Hello Reader,
The Blood Test That Your Doctor May Not Be Ordering
## (While Her Cholesterol Looked “Perfect”)
Dear Commander,
Last week, I told you about the cholesterol numbers that might be lying to you. This week, I need to share something that might shock you about heart disease.
Here’s a statistic that stopped me cold: Research published in major medical journals shows that roughly half of all heart attacks occur in people with normal or even low cholesterol levels.
Think about that for a moment. Half of all heart attacks happen to people whose doctors told them their cholesterol was fine.
How is that possible? The answer lies in a simple blood test that costs less than $20, takes 30 seconds to draw, and most doctors don’t routinely order it.
That test might be more important for predicting your heart attack risk than your cholesterol levels.
The Silent Fire Burning in Your Arteries
Here’s what I wish I’d known years ago: Heart disease isn’t just about cholesterol buildup. It’s about inflammation.
Think of your arteries like a highway. Cholesterol particles are like cars driving down that highway. But inflammation? That’s like construction zones, potholes, and accidents that cause cars to crash and pile up.
You can have low cholesterol (few cars) but high inflammation (terrible road conditions) and still end up with a heart attack. You can also have high cholesterol but low inflammation and cruise along just fine for decades.
This is why your "perfect" numbers could actually be hiding a ticking time bomb.
Meet Your New Best Friend: C-Reactive Protein (CRP)
C-reactive protein is your body’s inflammation alarm system. When there’s inflammation anywhere in your body—including your arteries—your liver pumps out CRP like a fire department responding to a call.
The test you want is called “high-sensitivity CRP” or “hs-CRP.”
Here’s what the numbers mean:
Low Risk: Less than 1.0 mg/L
Moderate Risk: 1.0 to 3.0 mg/L
High Risk: Greater than 3.0 mg/L
But here’s the kicker: Even if your CRP is in the “low risk” range, if it’s trending upward over time, that’s important information.
The Research That Changes Everything
The landmark JUPITER study, led by Dr. Paul Ridker at Brigham and Women’s Hospital, followed nearly 18,000 people with normal cholesterol but elevated CRP. Half received a statin drug,(statins are powerful anti-inflammatories), half received a placebo.
The results were so dramatic they stopped the study early. The group with high CRP who didn’t get treatment had significantly more heart attacks and strokes—even though their cholesterol was normal. The trial was stopped after just 1.9 years because it became clear that patients in one arm had significantly higher cardiovascular risk.
This study proved what researchers had suspected: inflammation might be an even better predictor of heart problems than cholesterol.
Even more compelling: A brand-new 2024 study published in the New England Journal of Medicine followed nearly 28,000 women for 30 years. Researchers found that women with the highest levels of CRP had a 70% increased risk of heart disease—compared to just 36% for high LDL cholesterol.
More recent research suggests that people with high CRP are: - 2-3 times more likely to have a heart attack - More likely to develop diabetes - At higher risk for stroke - More prone to cognitive decline
Key Studies to Know: - JUPITER Trial (2008): Dr. Paul Ridker, Brigham and Women’s Hospital - proved inflammation treatment reduces heart events by 44% - Women’s Health Study (2024): Published in New England Journal of Medicine - 30-year follow-up of 28,000 women showed CRP was the strongest predictor of cardiovascular events - Multiple validation studies from Harvard, published in leading medical journals
What’s Causing Your Inflammation Fire?
The scary truth? Inflammation can be brewing silently for years. Common culprits include:
Obvious ones: - Poor diet (especially processed foods and excess sugar) - Lack of exercise - Chronic stress - Poor sleep - Smoking - alcohol - simple carbs
Hidden ones: - Gum disease (yes, really!) - Chronic infections - Autoimmune conditions - Excess belly fat (it’s metabolically active and inflammatory) - Certain medications
The Good News: You Can Put Out the Fire
Unlike genetics or family history, inflammation is largely within your control. Here’s what research shows actually works:
Anti-Inflammatory Foods That Work:
- Fatty fish (salmon, sardines, mackerel) - 2-3 times per week
- Leafy greens - the darker, the better
- Berries - blueberries are inflammation-fighting superstars
- Olive oil - extra virgin, the real stuff
- Nuts - especially walnuts and almonds
- Green tea - multiple cups daily show benefits
Lifestyle Changes That Move the Needle:
- Regular exercise - even 20 minutes of walking reduces CRP
- Quality sleep - 7-8 hours nightly
- Stress management - meditation, yoga, or whatever works for you
- Dental hygiene - floss daily (seriously, your arteries will thank you)
Foods That Fan the Flames:
- Processed meats
- Refined sugars
- Trans fats
- Excessive alcohol
- Fried foods
- Processed foods
- Non-organic wheat based foods
Your Action Steps This Week
- Ask for hs-CRP at your next blood draw. If your doctor resists, explain you want to assess inflammation as a heart disease risk factor. It’s a standard test.
- If you already have recent labs, look for CRP. It might already be there under a different name (C-reactive protein, CRP, or hs-CRP).
- Start tracking the trend. One elevated reading doesn’t mean panic—you want to see the pattern over time.
- Pick one anti-inflammatory action to start this week. Get on my 5/2 diet. You 5 days of no simple carbs, no alcohol and no sugar will dramatically reduce inflammation.
- Try an elimination diet. There is a copy of Dr. Marc Hymen's elimination diet in my 5/2 PDF. Try that to see if other foods like dairy, soy, peanuts, etc. might be inflammatory for you.
The Real Truth About Heart Health
Here’s what the medical establishment is slowly figuring out: Your heart health isn’t just about the plumbing (cholesterol blockages). It’s about the environment those pipes are living in (inflammation).
You can have squeaky clean arteries, but if they’re inflamed and irritated, you’re still at risk. Conversely, you might have some cholesterol buildup, but if your inflammation is low, you might be in better shape than your test results suggest.
You are now armed with the information you need. Research like the landmark studies I mentioned has helped doctors recognize that heart health isn’t just about cholesterol—it’s about the complete inflammatory picture. Understanding these markers will give you the power to have an informed discussion with your doctor and to take control before it’s too late.
Your mission: Become the CEO of your own health. Know your numbers. Understand what they mean. Take action based on knowledge, not fear.
Stay strong,
Got questions about inflammation testing or want to share your CRP story? Hit reply—I love hearing from you and your experiences help other readers too.
Click on the link below for useful information from past newsletters.
