Microalbumin: An important marker of cardiac risk
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- čas přidán 29. 07. 2022
- Microalbumin and heart disease
Cardiovascular disease is the biggest cause of morbidity and mortality in the western world and despite all the advances in medical practice, the burden continues to increase. As a doctor, I have realized that there are several problems with the way we do things which probably contributes to the increasing prevalence of cardiovascular complications.
Firstly a lot of the emphasis on management of a condition is based on treating the condition and a lot less emphasis is placed on preventing the condition from developing in the first place.Unfortunately once the condition has developed, more often than not, it is impossible to reverse it and you spend all your time managing its complications. This is the equivalent of covering a problem with a sticking plaster and hoping that the problem will go away rather than examining and addressing the root cause of the problem.
Secondly the markers we use to diagnose a condition are late markers or may be even the wrong markers altogether. For example in diabetes, we use blood sugar or HbA1c as the test for diagnosing diabetes. Unfortunately however there are several studies which show that upto 26% of newly diagnosed diabetics have already got evidence of kidney disease, 24% have lower extremity disease, 12% have eye disease and 17% have cardiovascular disease. If you are using a marker to diagnose a condition because you want prevent complications but by the time that the marker has helped you make the diagnosis, a quarter of the patients have already developed the complications of the condition and many of these complications develop over a number of years then clearly we are relying on a very unsophisticated or even a wrong marker. Surely a better marker would be that which picks up the condition before the complications develop. So why do we continue to persevere with using HbA1c as a test to diagnose diabetes? The answer is because we are told to. This is what the guidelines say and we are protocol-bound doctors and many of us have lost the ability to think for ourselves any more. Unfortunately the guidelines are based around managing populations and always have a cost-effectiveness agenda. So doctors have assumed a number as the be-all and end-all determinant of whether you have a harmful process or not when it is so obvious that the number does not pick up the harmful process just as it is beginning but instead rises somewhere in the middle of the course of that harmful process. What this means is that there may be a number of people out there who have a harmful process going on in their bodies without knowing and they are falsely assured by their doctors that they don’t have the condition because the number has not risen above a certain man-defined threshold. It is also bemusing to note that that man-made threshold and those goal posts are shifted every few years.
Finally, even though the number is a poor guide to the process, we spend all our time treating the number or making the number looking prettier without really seeing whether our treatment is reversing the process. In diabetes, a lot of our management is about making the HbAic numbers appear nicer but actually this strategy has not been shown to actually prevent some of the macrovascular complications such as heart attacks and strokes. So we use the wrong marker and we spend our time treating this wrong marke so is it really a surprise then when the burden of complications continues to increase.
As the whole of the medical fraternity becomes more protocol-centered and less patient-centered, it becomes important that patients take matters thin their own hands and try and educate themselves so that they can advocate for themselves and asks for those tests which may allow us to look for harmful processes within our body rather than relying on the crude that medical professionals are advocate.
Today i wanted to talk about a really interesting test that we should be using more often but we don't and this is called Microalbuminura.
If you measure the amount of albumin in a 24h urine collection of a healthy person, the levels are generally less than 15mg/24h. Anything between 15 to 30 is considered high normal and anywhere between 30-300mg is considered in a range known as microalbuminuria. Anything above 300 is considered macroalbuminuria. Unfortunately a lot of doctors rely on the a dipstick of the urine to look for protein in the urine but the dipstick will not detect microalbuminuria because the amount of protein in microalbuminuria is less than the threshold for the urine dipstick test and this is why you have to have a specific test for microalbuminuria. This is usually a 24hour urine collection specifically for measuring urine microalbumin levels.
It is actually a very simple and inexpensive test and in an ideal world should certainly be offered and checked .
I turned 70 on July 30th so this is very important to me. Thank you. I have been taking care of myself and have no medical conditions. My yearly metabolic panel is due so I will ask for this test. I quit sugar, gluten, vegetable oils, and eat organically over ten years ago. I have never smoked and do not drink. I am hoping to live until 100 so I can be a great great grandmother.
❤nice
100 is a long shot, but i wish you luck.
I am 76 and thanks to a strict diet and your advice on Magnesium I got rid of 2 Arrhythmias and getting rid of sugars and starches etc I reversed an aortic regurgitation down to a trace that only machine could detect. Technician could not find.
And arrhythmia specialist said diet would not help just old age.
Wish I could find a doctor like you that realizes life style changes can make a huge difference. Oh I also walk/jog 2 miles a day and do deep muscle stretches and lift arm weights. All my blood tests normal NOW.
That is great to know well done
Good for of you🎉🎉🎉
This guy is the real deal. I wish more doctors were like him. He has helped me more than he’ll ever know.
There aren't enough words to describe how thankful we are for your guidance. As a victim of malpractice years ago, I've watched your videos to rebuild my life. Don't stop your videos because you give us the directions we need. Thanks.
Spot on 👍
Did you sue them for malpractice ?
@@AlexM-jd2ro they have an arbitration clause. You can't sue and you end up in front of their people. I spoke with an attorney and basically you have to be dead or paralyzed to collect. It takes 2 to 3 years to get to arbitration. If you don't pay they will sue you and send debt collectors ruining your credit.
@@jeffreybaier5312 you can thank Obama for that because all the chicken shit attorneys in the insurance industry pushed their agenda for Tort Reform and Obama signed off because he himself is a lawyer so the system is corrupt and people keep believing in the 2 party system and that's why it will never change
Exactly right. Gratitude to the good Doc. I have been misdiagnosed a few times (fortunately nothing serious).
An absolutely priceless cutting edge education, once again. Thank you, Doctor.🥰
In the US you can't get these tests unless you have presented with symptoms recognized by the insurance companies to warrant the test. So...you can know you need this test...but...you can't get a doc to give a requisition. So...no test. But you have helped me greatly with your videos. I watch you faithfully. The sad thing here is that if you learn about your heart and ask intelligent questions our docs here are threatened and often shut you down. It is so frustrating...you have to act like you have learned a little bit by accident and need his expert opinion...but you can never let on that you have learned enough to actually question prescribed protocol. I wish we had doctors like you. Thank you for being here.
You can order your own 24 hour urine test at Walk-In-Labs for $45.00. I don’t wait for my insurance company to approve anything anymore if I really want something I just order it myself and pay for it. My health is too important.
"Life Extension" website has cheap blood tests for a huge variety of things.
@@myoldvhstapes that's great to know...I checked it out. Not so cheap..but doable if you can draw blood. A doc lab won't order them though so I don't know how you'd get the blood sample.
@@betzib8021: Are you in the US? The site mails the customer/patient a lab order signed by one of Life Extension's doctors. The customer/patient brings it to a blood draw clinic such as Lab Corp where the money already paid to Life Extension covers both the procedure and the later lab processing. (They even have half price sales at least once a year- I once got a blood test for about $22.)
@@myoldvhstapes oh...wow...thanks for telling me.
Brilliant video DOC! The best thing you can do for your kidneys is give up the carbohydrates/sugar...
Fact so true - ‘we are protocol bound doctors and unfortunately many of us have lost the ability to think for ourselves anymore’ - exactly my observation and lament as a fellow practitioner regarding the medical profession for many years now!
Takes a brave doctor to say that. I had renal failure and diabetes without my doctors realising anything
Dr.: 9/2021, I had to dismiss my GI doctors. The meds were extreme poison for me and the surgery they wanted to do meant changing the structure of my stomach. This experience plus wrong diagnoses and conflicting tests results over many years, I had to move away from traditional/western doctors to save my life. Sounds dramatic but that's how I felt. I remembered reading (perhaps a Dr. Weil book) 20 years earlier "the gut is the backbone to your health". So, I started searching how to have optimum gut health. 9/21/2021, I stopped all processed sugar. Then next step, I learned about acid reflux, then adjusted stuff. And learned from the Mayo Clinic, that if you experience acid reflux, to avoid sleeping on your right side. Just 3 months later: 1. my blood pressure was stabilized (no meds), 2. no nightly issues at night with belching/pain (no meds), 3. a side effect was = I dropped 30 lbs without even having that as a goal. If someone had told me that would be possible, I would have thought they were disinformed. Then I went to a Naturopathic doctor to see if there was anything she could add. The 1st thing she did was to recommend a probiotic. The 2nd thing, she advised me that I had a wheat intolerance. So that's another reason my health got better as I moved to whole food eating 9/21/2021. Wheat was in the cookies and the waffle cone ice cream I was addicted to. Live-and-learn. 😘 from Kentucky
I wish more doctors thought like you. The system has them locked into a process where most of the time I don’t feel the doctor heard what I said and bam he/she is writing a prescription. I don’t blame them the insurance industry dictates way to much. But I do understand that my health is determined by me. Your patients are blessed. I look forward to your next post.
The best part of the video is he speaks the truth about what is wrong with the amERRORican healthcare system
Insurance Cos are the way they are because they are abused and used by a large quantity of dishonest people so don't be so quick to judge them. Its a catch 22 most of the time - the small percentage that ruin it for others!
I love listening to your videos they are so informative and interesting thank you for taking the time to educate all who listen. As a retired nurse I do everything I can to keep healthy including trying to understand my own blood tests with the help of my daughter-in-law who is a biomedical scientist. I wish it was easy to get other tests such as the ones you suggest but unfortunately unless you are really ill its difficult to get an appointment. My theory is that as my Mother has heart disease, kidney disease and vascular dementia, I try to follow a lifestyle that could prevent all of these. My knowledge is limited so I may not always get it right but listening to professionals such as yourself helps me to get it right. Thank you once again.
I’ve said it before, and will say it again, “you are amazing, and I wish you were my doctor”‼️ As always, all your videos are so informative.
You are the best of the best. I’m so happy to see this video from two days ago. The sound of your voice is healing in and of itself. Thank you for sharing and caring. ❤️
I enjoy your videos very much; your education is clear and succinct. I wonder if you could address the current popular claims that nasal breathing increases nitric oxide vasodilation, thus reducing blood pressure and blood vessel health.
Appreciate this very important information you have shared with us. I am in Delhi and normally the dipstick is used to detect albuminuria. Surprised to know that it will not detect the more serious albuminuria. Can't thank you enough for this. You have a pleasing personality, excellent articulation and ofcourse kn. Do continue to share
Most sincere, caring and down to earth Doc ever! Thanks Dr Gupta , from the USA 🇺🇸
Dr. Gupta has returned here to the uncommon embrace of excellent science tempered by an experience-based judgement that is borne of modest skepticism and desire to make a difference for individuals, vs whole populations. The latter is now a proxy for financially centered policies and treatment protocols. I am profoundly impressed and equally appreciative.
Excellent! My husband had normal A1C and his urine protein was over 300! His PCP hadn’t done urine testing for several years so we were shocked.
Hope you guys are taking action.
My husband has a great nephrologist who told him the problem can be reversed with proper diet and weight loss. It’s up to my husband to make the changes.
Hello; 1 yr later and wondering how is your husband? Was he able to make those changes? @@leslietascoff9784
You are an amazing man.
Thank you for all you do for us.
You are truly inspirational.
We absolutely Love You!! Thank You!!
Excellent as always. Thanks
Everything you said make sense to me. You made it clear & simple to understand. Thank you sooo much!!
Thank you, thank you, thank you, Dr. Gupta!! Again and again you are the exception and exceptional!!!
My appreciation for this video. I will actually be speaking to my kidney doctor about the information you have graciously shared. Thank you and there are no coincidences. God bless.
Always appreciate watching you share your experiential knowledge versus simply by the book which as we know is ineffective given all the epidemics and abnormally high medical issues which continue to increase despite all these bio pharmaceuticals being prescribed. Thank you
Great video! Thanks for putting this information out there and helping people!
We are thankful from bottom of our hearts for helping humanity. Keep it up the good work.
Genuinely a good human helping the community 👏
🙏 It takes a lot of humility to get down to such nitty gritty of health and diagnostics and also a passion to serve humanity. I am grateful for all your videos . Thank you doctor.
I will take the test and let you know if there is a message. In case you plan to visit Bangalore and if you wish I can organise for your presentation from one of the reputed medical universities.
He probably can do that by himself
Thank you so much, doctor. You are a REAL doctor! Caring and sharing!
Thank you for all of the great advice, information and insight. You have no idea how much you are helping people. I'm in the US and watch your videos faithfully. They have been so helpful to me. I will be telling my Dr. about the test to see if he'll order it for me. Many heartfelt thanks, Dr. G.
How refreshing what an incredible man you are .. pls keep
Posting 🙏🏻🙏🏻
You are wonderful, awesome. Keep teaching and guiding us.
Thank you so much.
Thank you doctor for posting all of your wonderful videos.
I recently had a follow up with my cardiology doctor after suffering a heart attack almost 2 years ago.
One of the drugs they put me on was Lisinopril. After watching one of your videos I talked to my doctor and brought up some of the points you discussed and to my surprise she was perfectly willing to let me stop taking the drug. Oh Happy Day.
You are spot-on about how we have to advocate for ourselves and not trust many of the doctors, thinking that they are doing the appropriate thing.
God bless you sir.
Very interesting. This is the first I've heard about the microalbumin issue.
That you doctor for sharing your knowledge! Like how you make your videos brief and precise to the point easy to understand.
It takes a lot of humility to get down to the nitty gritty of health and diagnostics to such detail and a passion to serve humanity. Way different from the mostly run of the mill type medical practitioners.
Very grateful to you doctor for your videos. Thank you. From Bangalore.
I love watching your videos to educate myself. You are a gem of a doctor and human being. Thanks for your sincere efforts in helping people.
You sir are a gift to humanity, bless you 👍🏻
What a presentation, Doctor! I seem to be in your classroom virtually and I am blessed to come across your life changing advice. Lots of love❤.
Thank you so much for this information. Based on this I requested an ACR at my recent physical and was thrilled to see my ratio is less than 5. Resting better because of your videos. Best!
Massive thanks for this very important information, you have given some great advice over the years, and I for one appreciate that and your time.
I got the Microalbumin / Creatine urine test. I figured it was cheaper than the 24 hour test. The only problem was that the albumin came back so low that they couldn't calculate a ratio. I think that is a good thing. I think that means I don't have a problem. The lab couldn't calculate the ratio so I did it myself and it came back at .07 per unit of creatine.
Great advise so thankful for your knowledge and giving of your time.
I'm so thankful for finding you. You have no agenda... like the healthcare 'industry' US doctors follow.
Thank you so much for educating us so well
Thank you so much for putting these videos out for us to watch. I will definitely be mentioning this test to my doctor at my next appointment. Your wisdom and knowledge are impeccable.
Prepare to be ridiculed by your doctor
@@AlexM-jd2ro you got that right.
Appreciate the videos, spot on and I use your videos to help guide patients at my community pharmacy in Devon👍 .
Wonderful info to stay ahead of the game of keeping ourselves healthy n avoiding complications. A stitch in time saves nine. Thk you v much.
WOE anf lifestyle can reverse heart disease💚..ty Dr for your time and knowledge to help your fellow brothers and sisters who may not otherwise got valueable information..God will bless you abundantly..ty for taking the call he gave you a position for🙏💯
As someone who was worried about my mother's health condition, your explanation was incredibly enlightening and reassuring. I feel much more informed and empowered now.
Thank you so much for this video!
wish I could get a consultation on her case from you.
Thank you once again, you are amazing 💜
I will share what I find out at my doctor visit next October. I made a note. TY
Awesome with an honest doctor
Thank you so much for all your excellent advice. JS
Thank you for sharing your knowledge and education with us.
Thank you 🙏
Thanks Doctor. Very informative
Marvelous program! Thanks Dr. Gupta. Your video volume is really very low - please look into this - make yourself more audible. 😊🙏
Thank you so much you are a wonderful person and doctor .
Really important information.Thanks for the effort you put in to educate .
My albumin 4.7 g/dL this year and two year average is around 4.56 g/dL. Thanks for the knowledge share definitely appriecated.
Thank you!
thanks a lot sir for such a lovely session
VERY useful video, Sanjay! Once the test is done, I will definitely advise you of the results, and my current health status. Thank You.
Thanks - useful information for transplant recipients too
i love dr sanjay gupta. who else love this intelligent, selfless doctor?
Dr you are simply the best. Thank you so much for your help and information.
Thank you again
Thank you!😎👍
Thank you very much Dr I will certainly ask my GP for the Test.
Thank you Dr Sanjay
Bless you doctor ❤🙏🏼
Thank you very much for sharing your knowledge❤
Dr sanjay gupta sir excellent feedback as always in your health videos thanks 04/08/2022
Great insights!
Thanks Doc, I looked at my test results of the last few years and made à connection between my rising level of microalbumin, even if still relatively low at 12.4, and some symptoms that started developing, I'll get an appointement with a specialist to see if it's real or an illusion of mine.Thank you very much and keep up your humanitarian work, real medical spirit.
Mario, Mario did you get your pseudonym from the opera Tosca?
@@mariaquinn920 Hi Maria Maria, although I'm of Italian origin I'm not an opera lover as my father was.
Mario just came out double by mistake.
Have a nice day.
Just make sure the specialist is a real professional and not just the typical person with a medical degree
Perfect excellent.Thanks doc.
Excellent! Functional DX offer comprehensive blood biomarker testing.
Thank you
Yes.. Going for it.. Would share later
I dislike sharing my medical hx on social media. However I am going to GP in Monday will ask for it . And will let you know . Thanks for sharing and caring so compassionately.🌟
Thank you thank you
Thanks a million for this video. Extremely useful information.
We now as patients have to learn to doctor ourselves not just to fully delegate our health to medical profession!
just tooo true--
Urinalysis test stripes are available on line for about $15.00 US. They are so easy to use, to check for yourself at home. Color codes on bottle to compare. There's a shortage of doctors where I live and a 3 month scheduling waiting for an appointment. If you can even find a doctor taking patients.
You are so right. Medicine is so protocol driven, it’s maddening. My mother was a professor of clinical medicine. She’s be horrified at this turn in how medicine is practiced. She taught me a lot in what to look out for and how to care for myself. I also have a degree in human physiology. This vexes my doctor because so have a basis to question. I know she will not authorize this test. After all, the only thing she looks at for my thyroid is the TSH. My cardiologist put me on thyroid, not my primary care doctor. She could tell I was subclinically hypothyroid. My pc doctor just relied on tests to tell her if so was or wasn’t. Maddening.
Thank you doctor. You are a good teacher. But for me, I think you really need to work more on dietary recommendations and interpretation. Dietary salt is not bad provided processed foods are avoided. Low salt intake can cause hypertension due to increase in aldosterone. The number one leading cause of microalbuminuria is SUGAR. But u never mentioned it. Those drugs you mentioned can not address the root cause of microalbuminuria. My contribution to what you said based on diet and healthy lifestyles: One with microalbuminuria should undergo daily intermittent fasting, cut out sugar & processed foods, moderate protein, high good fat intake, exercise and sunlight. With patience and consistency, the person would be cured.
GOD SENT YOU TO THIS EARTH TO BE A DOCTOR. & YOU DIDN'T LET GOD DOWN. NAMASTE TO YOUR PARENTS FOR BRINGING YOU TO THIS EARTH TO SERVE HUMANITY.
BLESS YOU FROM MY HEART AND BEST WISHES FROM INDIA
Wonderful video, in our ENDO practice we request it quarterly. Luckily we have SGLT2i and soon Finerone will be allowed in Canada both help in this situation
Great and useful information doctor. God bless you for all you do🙏🏾
Awesome information
Thanks Dr. I have a excellent cardiology doctor, he prescribed praluent for my cholesterol problem and it works great. I thank God for you and all people in the medical field.
@ DrGupta, firstly wanted to say, fantastic work on your helpful informative videos, question I have is around the correlation between Gout and heart disease, can we expect to see your views on this topic in a video anytime soon
Hello, you're brilliant and I love your videos. I have a bit of feedback. I have difficulty hearing when you speak, even with my volume on max. I believe the issue is with the recording and not your natural volume. I hope this helps to make your videos even better. Thank you.
Great video thank you again
This is great advice, but I wouldn't know how to approach my doctor with these tests requests. If I told them I saw it on CZcams they'd laugh at me.
Just educate yourself enough that they won't ask you because they can see that you have done your due diligence and can discuss intelligently your situation
Fantastic thank you x
Great information. Thank-you! I will get this test done and let you know how I used the information.
Thank you for this video ! My experience of late I find English Young Doctors lack something ! Without Prejudice ! In my local hospital which I visited on GP request ( having Covid at Sixty unvaccinated due to SJS and presented on day 7 with a bad chest ! Was checked for any blood clots in my lungs ! Lovely Doctors without any attitude obviously not English but faultless ! 👏🏻👏🏻 such nice and personable think Ours have a lot to learn ! Thank you to those Dear hardworking Souls ! 🙏❤️
Thank you for your video.
What about measuring the ratio albumin/creatinin ?
Brilliant! I'm hopping right on this and requesting the test from my GP. At 71 & pre-diabetic it may be after the fact, but why not? Many Thanks & Cheers from LA! BTW - Higher Resolution Videos Please!
Thank you doctor . This video was wonderful . I have watched all your videos belong to 3 to 5 years ago. . The new one was a good chance for me to get information about my situation with microalbuminurea which is in range of high normal . Do I need to start medication that you suggested . Appreciate for being so kind and concerned about patients .❤️