What tests are done at the CURE Center to measure arterial disease and its root causes?

The true progressing inflammatory nature of arterial disease (which causes heart attack, stroke and dementia) is not the model of mainstream medical care. New testing methods and technology enable the CURECenter to offer more individualized and effective treatments. We identify the root causes and eliminate or at least mitigate their effects. Like a sinking boat, we identify and patch the holes as completely as possible while preventing more damage for smooth and uninterrupted sailing.

We offer tests that are not generally offered in Standard Care:

• Discover Scan Carotid Ultrasound: This limited lower cost carotid ultrasound using point of care Butterfly iQ ultrasound probe and system is like a screening pap smear, mammogram or PSA to detect early cancer. If we find no disease, peace of mind is a benefit. If, however, even a little bit of arterial disease is found (like a little bit of cancer) the images can be sent for a CIMT report (see next paragraph) and then followed to make sure you are safer by following your CurePlan.

• Carotid Intima Media Thickness (CIMT) Ultrasound: CIMT measures arterial wall thickness/sickness/inflammation/swelling and documents atherosclerotic plaque stage and burden. A thicker artery wall is a more inflamed swollen sicker artery wall. This promotes formation of atherosclerotic plaque and related events such as heart attack and stroke caused by plaque rupture. Arterial wall thickness (inflammation/swelling) is more of a threat than luminal flow “blockage” in predicting new and unstable plaque formation. Unstable/soft/heterogeneous plaque rupture is the event we experience as a heart attack or stroke. This is more likely with new homogeneous unstable plaque. It becomes less likely as plaque becomes more homogeneous/healing and is minimal when plaque is calcified/healed/stable. Proactive optimal care can heal arterial disease and make your arteries healthier and younger with less risk of disability, death or need for rescue procedures.

• LpPLA2 (PLAC) Test: This enzyme rises when plaque and artery walls are inflamed or “hot.” You want your arteries to be “cool.” LpPLA2 drops with a less inflammatory diet, exercise, reduced insulin resistance, supplements (niacin, and bergamot and statins. It is a fire alarm or “arterial wall thermometer.”

• Myeloperoxidase (MPO): A rise in MPO should trigger a search for neutrophil mediated inflammation, especially from the dental abscess or periodontal inflammation. MPO indicates inflammation and erosion of the inner lining of the artery known as endothelium. A sudden rise should trigger a search for the driver of arterial inflammation, leading to heart attack or stroke. Think of a caustic chemical spill on your artery protective lining. Like a skin abrasion, blood clots form and can occlude flow.

• Microalbumin/Creatinine Ratio (MACR): MACR rises most commonly when blood pressure and blood glucose are poorly controlled.  This causes dysfunction and disruption of the arterial wall endothelium, allowing albumin to leak into the urine in greater amounts. A leaky endothelium fails to protect the intima from processes that lead to inflammation. Think of it as another fire alarm.

For more information about these and other tests, go to

https://www.knowyourrisk.com/

and other information from Cleveland Heart Lab, a major source of our testing

• Haptoglobin Genotype: Your Haptoglobin genotype determines if Vitamin E offers protection or increases risk of arterial disease. In addition, individuals with the Hp 2-2 genome are more sensitive to gluten, forming an inflammatory mediator called zonulin that makes your gut “leaky” and raises the risk of autoimmune disease. 

• Insulin ResistanceTesting: Optimally measured through an oral glucose tolerance test with insulin levels, insulin resistance (prediabetes) testing is important in identifying individuals who could be developing vascular complications before a Type 2 Diabetes diagnosis. The glucose tolerance test can identify insulin resistance long before the glucose starts to rise.

  • However, if there is other evidence of insulin resistance that does not require a visit to the lab, we can skip this step. Clues are seen in levels of nonoptimal HbA1c, glucose, triglycerides above 100, low HDL, and presence of small dense LDL (Pattern B).

  • The earliest indication for insulin resistance can be measured through body composition testing. We use the InBody 570, a device that can monitor insulin resistance response to changes in diet. Reducing insulin resistance is generally healthy for everyone, regardless of risk.

  • Continuous Glucose Monitoring (CGM) is now available without a prescription for an affordable $50 for each 2 week sensor. The feedback about individual glucose response to specific food intake provides immediate feedback for diet modification. www.stelo.com

  • Insulin levels: We rarely order these, mostly upon patient request. Normal fasting insulin misses early stage IR where lifestyle changes have the greatest long term return on investment and can provide a false sense of security. By the time fasting IR is elevated there are other indicators, like low A1c>5.0, fasting glucose >90, elevated triglycerides, low HDL, elevated visceral fat. More actionable data is obtained from CGM, showing the problem and solution in one $50 2 week learning experience and experiment.

  • Bottom Line: Insulin resistance is a feature, not a bug, in our software, regardless whether the program was a design or byproduct of natural selection. It gave the hunter gatherer to survive the food environment before agriculture. Grains and grazing are not a good fit. It is somewhat like using a word processing program when a spreadsheet would be a better choice. The “hack” is to revert our eating behavior away from grazing toward the feast/fast cycle of protein and fat based intake with more complex carbs as a fallback and rare high energy sugar treats like in season fruit and honey. We should all be considered guily and make changes according to the best of our ability and circumstances.

• Homocysteine: Elevation increases risk of:

• Osteoporosis - bone thinning

• Atherosclerosis

• Thrombosis (blood clotting)

• Heart Attack

• Stroke

• Dementia

• Kidney failure

• Neuropathy

Treatment is supplementation with methylated folic acid. Dietary sources of folic acid are leafy greens like spinach and kale. The needed amount of methylated folic acid and Vitamin B12 (and the blood levels) is dependent on the MTHFR gene variant. “Normal” blood levels of folate and B12 are not sufficient for those whose genetics require higher levels for homocysteine safe levels. Therefore, the test we rely upon is the homocysteine level, not the levels of folate or B12. Optimal homocysteine level is less than 8, which may require higher than population norms (yet safe) blood levels of folate and B12.

This paper from the American Heart Association offers a good summary of Homocysteine.

• Coronary Artery Calcium Score (CACS): This CT scan detects mature calcified plaque in the coronary arteries. However, it misses new noncalcified plaque. This test is not useful in monitoring therapy progress/benefit. We recommend CACS when CIMT does not reveal disease but there is still concern about coronary artery disease. If this test detects disease that would have otherwise been undetected, a more proactive approach to address root causes will be encouraged. Beware of the slippery slope to a stress test, stents or surgery. Coronary Calcium Score is a “loss leader”for interventional cardiology programs. Call us first before scheduling further tests, especially if you have no symptoms like chest discomfort and shortness of breath.

• Coronary CT Angiogram with AI Enhancement: This compelling advancement should and will eventually largely replace elective coronary angiography in the absence of acute symptoms. At a cost of $1500+ with radiation and IV contrast associated risk, it isn’t ideal as a screening process. Medicare and insurance coverage is increasing when the alternative is elective catheterization based angiography is the alternative for evaluation of symptoms or heart failure. If money is no object and there is nothing seen on carotid ultrasound focused on the wall (where the action is), it is an option for those who want to go “all in” looking under every rock and don’t mind the radiation and contrast risk and inconvenience. The tools don’t fit in a backpack or pocket, that is for sure. They tend to push toward stents and surgery, supporting the “oculostenotic reflex.” For more in depth info, click: https://patients.cleerly.com/education and https://vimeo.com/cleerlyhealth

• Home Sleep Testing and Auto Titrated CPAP: These tests have made diagnosis and management of sleep apnea more affordable and effective. Sleep apnea is a root cause of heart attack, stroke, atrial fibrillation, hypertension and heart failure. Treating it can lower your risk of these events, lower your blood pressure, and reduce arterial inflammation.

• Oral Microbiome Testing: Oral microbiome testing involves taking a sample of saliva to identify the types of bacteria present. If high risk bacteria are found, they likely contribute to periodontal and arterial inflammation. In some cases, this can affect management of periodontal disease and contribute to heart attack and stroke risk. 

  Knowing the occupants of your oral “neighborhood” can prompt a more proactive approach to your oral hygiene. If there are dangerous criminals in your neighborhood, you will be more careful to “lock your doors” and augment your protection. The progressing but reversible diseases affected by your oral microbiome include periodontal disease, cardiovascular disease, Type 2 Diabetes and prediabetes, and even some cancers and dementia. Options for intervention are best guided by a dentist and hygienist who understand this and the effective interventions. General steps include brushing, flossing, water flossing, antiseptic mouthwashes, oral focused probiotics and xylitol gum. More deeply established infections may require systemic antibiotics and debridement procedures like root planing and deep cleaning followed by maintenance routines.

What is Body Composition Analysis?

Scales measure weight, which includes lean body mass, water, and fat. We urge you to go beyond the scale and schedule a body composition analysis, which measures your percent body fat and visceral fat among other details.

We use the InBody 570. This cutting edge technoolgy reports visceral fat, which is the cause and effect of insulin resistance. Reduce visceral fat to reduce your insulin resistance, the most common and reversible root cause of arterial disease, diabetes, and prediabetes.

With the InBody 570, you can know more precisely what you’re made of: lean muscle mass, body fat mass, percentage of body fat, water, and visceral fat estimation, among other measurements. This will enable you to understand more completely the effects of the changes you make in your nutrition and exercise.

When you get a body composition analysis at the CureCenter, you will receive your results on the InBody App you can download from the App or Google Play Store. Results over time are reported and pushed to your phone to monitor your progress. Monitor visceral fat and percent body fat with the same interest as we monitor blood pressure and cholesterol. With our InBody technology, we can do this easily and frequently. 

To schedule, clickInBody. It might hurt is your feelings 🙄, but dealing with reality empower you and put you in more control of your metabolic health with your food and activity choices.🙂

Good News! Your first measurement is FREE! What do you have to lose other than excess fat and misery?

If you can’t come to our Springfield or Morton IL locations, you can find an InBody at this link: inbodyusa.com/support/nearest-testing-location/‍ ‍

Measure, Mentor, Monitor, and Maintain Momentum. This is the key to your improvement.
Our InBody composition analysis is affordable and easy to access. Insurers do not pay for this test. We don’t want this to be a barrier.

Your initial InBody analysis is free of charge. Subsequent measurements are covered by our Proactive Medicine or Personal Medicine Membership. Nonmembers are charged $20/appointment for subsequent measurements recommended every 2-4 weeks.

What will my other providers say about my CURE Plan?

Ideally, you should be able to trust your providers, from nurse practitioners to specialists, with your overall health and wellbeing. We all want to think of our doctor as “the best” and trust their advice.

Sadly, most “providers” are now employees of organizations that determine/dictate what they can and cannot offfer. It is reasonable to ask, “Can I trust those who control my providers’ paychecks and thereby their practice?”

Here are some helpful questions to ask yourself when determining if your provider is right for you:

• What did my current provider do to identify my progressive but reversible disease?

• What are they offering to not just manage it but achieve remission?

• Do they wait and watch while it advances toward a more serious event such as heart attack or stroke?

• Do they offer you what they do for themselves?

When asked to detect “presymptomatic” arterial disease, most providers will schedule you for a stress test. The benefits of stress tests are only in the assessment of symptoms. They miss all but the most advanced state of coronary artery disease. False positives or equivocal tests lead to coronary angiograms and often unnecessary life altering stents. Angioplasty fractures/breaks plaque with a stent/scaffold to hold it open. This increases the risk of blood clotting requiring potent antithrombotic medications with risk of bleeding. Saving you from an acute life threatening heart attack justifies the risk. Making your artery look better on angiogram does not.

Stop! Ask yourself, “How does this help me when I have no symptoms?” before agreeing to this approach. The only stent my patients have needed in the past 10 years was to fix the failure of a stent placed for a blockage in the absence of any symptoms. The other stent was placed in spite of measurement of no reduction in flow before stent placement. Unbelievable but true.

For more information, we recommend reading the book Prevention Myths by Drs. Ford Brewer and Todd Eldredge. 

Standard providers are constrained by convention, guidelines, groupthink, complacency, and financial incentives to monitor and manage arterial and other chronic disease. They profit more from invasive, lucrative procedures and rehabilitation than they ever would from prevention. This is the business model that serves “health care” more than people. Surgery, stents and rehab are more profitable than healthy patients. You are not the customer in this model. Your chronic disease is the product.

This is not a critique of individual providers who work within the health care system, including your PCP and specialists. It is a sad observation of system brokenness and the corrupting nature of third party payment, employment of providers, and consolidation of healthcare into fewer and larger institutions. These institutions are dominated by those who have never uttered the Hippocratic Oath or served to relieve a patient suffering.

You can do better.

At the CURE Center, we practice Proactive Medicine: Most of us are past the point of prevention. We tend to talk about prevention but act to fix a problem.

Our program reveals “presymptomatic” disease and “prevents” complications from progressive and unstable arterial disease. We expect to reverse your progressing disease and prevent untimely death or disability due to stroke, heart attack, or other major health events.

Side effects include feeling and looking better, more mental clarity and energy, and other positive effects. The goal is to live a long, healthy, and happy healthspan.

Request a Discovery Zoom Calland start today.