3 Underrated Markers That Are Essential For Heart Health, From A Functional MD
If you've got heart health on your mind, listen closely: There are a few underrated biomarkers you'll want to keep on your radar. Yes, you can find a host of heart-healthy foods and lifestyle tweaks to support healthy cardiovascular function, but how do you know what's actually working? It's all too easy to let the numbers consume you—especially with the plethora of wearable micro-trackers on the market—but sometimes it helps to look at a few measurements. And no, we're not just talking about a standard lipid panel.
I believe that suboptimal methylation is one of the biggest, most silent issues when it comes to our health and longevity—and so does Lipman. "Methylation is a key mechanism involved in brain health, heart health, and emotional health," he says.
See, methylation is a biochemical process that happens all day, every day in your body. We have a full explainer here, but we'll let Lipman explain: "Methylation is just a simple biochemical process that involves a transfer of four atoms, referred to as a methyl group from one substance to another. It's like a relay race: Your methylation goes from one substance, and then the baton gets passed on to another substance, and it gets passed on to another substance... It's getting passed on along all these different biochemical processes, and it's basically getting the gears to run properly and switching genes on and off." And you can measure this process by looking at your homocysteine levels: "When you see a high homocysteine level, you can usually assume that you're not methylating properly," Lipman says.
High levels of homocysteine are something I have personally dealt with, and they have implications for cardiovascular health. You can read all about my personal story here, but here's the gist: I felt physically fine, yet I had a homocysteine level of 63.3 umol/L (for reference, high homocysteine is defined as anything higher than 15 umol/L, so mine was especially shocking. Lipman even thought my labs were a mistake!). "No one usually feels that they have high homocysteine," he adds. "That's the issue."
And because more than 50% of the U.S. population1 struggles with the same issue I do that directly affects homocysteine levels (i.e., MTHFR gene variants), there's a pretty good chance you or someone you know has suboptimal methylation and doesn't realize it. That said, it's important to get your homocysteine levels checked if you can—and if yours is higher than ideal, there is something you can do about it. Personally, with a specific array of bioactive B vitamins and betaine, my homocysteine dropped from 63.3 umol/L to 12.2 umol/L.*
That's exactly what inspired mbg's methylation support+. Our gene-focused methylation support formula provides the benefits of optimal methylation in just three capsules per day.* This is thanks to its nutrigenomics-inspired array of fully bioactive ingredients that support MTHFR gene variants and whole-body methylation health and function: Quatrefolic® methylfolate (aka activated folate or vitamin B9), riboflavin (aka vitamin B2), vitamin B6, vitamin B12, and betaine.*
At your annual checkup, you might receive a standard lipid panel, which is a measure of your HDL ("good") cholesterol, LDL ("bad") cholesterol, and triglycerides. With that panel, you might want to also measure the level of lipoprotein (a) in your blood. Lipoprotein (a) is a type of LDL (or "bad") cholesterol, and high levels of it also have implications for heart health, even if your lipid panel looks OK. But the thing is, genetics determine your levels; in fact, you can have perfect cholesterol scores and still have high blood levels of lp(a).
According to a New York Times article, doctors rarely test for lp(a), but up to one in five Americans have high levels of it, including trainer Bob Harper of The Biggest Loser. "This speaks to a bigger problem with cardiac testing," says Lipman. "Most cardiologists or regular doctors will just check your total cholesterol—LDL, HDL, and triglycerides—which is basically a useless assessment of your heart profile." And while high levels of lp(a) are genetic, so there's not a ton you can do about it, it is something you should be aware of when you undergo cardiovascular testing. "Lp(a) is just one of those markers that I think is really important. Now, when we do a work-up, we're checking 10 to 15 different markers, not just the old-school ones."
Carotid intima-media thickness
Finally, we have the carotid intima-media thickness (CIMT) test, which measures the thickness of the inner layers of your arteries by your neck. After all, cardiovascular health is not just about the heart—it's about the brain, too. Your heart and brain are more intertwined than you think, as the arteries transport blood from your heart to your brain. The test itself is noninvasive—a doctor will use an ultrasound with a gel—and it usually takes about 10 minutes. And yet, it's not something doctors regularly administer, and it's not covered by many insurers.
"All these traditional medical tests are on the cutting edge, for some reason," says Lipman. "Doctors are not really catching on to them quickly enough. The CIMT test is one test." We have so many tests available that can take medicine to a whole other level, Lipman continues, but the traditional health care space needs to catch up. That said, if you do have access to a CIMT test, Lipman believes it's a helpful measure of your heart health.
Cardiovascular testing is becoming more and more sophisticated, but we have a way to go before these measures are widespread. If you wish to paint a whole picture of your heart health and are able to test for these biomarkers, we suggest finding a health care practitioner that will do so, if it's available to you. However, Lipman also stresses the importance of not becoming too caught up in the measurements: "Numbers can be helpful, but I think context is very important," he explains. "You can't just address numbers. You've got to address the person as a whole."
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