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Medical Professionals

WHAT IS YOUR CHOLESTEROL NUMBER? Roberta Foss-Morgan, D.O. completed post-baccalaureate training in Pre-Medicine at the University of Pennsylvania. After which, she received her medical degree from the Philadelphia College of Osteopathic Medicine. Her internship and residency in Family Medicine was completed at the Virtua Health System. Dr. Morgan was Board Certified in 1995. In 2005, Dr. Morgan authored her first book, What Your Doctor Won’t Tell You About Weight Loss. Further training in European Endocrinology, Mesotherapy, Medical Weight Loss, and Intravenous Therapies has required extensive travel throughout the US and Europe. Dr. Morgan has appeared on CNN, Ch 3 KYW, Fox News and numerous other live TV and radio shows. She is a frequently requested lecturer to physicians and patients.


ith every new patient I order a complete laboratory workup including internal medicine, nutritional, and panoramic hormonal laboratory studies. On the second visit, we review the laboratory results and decide which direction to take to reverse their medical woes. There is usually a tremendous amount of information to discuss. What no longer surprises me is the quintessential question nearly every patient asks as he/she leans over my desk and anxiously asks, “What is my cholesterol?” Television advertisements for cholesterol-lowering medication have seduced most to think they will not have a heart attack if they have low cholesterol. Yes, cholesterol is one small part of the puzzle in determining your risk of having coronary artery disease, but there are so many more studies to add to your cholesterol results to determine your chances of medical demise. So I tell my patient that their cholesterol is 200, and their next question is, “Should I take a statin [cholesterol-lowering medication]? My other doctors want me to take a statin.” The simple answer to whether or not you should take a statin is “maybe.” The medically correct question is, “Should I take a statin to decrease the inflammation in my arteries, to decrease the formation of plaque, to decrease the chance that a clot will form, which may break off and cause a cardiac event, to decrease the stickiness of my platelets?” The answer is still maybe. We need many more laboratory results. Of particular importance is a DNA test called SLCO1B1 that tells me if you are in the 60% of patients I will not harm if I prescribe a statin. If you are in the 40% of poor statin transporters, you are more likely to develop myopathy (muscle cell death and consequential muscle pain), elevated liver enzymes, and elevated blood sugar. You can still be placed on a statin, just a very low dose, and Harvard cardiologists suggest perhaps taking the lowest dose of certain statin medications two or three times a week. According to Drs. Bale and Doneen, who wrote Beat the Heart Attack Gene, women should not take Lipitor. Many patients come to me on a statin medication and have very low cholesterol levels. First of all, the regular lipid profile laboratory study only gives you the raw numbers; namely, total cholesterol, LDL (the bad kind of cholesterol), HDL (the good kind of cholesterol), and the cholesterol ratio. You need a different, more sophisticated test for cholesterol that tells you if you have the fat, puffy kinds of LDL particles or HDL particles --- or the small, dense kinds of LDL and HDL particles. The fat, puffy particles are good. The small, dense particles are bad. You need to know that your cholesterol should not get too low because cholesterol is the precursor to the hundreds of hormones that are declining with natural aging. Read Grain Brain

by Dr. David Perlmutter, renowned neurologist and integrative physician, who explains that to prevent dementia and Alzheimer’s you must have enough cholesterol for optimal brain function. In 2014 the American Heart Association advised that ALL physicians, not just cardiologists, do genetic and genomic testing. To date, no patient has come to me with their genetic results to determine their risk of coronary artery disease (heart attack), stroke, dementia, or Alzheimer’s. So I’m going to tell you what a complete laboratory workup looks like to prevent illness. Also, please know that just because you think you have the heart disease gene --- genetics is your gun, environment is your trigger. To turn on your supposed heart disease gene requires many maladaptive health behaviors. If your goal is to prevent the chronic degenerative diseases of aging, and you realize that you must participate in your care with the help of your physician, consider getting the following tests: 1) genetic tests such as Apo E, MTHFR, SLCO1B1; 2) inflammation markers such as fibrinogen, hsCRP, Lp-PLA2, MPO; 3) blood sugar tests such as adiponectin, HbA1C, insulin; 4) liver, kidney, muscle tests: creatine kinase, homocysteine, NT-proBNP, vitamin D, CoQ10; 5) hormones: DHEA-S, E2, FSH, LH, progesterone, SHBG, free and total testosterone, TSH, DHT, free T3, reverse T3, cortisol; 6) and, of course, a comprehensive lipid panel; 7) self-care, including measuring your waist/hip ratio, monitoring your blood sugar and your blood pressure, measuring your pounds of fat; 8) taking a judicious supplement program suggested by someone highly qualified in nutritional biochemistry; 9) learning how to eat…and what to eat. Then we put all this information together and create an individualized treatment plan outlining which supplements to take, a personalized exercise program, which medications to prescribe, change, or discontinue, which bioidentical hormones to replace in physiologic doses, and finally stress management. Psychiatry is quite excited that they finally have a quantifiable test for anxiety and depression --- namely measuring inflammatory markers. So number 10 is the most difficult part of your health program --- because constantly speaking darkness, worrying about your very stressful life, and anxiety and depression all cause inflammation, which enhances your chances of having a coronary event and/or some form of dementia. Published medical studies revealing the qualities of healthy centenarians tell us that centenarians are lean, still chop wood, move a lot, are in the upper quartile of most hormonal levels, sleep well, and have a sense of joy --- even in our complex world. So whether or not you shall live to be very old, being healthy is a little more complicated than having low cholesterol.


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November/December 2017

Atlantic County Woman - November/December 2017  

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