I am a holistic physician (holistic MD) who can provide alternative medicine treatments including: detoxification, bioidentical hormones, holistic thyroid treatments, neurofeedback, medical weight loss, nutrition counseling, bio-medical autism interventions, specialty lab testing, alternative cancer treatments, IV Intra-venous Vitamin C therapy for cancer, IV glutathione for Parkinson's disease, IV PCv iv phosphatidylcholine, anti aging,. I provide alternative and holistic treatments for heart disease.Home page of Karima Hirani MD MPH, holistic doctor and alternative medicine physician serving Los Angeles, Beverly Hills, Culver City, Santa Monica, Malibu, Pacific Palisades, Marina Del Rey, Venice and the SouthBay (including El Segundo, Manhattan Beach, Hermosa Beach, Torrance and Palos Verdes). - DAN Doctor - Hyperbaric Oxygen Therapy Los Angeles -HBOT and autism - health and wellness - medical weight loss. MD supervised CAM treatments. Functional Medicine Doctor Los Angeles. Ortho-molecular Medicine Doctor Los Angeles. Integrative Medicine Doctor Los Angeles

Vitamin D Deficiency Heart Disease and Diabetes

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Heart Disease and Diabetes

Are you pre-Diabetic?

You may be at risk. The prevalence of type 2 diabetes mellitus (DM) has increased dramatically over the past several decades, perhaps because of recent changes in diet and lifestyle. Among these are increased refined carbohydrate consumption, obesity, and reduced physical activity. These factors ultimately lead to insulin resistance, or the body’s inability to respond normally to insulin. Alarmingly, you can be thin but still be at risk for diabetes!

Why should I care?

Those of us with friends or family with diabetes can attest to the severe consequences of diabetes when left untreated or poorly managed. Diabetes in itself can be life threatening. In addition, diabetes will increase your risk of heart disease; damage your kidneys leading to dialysis, cause blindness because of retinal damage; cause nerve damage in your extremities; exacerbate infections and open wounds that do not heal; and the list can go on.

Diabetis and Cancer

Experts from the American Cancer Society and the American Diabetes Association published a consensus statement in 2010 indicating that diabetic patients are more prone to certain types of cancer including liver, pancreas, and endometrial cancers by double. Risks for breast, colon and bladder cancer are 20%-50% higher.

What can be done?

Don’t be alarmed. The good news is diabetes is preventable and reversible when caught early. Blood testing (see next section) is recommended. Exercise is of paramount importance. Managing your weight and making healthy food choices will also keep diabetes under control. Various dietary supplements have been clinically studied in the management and care of diabetes. Your last resort option is prescription medication.

Early Testing is in Order

There is a new comprehensive diabetes test available at my clinic. This test evaluates not only measures inflammatory markers that are seen in diabetes, autism, cardiovascular disease, and even cancer; but additionally this blood test evaluates other metabolic markers as well.

Inflammatory Markers:

Inflammation is the underlying driver of progression to diabetes, particularly in the development of insulin resistance. These include Tumor Necrosis Factor-alpha (TNF-alpha); Interleukins-6 & -8 (IL-6 & IL-8); highly sensitive C-Reactive Protein (hsCRP); and Plasminogen Activator Inhibitor Type I (PAI-1).

Metabolic Markers:

These markers measure the function of your hormones, pancreas and liver in producing and processing insulin. Markers evaluated include: Fasting Glucose - which measures the actual amount of glucose in your blood at the time of blood draw. Adiponectin - hormone derived from fast cells, lowers blood pressure, protects against cardiovascular disease, obesity, and insulin resistance, read more on Adiponectin. Fasting Insulin - insulin, which comes from the pancreas, can help determine the etiology of high blood sugar, and can be used to diagnose insulin resistance. ProInsulin - (the precursor of insulin) high levels indicate increased risk or presence of diabetes. HOMA-IR (homestastic model assessment insulin resistance) calculation of fasting glucose and insulin, considered a gold standard for quantifying insulin sensitivity. Leptin - hormone from fast cells that regulates appetite, metabolic rate, and body weight, considered protective against obesity. HbA1C - indication of blood sugar control in the last 3 months, small elevations can predict future diabetes among individuals with impaired glucose tolerance. As you can see, these metabolic and inflammatory markers are a powerful tool that can be used to assess your risk not only for diabetes, but other illnesses too. PPO and HMO insurance co-pay is only $49, except for Aetna. (As usual I have no financial gain in recommending any of these tests.)

Risk factors for Heart Disease and Diabetes

Otherwise known as Metabolic Syndrome, and previously known as Syndrome X, it includes hypertension (high blood pressure), hypertryglyceridemia (high cholesterol), obesity, hyperinsulinemia (high insulin, insulin resistance), and low HDL.

Having one component of metabolic syndrome means you're more likely to have others. And the more components you have, the greater are the risks to your health.

Metabolic Syndrome or Syndrome X

Doctors are paying more attention to the so-called "metabolic syndrome," saying it could indicate higher risks of diabetes or heart attacks for some people. The fear among medical specialists is that most people who have the syndrome feel perfectly healthy and show only the most minimal signs of disease. NPR Story on Metabolic Syndrome

More information on Metabolic Syndrome Information from Mayo Clinic website.

Recommended book: Eat, Drink, Be Healthy: Harvard Medical School Guide to Healthy Eating, Walter Willet MD DrPH Harvard University

Recommended book: Thyroid Power, Richard Shames MD

Recommended book: The Insulin Resistance Diet

Mediterranean Diet for Heart Disease

The Mediterranean diet is a heart healthy eating plan that has been scientifically shown to reduce cardiovascular disease, cancer, and other diseases like Alzheimer's and Parkinsons. It favors primarily plant based foods (whole grains, vegetables, legumes, fruit), fish, poultry, healthy oils, nuts, and some wine in moderation.

More information on Mediterrean Diet from the Mayo Clinic.

DASH Diet for Heart Disease

DASH is an acronym for Dietary Approaches to Stop Hypertension and is a diet plan primarily concerned with controlling high blood pressure by limiting salt intake.

DASH diet booklet from National Institutes of Health (NIH) (free)

DASH Healty Eating Site from National Institutes of Health (NIH)

Glycemic Index vs. Glycemic Load

The glycemic index (GI) is a numerical system of measuring how much of a rise in circulating blood sugar a carbohydrate triggers—the higher the number, the greater the blood sugar response. So a low GI food will cause a small rise, while a high GI food will trigger a dramatic spike. A list of carbohydrates with their glycemic values is shown below. A GI is 70 or more is high, a GI of 56 to 69 inclusive is medium, and a GI of 55 or less is low.

The glycemic load (GL) is a relatively new way to assess the impact of carbohydrate consumption that takes the glycemic index into account, but gives a fuller picture than does glycemic index alone. A GI value tells you only how rapidly a particular carbohydrate turns into sugar. It doesn't tell you how much of that carbohydrate is in a serving of a particular food. You need to know both things to understand a food's effect on blood sugar. That is where glycemic load comes in. The carbohydrate in watermelon, for example, has a high GI. But there isn't a lot of it, so watermelon's glycemic load is relatively low. A GL of 20 or more is high, a GL of 11 to 19 inclusive is medium, and a GL of 10 or less is low.

Mendosa.com for more information on GL of different foods and help with a low GL diet.

Diabetes Basics from About.com

Hypercholesterolemia (High Cholesterol)

This condition is a very common complaint in my patients. The first thing I do is to explore your diet and life style. The following should be instituted:

Exercise

Regular exercise, as this has been shown to lower cholesterol.

Avoid Saturated Fats

Avoid saturated fats like regular red meat. By this I mean red meat, and dairy that comes from cows that are not free range, the reason being that grain fed cows’ red meat is full of saturated fat, much more so than the grass fed. Saturated fat raises cholesterol in your body. So, if you like red meat, I recommend you eat only free range red meat available from the health food store and in moderation. This meat contains omega 3 fatty acids, which actually can help lower cholesterol and stabilize the plaque in the coronary arteries. Other sources of saturated fat include cheese, milk, yogurt and ice cream.

Avoid Hydrogenated Oils

By 2006 the food industry will be mandated to list on every packaged item the exact amount of hydrogenated oil otherwise known as a trans-fat, or margarine. These are artificial fats, essentially foreign to the human body, created by the food industry to increase the shelf life of packaged foods like Twinkies, chocolate chip cookies and even that protein bar that you thought was good for you. Fourty years after their introduction to the human diet, we now know that trans-fats or hydrogenated oils actually increase cholesterol and your risk of heart disease.

Avoid Refined Carbohydrates

Avoid refined carbohydrates like pasta, white flour products such as muffins, bagels, doughnuts etc. Too much alcohol can also raise cholesterol. There is now evidence that diets high in refined carbohydrates not only can raise cholesterol but also your risk for heart disease. In fact in my office I have begun to test those with heart disease for glucose intolerance otherwise known as pre-diabetes.

Eat Complex Carbohydrates

Eat foods high in complex carbohydrate, fiber and soy. Examples include lots of green vegetables like spinach, kale, collard greens, tofu, tempeh or miso. Flax seed (2 tablespoons a day fresh ground in the coffee blender) is not only a good source of fiber which is excellent for cholesterol lowering, but also a very high source of alpha linolenic acid which has been shown to reduce your risk of heart disease. Mix in water or juice and down it every morning (it can help those with constipation as well).

Supplements

Other supplements I find useful in my practice is Phoschol which comes from soy lecithin, which again has been found to lower cholesterol. Red Rice Yeast has also been shown to lower cholesterol naturally without the side effects of statin drugs. In fact, the drug company Merck is claiming that this naturally occuring substance documented 1200 years ago in China infringes on their patent for Mevacor! Plant sterols can also help prevent intestinal absorption of cholesterol from the diet. With all supplements, make sure you are using a high quality brand that meets is label claims by third party verification, or by the clinical results of your health care provider.

NPR Story: Red Rice Yeast Helps Cut Bad Cholesterol

Drug Free Approaches to Cholesterol Video

Remember, that lowering cholesterol is not the only answer to preventing heart disease which is the number one killer of Americans today. There are a large number of people who die of heart disease every day who do not even have elevated cholesterol. Evidence is now pointing to inflammation in the body. So I usually check a comprehensive cardiovascular profile test by blood in my office to evaluate not just cholesterol but also markers of inflammation such as CRP, homocysteine, and ferritin.