Dr. Cas

08/21/2026

08/21/2026

Is your standard cholesterol panel telling you the full story on heart disease risk?

As a functional medicine physician, I look beyond LDL-C alone.

Three markers matter most: • LDL-C — the traditional number •
ApoB — the actual count of atherogenic particles that drive plaque (consistently outperforms LDL-C in discordance analyses) •
hs-CRP — a key measure of vascular inflammation

The data is clear: JUPITER showed major risk reduction in people with elevated hs-CRP even when LDL looked “normal.” In statin-treated patients, residual inflammatory risk (hs-CRP) predicted future events and death more strongly
than residual LDL. And 30-year data from the Women’s Health Study found hs-CRP carried a higher hazard than LDL-C.

These markers are complementary. ApoB shows particle burden. hs-CRP shows the inflammatory fire. Optimal targets are generally ApoB

08/20/2026

Your gut is the foundation of your health—not just digestion.

In functional medicine we look at the microbiome as a living ecosystem that influences inflammation, immunity, hormones, mood, skin, and metabolic health. When diversity drops or the barrier becomes permeable, symptoms can appear far from the gut itself.

That’s why we use comprehensive stool analysis (far beyond a basic pathogen screen) and a clear clinical sequence: Assess → Remove → Replace → Reinoculate → Repair → Rebalance.

Many patients experience improved energy, mental clarity, and a restored sense of agency once the root drivers are addressed.

You don’t need “severe” digestive disease to benefit.

Ready to explore a root-cause approach? Link in bio or visit medsomma.com / drcasmd.com to schedule your gut health consultation.

08/15/2026

Reference Links (for end screen, description, or pinned comment)

Lp(a) variability over time UK Biobank analysis – levels can fluctuate, especially in intermediate range https://www.tctmd.com/news/lpa-levels-still-mostly-genetic-sometimes-vary-over-lifetime
Low-carbohydrate diet lowers Lp(a) Ebbeling et al., randomized controlled feeding trial (~15% reduction) https://pubmed.ncbi.nlm.nih.gov/34918037/
Hormone replacement therapy lowers Lp(a) Multiple RCTs & meta-analyses (oral estrogen particularly effective) Example review: https://pubmed.ncbi.nlm.nih.gov/32586221/
Insulin, metabolic health & Lp(a) Mendelian randomization and observational data on insulin–Lp(a) relationship https://academic.oup.com/eurheartj/article/45/Supplement_1/ehae666.2834/7837034
Inflammation (IL-6) regulates Lp(a) IL-6 response element in LPA gene; tocilizumab lowers Lp(a) https://pubmed.ncbi.nlm.nih.gov/25838435/
Non-genetic factors overview Review of diet, hormones, kidney/liver disease, and inflammation effects https://www.atherosclerosis-journal.com/article/S0021-9150(22)00183-6/fulltext

08/13/2026

Longevity isn’t just about living longer — it’s about maintaining capacity. Methylation plays a critical role in DNA repair, detoxification, and epigenetic health. At Evoke 5 (powered by MedSomma) we assess this pathway as part of a regenerative approach. Ready to go deeper?

08/12/2026

Fatigue, brain fog, mood changes, hormone symptoms, and chemical sensitivity often get treated separately. But they can share a common foundation: methylation capacity. We evaluate both genetics and functional status so we can support the system instead of just managing symptoms.