3 Underrated Markers That Are Essential For Heart Health, From A Functional MD

If you've got heart health on your mind, listen closely: There are a few underrated biomarkers you'll want to keep on your radar. Yes, you can find a host of heart-healthy foods and lifestyle tweaks to support healthy cardiovascular function, but how do you know what's actually working? It's all too easy to let the numbers consume you—especially with the plethora of wearable micro-trackers on the market—but sometimes it helps to look at a few measurements. And no, we're not just talking about a standard lipid panel. 

I believe that suboptimal methylation is one of the biggest, most silent issues when it comes to our health and longevity—and so does Lipman. "Methylation is a key mechanism involved in brain health, heart health, and emotional health," he says. 

See, methylation is a biochemical process that happens all day, every day in your body. We have a full explainer here, but we'll let Lipman explain: "Methylation is just a simple biochemical process that involves a transfer of four atoms, referred to as a methyl group from one substance to another. It's like a relay race: Your methylation goes from one substance, and then the baton gets passed on to another substance, and it gets passed on to another substance... It's getting passed on along all these different biochemical processes, and it's basically getting the gears to run properly and switching genes on and off." And you can measure this process by looking at your homocysteine levels: "When you see a high homocysteine level, you can usually assume that you're not methylating properly," Lipman says.

And because more than 50% of the U.S. population1 struggles with the same issue I do that directly affects homocysteine levels (i.e., MTHFR gene variants), there's a pretty good chance you or someone you know has suboptimal methylation and doesn't realize it. That said, it's important to get your homocysteine levels checked if you can—and if yours is higher than ideal, there is something you can do about it. Personally, with a specific array of bioactive B vitamins and betaine, my homocysteine dropped from 63.3 umol/L to 12.2 umol/L.*

At your annual checkup, you might receive a standard lipid panel, which is a measure of your HDL ("good") cholesterol, LDL ("bad") cholesterol, and triglycerides. With that panel, you might want to also measure the level of lipoprotein (a) in your blood. Lipoprotein (a) is a type of LDL (or "bad") cholesterol, and high levels of it also have implications for heart health, even if your lipid panel looks OK. But the thing is, genetics determine your levels; in fact, you can have perfect cholesterol scores and still have high blood levels of lp(a).

Finally, we have the carotid intima-media thickness (CIMT) test, which measures the thickness of the inner layers of your arteries by your neck. After all, cardiovascular health is not just about the heart—it's about the brain, too. Your heart and brain are more intertwined than you think, as the arteries transport blood from your heart to your brain. The test itself is noninvasive—a doctor will use an ultrasound with a gel—and it usually takes about 10 minutes. And yet, it's not something doctors regularly administer, and it's not covered by many insurers.