Podcasts about total cholesterol

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Last time we reviewed why interpreting your lab may lead you to the wrong diagnosis and treatment.  Today we continue our review of each lab panel and why the reference ranges on your lab results may not be the “Healthy Normal Range” that you should compare your results to. Lab reference ranges are established with a one-size-fits-all mentality, ignoring the numerous variables that influence blood results. Have you ever tried on a “one-size-fits-all “ANYTHING? Those clothes may fit 20% of the population but for the rest of us, the garment doesn't fit our width, weight or height! All one-size-fits-all lab reference ranges are much the same.  For example, the standardized “reference ranges” in the US serve as a one-size-fits-all “ideal range” applied to everyone, despite genetic differences, varying latitudes, and the diverse diets that characterize the American multiethnic population. This presents the first problem with using a single range for all people: variations among individuals based on differing genetic needs.  The second issue is that the ranges on the lab report indicate the minimum levels necessary for survival, not necessarily the healthiest blood levels for most individuals. Another example of one size doesn't fit all is the reference range for women's hormones. A range is displayed for cycling women, but there is no healthy range for menopausal women.  Does the range displayed refer to menopausal women with HRT, or menopausal women without HRT to treat their menopausal symptoms? Is the range based on what is healthy, or what is average? We aren't sure. Labs don't ask patients questions that could help interpret lab values. Therefore, they cannot provide a truly diagnostic reference range for any illness. They only consider gender and age, as reference ranges are solely adjusted for these two factors.  A doctor must interpret individual lab results alongside a patient's medical and surgical history, including established diseases, medications, supplements, hormonal treatments, and past lab values. For instance, laboratory companies should offer reference ranges based on whether a patient is menopausal, a woman is undergoing ERT, a man is receiving testosterone, a patient is on thyroid medication, a person is being treated for diabetes, or the diabetic tests are performed to diagnose diabetes.   Some Reference Ranges are Based on comparing results to Misleading formulas The best example of this issue is the Lipid Panel. Doctors use this panel to determine a person's risk for heart attacks caused by atherosclerosis. Most doctors don't know the formula for determining Total Cholesterol. This test doesn't predict heart disease in most patients, as the formula used to arrive at that number is not indicative of the disease. However, doctors have been advised that when   total cholesterol levels are high, a patient should start taking a statin, a drug that reduces blood cholesterol and sometimes lowers the rate of heart attacks in certain individuals, though it is rarely predictive in 50% of the population. The problem with the lipid panel is twofold: the LDL level indicates future atherosclerosis in only about 50% of the population and is not a specific test for future heart disease risk. Total cholesterol is even less predictive of heart disease because it stems from a flawed formula. Doctors interpret a high Total Cholesterol level as an indication that a patient may be at increased risk for heart disease in the future. When I test patients with elevated Total Cholesterol or high levels of LDL using a Cardiac Calcium Scan to measure plaque, only half of them actually produce plaque, and consequently, are not at risk for atherosclerotic heart disease. I believe that the Total Cholesterol number is derived from an inaccurate formula for determining a person's risk of future heart disease. The Total Cholesterol number is calculated using a flawed equation. The equation is as follows:         LDL + 1/5 Triglycerides+ HDL = Total Cholesterol Total Cholesterol = LDL (bad cholesterol) + 1/5 Triglycerides (high risk factor) + HDL (good cholesterol) Let's examine this formula simply like this:   Bad + Bad + Good does not equal Bad. Due to this incorrect formula, thousands, if not millions, of patients have been prescribed statin drugs for a lifetime without justification!  Statins carry risks. The list of side effects is extensive and includes muscle deterioration and statin-associated dementia. Unfortunately, most people who experience statin side effects are women. Women tend to have higher HDL levels than men. Additionally, they typically do not have atherosclerotic plaque until menopause and usually do not develop it after menopause if they undergo estrogen replacement therapy! This gender issue is just one of the problems with laboratory reference ranges that are not adjusted for sex. The total cholesterol values were developed solely from the blood levels of men, who typically have lower HDL levels. Women were excluded from the tests conducted to create this blood panel. For women, I dispel the myth that high total cholesterol predicts heart disease by recommending a Cardiac Calcium Scan to check for plaque. If a woman has no plaque by the age of 50 and is taking estrogen, she is unlikely to develop plaque in the future.  I still test them every 2-3 years to ensure that no metabolic changes have altered their risk, but I don't put much faith in the unreliable cholesterol blood panel. There is another blood test that has deceptive reference ranges: IGF-1 How about the GH-IGF-1 test, the test for Growth Hormone?  IGF-1 is a metabolite of GH that we can measure to determine how much the patient produces.  This hormone aids in healing and replenishing aging cells in patients after their growth is complete.  The healthy normal range with which I was trained, (150-350 MIU), has been changed to an age-adjusted normal that compares a person to others in her age category who had their blood drawn the previous year.  What is wrong with this? Growth hormone (GH) decreases with age and contributes to the declining health people experience as they grow older. Similarly, IGF-1 diminishes with age and illness, which means that the “reference range” essentially reflects that you are “average for the sick individuals who visit Quest to have their IGF-1 levels checked. ” IGF-1 levels can be enhanced through weight loss, testosterone replacement, and an increase in muscle mass. The current reference range does not indicate health or illness; it merely shows whether you fall within the average for your age group. This non-scientific method of determining “health” is widespread in contemporary medicine. By comparing aging individuals to others within the same age group, for hormones that decline with age, based on samples from sick patients who visit a specific lab in the past year, these labs label patients as “healthy” even when they are as ill as other individuals their age who go to that lab! This practice constitutes age discrimination! Regarding hormones, the levels we maintained during our fertile and youthful years correspond to the blood levels indicative of health in all individuals ages. For example: People who check their IGF-1 (Growth Hormone) levels and see a low “52 ng/ml” might feel satisfied that they are within the standard range (50-280 ng/ml). However, they may not realize that this range applies to older, unhealthy individuals, not to healthy young ones (150-350 ng/ml).  This is just one example of the issues that arise when non-medical individuals, who do not monitor these tests regularly, draw conclusions from the numbers.   Some illnesses require more than one blood test for diagnosis If you consider only one of the three tests for diabetes or prediabetes (Fasting Blood Sugar, HbA1c, and Insulin), you cannot self-diagnose as diabetic, prediabetic, insulin resistance or healthy.  Diabetes is a disease that has coincided with the rising number of obese individuals.  Both conditions affect nearly 50% of the American population. Blood tests cannot be interpreted accurately unless a patient has fasted for 12 hours; all three tests should be evaluated. When diagnosing diabetes and insulin resistance, we perform three tests to assess whether a patient has insulin resistance, prediabetes, or diabetes. These tests guide our diagnosis and inform the treatment we provide based on their results. Fasting insulin is a highly misleading test. Over 15 years ago, a significant study was conducted that was believed to change the reference ranges for fasting insulin.  The new range set for normal fasting insulin was less than 10 mIU/ml. By publishing the reference range less than 18 mIU/ml, they miss diagnosing many patients with insulin resistance HBA1C is a test that gives a value of average blood sugar over three months. The results are often used alone to determine prediabetes and diabetes; however, considering all three aspects makes the diagnosis and treatment plan more specific for the patient. FBS (fasting blood sugar) is the third diabetes test. It is generally used as a screening test that prompts the ordering of the other two blood tests; however, some patients exhibit symptoms of diabetes and insulin resistance without having elevated fasting insulin levels. Many medications can raise diabetic test values, causing a patient to seem diabetic when they are actually experiencing a side effect of the drug.  One such medication is Atorvastatin.  The solution is not treating diabetes but rather adjusting the medication.  Hormone tests are especially challenging to interpret, Especially when testing free Testosterone in women Here are the problems with the free Testosterone test itself: Women have extremely low levels of free testosterone and testosterone compared to men. I have been informed by Quest that women's free testosterone levels are not reliable with current methods because they are not always reproducible when a test is conducted twice on the same day. This leads me to believe that hormone levels do not always reflect the actual blood levels of free testosterone and estradiol. The levels of testosterone in women are based on menopausal levels of T. Women have long been thought to not produce testosterone, so the “normal” levels are quite low, and 0 used to be considered normal- until one day I managed to persuade a medical director at Quest to increase it to 0.2! Women's testosterone is influenced by their production of E2 and E1, which inactivate free T. Women vary in how their cells respond to testosterone and estradiol. Receptor sites and their genetic acceptance of hormones can mean that the same blood level of testosterone in both sexes does not produce the same effects in all patients. Some women (and men) are resistant to E2 and T, or to one of the two. This indicates that the hormone-free T level may be optimal for one woman while being ineffective in alleviating any low T symptoms for another. The latter individual is T resistant, and we currently have no means outside of research labs to determine which women are sensitive and which are resistant. This requires that doctors and NPs look beyond typical reference ranges to effectively manage E2 and T replacement for women. Lastly some labs use the total testosterone level through a formula determine the free T. This carries inherent risks of reporting the wrong active level of testosterone. Total and free testosterone blood levels for men, are derived from results of older men, rather than from the blood levels that indicate health and the levels at which men experience no symptoms. This leads men to believe they are normal, even though they are symptomatic, and they can't get treatment. There is no time to discuss the reference ranges for LH, FSH, Estradiol, and Estrone; these topics will be addressed in a future blog. I hope I have encouraged you to review your blood work with your doctor or Nurse Practitioner, and not to act as your own doctor by interpreting your blood tests.

Doing a deep dive into some common blood markers your provider might order for you during a routine workup:-Lipid panel - HDL, LDL, VLDL, Total Cholesterol, Triglycerides, ApoB + Lp(a)-A1C + glycemic control-Vitamin D-Blood PressureWe talk about what they are, what impacts them and what to do if they're out of range. I also use myself as an example + two other case studies at the end to tie everything together. Moral of the story.. go get your bloodwork done if you haven't in a while. It's important. Where to find me:IG: @lukesmithrdCheck out my website HERETIA for listening!!

This case report explores the intricacies of familial hypercholesterolemia (FH), delving into its genetic basis, atherosclerotic cascade, and early-onset cardiovascular complications. It examines established diagnostic criteria and emphasizes personalized management, including statins, novel therapies, and lifestyle modifications. CardioNerds cofounders (Drs. Amit Goyal and Danial Ambinder) join Dr. Irfan Shafi, Dr. Preeya Prakash, and Dr. Rebecca Theisen from the Wayne State University/DMC and Central Michigan University at Campus Martius in Downtown Detroit for some holiday ice-skating! They discuss an interesting pediatric case (see case synopsis below). Dr. Luis C Afonso provides the Expert CardioNerd Perspectives & Review segment for this episode. Audio editing by CardioNerds academy intern, Pace Wetstein. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Synopsis FH, a 9-year-old female with no previous medical history, recently moved back to the US from Iraq. She presented to establish care and discuss new-onset chest pain and dyspnea. A systolic ejection murmur was noted during her initial visit to the pediatrician, prompting cholesterol testing and a cardiology referral. Testing revealed, alarming cholesterol levels (Total Cholesterol: 802 mg/dL, LDL: 731 mg/dL, Triglycerides: 123 mg/dL) prompted concern for cardiac involvement. Due to persistent symptoms, FH was transferred to Children's Hospital of Michigan. Despite normal findings on EKG and chest x-ray, a 2/6 systolic murmur was noted. She was discharged with a cardiology clinic follow-up. However, two days later, FH experienced severe chest pain at rest, sweating, and difficulty breathing. She was transported to Children's Hospital again, and her troponin level measured 3000, and her total cholesterol was 695 mg/dL. An echocardiogram revealed valvar and supravalvar aortic stenosis, necessitating collaboration between Pediatric and Adult cardiology teams. CTA thorax revealed severe supravalvular stenosis, a hypoplastic right coronary artery, and significant coronary artery obstructions. Diagnostic cardiac catheterization confirmed severe aortic stenosis and coronary artery disease, leading to the decision for surgical intervention. FH underwent the Ross operation, left main coronary artery augmentation, and right coronary artery reimplantation. Intraoperatively, atherosclerotic plaques were observed in multiple cardiac structures. FH's recovery was uneventful, discharged on a regimen including Atorvastatin, Ezetimibe, evolocumab, and antiplatelet therapy. Persistent high LDL levels required regular plasmapheresis. Plans for evaluations in Genetics, Lipid Clinic, Endocrine, and Gastroenterology were made, potentially leading to a liver transplant assessment. Given the severity of her condition, a heart/liver transplant might be considered in the future. Conclusion: This case of FH highlights the complex presentation of severe aortic stenosis and coronary artery disease in a pediatric patient. Urgent diagnosis, interdisciplinary collaboration, and aggressive management were crucial. The case underscores the importance of comprehensive care for pediatric patients with rare cardiac conditions, emphasizing collaboration between specialties for optimal outcomes and long-term well-being. Case Media Pearls - Familial Hypercholesterolemia Mutations in LDLR, ApoB, or PCSK9 genes disrupt LDL-C clearance, leading to a cascade of events culminating in accelerated atherosclerosis and early-onset cardiovascular complications (e.g., CAD, aortic stenosis, PAD, stroke). Diagnosis of familial hypercholesterolemia relies on ...

Join Dr. Sanjeev Goel and Dr. Anil Maheshwari in a deep dive into cardiovascular health, discussing key risk factors, advanced lipid tests, and the importance of individualized care. Learn about cholesterol markers, genetic influences, and lifestyle modifications that can lower cardiovascular risk. Gain insights into the complexity of heart health and the latest advancements in cardiovascular care.   TIMESTAMPS: 00:00 - Intro 01:21 - Advocating for Your Health 03:45 - Ethnicity and Cardiovascular Risk 05:05 - Family History and Cardiovascular Risk 07:05 - LDL (Low-Density Lipoprotein) 10:32 - LDL Guidelines 12:51 - Oxidized LDL 14:03 - HDL (High-Density Lipoprotein) 16:33 - Total Cholesterol to HDL Ratio 19:54 - Triglycerides and Non-HDL Cholesterol 21:49 - Apolipoprotein B (APO B) and Lipoprotein A (Lp(a)) 24:21 - Lipoprotein A (continued), Genetic Risk, and Medication Considerations 30:13 - High Sensitivity CRP (hs-CRP) and Inflammation 33:15 - Additional Tests and Medication Options 36:02 - Conclusion   Visit our website: https://peakhuman.ca Shop here: https://peakhuman.ca/shop/ SUBSCRIBE TODAY: https://bit.ly/PeakHumanLabs * Link to Study https://jamanetwork.com/journals/jama...  

The audio for this podcast was extracted from a YouTube video that was recorded at an earlier time. While the information in the video is still valuable, some of the content might be date-specific. If you want to watch the video, please follow this link: ⁠Crucial Health Markers: Beyond Total Cholesterol The audio for this podcast was extracted from a YouTube video that was recorded at an earlier time. While the information in the video is still valuable, some of the content might be date-specific. If you want to watch the video, please follow this link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Ultimate Detox Guide: Answering Your Liver, Colon, and Microbe Questions!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Don't know where to start on your journey to better health and living?Get a copy of my FREE book here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.livingooddailybook.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Shop all Livingood Daily Products on Amazon here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/stores/page/6FF3F801-3EFC-4A52-A87E-5E98139627C3⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Follow and listen to Dr. Livingood on any of these platforms:YouTube: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/@DrLivingood⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/drlivingood⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/drlivingood/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ TikTok - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.tiktok.com/@drlivingood⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Pinterest - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.pinterest.com/drlivingood⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠... Blog - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drlivingood.com/real-health/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://Medium.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://medium.com/@drblakelivingood⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/drlivingood/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twitter.com/doctorlivingood⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ DISCLAIMER: Dr. Blake Livingood is a licensed Chiropractor in North Carolina and Florida, he founded a clinic in North Carolina but no longer sees patients. He received his Doctor of Chiropractic degree from Life University in 2009. Dr. Livingood uses “doctor” or “Dr.” solely in relation to his degree. This video is for informational purposes only and should not be used as a reason to self-diagnose or as a substitute for diagnosis, medical exam, treatment, prescription, or cure. It also does not create a doctor-patient relationship between you and Dr. Livingood. You should not make any changes to your health regimen or diet before consulting a qualified health provider. Questions regarding your personal health conditions should be directed to your physician or other qualified health providers.

The audio for this podcast was extracted from a YouTube video that was recorded at an earlier time. While the information in the video is still valuable, some of the content might be date-specific. If you want to watch the video, please follow this link: How To Calculate Total CholesterolDon't know where to start on your journey to better health and living?Get a copy of my FREE book here: https://www.livingooddailybook.comShop all Livingood Daily Products on Amazon here: https://www.amazon.com/stores/page/6FF3F801-3EFC-4A52-A87E-5E98139627C3Follow and listen to Dr. Livingood on any of these platforms:YouTube: https://www.youtube.com/@DrLivingoodFacebook - https://www.facebook.com/drlivingoodInstagram - https://www.instagram.com/drlivingood/TikTok - https://www.tiktok.com/@drlivingoodPinterest - https://www.pinterest.com/drlivingood...Blog - https://drlivingood.com/real-health/http://Medium.com - https://medium.com/@drblakelivingoodLinkedIn: https://www.linkedin.com/in/drlivingood/Twitter: https://twitter.com/doctorlivingoodDISCLAIMER: Dr. Blake Livingood is a licensed Chiropractor in North Carolina and Florida, he founded a clinic in North Carolina but no longer sees patients. He received his Doctor of Chiropractic degree from Life University in 2009. Dr. Livingood uses “doctor” or “Dr.” solely in relation to his degree. This video is for informational purposes only and should not be used as a reason to self-diagnose or as a substitute for diagnosis, medical exam, treatment, prescription, or cure. It also does not create a doctor-patient relationship between you and Dr. Livingood. You should not make any changes to your health regimen or diet before consulting a qualified health provider. Questions regarding your personal health conditions should be directed to your physician or other qualified health providers.

Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News Topic: Pots and COVID Show Notes: Web3 Working Group - DarkHorse Podcast Dr. Aseem Malhotra - Joe Rogan Experience Pharma: Not Their First Rodeo – Umberto Meduri & Paul Marik on DarkHorse Effect of alirocumab and evolocumab on all-cause mortality and major cardiovascular events: A meta-analysis focusing on the number needed to treat Questions:    Death by lab work Olivia writes: Hey Robb and Nicki! Long time listener and strong endorser of the work y'all are doing. I wish more people and healthcare providers were on the same page, or hell even in the same book as this community! ANYWAY....I recently got my labs done and I have some concerns on the results I received. For context: I am a 30 y/o female, no kids, work out 3-4 x week (mostly weight training and average 8-10K steps per day) I work as a nurse, tend to focus my meals around 30g or more of protein (red meat, chicken, dairy, eggs, I eat it all), and drink plenty of water and LMNT :), avoid seed oils and other ultra processed garbage. I went through some hormone issues for 5-7 years (i.e very infrequent cycle due to too much exercising and under fueling). Since then, I have become so much more educated and I have recovered my cycle *naturally*; gaining probably 30-40 ish pounds from my low; currently sitting at 155 5'6. I feel great, but these lab results got me shook! Any and all advice welcome. Total Cholesterol- 282 Triglycerides- 43 Non HDL- 169 HDL- 113 ApoA to ApoB- 0.41 ApoB- 113 Liver enzymes AST and ALT- slightly elevated Total T3 - 68 all other thyroid values "normal" Fasting BGL- 95 A1C- 5.0 Am I destined for an early death related to heart disease?? I've listened to Huberman on blood glucose control and will implement his ideas to lower my fasting number, but it's hard to eat my last meal 2-3 hours before bed on days I work since I get home at 8. I hope this isn't too long of question, feel free to cut out anything you'd rather not discuss and just give general guidelines. THANK YOU!!! Stay salty, Olivia   ApoB confusion Marit writes: Hi Robb and Nicki, I've been listening to your podcast and following your work for many years and I've thrown some similar hard questions at you, which you were kind enough to try to answer (thanks!). I'm so frustrated that I can't understand statistics enough to draw my own conclusion based on the literature on ApoB and statins. I listened to a Peter Attia's podcast and he said (I heard it twice to confirm) that if ApoB were low in the population he "thinks" AS CVD would be dramatically reduced. His pushes alot for statin use. On the flip side, reading the breakdown of studies on statins on Chris Kresser's website, I just can't understand why Peter Attia takes this stance. It doesn't add up! My gut feeling is risk for any chronic disease is never calculated on just one lab value (that's just logical). but even if it was, why does Attia use statins when they don't seem to reduce deaths, strokes or heart attacks by very much, in people without CVD? Don't statins obliterate ApoB? You're the absolute best if you answer this question for me. I'd be forever greatful! Thanks guys for all the work you do. It's appreciated!   Cholesterol and Diet Jay writes: Hi Robb and Nicki, One of your original six listeners here. (Can't be wrong!) Thanks for all the good work. Recent bloodwork revealed high cholesterol and LDL numbers (216 and 123, respectively), as well as non-HDL cholesterol (137) and apolipoprotein B (94). (HDL is 79 and triglycerides are 50.) For what it's worth, my glucose is in the normal range, though slightly high considering my otherwise overall health, activity level, and diet. My functional med practitioner has suggested the "Cardiometabolic Food Plan." (for reference: https://www.allinahealth.org/-/media/allina-health/files/business-units/penny-george-institute-of-health-and-healing/2_ifm_cardiometabolicfoodplan_comprehensiveguide.pdf) I'm reticent, considering the plan's emphasis on soy protein, legumes generally, grains, and limiting saturated fat. I could modify it to eliminate those things, but then I'm back to basically what I do already.  Quick background: male, 38, active (commute on a bike, strength train, chase kids), small business owner with two young kids (i.e., non-zero amount of stress, less-than-perfect sleep). I have a pretty good gluten intolerance (which is how I found your work right around when you published The Paleo Solution — thanks again!) and generally follow a paleo-primal-ish template, with some full-fat dairy and rice/corn, occasionally, mostly to coexist with my family without being a *complete* pain in the ass. So: Would those lab numbers concern you? What do you think about the Cardiometabolic Food Plan, specifically? And generally, what would you suggest for diet or any other interventions to right the ship? Thanks tons and keep up the good work!   Sponsor: The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT. Proper hydration is more than just drinking water. You need electrolytes too! Check out The Healthy Rebellion Radio sponsor LMNT for grab-and-go electrolyte packets to keep you at your peak! They give you all the electrolytes want, none of the stuff you don't. Click here to get your LMNT electrolytes

Buck and Alan Viglione, MD discuss the Cardio IQ® report in detail and battle it out to see has the best numbers in this 2 part episode. Part 2 will drop as Episode 22. 0:01:31 - What exactly is a Cardio IQ? 0:03:15 - the cost of Cardio IQ 0:05:18 -Lipid panel, Total Cholesterol, HDL, Triglycerides, LDL Cholesterol 0:08:29 - HDL the so-called good cholesterol 0:13:55 - Lipoproteins 0:15:42 - LDL Particle Number 0:22:46 - Apolipoproteins 0:25:40 - Apolyte protein tag 0:27:48 - Apolipoprotein B or apoB 0:28:31 - Lipoprotein(a) or Lp(a) 0:31:41 - Statins: Crestor and Livalo 0:32:41 - How do Statins work? 0:33:11 - Repatha 0:36:58 - Inflammation and Atherogenesis 0:39:39 - High-sensitivity C-reactive protein (hsCRP) 0:40:43 - Lp-PLA2 activity  0:41:43 - Oxidative LDL 0:42:04 - Myeloperoxidase enzyme 0:45:07 - F2-isoprostanes as a marker of risk

In this episode, Marta Boffito, MD, PhD, FRCP, and Jens D. Lundgren, MD, DMSc, address key considerations when evaluating antiretroviral therapy safety and tolerability in aging patients and those with possible cardiometabolic toxicities, including:Monitoring for cardiometabolic syndromes (eg, lipid panels, coronary artery calcification scores)Approaching antiretroviral-related weight gain in clinical practiceInterpreting results from RESPOND on cardiovascular risk with integrase strand transfer inhibitorsCollaborating with other specialties (eg, cardiologists, dietitians) to provide a multidisciplinary approach for managing comorbidities, including prevention and managementFaculty: Marta Boffito, MD, PhD, FRCPConsultant Physician/ProfessorHIV/ResearchChelsea and Westminster HospitalImperial College LondonLondon, United KingdomJens D. Lundgren, MD, DMScProfessorRigshospital, University of Copenhagen DirectorCentre of Excellence for Health, Immunity and Infection (CHIP)Rigshospital, University of CopenhagenCopenhagen, DenmarkLink to full program:http://bit.ly/3PM3nYeLink to downloadable slides: http://bit.ly/3WgYycz

CardioNerds Rounds Co-Chairs, Dr. Karan Desai and Dr. Natalie Stokes and CardioNerds Academy Fellow, Dr. Najah Khan, join Dr. Martha Gulati – President-Elect of the American Society for Preventive Cardiology (ASPC) and prior Chief of Cardiology and Professor of Medicine at the University of Arizona – to discuss challenging cases in cardiac prevention. As an author on numerous papers regarding cardiac prevention and women's health, Dr. Gulati provides many prevention pearls to help guide patient care. Come round with us today by listening to the episodes now and joining future sessions of #CardsRounds! This episode is supported with unrestricted funding from Zoll LifeVest. A special thank you to Mitzy Applegate and Ivan Chevere for their production skills that help make CardioNerds Rounds such an amazing success. All CardioNerds content is planned, produced, and reviewed solely by CardioNerds. Case details are altered to protect patient health information. CardioNerds Rounds is co-chaired by Dr. Karan Desai and Dr. Natalie Stokes.  Speaker disclosures: None Cases discussed and Show Notes • References • Production Team CardioNerds Rounds PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Show notes - Challenging Cases of Challenging Cases of Cardiovascular Prevention with Dr. Martha Gulati Case #1 Synopsis: A 55-year-old South Asian woman presents to prevention clinic for an evaluation of an elevated LDL-C. Her prior history includes hyperlipidemia, hypertension, obesity, and pre-eclampsia. She was told she had “high cholesterol” a few years prior and would need medication. She started exercising regularly and cut out sweets from her diet. Before clinic, labs showed: Total Cholesterol (mg/dL) of 320, HDL 45, Triglycerides 175, and (directly measured) LCL-C 180. Her Lipoprotein(a) is 90 mg/dL (ULN being ~ 30 mg/dL). Her HbA1C is 5.2% and her 10-year ASCVD Risk (by the Pooled Cohorts Equation) is 5.4%. Her recent CAC score was 110. She prefers not to be on medication and seeks a second opinion. Takeaways from Case #1 As Dr. Gulati notes, in the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease, South Asian ethnicity is considered a “risk enhancing factor.” The pooled cohort equations (PCE) may underestimate risk in South Asians. Furthermore, risk varies within different South Asian populations, with the risk for cardiovascular events seemingly higher in those individuals of Bangladeshi versus Pakistani or Indian origin. There are multiple hypotheses for why this may be the case including cultural aspects, such as diet, physical activity, and tobacco use. A better understanding of these factors could inform targeted preventive measures.In the same 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease mentioned above, history of an adverse pregnancy outcome (APO) increases later ASCVD risk (e.g., preeclampsia) and is also included as a “risk-enhancing factor.” Studies have shown that preeclampsia is an independent risk factor for developing early onset coronary artery calcification. Recent data has shown that the risk for developing preeclampsia is not the same across race and ethnicity, with Black women more likely to develop preeclampsia. Black women also had the highest rates of peripartum cardiomyopathy, heart failure, and acute renal failure. After adjustment for socioeconomic factors and co-morbidities, preeclampsia was associated with increased risk of CVD events in all women, the risk was highest among Asian and Pacific Islander women. Listen to Episode #174. Black Maternal Health with Dr. Rachel Bond to learn more about race-based disparities in cardio-obstetric care and outcomes.Our patient thus has multiple risk-enhancing factors to help in shared decision making and personalize her decisio...

Cardiovascular Disease and Strokes are the #1 and #4 killers, causing 30% of all deaths. And Atherosclerosis is the root cause of those issues, with the first symptom of Atherosclerosis usually being fatal. In this episode, you'll find out:—The overwhelming evidence from the Johns Hopkins study that showed the COVID lockdowns had an extreme negative effect on the health of Americans and were "a complete fiasco".—How a new study from the Netherlands shows the COVID vaccination collapses the immune system, while the data from Israel shows the vaccinated more likely to die than the unvaccinated.—Why Dr. Prather says masks have caused a tremendous amount of harm in childhood development that "we'll be paying the price for" in the future.—The damage caused by Free Radicals, toxins, and drugs (prescription and non-prescription) to the endothelial lining of our arteries.—Why smoking causes a 70% greater risk for Atherosclerosis. (And the smoking cessation program Dr. Prather uses for his patients.)—How 90% of Atherosclerosis is determined by lifestyle factors, such as controlling Diabetes and Hypertension.—The different perspective Structure-Function Care has towards Cholesterol, which is "a symptom of and not the cause" of the problem. (And the surprising reason why those who live to be over 100 usually have an extremely high Cholesterol level around 300.)—Why the Total Cholesterol to HDL ratio is a more important consideration than just the overall number. And how Cholesterol being too low is actually dangerous to the body.—How External CounterPulsation (ECP) Therapy is the #1 treatment for Atherosclerosis in Japan and China, which helped them to cut their Cardiovascular Disease patients by over a third.—The crucial role Fiber plays in fighting Atherosclerosis (and why Dr. Prather would choose Fiber as the #1 supplement recommendation). And how Vitamin D is "absolutely critical" in Atherosclerosis prevention.www.TheVoiceOfHealthRadio.com

"Is it appropriate for those with high total cholesterol and LDL to attempt keto?" asks Mandy Joan from Facebook. Here to answer is Dr. Anna Cabeca, board-certified Gynecologist and expert in functional medicine. In this episode, Dr. Anna gives her clinical expertise with keto and high cholesterol and LDL. Tune in to learn the tests and considerations she recommends to implement to safely enter a ketogenic diet. Check out Dr. Anna's FREE Keto-Green Recipe E-Book at book.ketogreendiet.com/keto-recipe-pdf-optin?utm_medium=podcast&utm_source=AsktheHealthExpert&utm_campaign=KGBookLaunch.

Meet Lara! After switching to a low-fat, plant-based, whole-food diet, Lara now eats whole-carbohydrate foods without experiencing dramatic blood glucose spikes, she enjoys her food, lowered her A1c levels into a healthy range, lost weight, and has more energy than she knows what to do with. March 2020 to August 2020 A1c (%): 7.1 to 6.4 Fasting Blood Glucose (mg/dL): 200 to 88 Total Cholesterol: 200 to 120 Triglycerides: 300 to 73 Carbohydrate to Insulin Ratio: 6:1 to 25:1 Carbohydrates p/day (g): 30 to 300 Weight loss (lbs.): 22 Listen to her story and prepare to be amazed!⁣ Make sure to subscribe so you don’t miss future episodes! Please leave us a review to ensure that the Mastering Diabetes message reaches as many people living with diabetes as possible. Connect with us on Instagram and Facebook

 Maia was diagnosed with type 1 diabetes in 2015.⁣ ⁣ She was told by her doctor what many type 1’s are told at the time of diagnosis, eat a low-carb diet. She followed their advice and returned to her life as an athlete. ⁣ Later, she decided to go full keto which worked for a while and she was able to maintain an A1c of 7.1%. Eventually, she developed amenorrhea (loss of her period) and was unable to keep her blood glucose from spiking during exercise. ⁣ ⁣⁣ She searched online and discovered the work of Anthony William and his book, Liver Rescue. She followed it for 2 weeks and ate just raw fruits and veggies. ⁣ Within those 2 weeks of being on a low-fat, plant-based, whole-food diet her blood glucose dropped, she gained tons of energy and decided she couldn’t go back. This leads her to the Mastering Diabetes book which she read in one night while she was attending college and she was blown away by the science. ⁣ Date: August 2019 to January 2020 Fasting BG (mg/dL): 180 to 120 A1c (%): 7.1 to 6.3 Weight (lbs.): 150 to 136 Carbohydrate to Insulin Ratio: 7:1 to 20:1 Total Cholesterol: - to 116 Carbohydrates p/day (g): 50 to 300 After switching to a low-fat, plant-based, whole-food diet, Maia now eats whole-carbohydrate foods without experiencing dramatic blood glucose spikes, she enjoys her food, her period returned and has more energy than ever. Make sure to subscribe so you don’t miss future episodes! Please leave us a review to ensure that the Mastering Diabetes message reaches as many people living with diabetes as possible. Connect with us on Instagram and Facebook The Mastering Diabetes Book is ready for YOU! Order your copy today! https://www.masteringdiabetes.org/book/ 

In this episode of the Gene Food Podcast, John breaks down the results of his blood work after weeks of holiday eating. Biomarkers discussed: sdLDL, VLDL, ApoB, Lp(a), and Total Cholesterol.

For full show notes, transcript, link to video, and more visit the show's blog at https://robbwolf.com/2020/02/28/longevity-statins-blood-flow-restriction-training-thrr018/ This episode is sponsored by Joovv. Joovv is the leading manufacturer of personal, in-home red light therapy devices, with several different sizes and setups. Clinical grade power to help reduce pain, fight inflammation, so you can live a happy healthier life. Check them out at joovv.com/robb and use code ROBB for a free gift with your purchase. Show Notes: News topic du jour: Obesity: More Than an Inflammatory, an Infectious Disease?   1. Can We Really Increase Our Longevity? [11:42] Christopher says: Do you think that as we deepen our understanding of the biochemistry of nutrition that we will reach a point where we can indefinitely prolong life?   2. How Salty Are You? [15:44] Jason says: Robb, I was wondering what your sodium numbers are daily, does it change when you train?  Now imagine being 230lbs, what should my sodium numbers be, on BJJ days and non-workout days? thanks, Jason   3. Cholesterol and Statins? [22:12] Tom says: Hi Robb and Nicki, Thanks to your work, along with Kresser and Sisson, I've lost about 50 lbs since discovering Paleo/Keto in 2013.  Before that I was on Lipitor, but after getting down to about 200 lbs (and all but completely solving my IBS) I decided on my own to go off of it and visit a functional doctor/nutritionist.  My numbers looked worse initially (Total Cholesterol from 204 to 290, Triglycerides 138 to 285, HDL 40 to 34) but she put me on a variety of temporary supplements and therapies, such as saunas and detox foot baths, and also recommended I replace cow dairy with goat dairy. I was encouraged 6 months later when my total cholesterol looked similar, but my Triglycerides went from 285 all the way down to 131 and my HDL ticked up to 38.  But then I became discouraged again when she had my LDL-Particle number tested and it was off the charts at over 2500.  So my question is, while I know you can't dispense medical advice on a podcast, should I at least consider going back onto a statin?  I'm 38 years old and 5'7, so I could certainly try to lose another 30 lbs or so and have my blood tested again, but I feel really good in every other way.  My sleep is good and I don't feel stressed, although I could stand to exercise more.  I'm willing to put in the work of losing more weight if it means better health, and perhaps it will anyway, but after losing so much already, I feel like I'm in a really good place in my life where I can maintain the weight I'm at and still feel like I'm living my life.  I've come this far largely thanks to you, so any advice you can give me now would be greatly appreciated. Thanks!   4. Blood Flow Restriction Training? [34:28] Sara says: How do you feel about BFR training to help with muscle gain?   5. What Affects HRV? [37:40] Susie says: Dear Robb I’m trying hard to find anything you’ve done on CrossFit/keto/women/PMS/HRV ... managing all of these things. I feel like I am constantly googling to sense check things - like does HRV drop when we PMS? Does keto impact on HRV? Perhaps you’ve done a podcast and I haven’t found it yet? Best wishes, what you do is brilliant ...

Question: Should I manage my total cholesterol of 305 just for my doctor or should I be doing it for my own sake? If so, how should I do it?   You should want to improve your lipid profile for a lot more than to please your doctor.   Let's revisit this from a cholesterol skeptic point of view. Uffe Ravnskov, he wrote a book called The Cholesterol Myths. In that book, he shows a graph from the Framingham study where he maps out the people who have heart disease and the people who don't. If you look at that graph, one thing that you see is that everyone who had total cholesterol over 300 had heart disease and no one who didn't have heart disease had cholesterol that high.   Look, the only way to have a total cholesterol of 300 or more in most cases is to either have a thyroid disorder or to have a familial hyperlipidemia. We're talking about fasting levels here. You should want to manage your blood lipids for your own sake because people with familial hypercholesterolemia have a dramatically increased risk of having heart disease decades earlier than it becomes normal for the general population.    I'm not saying it's 100% certain that if you have a cholesterol of 300 you will have heart disease, but you are way disproportionate in risk for that reason. You definitely want to address this for the sake of your health.   I think that if you have weight to lose, that losing weight should be one of the first things that you do to normalize your blood lipids and your inflammation. Being overweight also contributes to elevated free fatty acids, and elevated free fatty acids do raise your blood lipids. That's, in fact, the entire rationale of using high-dose niacin to lower LDL-C is by suppressing free fatty acid release.   It’s also important to address any inflammation in your gut. You might have microbiome issues, and working more high-fiber vegetables into your diet and diversifying across the different plant fibers is a great way to nourish your microbiome, reduce inflammation that comes from the intestines that would negatively affect your blood lipids.   If these things that we just talked about aren't enough to get the blood lipids into the normal range, then I think you want to experiment with eating more carbohydrate and a low-fat diet, but selecting those foods to maintain nutrient density. You could add something like psyllium husk fiber , which might be both good for your gut and the inflammation coming from your gut. It will also help reduce your cholesterol by making bile acids go into your feces and making your liver draw cholesterol from the blood.   If those natural things don't get your blood lipids into the normal range, then I think that you should consider being open to pharmacological methods. I've gone through all the cholesterol-skeptic literature and I'm against demonizing cholesterol. I do not believe that high cholesterol is the cause of heart disease.   But if your lipids are that high, it's overwhelmingly because you are not clearing them from the blood, and not clearing them from the blood is the single most important risk factor for them oxidizing, and them oxidizing does cause heart disease.    This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019   If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a

This episode is the second part in a two part series talking about biomarker testing. If you have not listened to part 1 then do dive in (link below.) In essence, I utilised a testing service called Forth With Life (baseline plus test) in order to measure a series of bio markers over the last year or so ( initial test Aug 2018, follow up test Oct 2019.) This episode directly covers Cholesterol, Triglycerides and Lipoproteins (chylomicrons, HDL, VLDL, LDL.) I looks past ‘good’ or ‘bad’ cholesterol lovely people and I hope you find it useful. Forth with Life are not paying me to say any of this or do any of the testing. I self funded everything and bought their baseline plus test kits, because I was interested in looking under ‘the hood.’ Follow Forth With Life and their sports performance testing service Forth Edge: https://www.forthwithlife.co.uk/ https://www.forthedge.co.uk/ Listen to ‘Bio Marker Testing With Forth With Life - Part 1’ https://soundcloud.com/user-188029167/bio-marker-testing-with-forth-with-life-part-1 Listen to Ep 26 of the Big Feed Up HQ podcast with Sarah Bolt CEO of Forth ‘ A Deep Dive Into How To Interpret Your Blood Results With Forth’ https://soundcloud.com/user-188029167/a-deep-dive-into-how-to-interpret-your-blood-results-with-forth Some of my scores: Bio Marker - Aug 18 score - Oct 19 score - (Levels) Active B12 - 105 -118 ( Low

A Health Screening is a test that looks for a problem or disease when no symptoms are present. We recommend everyone have a yearly wellness visit with your personal physician and ask them about any screenings you may need. Pap Smear: looking for cervical cancer cells or dysplasia (abnormal, possible precancerous cells). Begin at 21. If normal, repeat every 3-5 years. Human Papilloma Virus (HPV): responsible for most cervical cancers. Screening starts at age 30 and continues every 5 years. Breast Cancer Screening - Mammogram: Begin screenings between age 40-50 and continue every 1-2 years. Talk to your doctor about family history of breast cancer or other risk factors. Chlamydia Screening: Sexually active women younger than 25. Men and women at any age with multiple sex partners. Screening is done with a urine sample. Prostate Cancer Screening: Some recommend PSA (prostate-specific antigen), but some do not. We will have a full episode on men’s health to discuss this. Men should talk to their doctor about recommendations. Colon Cancer Screening: Options include colonoscopy, fecal occult blood test and barium enema with flexible sigmoidoscopy. Most common and accurate is the colonoscopy which is recommended at age 50 unless at higher risk. You are at higher risk if you have a relative who had colon cancer and should discuss that with your doctor. During a colonoscopy polyps can be removed. Clear colonoscopies can be done every 10 years. Lung Cancer Screening: Low radiation dose CT scan for people older than 65 who smoke or quit smoking less than 15 years ago and who have a 30 pack year history (1 pack a day for 30 years or 2 packs for 15 years) Abdominal Aortic Aneurysm Screening: This screen is looking for symptoms of an aneurysm in the largest blood vessel, the aorta. Men 65 or older who have ever smoked need an abdominal ultrasound to check the size of the aorta. If enlargement of the vessel is found, your doctor will follow up with more tests. Lipid screening: Lipids are Cholesterol, Total Cholesterol, High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL), and Triglycerides. Everyone should be screened for lipid disorders in adulthood and continue screenings every 5 years if normal. Keeping these levels in check will help reduce the risk of heart disease and stroke in the future. Hypertension Screening: at each doctor visit, vital signs checked, including blood pressure. Treat if it is high. Diabetes Screening: Have a screening early in adulthood to get a baseline blood glucose level. If level normal, check again every 5 years. If there is a family history of high cholesterol, hypertension or diabetes, testing more frequently may be appropriate. When any of these are high it can contribute to heart disease and risk of stroke. Hepatitis C Screening: All baby boomers (currently 55-75 years old) should be screened. People at higher risk include IV drug user or someone who has had blood transfusions. This is rare today because of improved blood screening practices. HIV Screening: Everyone should be screened at some point, especially if you are at risk Depression Screening: It is a questionnaire that you complete at your doctor visit that helps determine risk. You can also find and do a questionnaire on your own and talk to your doctor if you score high. Also, if you have any concerns without a questionnaire, if you have been feeling symptoms of depression or if you have a family history, please talk to your doctor. --- Send in a voice message: https://anchor.fm/realhealthchats/message

If you have not heard Episode 1 in this series get on over to the show to gain a little context: https://soundcloud.com/user-188029167/a-5-day-fasting-mimicking-diet-before-i-do-it Summary - 1. Weight down by 3kg and HDL up, everything else pretty stable. 2. My sleep was not affected. 3. I consumed x 3 caffeinated beverages in 5 days. 4. I did not have a bowl movement on Wednesday but apart from that my digestion was ‘normal.’ 5. By Wednesday I felt my best, I did not eat until 16:30pm,I had good energy levels and I could concentrate very well. 6. By Thursday night I felt my worst. It was hard to talk, I slurred my words and I found it very hard to concentrate. 7. I exercised x 3 times during the 5 days. 8. In general it was useful to eliminate decision fatigue when it came to meals and snacks. I saved time on preparing foods and I did not spend any time washing up. Before: Weight - 86.6kg / Body fat - 11%. Blood work - HDL 1.34 mmol / TG 0.61 mmol / LDL 4.35 mmol / Glucose 4.5 mmol / Total Cholesterol - 5.97 mmol After: Weight - 83.2 kg / Body fat - not tested. Blood work - HDL 1.51 mmol / TG 0.6 mmol / LDL 4.3mmol / Glucose 4.00 mmol / Total 6.08 mmol Exercise: Tuesday night - 5km and some bodyweight lunges and burpees (18:30-19:30pm) Wednesday - 9 pull ups / 15 push ups / 15 seconds side plank each side x 3 rounds + 15 minutes in the sauna (15:00-16:00pm) Thursday - 5km run in Kings Cross area (19:00-20:00pm) Additional information: Information on cholesterol - https://m.youtube.com/watch?v=fuj6nxCDBZ0&t=1323s Information on blood sugar - https://www.diabetes.co.uk/diabetes_care/fasting-blood-sugar-levels.html - In order to ‘keep the lights on’ with this podcast I have teamed up with 33 Shake. 33 Shake produce 100% natural, powerful sports nutrition for performance. But because they use only natural ingredients, they're also ideal for anyone looking to boost their overall diet, increase their nutrient intake and get a natural protein hit. I have been using their products for over a year and their chia seed gels are very handy for those longer runs and active weekends. Head over to https://www.33shake.com/ to check out their products and use the code MATTGARDNER33 to get 10% off your first order and to support the Big Feed Up HQ Podcast. Shop: https://www.33shake.com/all-products/ In order to fuel the podcast I have also team up with CRU Kafe. CRU Kafe produce certified organic coffee capsules, coffee bags and beans and grounds. https://www.crukafe.com/ The coffee I consume from CRU during podcasting at the moment: https://www.crukafe.com/collections/beans-and-ground/products/honduras AS ALWAYS LOVELY PEOPLE IF YOU LIKE THE SHOW PLEASE SHARE IT WITH SOMEONE.

In this episode, I discuss the context that surrounds total cholesterol and how you need to look at your HDL cholesterol, as well. YouTube: bit.ly/2JUjXVt Facebook: bit.ly/2PlIOaB Instagram: bit.ly/2OBFe7i Email List: bit.ly/2AXIzK6 Patreon: bit.ly/2OBBna0

Are you intrigued by functional lab testing and wondering where to start? Know that something is off in your body and want to know how lab testing can help you dig deeper? Want to know how functional testing and conventional testing differ and how you can get the most out of your doctor visit? Tune in to hear Ali and Becki discuss functional lab testing from micronutrient to food sensitivity to stool testing and beyond. Learn about the hows and whys of testing, how functional ranges differ from conventional reference ranges and how it can be used to determine root cause.   In this episode, Ali and Becki describe the various functional medicine lab tests they use in clinic every day. From detection of pathogens with a stool test to screening for food sensitivities to unearthing micronutrient deficiencies or hormonal imbalances, learn how functional medicine approaches lab testing differently than conventional doctors and looks for root cause versus simply screening for a diagnosis. Hear about common misses with conventional testing and how getting a more complete look can provide symptom or disease resolution. Plus, Ali and Becki work through several real patient cases and describe lab interventions in each case to give you a better idea of where to start on your own journey!   Also in this Episode:   What is Functional Lab Testing Specimen Types Comparing TSH vs. Complete Thyroid PanelThe Stress Thyroid Connection (more on optimal ranges in this blog!) Total Cholesterol vs. Lipoprotein Particle Size Food Sensitivity Testing vs. IgG Only Top Tests to Ask Your Doctor ForCRP Homocysteine CBC HgbA1c Comprehensive Metabolic Panel GGT DHEA Vitamin D Fasting Insulin Lipoprotein Particle Size Ferritin Note: The majority of these are assessed in our Weight Loss Plus Panel Access to Our Functional Lab Testing - Read About All Labs We Offer Here   MRT Food Sensitivity Panel   Micronutrient Panel Thyroid Complete Panel Comprehensive Stool Analysis CardioMetabolic Panel Neurohormone Complete & Complete Plus Weight Loss Plus Weight Loss Basic 55 SNP Genetic Test   This episode is sponsored by Bonafide Provisions, makers of TRUE bone broth found in the frozen section of your grocery store. Use code ALIMILLERRD for 20% off.

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I’m looking forward to sharing with you some of our community’s questions that have come in over the past few weeks… Let’s get started! Carla: I have PCOS, and possibly endometriosis & some type of thyroid dysfunction (these two haven't officially been diagnosed, but I have symptoms that have lead me to think I may have them). As I learn more about my condition and how to heal myself through lifestyle & supplements, I also try to get rid of toxins, do detoxes, eat well & exercise. However, I've worked with fire resistant garments for almost 15 years of my life and recently I learned that fire retardants are endocrine disruptors. I'm not able to immediately leave that field of work. Is there a way I can protect myself? I recently started wearing gloves (but they are plastic which is possibly not ideal either) and a cotton mask to keep from breathing in the fibers. What would you recommend? I'm not sure exactly HOW bad it is to continue working like this or if it's something I definitely need to get away from as soon as possible. Thank you for any guidance! Kate: Hi Dr Cabral, I had my gallbladder removed 10 years ago but didn't drastically alter my diet until about 3 years. I eat a mainly paleo lifestyle (with occasional legumes), and I've discovered through recent bloodwork that I have deficiencies in a number of areas. Specifically with Vitamin D and also with my thyroid (I am well outside the "optimal" range but technically still "normal"). I take 3000 IU Vitamin D each day but after researching saw that having no gall bladder can lead to the inability to absorb fat-soluble vitamins as well as possibly affect thyroid and even cholesterol. Is there a way to overcome this? If I were to start taking your daily digestive enzymes, could that help my vitamin absorption? Thank you! Julie: Dear Dr. Stephen Cabral, A friend of mine suggested your podcast last week and I have binged listened ever since. I have dealt with different issues such as Candida and fatigue. I overcame Candida with an elimination diet. Or maybe so I have thought… I have had my thyroid tested and it is normal. All my markers are normal except they found that I have Kidney disease. They were not able to find the root cause of it… My glomerular filtration rate is currently at 46 mL/min. The nephrologist stated that since I am an athletic build that is why. I am currently dealing with mood and fatigue. So if you can point me in the right direction of testing and why, that would be very helpful. Thank you! Julie Johnson  Jill: Hi Dr. Cabral, I have a friend who has achalasia. She has had the balloon dilation procedure done 2-3 times. It often works for a time and then she has difficulty getting food down her esophagus. I'd love to hear your thoughts on diet info related to achalasia, the possibility of overcoming it, and any steps she could take to find health/healing. My understanding is that it's an autoimmune disease ... and can't be "cured" ... ? But I know you overcame Addison's. Any help/direction would be so amazing! Thank you so much for these house calls!!! Claude: Hi! Don't know if you've already talked about this on your podcast: "Elderley's falls" (sarcopenia)?Is there anything i can do for my 93 years old dad?Thank you from Quebec.Canada Elizabeth: Dear Dr. Cabral - I found your podcast about 6-8 months ago after you appeared on EOFire. My daughter was "cured" from her gut, thyroid, chronic EBV through holistic/funcational/naturopathy and it literally gave her a life again! (She lives in Florida and we live in the middle of the country. )So thankful! But today, I'm writing about my husband. Genetically he is challenged. By that I mean that everyone in his family is/was obese. His 2 brothers died in their 50's, (one from a PE and one from untreated diabetes) His two living sisters are in their late-50's and early 60's. One is riddled with fibromyalgia, chronic fatigue and both are overweight. His father died of Lymphoma at 72 and his mother from congestive heart failure at 82. At 40 my husband was diagnosed with prostate cancer, but considered cured from that. At 46, he developed progressive hip pain and the joint was so eroded that he had to undergo a hp replacement at 47. All the nsaids and steroids that he took for that and for years prior to that for a football (knee) injury lead to acute renal failure before the replacement was done. His knee was replaced about a year ago. He has a stressful job and works about 7 days a week. He was also diagnosed with osteopenia at 46 and used Forteo for about 6 months, but I just wasn't comfortable with him continuing that. Since then he has been on Prolea. Uses supplements from the Shalkee Corporation. Daily vitamin, D3, Calcium, Iron and CoQ10. About 2-3 years ago he began gaining weight and becoming more and more fatigued. But our diet had not changed and in fact has gotten cleaner and healthier due to my desire to feel my family whole foods For 25 years he maintained a weight of 165 +/- 3 pounds. He's gained about 35 pounds; mostly around his umbilical area, but also in his groin area. He is tired ALL the time, cold, his eyes are puffy every morning, decreased libido, frequent nose bleeds, (but only after blowing his nose) decreased muscle mass and seems to catch every cold virus that comes around. He's always had periodic bouts of HSV II which seem to be worse with increased stress. He had extensive lab testing done last fall through Veridia Diagnostics. I would be happy to send these to you. Cardiac inflammation is a little high with hs-CRP 2.1 and Homocysteine (10). Food Allergies (IgE) were all negative, but IgA was not done. Lipid; Total Cholesterol 217 Triglycerides 100, HDL 70, LDL 141, Apo B 104. Fasting glucose 97, Insulin 7, A1C 5.3, Cortisol 11.2, Adiponectin 25.6, Leptin 13.9 Ferritin 156, Vitamin D 66, Magnesium 2.2, Creatine 1.3 Cystatin C 1.07 TSH 2.0, T4 5.3, Free T4 1.0, T3 1.23, Free T3 3.0, Thyrodglobuin antibody 10.6, Thyroid peroxidase antibody 12.93, Testosterone 640.6, FTI 31.7, SHBG 70.2, Estadiol 29.6 I think we have a thyroid problem, even though his labs are "normal". What should we do next? Sorry this got so long, but I really value your opinion. He would like to feel more like himself again and lose the weight. I would like to have a more energetic husband. Thank you in advance, Dr. Cabral! Lizzie: Hello! My husband has had a persistent rash on his face that seemed to come out of no where. In January it started. It looks like small tiny pimples and red dots. Forhead, nose, cheeks. Subsides slightly and always comes back. His face is not itchy and it is most prominent when out of shower. Then in Feb his stomach started becoming itcy, more patches of dry skin, not rash-like on his face. He also has had toe-fungus for years, from sports in college. What could be causing this rash and how can he work to get rid of it? He eats very little protein, when he does, crappy chicken. Lots of veggies and he does have a massive sweet tooth. He is 37 yo. he is also going through a job transition. thank you! Terri: I just purchased your digestive enzyme. Do I take this 15 min before each meal or only the first meal of the morning? It then works all day with just taking in the morning? Thank you  Catherine: Hi Stephen, I regularly listen to your podcasts and would love it if you could help me out. Here’s a bit of information about myself, I’m 24, came off the pill just over 2 years ago and got quite bad acne all over my face (got worse and worse over time). Previous to coming off the pill, roughly about 1-2 years before, I became intolerant to dairy. In the past year I have been getting reoccurring yeast infections ("lady regions"). I have just completed a 3 month parasite cleanse, saw lots come out in my poop and I feel much better for doing it. However I am still getting yeast infections, I have figured out I have candida / gut issues. Would you recommend any other tests apart from the acids test? I’m not sure if my hormones could still be imbalanced? I have cut out a lot of foods that I used to eat such as bread, refined sugar etc but it’s not enough to kill whatever yeast/bacteria is inside me. Thank you Annie:  Hello, I have been suffering with halitosis for around 15 years. I have been to every specialist that there is. I have even had my stomach biopsy and I have been to several dentist and gum specialist to rule out oral health care and everyone tells me I am fine and they cannot find anything wrong. My breath smells like feces and I didn't know what else to do? Please tell me where to start. Do you except health insurance? Thank you for tuning into this weekend’s Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Specific Show Notes & Resources: http://StephenCabral.com/884 - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -   Dr. Cabral’s Most Popular Supplements: > “The Dr. Cabral Daily Protocol” (This is what Dr. Cabral does every day!) - - - > Dr. Cabral Detox  (The fastest way to get well, lose weight, and feel great!) - - - > Daily Nutritional Support Shake  (#1 “All-in-One recommendation in my practice) - - - > Daily Fruit & Vegetables Blend  (22 organic fruit & vegetables “greens powder”) - - - > CBD Oil  (Full-spectrum, 3rd part-tested & organically grown) - - - > Candida/Bacterial Overgrowth, Leaky Gut, Parasite & Speciality Supplement Packages - - - > See All Supplements: https://equilibriumnutrition.com/collections/supplements  - - -   Dr. Cabral’s Most Popular At-Home Lab Tests: > Hair Tissue Mineral Analysis (Test for mineral imbalances & heavy metal toxicity) - - - > Organic Acids Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Thyroid + Adrenal + Hormone Test  (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Adrenal + Hormone Test (Run your adrenal & hormone levels) - - - > Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Omega-3 Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > Stool Test (Use this test to uncover any bacterial, h. Pylori, or parasite overgrowth) - - - > Genetic Test (Use the #1 lab test to unlocking your DNA and what it means in terms of wellness, weight loss & anti-aging) - - - > Dr. Cabral’s “Big 5” Lab Tests (This package includes the 5 labs Dr. Cabral recommends all people run in his private practice) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family!)

Cholesterol theory runs deep.  Look twice and better understand what the Cholesterol Theory is based on, and what really causes Cardio Vascular Disease (CVD).  Don't Just jump on the "Statin Train" if you have Cholesterol over 200 mg/dl.  Take a closer look at your CRP C- Reactive Protein levels and make a more informed decision. Look at what you can do TODAY, it is NEVER too LATE to change your lifestyle to prevent or even reverse CVD in your life and the life of your family.  

AIR DATE: March 1, 2012 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: “What Questions Should I Ask My (Non-Low-Carb Friendly) Doc?” Famed low-carb clinician Dr. Mary Vernon, MD is the co-author of  with Jackie Eberstein, RN (who was our very first guest in ). She is a Past President of the American Society of Bariatric Physicians. Dr. Vernon is well-known amongst her medical professional peers as an expert on the therapeutic use of low-carb ketogenic diets on patients to treat a variety of health issues, including diabetes and metabolic syndrome. She is the CEO of  which seeks to educate her fellow physicians and medical professionals on how to use science-based modalities with patients. Dr. Vernon has a heart for arming doctors with practical ways to implement low-carb diets where they are necessary for improving key health markers. What better expert could we have to address what questions you should be asking your (non-low-carb friendly) doctor than her! Here are some of the questions we addressed in this podcast: KELLY ASKS:My frustration with doctors is they spout the conventional “wisdom” of the food pyramid or MyPlate or whatever it is now, but yet when it doesn’t work for me they say I’m just not trying hard enough – which is without a doubt not true. So I guess my question would be – If something isn’t working, wouldn’t it be smart to try something else? And really – where are the medical studies that back up that a low fat diet is better for my health? Where are the studies that correlate fat = heart disease? If I lose weight (even if it’s a small amount) and feel better and have lower blood sugar on a low-carb diet, then shouldn’t I stick to something that’s working? And is it so wrong that I want to be personally involved in my health enough that I HAVE done research and have looked up the studies and that I might actually have a working knowledge of what is best for my body? CONRAD ASKS:I am currently in the process of looking for a new Doctor (already checked http://lowcarbdoctors.blogspot.com/) What questions can I ask before visiting to find out if they might support a low carb lifestyle, other than the obvious “Do you support low-carb, high-fat diets?” I have read that I should make sure they perform and understand a VAP instead of standard cholesterol test. Are there any other tests or procedures I should be aware of and ask for? KATHY ASKS:I just got my lab work back from my doctor and my total cholesterol was 249 with LDL at 171 and my sugar at 103. That’s basically all he said and then of course, “I’d like to start you on a low dose statin, keep eating a low carb, low cholesterol diet”. The cholesterol is up a little and so is the LDL from 6 months ago. I am not a diabetic and have never had problem with that. I wanted him to run an NMR. My doctor called me and had absolutely no idea what the NMR Lipoprofile test was even after I gave him the CPT code. Then he went on to say “size doesn’t really matter and thats for HDL, not LDL. And if I went to any hospital they wouldn’t know what an NMR test was.” So, he is having me do a VAP profile test. He said, “elevated LDL is bad no matter what the size.” Mine isn’t horrible for a women without a risk factor, but it keeps going up. Any suggestions? MIKE ASKS:How do you have a conversation with your doctor about putting you on a statin drug with and HDL of 75 and triglycerides of 80 when your LDL is 225? I got these numbers in a blood test at my doctor’s office after consuming a low-carb diet. KATHY ASKS:How should patients deal with doctors who want to follow the guidelines put out by a group like the American Heart Association or American Diabetes Association if that association’s guidelines aren’t in keeping with our own opinions of current best evidence or even n=1 experiments we’ve done on ourselves? Sometimes doctors seem to think they have to follow those association-based guidelines to protect themselves against malpractice, do they have a point? How do we get around that if we believe those organizations aren’t up to date with their evidence or if we think the guidelines are politically motivated or otherwise flawed? JOHN ASKS:I’m a Type 1 diabetic and I believe I suffer from insulin resistance. I use 18.3 units for basal and my TDD on 10% carbs and 25% protein runs in the high 30’s. Whenever I fast, even for a single meal, I get a major liver dump at the next meal followed by some major cravings which seem to counter any benefits I might have seen from fasting. I’m stuck in my weight loss, and I think Metformin or a GLP-1 would help. Symlin is not an option where I live in Canada. My endocrinologist says my TDD insulin is already much lower than “normal” and refuses to consider giving me a prescription. He’s the local head of internal medicine and is known for not listening to colleagues. Any suggestions on how to proceed would be helpful. SPARKY ASKS:I would love to go to a doctor and find out what all my lipid numbers and thyroid numbers are. But I dread talking about my diet — I can’t defend it in terms of weight loss, because I weigh only about five pounds less than when I first started low-carbing 10 years ago. (Although a lot of women gain weight during their 40s, so maybe I’m better off than I think!) There are no low-carb friendly doctors where I am (at least none listed on Jimmy’s List of Low-Carb Doctors blog). I’m afraid of getting caught in the gears of the medical machinery. For example, what if my cholesterol is “high” and they want me to take statins? Can you just go to your family practice doctor and say, “I want these tests, please have them done for me”? What exact tests should I ask for? I don’t want just a couple of numbers that don’t REALLY tell anyone anything, which seems to be what most people wind up with. I suspect thyroid issues (20 extra pounds of fat won’t go away, cold hands and feet, dry skin). Also, one hand or the other occasionally gets a pins-and-needles feeling — I have no idea what that could mean. I just turned 50 and am in excellent health overall. I have regular periods, no change in that regard. I haven’t had a checkup for nearly 8 years, since my last postpartum checkup. I’ve never had cholesterol tested or a glucose tolerance test. Blood pressure has always been around 90/70. I’ve eaten mostly real, whole foods since I was a teenager (including 17 years of vegetarianism), and mostly low-carb/Paleo/Weston A. Price for the past several years. I keep the carbs to around 25-75g and rarely eat wheat or other grains. PENNY ASKS:While my mother’s doctor always congratulates her on her steady weight loss (and better blood sugar level control) he never fails to tell her that cutting back on her carbs is going to cause more problems in the long run. He points out that her cholesterol levels are elevated above normal, caused by eating too much saturated fat of course, and her refusing to take statins, which caused her muscle pain in the past, is leading her to a massive heart attack. She never knows how to respond to him so I thought perhaps giving him a book to read might be one solution. I was wondering if Dr. Vernon might suggest a book that she could give to her doctor that he might read? I know there are many books out there written for the average person who does not have a medical background. Is there a book that perhaps would carry more weight with an MD and not just be seen as a fad diet book? Because the doctor is probably not going to read that type of book. BRIAN ASKS:My low-carb doctor may lean even too far away from statins and other medications. When should I really think is the right time to take a pharmaceutical drug — in other words is there a risk of having too much of a low-carb friendly doc? JOCELYN ASKS:So, my friend went to see her doctor yesterday. Her HDL is 57, her LDL is 135. She got a heart scan a while back and got a value of 19. Her doctor prescribed a statin for her. My friend asked her Doctor to do a VAP test and the doctor said that she already knows that she is starting to have some heart disease starting, so she doesn’t need the VAP test. My friend has been starting to read Robb Wolf’s book and other Paleo people’s information, so, she’s getting wild ideas like saying no to statins. Her doctor is slightly insulted that my friend is ignoring her advice. “When you get heart disease will you go to your friends and the internet for help?” I told her to find another doctor, but she apparently wants to stay with this doctor. How would you approach this doctor? But, how would you educate a doctor who already seems to be on the defensive about learning new things about cholesterol and statins? ROCHELLE ASKS:I did attempt to speak with my doctor recently. I had recently gotten some blood work back and he said, for someone with such a high BMI (30) I didn’t deserve such good numbers. Total Cholesterol 222, HDL=90, LDL=118, non-HDL=132, Triglycerides=68, Glu=84, HbA1C=5.1 I told him that I had started eating Paleo. He did note that I still needed to lose some weight. I’ve lost about 30 lbs since starting Paleo. I asked him how he would suggest that I accomplish that. He said he recently decided that he needed to get his BMI down. He did what he tells his patients to do. He restricted his calories and exercised more. It’s painful, but it works. I asked him what he ate. He said a bagel in the morning. A yogurt for lunch and a regular dinner but no dessert. I asked him if he’d read “Good Calories, Bad Calories”. He said no, I don’t care about that. It doesn’t matter where the calories come from, you can eat 1200 calories of whale blubber and you’ll lose weight. I told him that I cut out the grains and sugar and it was *not* painful. He said, “Come back when you’re at your goal weight and we’ll redo all those numbers and we’ll talk.” He is about ready to retire. Should I even bother trying to talk to him about other ways of eating and getting healthy? Or should I find a new doctor? I looked on both the Paleo physicians network and the low-carb doc site and there are a couple of oriental medicine practitioners and a chiropractor. They don’t seem to be on my insurance plan. So…what’s a woman to do? DAN ASKS:I’m a type 2 diabetic who has been on low carb (Dr. Bernstein’s Plan) for about 6 years. Last year I found a low carb doc from Jimmy’s list. He favors South Beach phase 1. The only problem is that he believes in the lipid hypothesis. At my last visit, he told me that, as a diabetic, my LDL needs to be 70, even though my cholesterol would be “normal” for a non-diabetic. He said that controlling my blood sugar will not prolong my life. Only getting my LDL down to 70 will prolong my life. The strong implication is that I will die an early death unless I get my LDL down to 70. He is very pushy about statins, though I have resisted the pressure. I tried to tell him that the studies show no conclusive benefit to statins, but he won’t buy it. Do you have any suggestions on how to handle it in addition to being stubborn in refusing to take statins? HAROLD ASKS:I am a Type 2 diabetic. At the time of my diagnosis two years ago, my triglyceride/HDL ratio was 6 to 1. Now, after carefully watching my postprandial glucose levels (rarely, if ever over 110) my triglyceride/ HDL level is down to 1.6 to 1. My cardiologist couldn’t care less about my triglycerides and only focuses on my LDL (which were 120) and wants me on statins, I refuse them. Here’s my question, what can I use to convince her that controlling my diabetes and my trigs/HDL ratio are greater heart risk factors than LDLs. Filed Under: , 

Back with Episode 66.  I will include the show topics list and detailed questions for each future episode. Show Topics: High Work Load Drop in Triglycerides and Increase in Total Cholesterol and HDL Endometriosis Craving Salt Hershel Walker Adrenal Fatigue Other Sources of MCFA Zero Calorie Energy Drinks Isometric Exercise Podcast Slogan Low Thyroid Low Energy Levels and Hungry at Night Leptin Resistance Look Awesome Naked Detailed Questions: 1. Question from Diana: Hi Robb and Andy I am a 45 year old female personal trainer in Australia who has been Paleo now for about 4 weeks. Previously a vegetarian, I decided to try Paleo because I was run-down, gaining lots of abdominal fat and feeling bloated all the time. I chose to switch to Paleo over the Christmas holidays as I would have a three week break from my work and the associated exercise load from it. I feel great and am loving it (although I only eat fish and chicken - not sure I could cope with beef after all these years!) Anyway, my question is this: How do you recommend I sustain my training load from work (6 hours of classes - 3 x 1 hr Spin classes, 2 x 1 hr Bootcamp classes and 1 Body Pump class) without shooting my cortisol sky high and overtraining (which I think was the problem that brought me to Paleo originally.) In addition, to the above training, I also run 5-6 days a week (sorry!)generally in the 8-12km range though previously while training for marathons, much more. My goal is to maintain Paleo and maintain my teaching/exercise load. Sleep is good, consistently 7-8 hours a night in pitch black room. Height 5'6'' Wt 140 and dropping Thanks for your help. 2. Question from Stephan: Hi Robb and Andy. I've noticed this issue come up several times on your show. Someone starts out with a paleo diet and gets their bloodwork done. The results are often a big drop in triglycerides and an increase in total and LDL. After first switching to a paleo diet, I had a total cholesterol of 247, triglycerides of 97, HDL of 53, and LDL of 175, in units of mg/dL. A month and a half after that, I had a total cholesterol of 200, triglycerides of 62, HDL of 47, and LDL of 141. To my knowledge, I did nothing different during that time, except for one thing: I started taking 400 mg of magnesium daily as Mg glycinate. I'm wondering if my situation is not all that uncommon. 3. Question from Jesse: Robb, A friend of mine has been struggling to get pregnant for the past 5 years. Are there any resources or information highlighting the dietary/lifestyle effects of endometriosis? 4. Question from Sally: Hi Rob and Andy, Your podcast’s not bad!! Yeah, you might have changed my life a bit, but whatever... Moving on to the important bit – me! I have been overweight my whole life – near enough, apart from the last 5 years where I’ve stuck to around 8st (I’m a 5ft 1, 41 year old female). Up until beginning the paleo way, I kepts weight off using extended cardio, vegetarianism, masses of willpower and a lot of stressing about food. Since adding protein and cutting cardio for weights I have found it so so so much easier to maintain my weight. However, I still crave salt and I eat ENORMOUS amounts of it. I can’t seem to give it up or even really want to give it up. Can you give me some motivational reasons as to why I should get rid of this final unhealthy part of the jigsaw? I’d be grateful for any scare tactics you can come up with. Thanks a ton – P.S. love your podcast really! Sally in the UK 5. Question from Tiki: Saw this guy fight on strikeforce over the weekend. He is 48 and from what I've read and heard the announcers mention, he only eats one meal a day , at night, usually soup and salad. Any insight on how someone can do his workout routine and only eat one meal which is mostly vegan and be in the shape he is in at 48 no less? Is it the sprinting? Is it the fasting? Fucken sickass genetics? Thanks for the amazing show guys. Link http://www.tryingfitness.com/herschel-walker-workout/ 6. Question from Kass: Hey Robb and Andy! I'm trying to trouble shoot some possible imbalances I may have with my doc, who happens to think I'm a hypochondriac hippy because my blood work is freaking perfect from eating paleo for almost 2 years now. Despite my doing everything you say (I'm serious), I still haven't been able to lean out and am narrowing down possible hormonal issues. I just wanted to see if you could shed some light on these tests so that I can get my research on before I see the doc. 1. Is it possible to still have Adrenal Fatigue after adopting a Paleo lifestyle, sleeping very well, and training smart for two years? (sidenote: training smart means strength bias, not working out when I'm tired, and generally not being an idiot). 2. For the cortisol test, do you like the results from the blood test or the urine test better? 3. Are there any other tests/conditions that I should study up on? Thanks for the guidance 7. Question from Mrs. F Hello Robb and Andy, I understand that coconut oil is a great way to get the benefits of usable Medium Chain Fatty Acids into our diets, but in the interest of keeping things more local because, like probably most of your listeners, I don't live in Thailand, what are some other sources of MCFA's that might be more available in a the U.S.? This is sort of an issue with all non-animal fat sources like olives, avocados, almonds, etc., but coconut just seems particularly outside the basic idea of eating local. Also, is coconut the new agave nectar? Meaning, once coconut becomes so in demand, the quality and subsequent alleged health benefit is shot to hell? Love you- love your show! 8. Question from Ultimate Russell: Hey Robb and Andy, hope you guys are well. Robb, I saw your blog post about fitness at almost 40 and I think you look great, man. And of course Andy, you're beautiful as ever... Anyway, Robb and Andy, how do you feel about Zero Calorie Energy drinks? I do enjoy one a couple times a week but am a little concerned about artificial sweeteners (I've read a lot of negative things but then I read totally conflicting statements) I figured if I want an answer that jives with my lifestyle you would be the guy to ask. Usually when I have one it's during a long drive home in place of a cup of coffee. I have paid attention to see if I notice any negative effects on myself and as of yet there have been none. So tell me, anything to worry about or is a couple of energy drinks a week okay? 9. Question from Keith Norris Wannabe: Thoughts on isometric exercise? A worthwhile pursuit? (general goals of all around strength development) Link to a study abstract: http://www.ncbi.nlm.nih.gov/pubmed/6706740 Thanks, (Patrick) aka, Keith Norris Wantabe 10. Question from Future David: It's not so much a question, rather, a general "podcast slogan" as I was contemplating T-shirt designs for you guys. Tell me what you think... 6 listeners 5 fries 4 grams of fish oil daily 3 things to avoid: grains, legumes, dairy 2 crazy dudes 1 gato Keep up the great work, fellas! 11. Question from Deb: Can eating paleo heal a borderline low functioning thyroid? 12. Question from Alex: Hi Rob and Andy, Firstly - fantastic things you are doing, the books, the podcast, the site all great sources of information and I am recommending your content to anyone who notices my new "paleo physique" (most people). I have hit a bit of a stumbling block though and not sure how to proceed. 3 months ago I was an almost podgy, moderately sedate software developer with a fairly poor diet (by paleo standards at least). I also think I may have been heading for diabetes with an extremely volatile blood glucose levels all day long. The only thing holding me together I think was that I play an elite level of squash 2-3 times a week. I am 29 years old. A career change in mid Oct 2010 allowed me to work from home and also gives me some more spare time. I started cooking for myself and my wife and research and reading soon led me to Paleo. My wife is not yet convinced but for me the results were astounding, within a few weeks I had lost pounds of fat and gained pounds of muscle - on the squash court I was performing to a higher level. Generally feeling good and actually felt like training for the sport for the first time in a long time. I have always wanted to play professional tournaments so in mid Dec 2010 I joined the Professional Squash Association World Tour and will be looking to achieve a significant world ranking this year and hopefully beyond. Where I am now in January 2011 is inconceivable to how I was performing just 3 months ago. I attribute most of these gains to the huge change in my eating habits since reading the The Paleo Solution, and since then, many other books on this fascinating topic. However, just recently I feel like I have hit a significant road block. I have trouble sleeping, wake up middle of the night extremely hungry and also needing to take a leak. Energy levels are a bit lower than before. I am tired a lot due to the lack of sleep. I am also for some reason trying to fight off a slight cold as I write this for the first time since going Paleo. My theory for my road block is that I have reached the point where I can no longer just burn off my (until recently somewhat generous) fat reserves. I have not accompanied this with an increase in caloric intake (I guess I need to but I don't feel like eating that much more during meal times). Eat until satisfied right? Just from looking I think my body fat is now in the 8-12% range but I have a test booked this week to get more of an idea. My training looks like this: per week I am doing 2 weights sessions, 2 speed sessions (sprints or jumping rope) and 3 on court practice sessions or matches. A session lasts 30-60 minutes, with some matches or on court sessions lasting slightly longer. My adherence to Paleo is at least 90% (no grains, cereals or legumes but the occasional consumption of dairy in the form of cheese or milk). Should I be eating more meals, bigger meals, different foods? Any other ideas as to why my energy levels would suddenly drop off? Any help or advice you can give me would be amazing. Please also blind me with science where possible :-) Alex. PS I am English so if you do choose to read this out on the podcast, try and use an English accent for amusement factor ;-) 13. Question from Mike: Robb and Andy great show. My question today involves Leptin Resistance. I began Paleo just before Thanksgiving. I know, not the best timing. Made it through the holidays and lost 20 lbs. Since the beginning of the New Year I seemed to have plateaud, only losing 3 lbs. I admit that I have minimally deviated with flour. On no more than 5 occaisions since I started Paleo I have had either bread, a kolache, or something similiar. If you don't know what a Kolache is let me know I'll send you a dozen. You'll be throwing rocks at the Ferris chocolate croissants. Also ala Tim Ferris I did have some beans (black beans or black eyed peas). I am concern that I have over the years of yo-yoing I have become leptin resistant. What do you think? Also how do you overcome leptin resistance. Thanks for your concern and please keep up the great show. 14. Question from Adam: Hey Robb and Andy, love the book and podcast. Thank you for all you two do. I want to look awesome naked (think Brad Pitt in Fight Club, or a gymnast.) I have a lot of equiptment at home (pull up bars, kettle bells, dumbbells.) I like the idea of P90X for getting ripped, but I think I overtrained when I did it. What type of exercises/frequency would you recommend for someone at home to get jacked. I do care about having functional strength, but I prefer to look good. Sorry I never have had a six pack and I want to by the time I turn 30 in six months. Thanks a ton guys. Adam p.s. I got a sunlight for Christmas because the sun can be nowhere to be found in winter in Buffalo. What is your opinion on these? Show Notes - The Paleo Solution - Episode 66

Background: Toll-like receptor 4 (TLR4), the signaling receptor for lipopolysaccharides, is an important member of the innate immunity system. Since several studies have suggested that type 2 diabetes might be associated with changes in the innate immune response, we sought to investigate the association between genetic variants in the TLR4 gene and incident type 2 diabetes. Methods: A case-cohort study was conducted in initially healthy, middle-aged subjects from the MONICA/KORA Augsburg studies including 498 individuals with incident type 2 diabetes and 1,569 noncases. Seven SNPs were systematically selected in the TLR4 gene and haplotypes were reconstructed. Results: The effect of TLR4 SNPs on incident type 2 diabetes was modified by the ratio of total cholesterol to high- density lipoprotein cholesterol (TC/HDL-C). In men, four out of seven TLR4 variants showed significant interaction with TC/HDL-C after correction for multiple testing (p < 0.01). The influence of the minor alleles of those variants on the incidence of type 2 diabetes was observed particularly for male patients with high values of TC/HDL-C. Consistent with these findings, haplotype-based analyses also revealed that the effect of two haplotypes on incident type 2 diabetes was modified by TC/HDL-C in men (p < 10(-3)). However, none of the investigated variants or haplotypes was associated with type 2 diabetes in main effect models without assessment of effect modifications. Conclusion: We conclude that minor alleles of several TLR4 variants, although not directly associated with type 2 diabetes might increase the risk for type 2 diabetes in subjects with high TC/HDL-C. Additionally, our results confirm previous studies reporting sex-related dissimilarities in the development of type 2 diabetes.

Gas-liquid chromatographic determinations of nonesterified and total urinary cholesterol were performed in 137 normals, 264 patients with various internal diseases without evidence of neoplasias or diseases of the kidney or urinary tract, 497 patients with malignancies and 236 patients with diseases of the kidney, urinary tract infections or prostatic adenoma with residual urine. A normal range (mean±2 SD) of 0.2–2.2 mg/24 hours nonesterified cholesterol (NEC) and of 0.3–3.0 mg/24 hours total cholesterol (TC) was calculated. Values of urinary cholesterol excretion were independent of age and sex and did not correlate with cholesterol levels in plasma. Patients with various internal diseases, without evidence of neoplasias nor diseases of the kidney or obstruction of the urinary tract, showed normal urinary cholesterol excretions, as did patients with infections of the urinary tract. However, elevated urinary cholesterol was found in patients with diseases of the kidney or urinary tract obstruction (prostatic adenoma with residual urine), malignant diseases of the urogenital tract and metastasing carcinoma of the breast. In patients with other malignant diseases urinary cholesterol was usually normal. Lesions of the urothelial cell membranes are considered to be the most likely cause of urinary cholesterol hyperexcretion. The clinical value of urinary cholesterol determinations as a possible screening test for urogenital carcinomas in unselected populations is limited by lacking specificity, expensive methodology and low prevalence of the mentioned carcinomas, although elevated urinary cholesterol excretions have been observed in early clinical stages of urogenital cancers.

Gas-liquid chromatographic determinations of nonesterified and total urinary cholesterol were performed in 137 normals, 264 patients with various internal diseases without evidence of neoplasias or diseases of the kidney or urinary tract, 497 patients with malignancies and 236 patients with diseases of the kidney, urinary tract infections or prostatic adenoma with residual urine. A normal range (mean±2 SD) of 0.2–2.2 mg/24 hours nonesterified cholesterol (NEC) and of 0.3–3.0 mg/24 hours total cholesterol (TC) was calculated. Values of urinary cholesterol excretion were independent of age and sex and did not correlate with cholesterol levels in plasma. Patients with various internal diseases, without evidence of neoplasias nor diseases of the kidney or obstruction of the urinary tract, showed normal urinary cholesterol excretions, as did patients with infections of the urinary tract. However, elevated urinary cholesterol was found in patients with diseases of the kidney or urinary tract obstruction (prostatic adenoma with residual urine), malignant diseases of the urogenital tract and metastasing carcinoma of the breast. In patients with other malignant diseases urinary cholesterol was usually normal. Lesions of the urothelial cell membranes are considered to be the most likely cause of urinary cholesterol hyperexcretion. The clinical value of urinary cholesterol determinations as a possible screening test for urogenital carcinomas in unselected populations is limited by lacking specificity, expensive methodology and low prevalence of the mentioned carcinomas, although elevated urinary cholesterol excretions have been observed in early clinical stages of urogenital cancers.

The excretion of protein and cholesterol in 24 h urine was measured in 42 patients with the nephrotic syndrome. The finding of a positive correlation (r=0.76,p