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You are already familiar with the usual blood tests that tell you whether you’re at greater risk for heart disease—total cholesterol, LDL and HDL cholesterol, triglycerides, and blood sugar. But these tests only give part of the picture (and when it comes to cholesterol and LDL cholesterol, the numbers aren’t as accurate as you’re led to believe). The following four blood tests for heart disease —that your doctor probably missed—will give you a better overview of your heart health than conventional testing alone.

NMR Lipoprotein Particles

The NMR (nuclear magnetic resonance) lipoprofile is a cholesterol test that provides more information than the standard lipid profile your doctor orders. This test includes conventional markers for total, LDL, and HDL cholesterol, as well as triglycerides, but it adds insulin markers, lipoprotein particle number and size, and lipoprotein subfractions.

These additional tests help give you a more accurate picture of what’s going on in your bloodstream. For example, you might have a normal LDL cholesterol level, and yet your LDL particles are small and dense, which indicates that you are at higher risk for heart disease. Or, you might have a high LDL level but your LDL particles are large and buoyant, which indicates that you aren’t at a higher risk for heart disease.

You see, small, dense LDL particles more easily embed into the lining of the arteries, causing damage that triggers inflammation and atherosclerosis. But large, buoyant LDL particles bounce off the artery lining, causing no damage.

Unfortunately, most conventional doctors are not familiar with the NMR test, so you may have to find an integrative practitioner who can order the test for you.

C-reactive Protein

C-reactive protein is a substance produced by the liver in response to inflammation from a wide variety of causes. While a high CRP level won’t tell you where the inflammation is coming from, inflammation from any source can make its way to the bloodstream, increasing heart disease risk. Any physician will be familiar with this test and able to order it for you.


Lipoprotein-associated phospholipase A2 is an enzyme that plays a role in the inflammation of blood vessels and is thought to help promote atherosclerosis. The LP-PLA2 test is used to help evaluate a person’s risk of developing heart disease or stroke, even if they have no other markers. It’s a good way to identify inflammation related to heart disease rather than from other causes. Not all physicians will be familiar with this test. Ask your doctor about it, or find a practitioner who is knowledgeable about the test.


The methylenetetrahydrofolate reductase (MTHFR) mutation test is used to detect two common mutations in the MTHFR gene that are linked to elevated homocysteine levels, which increases heart disease risk and is also linked to a range of health conditions including:

  • Autism
  • Addiction
  • Down syndrome
  • Spina bifida
  • Miscarriage
  • Pulmonary embolisms
  • Depression in post-menopausal women
  • Post-menopausal breast cancer
  • Bipolar disorder
  • Fibromyalgia
  • Chronic fatigue syndrome
  • Chemical sensitivity
  • Parkinson’s
  • Irritable bowel syndrome
  • Preeclampsia
  • Low HDL cholesterol levels
  • Stroke
  • Blood clots
  • Congenital heart defects
  • Colorectal adenoma
  • Gastric cancer
  • Idiopathic male infertility
  • Alzheimer’s
  • Deficits in childhood cognitive development

About 20 percent of people carry the MTHFR mutation, which inhibits the body’s ability to convert certain vitamins into their active form. Knowing whether you carry this mutation can help you prevent many of the issues above.