Articles

Educating a Farmer

A patient recently came into my office for erectile dysfunction, high blood pressure, elevated cholesterol, multiple joint pains, and a 6.0 on his hemoglobin A1C, meaning he is heading toward Type II diabetes.

Over the years, I’ve seen and treated my share of farmers. Farmers work under harsh conditions, their eating habits are whatever is on the table, and whenever it can get eaten. Problems are compounded by not always using gloves for exposure to hazardous materials—because it’s just their way of life.

For these patients, when I inquire about regular exercise, I am told, “life is my exercise, son.” The thing is, the patient wasn’t exactly within the body fat regulations or standards for a healthy body mass index. If, and assuming if, they are working hard on the farm all day, why are they overweight? Other individuals work out often, and they to find themselves stuck and not losing weight. I must ask, why is the body not burning fat, or are there other factors in play sabotaging their ability to function?

Because of his previously heightened cholesterol, he was prescribed several anti-cholesterol medications, blood pressure-lowering drugs, antacids, and when given a chance, Viagra. When asked how he felt for his current treatment, he was happy to report his cholesterol had gone from 220-120 over the past few years, and his blood pressure was stable, yet he was tired all of the time, and at times, dizzy. His erectile dysfunction had worsened during that period.

Reviewing his history for cardiovascular risk, I discovered he had never had homocysteine or C-reactive protein tests. Furthermore, when I explained the difference between particle size that LDL and HDL aren’t necessarily a myth on good or bad, but it’s more about the size with larger being less risk and smaller being more.

He agreed to let me test more than just the standard LDL/HDL and triglyceride. (The test run millions of times a year in the US.) While his C-reactive protein (a test for intravascular inflammation) ended up being under one, perfect, his big cholesterol were elevated (less risk), and his small cholesterol was within normal limits, also less risk. His homocysteine was above 12. Homocysteine is linked to cerebrovascular disease and cardiovascular diseases. Increased concentrations above eight can lead to atherosclerosis and arterial plaque much the same as cholesterol. The higher the density, the higher the risk of disease. Elevated levels of homocysteine can be reduced by adding the correct dosage and type of B12, folic acid, B6, Vitamin C, and L-arginine.

After treating the true cause of this cardiovascular problem (and, by the way, if you remember that taking antacids decreases or eliminates your ability to absorb B12 and folic acid), we decreased his homocysteine. Many of his symptoms are decreasing, and when he made his yearly appointment with his MD he was able to reduce some of the medications. After some time, his cholesterol began to rise, which was alarming to his MD, but they were all in the low-risk category. He now understands what raises his insulin and what foods slow down his digestion leading to several of his symptoms. His ED was much better, his dizziness resolved, and joint pain is, for the most part, is limited to the self-inflicted as part of his job.

Be well,

Dr. Trites