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Nutri meter
  • Test CYP2c19 (a genetic test) before initiating Plavix (clopidogrel), an antiplatelet therapy.
  • There are several genetic variances in CYP2c19 activity. Individuals with low enzyme activity may need higher starting doses or the addition of other platelet inhibitors.
  • Individuals with a recent heart attack, ECG changes, stroke, recent revascularization or vascular wall disease, such has cardiomyopathy, are good candidates for antiplatelet therapy.
  • Measure CYP2c19 once in a lifetime.
  • ApoE ( a genetic test) aids in receptor recognition for triglyceride removal. 3 alleles exist- E2, E3, and E4. Each allele has a different risk and response to therapy:
  • hyperlipidemia. E2 isoforms show a decreased binding to LDL receptor so levels of triglycerides remain high and possibly lower levels of LDL. They respond the best of all three allele types to lipid lowering therapy and lifestyle changes especially exercise, fish oil and alcohol.
  • E3 individuals show a normal processing of cholesterol. E3 individuals respond well to lipid lowering therapy, fish oil, moderate alcohol and exercise. o E4 individuals show an increased binding to LDL receptors resulting in higher levels of LDL.
  • E4 isoforms also show an increased absorption of dietary cholesterol. E4 individuals are less responsive lipid lowering therapy, exercise and fish oil. They are most responsive to a healthy
diet lower in fat and higher in complex carbohydrates. They have higher rate of cardiovascular events if they smoke or use alcohol.
  • Apo E4 individuals have the highest risk of heart disease.
  • Measure ApoE genotype once in a lifetime.
  • Individuals with specific mutations to the MTHFR gene are at higher risk of hypertension and coronary artery disease due to high homocysteine levels.
  • MTHFR is the enzyme responsible for theproper metabolism of amino acid homocysteine into the amino acid methionine.
  • 55% of the population carries one or both high risk variants of the MTHFR gene (C677T or A1298C).
  • Monitor those with high homocysteine levels and family history of premature cardiovascular disease or thrombosis.
  • Individuals with C677T or A1298C respond well to an increased Omega3:Omega6 food intake ratio and possible folic acid and B vitamin supplements based on homocysteine levels.
  • Measure MTHFR once in a lifetime.