How can I get my lipoproteins tested?

20. October 2006 William Davis (0)
This question came up on our recent online chat session and comes up frequently in phone calls and e-mails.

If lipoprotein testing is the best way to uncover hidden causes of coronary heart disease, but your doctor is unable, unknowledgeable, or unwilling to help you, then what can you do?

There are several options:

1) Get the names of physicians who will obtain and interpret the test for you. Go to the websites for the three labs that actually perform the lipoprotein tests: www.liposcience.com (NMR); www.berkeleyheartlab.com (electropheresis or GGE); www.atherotech.com (VAP or centrifugation). None of them will provide you with the names of actual physicians. They will provide you with the name of a local representative who will know who the doctors in your area who are well-acquainted with their technology. I prefer this route to just having a representative identify a laboratory in your area where the blood sample can be drawn, because you will still need a physician to interpret the results¾this is crucial. The test is of no use to you unless someone interprets it intelligently and understands the range of treatment possibilities available. Don’t be persuaded by your doctor if he/she agrees to have the blood drawn but has never seen the test before. This will be a waste of your time. That’s like hoping the kid next door can fix your car just because he says he fixed his Mom’s car once. Interpretation of lipoproteins takes time, education, and experience.
2) Seek out a lipidologist. Lipidologists are the new breed of physician who has sought out additional training and certification in lipid and lipoprotein disorders. Sometimes they’re listed in the yellow pages, or you can search online in your area.
3) Contact us. I frankly don’t like doing this because I feel that I can only provide limited information through this method. I provide a written discussion of the implications and choices for treatment with the caveat to discuss them with your doctor, since I can’t provide medical advice without a formal medical relationship. We also charge $75 for the interpretation. But it’s a lot better than nothing.
4) Make do with basic testing. Basic lipids along with a lipoprotein(a), C-reactive protein, fibrinogen, and homocysteine would provide a reasonable facsimile of lipoprotein testing. You’ll still lack small LDL and postprandial (after-eating) information, but you can still do reasonably well if you try to achieve the Track Your Plaque targets of 60-60-60.

In 20 years, this will be a lot easier. But for now, you can still obtain reasonably good results choosing one of the above alternatives.
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Who knows what

Who knows what

4. September 2008 William Davis (4)
You know that cynical old saying:


It’s not what you know, it’s who you know.

In other words, knowing the right person provides you strategic advantage in business, social advancement, etc.

In health, it was often true. Knowing who the better doctors were, for instance, in your city might provide you with access to better care.

Enter the Information Age. You now have access to medical information equal to that of your doctor. You now have access to patient discussions about doctors, their practices, their performance records. There is now a depth and breadth of information on health that was never available before.

I’d therefore turn the old saying into the new Health 2.0 version:


It’s not who you know, it’s what you know.


In health, information now reigns supreme, not knowing somebody else who has the right connections.

Positive: Everybody now theoretically has access to an equal amount of information, since you can access information on any topic just as easily as I can.

Negative: It puts more of the burden on you. If you screw up in health, perhaps you didn’t try to get the best information hard enough.

I love this new development, this emergence of empowerment in health. I call it self-directed health, the individual capacity to exert enormous influence over the quality of your healthcare.

This is obviously a work in progress. All the answers and tools for self-directed care, self-empowerment are not yet available, some haven’t even yet been imagined.

But they are coming.
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Comments (4) -

  • Jenny

    9/4/2008 6:55:00 PM |

    Dr. Davis,

    The big problem with this change is that I am still paying MY doctor big bucks to give me prescriptions that result from my many hours of totally unpaid research.

    If I didn't have to pay over $7,000 a year for "health care" that is mostly me doing my own research I would feel much more excited about this new turn of events.

    But until the doctors start paying ME for doing all the work it takes to keep myself healthy I'm not going to be as excited.

    My docs, alas, even the "good ones" seem to get 99% of their "medical education" from drug company reps and the rest from newsletters that treat as news  the latest drug company PR released about drugs.

    Even specialists seem to be way behind the online patient support community. For example, I have yet to hear of a gastroenterologist who knows that cutting wheat out of the diet can usually eliminate acid reflux. And we all know most docs are still pushing high carb/low fat diets on people with diabetes.

  • Anonymous

    9/4/2008 7:47:00 PM |

    I think that this will be a positive factor in the future but there are many of us well-informed patients who have been dismissed by our doctors for daring to question said doctor's recommendations.  Will this change?  I think not.....

  • Nancy R.

    9/5/2008 2:04:00 AM |

    Dr. Davis, your optimism is wonderful. But alas, it's hard to find doctors such as yourself to compliment the information patients can now arm themselves with.

    As an adjunct to this "empowered patient" age, I'd like to see some online databases created that list names of enlightened doctors grouped by geographical region. It can be so hard, armed with the knowledge I have, to find doctors who want to work with me, not fight me. It's difficult to find doctors who really want to partner with you to find the path to health, not just parrot the party line and prescribe some useless medication.

    Perhaps is just a matter of time...

  • Ricardo Carvalho

    9/9/2008 12:03:00 AM |

    I remember once seeing a milk advertisement on TV where a very beautiful lady used to say: "If I don't worry about my self, who will?". Each one has the responsibility of taking care of his own health and, desirably, of the people surrounding himself. So, I really don't mind spending a few hours studying whatever the subject to help me and others, and it doesn't matter if this is paid or not. What I want is doctors who are technically excellent and independent from insurance and drug companies. We don't have the first one in Portugal, but we fortunately still have much of the second, because our national health service is still based in solidarity and respect for human dignity (I've recently seen Michael Moore's "Sicko", but I'll not comment on this). I think the so called "empowerment of health" that Dr. Davis refers to is even more important in the countries where people have low resources and difficult or no access at all to proper healthcare. We use to say around here that "ignorance is the cause of all evil". The opposite is also true: education, access to books, information, will always be the key to improve human overall quality of life.

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