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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do you suggest for atherosclerosis?

So I ve recently had a few health concerns (fortunately seemingly non-serious), and I m really hoping this is just fear and I m fine. I am seeing a primary care physician (have another appointment in a couple weeks), and I ve also been working ~8 months on some really good lifestyle changes in general (a good exercise program, more whole foods, vitamins and supplements in reasonable doses without going overboard, etc.). As a quick introduction, my anxieties about health started with some random muscle twitching after starting a rather intense exercise program last year. Fortunately, most of the potential serious causes of twitching seem unlikely at this point, and I now believe it to be either an electrolyte imbalance (which is being tested for) or perhaps BFS, a benign condition. This all lead to me realizing my blood pressure is a bit higher than it should be; it was borderline hypertension, and while it s still considered pre-hypertension, I ve lowered it a lot through exercise (now a bit more moderate - I think I overdid it at first), eating healthier, and healthier supplement choices. That said, I ran across some studies the other day that really concerned me. Years ago (in my 20 s) when I started supplementation, along with some other things (arganine, fish oil, a good multivitamin, and some stimulants/fat burners I ve since cut out). I used a rather heavy does of Soy Triple Lecithin (7200mg per day at its peak with a phosphatidylcholine content of 2,520mg), and I was on this for several years (guessing around 7-8). At the time, there appeared to be evidence that it cleared arteries of plaque, protected the liver, was great as a sexual supplement, was good for the brain, and helped with fat loss. Seemed like a win-win. But I came across a Cleveland Clinic study (2011) and then a followup (2013) indicating that when choline (and carnatine, which I also took for a while, though not as long and not nearly at this dosage [there s still a little bit in a blood pressure health blend I take]) were metabolized by the gut, they created something called TMAO, which actually leads to atherosclerosis. This has caused me a lot anxiety, given the dosage and period of time, and I ve been wondering if I maybe caused longterm and irreversable damage as far as plaque buildup in my arteries. To be honest, I m a bit freaked out. There are a few comforting things. My supplement was soy lecithin; whereas as far as I can tell, this study used animal (meat/egg) choline + a choline supplement. A previous study seemed to indicate that lecithin/phosphatidylcholine did not create TMAO in the gut in lecithin form, so this seems contradictory, and I m not sure what to believe here... Also, other foods than the ones tested (such as fish) are very high in TMAO itself, and we know that fish is anything but heart-unhealthy. Also, they tested genetically modified mice that were already prone to atherosclerosis, and the human sample was fairly small. I ve also seen anecdotal stories of soy lecithin being used to clean arteries successfully, after heart attacks, and for much longer durations than I was on it (30 or 40 years), but obviously anecdotes are anecdotes. Though if you search just for soy lecithin, it s still being touted as something that s good for cardiovascular health. (It s one of the reasons I started taking it, as my dad died of a heart attack and atherosclerosis in his 50 s). The good news is, right now, overall, I feel pretty good. Exercising is going well, I m slowly losing weight (still have a ways to go), I don t have chest pains/shortness of breath/numbness/anything too alarming, my resting heart rate when getting up is good. I can touch my toes (as a few recent articles indicate that s a good sign as far as atherosclerosis, though I m not sure how much stock to put in that simple of a test) and sexual health is good (which I think might be an indicator if there was a major problem). Aside from slightly elevated blood pressure (which is still under stage 1 hypertension and sometimes fairly normal; in the morning, in fact, sometimes it s under 120/80 now) and cholesterol numbers I m still waiting on (last time was slightly elevated but nothing I was told was alarming), I seem to be healthy. So, I guess I m asking, how worried should I be that I really caused damage? Are there any tests that can be done that can alleviate my fears? Thanks for listening, and sorry this was so long. This anxiety is just driving me a bit bonkers! Warmly & To Good Health, Shaun
Wed, 12 Feb 2014
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General & Family Physician 's  Response
Hello Shaun,

I have gone through your post & understand your concern.

Since you do not have any clinical symptom suggestive of Cardiovascular involvement, there is no need to worry.
To be on the safer side, kindly consult your General Physician for proper clinical examination.
Also get certain basic investigations like complete blood count, Lipid profile, Liver & Renal function test and an Electrocardiogram.
These tests determine the risk of coronary heart disease in an individual.

Till then, maintain adequate hydration & proper nutrition status, exercise regularly and avoid stress.

Wishing you a Good Health.
Take care.
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