Treating Atherosclerosis (CAD)

The Bullet Points:

• Our first two articles in this series can be found here:
•  LDL: The Life Delivering Lipoprotein 
• Detecting Atherosclerosis
• Learn to treat yourself, with guidance from a Functional Medicine Practitioner.
• Look both at and beyond traditional risk factors.
• A breakthrough in the treatment of CAD exists with the combination of:
• Red Yeast Rice Extract
• Kyolic-Aged Garlic Extract
• High Dose Nattokinase

One could write an entire book about this subject. First, always remember that with Integrative Medicine we treat the person with the condition, and not just the reductive approach of treating you as a disease that so happens to have a person. Western Medicine treats diseases, Integrative Medicine/Functional Medicine treats people.

This very important distinction allows you to eat and exercise and meditate for the you who has CAD, not the CAD that “has you”. Any time someone succumbs to the delusion of treating themselves with lifestyle medicine focused on treating diseases, instead of treating unique humans with unique biochemical/physical/emotional/psychosocial individuality, they will never succeed.

Turn first to our Foundations of Health, Stress Management Series, and Basic Nutritional Protocol for treating CAD as these resources are the foundational principles of treating CAD. May I ask you to give special attention to stress management and approach “hardening of the heart” from a deeper level than just medicines and supplements.

We all need psychotherapy. We all need to look at the “heart” of healing. Address all addictions, not just smoking. This level of healing comes from you and not scientific research, or worse yet, podcasts! I am being a bit sarcastic there, but never give over your locus of control in health care to your doctor or a podcaster.

A special note about blood pressure (BP), as there will eventually be a separate article on this. Omron still makes a great home monitor and arm cuffs with sizing options. Never make treatment recommendations based on office BP readings! Check home BPS between 6-10 PM as only evening BP's correlate with outcomes/bad things. People with reactive high blood pressure do more frequently have high evening BP.

Do these readings sitting comfortably for 10 minutes, no news programs! After a few weeks you will notice how much your numbers vary. We are looking for the BP average more than any one number. Overtreatment of hypertension runs rampant in our country. Low BP from overmedication based on office BP readings is far more dangerous than high BP. However, hypertension must be treated to control the progression of CAD.

In this article I will mention the traditional “normal” BP of 120/80 as a good number to start with. At age 50, the lower (diastolic) number correlates best with outcomes and average numbers over 90 need intervention, if lifestyle changes are not enough. After age 60, the top number (systolic) and pulse pressure (the difference between the two numbers, normal is 40) become the numbers of greatest concern.

Please see a Functional Medicine Specialist and not a Cardiologist for the appropriate evaluation and treatment of BP specific to you as an individual.

Markers of glycation (A1C & fasting insulin), inflammation (hs-CRP, Fibrinogen, LpPLA2, MPO, Galectin-3), oxidative stress (Ox-LDL), methylation (Homocysteine), cholesterol metabolism (particle fractions and Apolipoproteins not just Lp(a)), all hormones from adrenal to thyroid to sex steroid are involved in these risk factors, and much more. Please see a Functional Medicine Practitioner for the diagnosis, evaluation and treatment of Atherosclerosis.

The average Cardiologist can do stress testing and Angiograms to evaluate and treat the end stage of CAD. They know almost nothing about what Atherosclerosis really is and how to slow its progression. Slowing the progression of CAD would be bad for business. I see no attempt at all for an average Cardiologist to actually treat CAD, beyond Statins, stents and bypasses. They are overwhelmed with their workload most of the time. You, with the guidance of a Functional Medicine Practitioner can do the “primary care for treating CAD” and save Cardiologists for plumbing fixes when needed.

I will now give you the algorithmic protocol for treating the disorder known as CAD (Coronary Artery Disease) while you treat the individual.

• Red Yeast Rice Extract (RYR-Designs For Health only) - 600mg, 2 capsules, twice daily. Yes, this is where the Statin drugs came from, but this intricate herbal blend has far greater safety in primary prevention. Works as an anti-inflammatory not by lowering cholesterol, although it does this too. Prevents acute MI (myocardial infraction) and improves cardiovascular mortality. Statin drugs for 1-2 years in secondary prevention (after stent, bypass, or MI) makes a lot of sense in most cases.

• Kyolic Reserve - Aged Garlic Extract (AGE - 600mg caps) - 1 capsule, twice per day. As we know, Statins or RYR do absolutely nothing about slowing CAD progression, but remember they do help prevent acute events, very important! We do however know that adding AGE slows the progression of CAD as evaluated by CAC.

• Nattokinase Pro (Enzyme Sciences) - a “systemic enzyme.”
• Dozens of articles exist, but a relatively recent article showing that higher dose Nattokinase impacted reversing Carotid Artery Disease helped guide me into adding this for anyone with a CAC score greater than 100, or simply with progression despite our existing protocol.

The full protocol includes components from our BNP, especially Omega-3 fatty acids, aka “fish oils”, CoQ10 and D3/K2. I am very specific about exact brands of products as cheap versions of these supplements can even be harmful. I have no affiliation with any of these companies.

Of course we need to treat individual risk factors. This takes the guidance of your Functional Medicine Practitioner and knowledge in using the laboratory and radiology testing we have mentioned.

Articles with more information (and references) on each supplement will come in the following weeks!

Your Journey to Health and Healing,

Gary E Foresman MD