What’s Inside This Episode?

• The biggest myth about heart disease that could be costing lives
• Why elevated insulin—not just cholesterol—is a major risk factor for heart attacks
• The standard lipid panel mistake most doctors make (and the tests that actually matter)
• What a continuous glucose monitor (CGM) can reveal about your cardiovascular risk
• The one overlooked genetic marker that increases sudden heart attack risk (and why most doctors never check for it)
• Why the first symptom of heart disease in 50% of people is sudden death—and how to prevent it

Resources and Links:

• See the Full Transcript here
• Get the 17-Page Heart Health Test Guide: Discover exactly which tests your doctor should be running at drritamarie.com/hearttests.
• Click here to order labs direct through Evexia
• Join the Next-Level Health Practitioner Facebook group here for free resources and community support
• Grab your copy of the  ReInvent 2025 Conference Replay and Slides here for a deep dive into the microbiome, lab testing and genetics
• Visit INEMethod.com for advanced health practitioner training and tools to elevate your clinical skills and grow your practice by getting life-changing results.
• Check out other podcast episodes on metabolic health here

 

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Transcript

Dr. Ritamarie Loscalzo  

Welcome back. On this episode, we’re going to talk about the common misconceptions that conventional doctors have about cardiovascular disease that are keeping people sick and possibly even putting them at risk for autoimmune diseases and even cancer. 

 

There are so many misconceptions that doctors have been taught in their medical training that they take into practice, and they use with clients and with patients, that put people at risk. So I want to talk a little bit about some of those. 

 

One is the focus on fat and cholesterol. What they’re not focusing on is the metabolic health of the individual. They’re not focusing on sugar in the diet, processed foods in the diet, all the processed oils and seed oils and hydrogenated oils.

 

They’re just focusing on how much fat, saturated fat, and then for testing, what’s the cholesterol, what’s the LDL, what’s the triglycerides. And they’re not focusing on the role of insulin. Huge role. 

 

Insulin has a huge role in the development of cardiovascular disease, in the development of hardening of the arteries of atherosclerosis. Insulin’s role is not discussed enough.

 

Testing for cardiovascular disease is just part of the routine annual lab testing, right? So the lab testing that most doctors are taught to do is test for the cholesterol, total cholesterol, test for triglycerides, test for HDL and LDL, and that’s where it stops. They’re not looking at all the other markers. They’re not looking at inflammation.

 

There’s a lot of inflammatory markers that are elevated really a long time before even symptoms start to occur. In terms of metabolic health, most doctors ignore it until a person comes in, and they have type 2 diabetes. The fasting glucose goes above 120, 125, and they say, huh, you have diabetes, and we have to watch for it. They’re still not making the connection in most cases with cardiovascular health. With that, did you know that the white flour and the sugar and all the foods that you’re eating that are raising your sugars and giving you type two diabetes, that’s related to cardiovascular disease? 

 

Dr. Ritamarie Loscalzo (02:47)

Yes, we know that one of the serious side effects of long-term diabetes is cardiovascular disease. The signs are there decades before someone becomes type 2 diabetic. And even if they never become type 2 diabetic, that person is at risk because of the long-term elevation of blood sugar, not fasting blood sugar, but blood sugar throughout the day, what we as doctors call postprandial glucose. 

 

We don’t really test that in most people. Doctors in medical school are not trained to test for postprandial glucose until they’re doing a glucose tolerance test with someone who they suspect might be heading towards diabetes or has hypoglycemia. What they’re not realizing is the spectrum of disease. 

 

The spectrum of disease starts decades before someone becomes type 2 diabetic, and they’re at risk long before they become type 2 diabetic. This is a fallacy, and these people are suffering, because their insulin levels go up. Nobody tests for insulin. We’re not taught in school to test for insulin.

 

Insulin is something you test for when you suspect type 1 diabetes. Some long-term type 2 diabetics are tested for insulin, and their suspicion when they’re tested is that, maybe they’re not producing enough insulin. Maybe the pancreas is now burned out, and we’ve gone from being effectively a type 2 diabetic into a type 1 and then insulin is recommended. This is a fallacy. This is a mistake and this is putting people at risk.

 

The most common cause of sudden death from cardiovascular disease, from heart disease, from heart failure is actually elevated insulin. And it’s not taught that way in medical school, but there’s a plethora of studies out there that show this. So this is a big mistake. 

 

Dr. Ritamarie Loscalzo (04:47)

And if your doctor is not testing you, or if you are a doctor and you’re not testing people for metabolic imbalance, you’re not testing their fasting insulin.

 

 You’re not testing their postprandial glucose. You’re not talking about hemoglobin A1C, and you’re not looking at the inflammatory markers that long-term imbalance in metabolic health, long-term imbalance in glucose and insulin causes, this is a huge mistake. 

 

So there’s a mistake in the kind of labs that are done to identify somebody at risk of cardiovascular disease. One is what’s tested. The routine lipid panel, which is just testing, as I said, cholesterol, HDL, LDL, and triglycerides is just inferior to what should be tested. 

 

Someone can have perfectly fine numbers, cholesterol is like 180, and HDL is 70, and LDL is 90, and be at risk because of the type of LDL that’s going on in there because of other markers that are not measured. 

 

So for example, there’s a test that’s routinely available. It’s been available for decades that most doctors don’t do, and it’s called particle size, LDL particle size. We’re looking, are the LDLs that are there small and dense, and they can burrow  their way into the walls and create the atherosclerotic plaques that cause heart disease? Or are they big and buoyant and too big to get into the cells? Somebody could have elevated LDL higher than the routine range and not be at risk because of the size of those particles. 

 

And it’s a simple test. costs maybe $150 to get done. In some labs, it’s even less than that. There are labs that people can get access to directly, that you can get that test done for like $75. So it’s not like it’s only the rich can test for this stuff. It’s really serious. And I think everybody who’s over 50, who has a family history of cardiovascular disease, or has shown signs of elevated lipids or imbalances absolutely needs to get this test done.

 

I have a family history of heart disease. My mom died of heart disease at 56, sudden out of the blue, nobody knew she was sick. Her doctors missed it. Two years later, the same thing happened to my dad. Had they been tested and then counseled properly, because that’s the second step, had they been tested, saw the risk, and the doctor said, hey, you’ve got to stop eating this, you have to start eating that, to do the stress, and there’s a whole bunch of things that could be recommended, I think their deaths could have been prevented.

 

Dr. Ritamarie Loscalzo (07:27)

So these are super important tests that are not done. Another thing that’s not done, and it’s an independent risk factor for cardiovascular disease, a mistake almost every conventional doctor makes is not testing a marker called lipoprotein A. That is an independent risk factor that can increase the risk of sudden death from heart attack. 

 

It’s a genetically controlled marker. Most things, genetics is one thing but then the lifestyle is affecting what actually is putting people at risk. With this, it goes up if you have the genetic marker. Now, if you control the lifestyle factors around it, then you can keep the risk down. But most doctors aren’t testing for it. 

 

So they’re not sitting down with my mom and saying, Mary, you’ve got to stop eating this, and you’ve got to start eating that and smoking is not good for you with this particular profile that you have. Things are going to go wrong. And I know my mom or my dad or both had it because genetically I have it. In spite of my amazing diet, and my amazing exercise program, and my amazing stress management program, I have elevated Lp(a), which puts me at risk. 

 

Do I want to know that? Absolutely. Do I want all my siblings to get tested for it? Absolutely, because I’ve already made the changes. They haven’t. And I want to like, light a fire under their butts and get them to not wait for their doctor to recommend it. Very inexpensive test, $25 or less. 

 

So everybody should be getting this test. You don’t need to take it over and over again unless it’s high. If it’s 10, 15, you probably don’t have the genetic marker, and you’re good to go, right? 

 

But if it’s elevated, we don’t know is it elevated because of lifestyle factors or genetics? It’s worthwhile to go back, update the lifestyle factors, and then retest. This is a huge mistake, huge mistake that the doctors are not doing. So those are just some of the things. 

 

The other things they’re not testing are a whole bunch of inflammatory markers, C-reactive protein. A lot of people have heard of that, but they don’t routinely test it. Everybody with a family history of heart disease, everyone who’s over 50 should have it tested. 

 

Dr. Ritamarie Loscalzo (09:41)

Anybody with any inflammatory conditions should have that tested as well as homocysteine. Another marker that might be genetically controlled, maybe not, but we have things we can do to reduce the risk when we know this. And this is a huge mistake that doctors are making, that they’re absolutely not testing these things and putting people at risk. There’s a whole bunch more, and I have this beautiful 17 page document if you’re interested in your own health and for the health of your patients, we’ll have that link in the show notes. So you can download that and you can get these tests done. 

 

Go to your doctor, get them done. If you’re in the U.S. in most states, you can actually, if the doctor says, no, you’re not at risk, you can take them to these external labs and get the stuff tested. You owe it to yourself. You owe it to your family. Don’t wait for your doctor to tell you about it. 

 

So we’ve been talking about the risk factors, identifying the risks. And I just always tell my clients, “Don’t wait for your doctor to wait for symptoms, because in 50%, five zero, and in women it’s a little bit higher, of people who have existing cardiovascular disease, the first symptom is a fatal heart attack.” How do I know this? Happened to both my parents, it happened to a grandfather, it happened to an uncle, it happened to a cousin, it happens all the time. 

 

And I always tell my patients, my clients, my family members, don’t become a statistic. If your doctor’s waiting for you to have symptoms like, I have, you know, angina, chest pain when I exercise, you might not get it. You might just die of a heart attack. It’s not worth the risk. So you need to get these things tested. If you already have signs of it, you already have the angina, it’s not enough to just have the doctor give you nitroglycerides to help with that. There’s so many things, dietarily, that you can do. Supplements you can take.

 

This is critical and learning what those things are is going to save your life. And doctors need to be trained in order to detect these things so that when somebody comes in, and they have chest pain on exertion, or they have shortness of breath, or maybe they have pain in their arm, and they think they have heartburn, because it’s a mimicker, right? Heart disease may be happening. This looks like heartburn. 

 

Dr. Ritamarie Loscalzo (12:00)

 And I’ve had that happen to a friend of mine’s husband. So it’s not that it happens so bad that he had a heart attack, didn’t know it, got to the hospital, and his was fatal. This happens all the time. So we need to be really aware as people, as self healers, and also as practitioners, when someone has these things brewing, or they have a family history, that we are on the mark, and we are getting the right testing, and we are getting the right counseling. 

 

My podcast, Reinvent Healthcare, has a ton of episodes about heart disease, about the testing and about some of the herbs and foods and various things that you can do to solve this. I am on a mission to prevent folks from experiencing the pain I felt at losing my parents. And I’m dedicated to not losing the rest of my family members that way, but also to keeping myself healthy. And you owe it to your patients, your clients whether you’re a doctor, a nurse practitioner, a nurse, health coach, you owe it to yourself to learn this so that you can save lives and improve the quality of people’s lives. 

 

So when doctors focus on, you have high cholesterol, you need to go on a low fat diet or a low saturated fat diet. And more and more of them are questioning the logic of this, but they’re not focusing on the quality, the overall quality of somebody’s diet. They’re not focusing on the metabolic implications of the diet. And so a lot of these low fat diets are loaded with sugar. They’re loaded with refined carbohydrates or even carbohydrates that haven’t been refined. 

 

They’re not talking to people about testing their own glucose. We mentioned this earlier in this episode, they’re mentioning to get the testing of postprandial glucose. What does that mean? What the heck is that?

 

What it means is monitoring what’s happening to your glucose throughout the day in relation to your food, in relationship to your stress, in relationship to your exercise. And when we do this, with the advent of CGM’s, continuous glucose meters, over the last, I don’t know, five to seven years, they become way more readily available, and people are starting to test, and they’re realizing that a lot of their favorite healthy foods are causing their glucose to spike.

 

Dr. Ritamarie Loscalzo (14:23)

And every single spike in their glucose throughout the day is contributing to stiffening of those arteries, stiffening of the arteries. if you’re like, your doctor says, oh, as long as your glucose is at 140 or less, two hours after your meal, you’re fine. No, every time it goes above 100, you’re having some issues. But every time it goes above 120, there are numerous studies that show that it’s contributing to the stiffening of those arteries. It’s contributing to damage to the kidneys, to the eyes, the retinas in the eyes, to the peripheral nerves. All of this stuff is happening. 

 

So how do you recognize this? As a doctor, you can prescribe a continuous glucose monitor. And you can get that for people who are not diabetic, who are not even in your eyes, pre-diabetic. Because when we go back to the kinds of testing, the criteria for diabetic and pre-diabetic are missing people who are already at risk, because they have that, what I call pre-insulin resistance. 

 

And we need to step in and get these people to test. Now, not everybody needs a CGM, but if they have any of this going on, we get them a CGM. You do it for two to four weeks. If you see questionable results, then you can work with them more closely on cleaning up the diet.

 

And those elevations, when you’re causing stiffening of those artery walls, you’re putting a person at risk. And if you’re not detecting this early on, that person is at high risk. So we really need to focus on the metabolic health. We need to focus on getting the glucose and insulin under control. Spikes of insulin stiffen those arterial walls. It causes inflammation, causes hypertension, high blood pressure, which is a leading underlying cause of stroke and so much more. 

 

We need to give people the education they need to make changes to their diet and their lifestyle early on. before they become a statistic. So I have a document that I created for a couple of recent multi-day events, one for doctors and one for patients that had a list, a 17 page document of all the different tests that are advisable to be at least looking at.

 

Dr. Ritamarie Loscalzo (16:46)

Not everybody needs all 17 pages. The reason it’s 17 pages is because I also give you a description. I don’t just give you the list. It’s an invaluable tool. It took us a lot of time to put it together and research it. And I’m giving it to you for free. So if you go into the description, the text below, you’re going to find it.  DrRitaMarie.com/hearttests  is the link directly to that. Just give us your email address, and we’ll send it on off to you, and you can take this into your own doctors, or if you are a doctor, you can use this when you’re evaluating people. 

 

The best way to reach me is my website or social media. My YouTube channel and podcast are loaded with information and links where you can get more information. I highly recommend that you do that. Check out if you’re a doctor, our website inemethod.com. Check out DrRitaMarie.com if you’re a self healer. 

 

And we as practitioners, as functional practitioners, are the future of healthcare. Those of us who are putting the care back in the term to replace the focus on symptom suppression and disease management that our system has become, unfortunately. 

I’ve dedicated my life to empowering people to take back control of their health and to supporting health practitioners to truly help people get to the root causes of their issues. If you’d like more in-depth training and resources to take your practice to the next level, download our free guide to asking the right questions at inemethed.com. We welcome you to join us in the movement to reinvent healthcare. And until next time, shine on.