(Janice:) And this is Janice and Ford. We are here to talk about inflammation today. Going
back to our previous videos, we talked about insulin resistance and cholesterol
I'm going to start out by asking Ford, I've gone to my internist or family
medicine doc many times and I've never heard implement - inflammation mentioned.
What is inflammation and why don't we hear about it? (Dr. Brewer:) Well, actually to go back
to inflammation you might need to use a military term. Have you ever heard the
term friendly fire, taking friendly fire in a battle? (Janice:) Yes. (Dr. Brewer:) And that's where you're
getting shot by your own. Somebody that's supposed to be on your own side right?
That's exactly what inflammation is in - in this sense. Our immune system is
actually causing the damage. It's doing that by trying to clean up LDL or bad
cholesterol which has been deposited in the artery wall. (Janice:) Okay and so through our
own practice, we do labs for inflammation or inflammatory markers. (Dr. Brewer:) Right. (Janice:) Can you
describe a few of those in detail and what they mean in terms of inflammation?
(Dr. Brewer:) I sure can. So, you know when I mentioned that the
immune system is actually causing damage, here's how it does it. The immune
system is doing what it's supposed to do. It finds LDL in the artery wall in it -
and it goes in and it sends sitting immune cells in. These immune cells
release enzymes. Those enzymes dissolve that LDL so the body can absorb it; but
here's where the problem is. Those enzymes and some of the other chemicals
involved in this process. If those enzymes touch blood, they form a clot. So
if that hot plaque or that inflamed plaque comes back out leaks back out of
the artery wall and into the blood, it forms a clot. If the clot is big enough
then it goes to the heart, it's a heart attack. If it's big enough
and it goes to the brain, it's - it's a stroke. (Janice:) Okay, just for further definition,
you mentioned hot plaque. (mm-hmm) Can you describe the difference so we all know
what you're talking about? (Dr. Brewer:) Well normal plaque is a waxy substance
just like it's a waxy substance. After those immune cells start releasing these
enzymes, then it becomes liquid and if that liquid comes back in, we talked
about it, it can form a clot. Now you ask me about markers. It just so happens that
two of the markers for this process are those enzymes. MPO or myeloperoxidase, an
LP-PLA2 which we just called Plaque-2. Those are both enzymes that are released
by the immune system to dissolve this LDL. There are a couple of other markers
that we look at as well. Well, one of them is CRP c-reactive protein. There are more
and more docs that are beginning to understand the role of inflammation in
this process. Now, usually if you find a doc who does think about inflammation in
terms of heart attack and stroke, they usually just look at CRP. That's a
protein that's made by the liver as a reaction to - to any type of inflammation;
and it's - it's not very specific that's why we look at more than just CRP. Some
dogs just look at CRP and think they know enough information. Here's the
problem with CRP. There's too many false positives. If we had a hundred people,
(Janice:) ...which again let me stop you right there, false positive... (Dr. Brewer:) So you could get a
positive CRP test and it may not mean any heart related inflammation, it could
be something else. (Okay.) So where I was gonna say, if we gave a hundred people a
flu shot today, two days from now, 66 of them
have an elevated CRP. They don't have a heart disease but it's just another form
of inflammation, (Okay.) Which the - which the flu shot is programmed to stimulate. (Janice:) Okay.
Well, I think that's it for this video. (Dr. Brewer:) Not quite. This - there's one other - there's
one other test that we look at and it's the most important test in in my book.
It's looking at the microbiome and creatinine ratio. (Okay.) Now it isn't the
amount of LDL that causes that - that deposit in the in the artery walls. It's
whether or not the intima, the lining of the artery walls has been burned and
usually it gets burnt and irritated or inflamed by high glucose. Other things
can as well but the major focus is high glucose or pre-diabetes. Now, when you
look at microbiome and creatinine ratio, here's what you're looking at. You're
looking at albumin which is the most common protein in the urine, now in the
serum; and you're looking at it in the urine. The micro human creatinine ratio
is a urine test so if you are spilling protein in your urine, then it's coming
through the filter in your kidneys. Guess what that filter membrane is. It's the
intima, that lining of the artery wall. So if you're spilling protein through that
lining of the artery wall, that means the artery wall is irritated and inflamed
throughout your arterial system. That is a critical thing for us to know in terms
of heart attack and stroke risk. (Janice:) Okay, so how would patients out or people out
here listening to this? What could they carry forward to their own internist or
family medicine? What kind of questions should they ask? (Dr. Brewer:) It's a very simple thing
and in fact these days in almost in all the states that I know, you
can even get your own lab tests and CHL Cleveland Heart Labs which is part of
quest has an inflammatory panel- A cardiovascular inflammation panel. You
can just go to a nearby quest and get that test for yourself. Take it to your
doc and see, see how it reacts. You can also come to us this is what the - this is
the purpose of this whole channel, is to help people understand a little bit more
about the key risk factors for heart attack and stroke. If you want to get
deeper in terms of working with us, you can email Michelle, MyHealth@PrevMedHeartRisk.com.
(Thank you!) Thank you! If you hit the like button and for sure, if
you subscribe or share, the algorithm reads that as a strong message that
humans think this is interesting and important information and the algorithm
can share it more than any of us humans. Speaking of sharing, the one of the best
ways of sharing is on social media. We've got active Facebook, Instagram, and
LinkedIn activities going on right now. We've recently started up things in
Pinterest and Twitter so we'd love to see you there. Check us out! Finally
with over 500 videos, a lot of people are saying I can't find this video or that
video. Our new social media manager Caim Hermoso is starting to work on ways to
help with that. So join the community. You can click on the links below and you can
get a little bit better access. Thank you again for your interest!