Triglyceride-to-HDL Ratio After assessing each of these five biomarkers, there is one more step: calculate your triglyceride-to-HDL ratio to better u… - Casey Means

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Triglyceride-to-HDL Ratio After assessing each of these five biomarkers, there is one more step: calculate your triglyceride-to-HDL ratio to better understand insulin sensitivity. Simply divide your triglycerides by your HDL. Interestingly, studies have shown that this value correlates well with underlying insulin resistance. So even if you are unable to access a fasting insulin test, the triglyceride-to-HDL ratio can give you a general sense of where you’re at. According to Dr. Mark Hyman, “the triglyceride-to-HDL ratio is the best way to check for insulin resistance other than the insulin response test. According to a paper published in Circulation, the most powerful test to predict your risk of a heart attack is the ratio of your triglycerides to HDL. If the ratio is high, your risk for a heart attack increases sixteen-fold — or 1,600 percent! This is because triglycerides go up and HDL (or ‘good cholesterol’) goes down with diabesity.” Dr. Robert Lustig agrees: “The triglyceride-to-HDL ratio is the best biomarker of cardiovascular disease and the best surrogate marker of insulin resistance and metabolic syndrome.” In children, higher triglyceride-to-HDL is significantly correlated with mean insulin, waist circumferences, and insulin resistance. In adults, the ratio has shown a positive association with insulin resistance across normal weight and overweight people and significantly tracks with insulin levels, insulin sensitivity, and prediabetes. Perplexingly, the triglyceride-to-HDL ratio is not a metric used in standard clinical practice. If you remember one thing from this chapter, remember this: you need to know your insulin sensitivity. It can give you lifesaving clues about early dysfunction and Bad Energy brewing in your body, and is best assessed by a fasting insulin test, discussed below. Right now, this is not a standard test offered to you at your annual physical. I implore you to find a way to get a fasting insulin test or to calculate your triglyceri

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According to Dr. Mark Hyman, “the triglyceride-to-HDL ratio is the best way to check for insulin resistance other than the insulin response test. According to a paper published in Circulation, the most powerful test to predict your risk of a heart attack is the ratio of your triglycerides to HDL. If the ratio is high, your risk for a heart attack increases sixteen-fold — or 1,600 percent! This is because triglycerides go up and HDL (or ‘good cholesterol’) goes down with diabesity.

Additional quotes by Casey Means

At the start of my residency, the Affordable Care Act (ACA) was passed and all doctors had to get up to speed on the Merit-Based Incentive Payment System (MIPS), a new program under the Quality Payment Program (QPP), where a physician would now receive substantial adjustments to payments from Medicare if they met specific quality-of-care criteria. One would think that “quality” and “merit” in medicine would mean that the patient was actually getting better. But when I dug deep through the MIPS website to find the specific quality metrics for each specialty, I was shocked to see that these quality criteria were primarily based on whether doctors prescribed drugs regularly or did more interventions. Yes, a government incentive program focused less on actual patient outcomes (i.e., Did the patient get healthier?) and more on whether doctors prescribed long-term pharmaceuticals.

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He observed that when we build rockets we put over 10,000 sensors on them to understand the functioning of all parts of the spacecraft and to enable prediction of mechanical dysfunction and systems failure before it happens... Yet with human health, we adhere to an opposite paradigm. We wait for the human body to develop fulminant systems failure, which shows up as symptoms and meeting diagnostic thresholds for disease-specific biomarkers.

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