I think we are going to see a change in the way we approach chronic diseases. For example, we know that there is more that we physicians need to do when we treat diabetes than just lowering blood sugar levels. For years it has been accepted that low HDL (good cholesterol) increased the risk of heart disease. This study looked at the FUNCTIONALITY OF HDL. Studies showed that HDL-cholesterol levels are not reflective of HDL functionality. One of the key functions of HDL cholesterol is the cholesterol-efflux pathway, which is the pathway where cholesterol is removed from macrophages within the arterial walls back into the bloodstream and out to the liver. As one of the key functions of HDL, their hypothesis was that if they could measure HDL-cholesterol–efflux capacity, they’d have a better handle on the role of HDL in atherosclerosis. It looks like the actual HDL number may in fact be meaningless and that low HDL’s do not appear to increase your risk of heart disease. Several years ago, the FDA refused to approve two new drugs that would have increased HDL levels in everyone to 100 because studies also showed a corresponding increase in heart disease! This is also why we no longer prescribe NIACIN.
We have already started practicing functional medicine and many of our patients have been screened for nutritional and metabolic deficiencies. Even large institutions like the MAYO CLINIC and the CLEVELAND CLINIC have started functional medicine departments.
If you would like to be screened, contact our office. 941-747-2090