the test people know anything about. No one has ever taken the time to explain the rest to them. But nevertheless, let’s just say that someone has high total cholesterol of 225. The doctor wants to put them on cholesterol lowering Statin therapy immediately. They do as they are told because if they didn’t they fear death, or worse… A terrible golf game. The follow up test showed a marked improvement in their total cholesterol. It is now 185! Yay!! Problem solved right? By all mainstream thinking heart disease is now under control because the paper showed that the cholesterol is within the “normal” ranges. Well, don’t get too comfortable. That’s not the whole story.

What the doctor didn’t tell you is that not all cholesterol is the same. The “Bad Cholesterol” called LDL is actually made up of different sized particles. The large LDL particles tend to not be dangerous to your arteries/heart in that they do not lead to plaque formation and subsequent poor health. But the small, dense LDL particles tend to be very likely to promote heart disease. The rub here is that Statin drugs are very good at lowering LDL cholesterol, but they lower the wrong kind of LDL. They are great at lowering the large “safe” type and terrible at lowering the small “dangerous” type. So here you have a scenario where someone was told they were in danger without the doctor looking into what size LDL particles there are (any many other important factors such as hsCRP, homocysteine, RLP, Lp(a), and more), and then giving a drug which quite a lot of research has shown to have rather suspect safety records. This then lowers the overall cholesterol by lowering the not-so-dangerous type of LDL while leaving the more dangerous type intact, and leads people to believe that they did the right thing and are now protected!

Well according to the Centers for Disease Control, only 50% of the people who die of heart disease die with high cholesterol. The other 50% have either normal or even low cholesterol! Wouldn’t you, a thinking person, rather compare yourself to the most up to date scientific standards and look into the true markers for heart disease rather than just settling on going the faith based path of doing what you are told by your doctor? And who do you think teaches the doctor? There are several rather large companies behind that one for sure. So the bottom line here is that just making the number smaller on the lab report does nothing to your overall health. This is especially true if you got it that way through the cunning use of medications and not by proper diet and exercise. Aerobic exercise by the way is one of the only things that actually lowers the more dangerous type of cholesterol.

One more concern that I have is pertaining to hormone replacement therapy. I specialize in hormone conditions so I see a significant amount of lab reports and see a lot of hormone replacement therapy going on. This story lends itself to treating a lab report and not the person quite well. It usually goes like this… A person goes into a doctor complaining about various mid-life problems and ends up on hormone replacement. Follow up tests show that the hormone levels are normal and the doctor and patient feel that the proper treatment was given. There is only one thing wrong though. Given six months or so the patient starts feeling the same symptoms returning, but the labs still show normal hormones. When was the last time you heard of anyone on replacement hormone therapy that was actually happy with the results 6 months to a year after starting? What gives?

Quite simply put hormone testing when done in a typical medical office does not look at what are called “free fraction” hormones. These are the ones that are actually doing the work. They are the active form of the hormone. It is much cheaper to look at the “serum” hormones. These are easy to find in the blood and happen to be in the inactive state. Two problems come from this depending upon what hormones were given.

Most commonly synthetic hormones are given. There is currently no test that looks for levels of synthetic hormones in the blood. Synthetic estrogen simply isn’t estrogen. I once asked the Head of Endocrinology (hormones) at the VA hospital in Portland how they monitor synthetic hormone levels and he said quite sharply and with contempt, “we don’t, we monitor symptoms.” If that doesn’t scare the hell out of you it should! So if they do test for hormones they can only test for your own natural hormones which are not representative of what is going on now that there are synthetic hormones in the mix. It is totally bass ackwards thinking!

The other increasingly common thing to see is someone who is tying to do the right thing and take “bio-identical” hormones. Now these are better because they are natural and can be tracked, but for some reason, probably expense, serum hormone levels are what are tested for and not the more expensive free fraction levels. It is important to know that bio-identical hormones are delivered usually through the skin via a cream and enter the blood only in the free fraction state. So looking at serum levels will look normal or even low when in fact the active free fraction levels are usually quite high. This little concept gets missed almost every time. So once again what we see on the report might look great, but the actual state of the person could still be a mess! In fact worse than before starting on the hormones in the first place.

I write this article partly out of anger and frustration I’ll admit. I see so much in the current medical system that is dangerously misguided and unsustainable. Change needs to happen. But I write it more for you, the reader. You deserve to know about your choices. To be fully aware of what you are being told you “need” to do. It is very easy to roll over and submit when it comes to our medical experience. I urge you not to. I urge you to pay attention, to be curious, and to question what you are being told. Hold your doctors accountable for what they say. And above all learn as much as you can about everything that you can. That is what I try to do, and that is what I try to pass along to the people in my life.

Please consider me a powerful resource, and in the mean time, be happy, be empowered and enjoy great health!