I was so engaged in the delivery and content of your argument that when finished I left the site dazzled but realized I’d forgotten to hit the thumbs up so I came back & did. You’re a warrior, man, of the truth and you bring the data & studies to support your assertions and counter arguments. It’s a beautiful thing. I’m counting on people like you to change the medical world for the better for us all if they don’t crush you first. They are coming at you and you did an excellent and bold job pushing back. Keep at it my friend and thank you for doing so.
Funny. In all seriousness, I don't know how I can be more clear. I hope you found my "accusations" at 9:00 minutes and beyond well reasoned, if quite direct.
@@nicknorwitzPhD Paraphrasing, "Here's the published research; I've cited it for you more than once; you're not only ignoring it, you're claiming that it doesn't exist. Therefore, you're just flat wrong." How much more well-reasoned could you have been?
Solid intro. Thanks for not wasting my time. The doctors making mistakes publicly, need to be called out and given a polite opportunity to retract or correct. And if they persist, they must be held accountable. Maybe create a LMHR Disinformation Hall of Shame.
"The doctors making mistakes publicly, need to be called out and given a polite opportunity to retract or correct. And if they persist, they must be held accountable." 100% agree.
Don’t quit Nick! We need doctors like you to explain this stuff. And yes ..we can learn more from doctors on RUclips because our doctors don’t care to take the time to learn or want to bother to explain things to us. I have absolutely zero faith in mainstream medicine anymore.
Your frustration is long overdue and frankly surprising it's taken this long to surface. Don't allow these nay sayers get to you the work you do is so needed and appreciated. Only with clear verifiable and unbiased data can we learn and understand what the facts are. The false data is getting so bad that many people don't believe anything a MD has to say.
You are so right about that. My distrust for standard medicine has been growing in leaps and bounds as I see it reflecting more ignorance, corruption, and greed all the time. So very sad for our country. Yet, I still have hope but we all must speak out and confront them. We need a country-wide organization that represents medical patients on a whole range of issues with an education arm to make the public aware of things and organize those that have concern,a lobbying arm of keto and carnivore people and other Americans who want to see more transparency, functional doctors in insurance networks, naturopathic doctors, real supplement accountability, a quarterly magazine to educate members of our organization of new upcoming issues and old ones not adequately addressed. And more.
"getting so bad that many people don't believe anything a MD" ... that's - sorta' - what I'm so afraid of and pointing out ... when egos are so large they can't see their own clear misinformation, it gets called out, and discredits the community ... dangerous situation
This vid should be watched by everyone in medical school. What a great presentation. For me, as a non-scientist, non- medical person, such a presentation helps me spot and learn to identify the useless crap in arguments.
It wont be watched in medical school because its pseudoscience. In the end you should be glad that people actually saving your life when you get stroke/Heart attack or whatever due to poor life choices werent educated on pseudoscience.
I actually think that his integrity is very suspect. He says nothing about all of the carnivore doctors that say that LDL-C is meaningless and cite LMHR as the justification for their proposition. I don’t think he’s a charlatan in the same way that they are but birds of a feather.
@@davidzip8841 why is Nick responsible for any of those folks? How does “Birds of a feather” apply when Nick takes bgreat pains to distinguish his view from others?
Regarding Dayspring and others mentioned here, this is human ego on full display. This represents the inability to backtrack and say, maybe I was wrong or what I believed was possibly wrong. The curiosity has left the building. To Nick and team, nicely done and very necessary.
Even those who are Dayspring fans can't deny his arrogance is a bit "much," and there are some examples here where he's clearly speaking as an expert on something he hasn't taken the time to properly research. That may sound arrogant coming from me, but for those who watch the video in full, I think it's undeniable. Doesn't mean he isn't smart and informed on other matters or in general, but... here... on this specific topic...
They will continue to attack you, you are young, intelligent, not willing to simplify follow, but actually have a scientific mind that looks for facts. This goes against their rules. Please stay strong, the world needs you and you are being an positive role model for others like you. At this point in human history when society has lost all trust in the medical profession, you are a ray of hope.
I’m content to let you scientists fight out the truth about LMHR’s and LDL. Thank you for your work. Meanwhile, I will continue to live my life in the healed condition from day-by-day agonising IBS (and many other issues) Fatty meat ,eggs and a little fish for me👍
I completely understand where you are coming from, per my commentary about my own background mentioned just after 9 min into this video and covered/disclosed elsewhere.
I went full Carnivore in December 2023 and I have lost 35lbs in 3 months to get to my target weight. I wanted to be healthy again and get away from Carbs. I am now off all my blood pressure meds, I feel young again. My Migraine headaches are gone and now I'm on a Keto Diet. My Doctor was concerned but she had been on a Keto diet for 3 years and understood. She wanted to do an EKG and blood work as she was concerned. I just went on Medicare and physicals are not a thing. So I have no idea what my numbers are but damn I feel good now. I wake up in the morning and feel like a million bucks. When I was eating the IC it diet I always felt lethargic. Once my Doc saw my blood pressure she told me to quit my meds. I'm happy and won't change a thing. 😄
That's an encouraging personal story for me Annette and congratulations on your success. That's a situation I can relate to personally having gone keto six months ago to address an IBS (SIBO) condition that developped as a result of a food poisoning instance. However, I have suffered a relapse of my symptoms three weeks ago, so I'm not completely out of the woods yet.
@@JesusMartinez-mk6fc I certainly don’t have all the answers and am forever ‘tweeting’ and experimenting with what I eat. I don’t think my gut is totally healed, but am sure I am more comfortable eating high fat / low fibre foods. I’ve spent years and years trying to discover why eating food ends up causing me gut pain, all the whole trying to eat ‘healthily’ according to nutrition advisors and guidelines. Good luck with your journey.
I respect people who say “I don’t know” because most of them will persevere in finding out. Science is all about finding out. I am intensely interested in learning more. Thanks NN.
Keep it up, Nick! Here is why. They're scared! A lifelong career in what you believed is wrong is a huge mountain to climb if motivated to do so. As I battle with my PCP who thinks I'm going to drop dead of a heart attack despite all the metabolic improvements I have made. I think of her position being governed by protocols established with outdated studies, if she changes her position what are the liability implications of patients, insurance and big pharma contracts. So keep it up! That mountain needs to be climbed! ❤
LMHR is a very specific phenotype for which high LDL may have a different implication. NN is not seeking to disprove the entirety of the lipidology field. This is a specific case. Many of you need to slow your roll.
I just dropped all my meds because my doctor is annoying and I don’t want to talk about it anymore. They don’t deserve my time or money. He’s fat and I’m not. Who should be telling who how to eat?
Fantastic job! Too many are "Don't confuse we with the facts! My mind is already made up!" and or their ego wont let them change their stance on the subject. If this video does not work, keep doing what you and Dave are doing and move forward and ignore the peanut gallery.
I have high HDL, high LDL, trig below 70, BMI 21. I am not worried about high LDL because on balance of all risk factors (obesity, high blood pressure, UPF intake, prediabetes - all now reduced/resolved) I would rather have high LDL than multiple other factors with a much higher association with CVD. My LDL is way up, but my blood pressure is way way down. Along with GERD, arthritis, sleep apnea, depression, psoriasis, all resolved.
Kudos. You are encouraging intelligent, unbiased discussions in the hope it will lead to better health outcomes for both individuals and the general population.
Dr Nick, first and foremost, your presentation skills are quite incredible 👏🏽 I misclicked and ended up at this video, but I stuck around because the clarity of your explanations. Very impressive. LMHR doesn't apply to me as my LDL is in the late 50s (I've been whole foods plant based for years), but I do find the concept very interesting. It's a massive departure from traditional views on LDL, but ultimately what matters is not whether or not something makes peers happy/unhappy, but whether or not something is part of a quest for truth. Whilst I'll never be doing low carb myself, I do find the LMHR theory very interesting. I genuinely hope that further LMHR studies happen in the future 🙏🏽
Recognizing the tremendous knowledge of the functional need of the human body for LDL, and how the levels of LDL respond to varying dietary and health factors, I believe that we should agree that LDL is a very important, indeed a critical component of overall health.
Great delivery of forward thinking arguments for the new sciences of cholesterol and lipidology. Keep presenting the data and studies, the medical world will be changing finally, and you will be one of the pioneers for this along with many others. Thank you for all the work you do!
Thank you for such a clear and concise overview of the disperate position that your detractors have taken. It clearly show them up for what they are. Keep up the superb work you do.
An entirely logical response which is easy to follow and understand. Well done, Nick. I'm glad you took the time to produce this piece as it helps many who are influenced by this specific misinformation. The misinformation is resultant from either ignorance, ego, monetary reasons or a combination. But whatever the reason, it's harmful of them to mislead. I hope you keep us informed of any responses by those individuals. Thanks.
Conversation and debate are not dead despite what you see in colleges. These individuals, Doctors, should be amenable to an open discussion regarding this very important topic. They are hiding in plain sight and it’s quite obvious why. Keep up the outstanding work. Thank you
You should have 10X more subscribers. Your content is far more grounded in intelligence, as well as critical , discerning, and nuanced thinking than anyone else in this space! You're pushing back at something that you said you're beginning to find frustrating. Well I find it (the willful ignorance and misleading and misinforming criticisms) infuriating. I am SO glad that someone of your intelligence and intellectual honesty is weighing in on this topic.
"You should have 10X more subscribers. Your content is far more grounded in intelligence, as well as critical , discerning, and nuanced thinking than anyone else in this space!" You're making my day!
Thank you for what you’re doing. I worked in the medical industry for over 40 years, and saw exactly what your fighting against. Please don’t stop, we need to get the information out. ❤
If low carb sends TG and HDL in the right direction, it will NOT be far-fetched to assume the LDL is equally in the right direction. The problem arose because LDL has been labeled "bad cholesterol " by the medical community. The nuances in the case of LMHR should be considered. It is well-known that inflammation is at the root of many diseases including cardiovascular and metabolic ones. Does cholesterol, a saturated lipid, cause inflammation? Saturated lipids do not have bonds that enable reactions and hence unable to cause inflammation.
@@danielmccarthyy Actually Dayspring hasn't called me anything directly. He has historically avoided any engagements with me in any form. It's an interesting behavior pattern.
I see your motives, you are unbiased. Stay on track, I’m cheering you on, my personal low carb experience is exactly as you describe, my metrics did the same as you describe.
7:00 excellent re Journal of Lipidology piece. Hopefully in show notes. Otherwise I will get it and read. very much appreciate your being cautiously optimistic.
Amazing video Nic! Sometimes a man has to do what he doesn't like but he does it because it's necessary. Congratulations! You've always been quite clear and nuanced in all your videos. This video was no exception and dare I say, you've taking it up quite a huge notch. This video is super clear, transparent and nuanced and a bulletproof response that draws the line on the sand to those opposing critics - most of which I've watched unfairly ridicule you - and that are not only perpetrating a disservice to the scientific community but to the advancement of learning and science. Keep up the groundbreaking work! 👏🏆👏
You are my favorite nerd to watch & I watch a lot of them. You are engaging, respectful, knowledgeable and come across so genuine and educated. You know youre shit and you stand up for yourself against some major assholes (Layne). Thankful for your content! 👏🏽
This might be my most liked post you have done. Very clear on what your goal is and your view. And how a few doctors are either ignorant or are “well let’s say not being completely honest”. Thank you
This is the kind of videos I want to see! Even better, if we could gather all these people in a room and make a podcast of the discussion. We understand the subject is nuanced and we have a lot of unknowns, however in a discussions between opposing forces the new research directions will be decided. Thanks for this video, I hope the people mentioned will respond to it in a meaningful and constructive manner.
I’m glad you are keeping this. Attia seems to be misusing his position by simply parroting Dayspring. & it's obvious that Daysprimg is not listening. Hopefully they will see their errors, correct them, & move on.
I love your pursuit of truth. It comes across in your vids. This is the kind of world I want to live in where actual science drives the narrative. That said, there are those “professionals” with their version of truth which, I think, is more an expression of position, ego and righteousness than it is of observable facts and ground truth. We are seeing an upwelling of that in recent years. Maybe the best way to deal with this is to just maintain YOUR position of truth and let those who resonate with truth find you, and let those who resonate with ego find them. Both are OK, but I just know the kind of world I want to live in.
I am a Lean Mass Hyper-Responders. My LDL 196 HDL106 Tri 32 Total testosterone 842 at almost 50 years old and I am in the best shape of my life. My metabolic biomarkers are optimal as well. I believe my results are not hurting my cardiovascular system and it is keeping me healthier. I have been practicing IF Restricted window 20 hours for over 4 years and I eat healthy fats and low carbs faithfully. I have changed my DNA expression/ epigenetics.
Nick, Great video! Love your approach. LDL being part of a causal chain is supported by scientific studies is an accurate statement, and yet so so much more can be said and is yet to be understood. I think what is missing in so so much of this debate is an evolutionary biology perspective, and a broader perspective that goes beyond the lipid energy model. VLDL, LDL, HDL are fundamental to our physiology.. they are mechanistic in that they have roles to perform in a complex system for which the lipid energy model sheds some light on. LDL also plays a role in the immune system. LDL is also essential for ferrying "building blocks" of fat and cholesterol used in the construction of cell membranes. A discussion that limits LDL to just being part of a causal chain while accurate as you have carefully explained is and can be misleading. As you point out.. high LDL being a normal physiological response does not actually make it casual in any way. As a principle in the case of CVD and plaque we should be highly suspect of the idea that such a fundamental component like LDL which the body makes for so so many processes would in any way be the root of the problem.. or casual. I'm sure you will respond by correcting me with a definition of casual that I am not considering... but my point is that someone needs to start describing LDL in a very very different light.. because it does so so so much more than just participate in the energy lipid model and being part of the bodies repair response to damage in our arteries. I feel like we are still very much caught up in the false debate using the Fire and fireman analogy... People keep seeing firemen at the scene of a fire and then blame the firemen. While you are focused on an energy model, LDL is participating in a damage control model as well. It is participating in a construction model as well.. and there is really no discussion of that here about all those other models. I believe that in that repair process high LD may yet take on new meanings when considering that or immune response etc etc etc. No where do I here any discussion of oxidized LDL. Maybe consider broadening the discussion about full scope of LDL to respond to all the naysayers.. like Rhonda Patrick. Maybe they need to be educated about more than just LMHR and the lipid energy model...
I don’t even understand the debate. Let’s just say hypothetically that the lmhr cohort is at risk, what’s the solution? It’s obviously not the standard diet and pharmaceutical protocols because that’s clearly not working for the majority of people.
The debate is that there are a group of individuals that hate keto/carnivore and will deny any evidence of positive health outcomes from those dietary patterns. They will frame any study suggesting such as a scam and pseudoscience and any attempt to convey or discuss the nuanced science as grift. Basically, they think the LMHR phenotype, the Lipid Energy Model, and all of Nick and team's work and literature is made up, pseudoscience grift.
One sweet potatoe per day is ,apparently, sufficient to prevent ldl elevating further in lmhr's. The carbs would partially decrease ketogenesis and its therapeutic affects , though.
Maybe the problem is you cannot teach an old dog (Dayspring, for example) new tricks. I recently met with 3 different cardiologists in a hospital after experiencing a new (relatively minor) angina episode. I've been eating low carb and more animal-based for about 5 years, and the stricter I've become, the higher my cholesterol has risen. I'm lean and similar to an LMHR but not quite (LDL-C 250 mg/dL, HDL 55 mg/dL, Trigs 75 mg/dL). I did have a triple bypass in 2016. Now, 8 years later, all 3 cardiologists felt my current angina was from my elevated cholesterol. I introduced the LMHR concept to all 3 cardiologists. They weren't interested in hearing what I had to say but I told them anyway. I ended up getting a 64-Slice CT angiogram that revealed all my bypasses were open and clear. I sometimes wonder whether they found out about my good looking CT angiogram and what they thought of it. My guess is they never followed up to see and just moved on to their next patient, carrying on with their standard beliefs. I did get some feedback from my family doctor, however. He's more familiar with me than the other cardiologists because I've been his patient for about 10 years. He knows I don't take a statin and never will. He reviewed my CT angiogram results and agreed that they revealed my bypasses were all looking great. Then he said... are you ready for this?... he said I should take a statin to lower my cholesterol. Ouch! NOTE: The general consensus is that the angina I experienced was likely on old, "native" artery that was getting tight and blocking blood flow to a small region of my heart. The angina has gone away now, maybe on its own or in part because I am now taking baby aspirin and a low-dose beta blocker (which can help alleviate angina).
" I introduced the LMHR concept to all 3 cardiologists. They weren't interested in hearing what I had to say " ... that's unfortunate. Irrespective of what their perceptions might be, the fact that a patient walks away with the notion that his doctor's are close minded to learning more is... telling
@@nicknorwitzPhD Yes, it's "telling" and it's pretty darn common. And yet quite a few doctors I follow changed their entire paradigm of treatment simply because a single patient told the doctor what they did and the doctor listened. A few that come to mind are Dr. David Unwin, Dr. Brian Mowll, and Dr. Steven Gundry (patient Big Ed).
Chris McCaskill was having (yet another!) go (yesterday) at the (in his opinion) “limited” scope of your LMHR research study results / findings once again yesterday. This division of thought / belief / re LDL doesn’t seem to be going away anytime soon!
I like Chris as a person. He's coming from a different angle. I texted him this AM aim to follow by encouraging him to watch and engage on this video and the topics covered herein. I realize it's going to stir emotions, but I hope the net effect of the discussion that arises is productive. I am optimistic. I feel like I was direct, but fair.
@@nicknorwitzPhD That’s brilliant Nick. Let’s hope these silly social-media driven diet divisions and associated cherry--picked science data can be steadily outclassed by such courteous, intelligent debate.
You're winning. And it's obvious to all, lay, professional, does not matter. Slowly but surely, a massive paradigm shift is in motion and we're winning; humanity is winning. There's still a ton more to go, much more fighting, keep up the good fight.
4:17 min: "LDL particles ApoB containing particles are part of the causal pathway of ASCVD. They are necessary but not sufficient to drive ASCVD." From what I've gathered, the mainstream (cardiologist / lipidologist) view on ASCVD is that LDL particles (ApoB) are causal, necessary AND sufficient. In discussions on why the high concentration of LDL particles (over time) is sufficient (ie, other driving factors not necessary), it's explained that hypotheses on (pre) oxidised LDL, (pre) injury (mechanical, chemical etc), (pre) inflammation, & so on, in the development of atherosclerosis, were found not to be substantiated (after 2 to 3 decades of research). Ie, these factors were not necessary as precursors in the development of ASCVD. At some point, could you elaborate more on why you don't share the view re. LDL particles (ApoB) being sufficient in the development of ASCVD? I imagine you may be referencing something else.
THANK YOU! Been Carnivore for 14 weeks. Just got a thyroid & lipid panel (NOT fasting) and the numbers freaked me out! I've never cared about cholesterol until getting my results today! 617 total, LDL 456, HDL 111- BUT TG: 210... although I had just eaten 2 eggs/3 pcs bacon & coffee with protein powder. Should I be concerned? (I'm hypothyroid, menopause & 10 lbs overweight)
Thank You! I am still obese, yet a LMHR by the numbers! BMI does affect our phenotype, but DOES NOT define it. Hoping to soon be an actually LEAN, LMHR, but know this current research direction is currently applicable to me, too. When will a study be designed, not just to determine LDL-atherosclerosis risk, but also to explicitly compare the budding LMHR data to current/historical BMI, changes in BMI and current/historical athleticism! I strongly hypothesize/believe that my historical high athleticism may have been causal to having this very specific phenotype with keto!
Do you agree with cardiovascular researcher, Dr. Malcolm Kendrick, that LDL particles, whether LARGE FLUFFY or small dense, cannot/do not damage the coronary glycocalyx and endothelium? So, no matter how many LDL's a person has floating around, there can be no atherosclerosis UNLESS something else (INSULIN RESISTANCE with high glucose) has first damaged the coronary intimal lining.
@@northerncoloradotransparen1454 You are obviously an expert. Care to elaborate on your comment? Is large fluffy a problem? Is LDL always a problem irrelevant of size? Is there never anything else involved?
5:55 The fact that very high LDL particles is a physiological response that’s possibly unique hasn’t yet convinced me that the ultimate result, elevated apoB, somehow functions in a different manner. Ie, HOW apoB ends up elevated is not yet clearly associated with any difference as to WHAT happens as a result, whether LDL receptor defect or massive ketone driven production of apoB containing particles by the hepatocytes. Reduced sub endothelial deposition, if that is in fact the case (still looking to see whether arterial dilation - which maintains lumen diameter- the first stage in plaque deposition, not stenosis, has been ruled out) would have to be explained by different phenomena such as resistance to sub endothelial deposition or higher subendothelial efflux vs influx (maybe a combo?)
Btw - shout out to @RealDaveFeldman for collegial exchange which hopefully we can continue here 3:30 - maybe you will mention it but it’s now fairly well established that hepatocytes also directly produce LDL particles. So not all LDL particles are a result of Lipo protein lipase associated transformation of VLDL to LDL. Also haven’t seen any functional HDL study to show that the HDL particles in LMHR are ideally functional.
Nick, I've met Dave a few times. He applies more caveats to his position than a teenager trying to explain a scratch on the family car! I have been one of those Carnivores: "I don't care about My LDL. It was 200 when I was 19, and it's 250 now that I am low-carb. I am NOT a LMHR. My wife appears to be!" But she has a CAC of ZERO. And the doctor no longer threatens her with a statin (She is like 360+ LDL, normal weight, not low-carb, but usually in ketosis!). Part of the problem... Doctors have lied to us about SO MANY THINGS. Our trust is gone. And as a layperson, I do see your results and I think "It doesn't matter... Blaming LDL for the plaque is like blaming firemen for fires, or scabs for cuts!" But the more I listen, the more nuanced this becomes. It's almost like the message needs to be: "LMHRs: We don't know if it is safe. And even if our studies show that it is/might be... It does NOT say anything about High Cholesterol in NON-LMHRs. Or in unhealthy people eating a SAD diet. And it will PROVE NOTHING other than what the LIMITED data will show us for a small sample size of people!". These studies are interesting because CONFUSION about why something isn't doing what you expect (think particle physics), it usually means you are on the verge of discovering something (a new particle, or in LMHRs... a different reason for LDL). Finally, Malcom Kendricks has some numbers about statins. 30yrs of statins might add 2-3 days of extra life... Are they worth the side-effects?
Thank you for treating this in a sane and logically consistent way. To be honest I've stopped listening to Layne after initially listening to his work intently. The loudness wasn't being helpful. So I'm instead going back to the papers and trying to read carefully.
Nuanced medicine doesn’t fit into a one size fits all treatment algorithm. Most docs really don’t understand this stuff to begin with and rely on treatment algorithms to come up with a plan. Keep up the good work. Fan of your channel.
In light of the precision of measure necessary in the communication of the hypothetical LMHR concept, all studies and the conversation in general, whenever possible, should immediately shift to apoB not LDL-C. LDL cholesterol is a crude estimate of apoB (ie ldl cholesterol it’s only one of three factors that determines LDL particle number, certainly in individuals, but even in group studies, particularly smaller groups studied like this. ApoB is gold standard. Plenty of evidence re discordance between LDL cholesterol and apoB especially, but not exclusively, in the insulin resistant Play by play - ie moving on to minute 3
I was wondering your views on the following case study: Takemura et al. 2024, "The impact of dietary fat type on lipid profiles in lean mass hyper‐responder phenotype" Clin Case Rep. 2024 Feb; 12(2) e8485. Note, the patient did not have the LMHR triad of high HDL-C & low TG, had the inverse (had high LDL-C and high TG in response to a ketogenic diet, but lean (BMI 23). HDL-C remained low (heavy smoker)). What was interesting is that high TG levels dropped in response to switching from high saturated fat to unsaturated fat ketogenic diet, although LDL-C remained high. It wasn't until carbohydrates were introduced that LDL-C dropped to normal range, yet TG levels remained relatively unchanged from the unsaturated fat ketogenic diet levels. Interesting all the different individual variables and responses to diets.
Dr Nick, always enjoy your videos. Straight and to the point! Once you have solved all of the world's cholesterol problems 😉, would you consider doing a video on MTHFR? I recently found out I have the heterozygus gene mutation and am in the process of doing research. It's hard because there are very few people I trust to provide good information on this topic. You would be the perfect resource!
This is the first time I’ve heard that LMHRs do not need to be thin. I’m 86kg and have lost some weight on a ketogenic diet over the last twelve months. My ldl has continued to rise, latest is 194. My HDL is 74 and triglycerides are 42. So I don’t quite meet the three criteria, and if I trust my doctor, I’m unlikely to do so as he has prescribed rosuvastatin. I went keto after my bp went up and I had a cac score of 253, possibly due to prescription of calcium tablets for osteoporosis and a high carb/ low fat diet. I’m 68, and looking forward to hearing more about this topic.
As a LMHR genotype, I have been cautious. While I am in ketosis for a significant portion of every 24 hour period; due to IF; during my feeding window, I eat significantly more carbs than someone on a ketogenic diet would. The results are Non-HDL: 214 HDL: 60 Trig: 100 So in my current state I don't match the phenotype, however, I am definitely the genotype and if I were on a strict ketogenic diet (rather than diurnally transitory keto), I'd be something like: Non HDL: 300+ HDL: >80 Trig:
@@nicknorwitzPhD yes, i realize that. More correctly stated, I am of a genotype (and have the environmental conditioning) that is compatible with expression of the LMHR phenotype. The evidence of this is that if I consume a strict ketogenic diet I have the triad, and I am able to accurately modulate the magnitude of the variables in the triad by varying my carbohydrate intake. My father was extremely lean so was my maternal grandfather. My son is 5'9" 108 lbs and I am 6'1" 135 lbs. I used to he on a high carb crap diet and my LDL was absolutely fine according to my doctor, but all my other markers were horrible. Now, on a low carb diet (~50g/day) every one of my other labs (besides non HDL cholesterol) are *perfect*.
Thanks for making this. It was very clarifying and I hope everyone watches it. I understand better your issues with Thomas Dayspring and for me, I hear nonstop that you and Dave have proved that Ken Berry is right and the idea that high cholesterol can be harmful is a lie (quoted from his best-selling book). I think it was an important clarification to hear you say that LDL can be associated with increasing risks of heart disease.
@@nicknorwitzPhD Yes, chapter 5 of his best-selling book leaves absolutely no doubt. He makes it clear higher is better. Here's just one quote: "the published fact that most patients who have a heart attack have a cholesterol level of less than 200." No mention of FH. Just mentions that it's a lie and we'll look back on the cholesterol theory of heart disease with shame and embarrassment.
@@Viva-Longevity Haven't read his book. If there is a video (esp from the past year) where he or Shawn or any major low carb influencer says explicitly "LDL doesn't matter" in heart disease and you can provide a link, I'm happy to try to be a voice of nuance and reason.
@@nicknorwitzPhD They're all over the Internet, no? They go further to say higher LDL is better. If you're up for a game of whack-a-mole, you can start with Chaffee. ruclips.net/video/fpiRxen9gNk/видео.htmlsi=G4bu5LKIzY8nRvPA
I enjoyed your careful breakdown of exactly why the meme that doctor posted was inappropriate and does a disservice to anyone who sees it and society at large. It’s like I paid someone to articulate using only logic why I’m feeling a certain way
Thanks so much for this clear discussion. I will re-listen for sure and watch your other videos. I have been off and on keto/carnivore for over a year - recently in Feb - shifting to a Primal approach with carbs @50 g. Recent bloodwork has me meeting your criteria- LMHR and my Dr wants me on statins. I am not ‘lean’ with about 10 lbs to lose - 😂acknowledge that you are clear what the criteria are. My gamma GT was elevated as well. So more research to do. Sigh. I feel great eating low carb high fat.
Thank you Nick! We support your selfless search for our optimal health while encountering the falsehoods & closedmindedness from obvious big pharma advocates. Keep up the awesome work!
Could you do an explanatory video about the “ normal “ population please. You explain things so well. I am not capable of understanding the technical papers and my Dr does not explain. Quite happy that I am in no way a lean mass anything but I do need to be keto for T2 diabetes.
Stay tuned for my conversation with @theProof (Simon Hill). I hope we will cover the distinction about LDL/ApoB in the "normal" population vs LMHR in depth, approaching it from new angles with new articulations. I'm counting on him to "push me" there.
@@nicknorwitzPhD Looking forward to that discussion, I am relieved when two people from opposing views are able to sit together and talk science. You rarely ever see that, unfortunately..
Thank you for your presentations & for providing links to the papers. I asked another RUclipsr to provide links to her cited studies. She gave me the excuse that she can’t because RUclips frowns on this practice. She asked me to email her. I now assume she has nothing to back up her video presentation on hormones. Thanks for being honest & informative!
Low carb is low sugar -> low stimulation of glp-1 and therefore less stimulation of glp-1 receptor on the lymphatic sensory neurons where there is less stimulation of TRPV1 on the neurolymphocrine system defined in the 2020 Berkeley study. This leads to less stimulation of insulin and less stimulation of TRPV1 by insulin leading to less glucose metabolism and mitochondrial production of ROS and less lipid oxidation and peroxidation. Additionally on a normal carbohydrate diet both TRPV1 and TRPV4 are up-regulated and increase NO and vascular relaxation but also changes the endothelial intercellular junctions and leads to a weaker endothelial layer that breaks in atherosclerosis. You will see increase in TRPV4 and klf4 in active atherosclerosis.
@@stellasternchen wow, please ck out TRP channels particularly sugar glp-1, glp-1 receptor and TRPV1 insulin stimulation and mitochondrial function. Here’s a start: 2020 Berkeley study Reveals the neurolymphocrine system. Are you familiar with how this works? Glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide stimulate release of substance P from TRPV1- and TRPA1-expressing sensory nerves Here’s how insulin stimulates TRPV1 and TRPV1 puts glucose into the cell independent of the insulin receptor 2021 TRPV1 Activation by Capsaicin Mediates Glucose Oxidation and ATP Production Independent of Insulin Signalling in Mouse Skeletal Muscle Cells TRPV1 increases ROS in mitochondria 2020 TRPV1 and mitochondrial dysfunction TRPV1 Channel: A Noxious Signal Transducer That Affects Mitochondrial Function Drs. Julius and Patapoutian shared the 2021 Nobel Prize first their discovery of TRPV1 and Piezo 1 in humans. These channels are highly conserved in our systems since the prokaryotic level of evolution in the kingdom of Animalia and are essential to life in our system. The more you learn about them the more amazed you will be at their ability to respond to multiple stimuli and each other in every cell in our bodies.
LMHR...that's me! Carnivore 6 months...heart attack 2 months in. Still down the rabbit hole of testing. CHC next week. Thinking I should decrease red meat and have more variety.
Good video. I like that you point out, and are ultimately motivated by, the need for an accurate assessment of the pros and cons of carb restriction. The list of pros is getting pretty extensive, from mental health and bowel problems, to it's success reversing the conditions of the great epidemic of our times in obesity and metabolic syndrome. The primary con with respect to individual health has always been "but it might sometimes raise your LDL". People who are seeing benefit are rightly motivated to put that assumption under the microscope and tease out the intricacies with an open mind. The establishment response to that questioning strikes me as knee-jerk, irrational and anti-science as the examples you put forward demonstrate. It's evidence, in my mind, of some deeper ideological commitment being threatened.
6:25 Maybe other people have been making such an argument, but it seems like a strawman to me. I certainly don’t think it’s a “abnormal” response to have super high cholesterol in the face of a very high saturated fat and dietary cholesterol intake. can you point out who has been saying that it’s an abnormal response to have very high LDL on keto when one is lean? Or did I miss something?
Great video. I'm not a lean mass hyper responder, but if I stayed on carnivore long enough, I probably would get there since a lot of my numbers are Pretty Close. I have a lot of patients Who I work with to help them with Weight loss and I go through their blood work to tell them where I think they can change things up. And what's going on with your body. Most doctors refused to do a fasting insulin and tell the person starts having prediabetes. I find this very annoying. You can have a great fasting, insulin and a great A1C. And your insulin Could be through the roof.
I find it shocking the number of people that think measuring glucose is a suitable proxy for insulin: they think low glucose means low insulin. How many of these people have good glucose/A1c and sky high insulin???
@@descai10 Many people are getting long term elevated insulin. That's the point. They are measuring good glucose but don't realise their insulin is often high, to keep glucose lower. Eating carbs (sugar) 6 times a day with meals and snacks is 6 spikes of both glucose and insulin. For most people that is constantly high insulin and that will catch up with them.
I'm guilty of believing the LMHR group was pushing high LDL-c was "ok". My fault. YES, agree no one is pushing or should be pushing it is ok. Agree, we don't yet know what we don't know. Agree with all things case by case, person by person.
![I.N "HALLUCINATION" | [Stray Kids : SKZ-PLAYER]](http://i.ytimg.com/vi/n5B5q1Hwt_U/mqdefault.jpg)
I was so engaged in the delivery and content of your argument that when finished I left the site dazzled but realized I’d forgotten to hit the thumbs up so I came back & did. You’re a warrior, man, of the truth and you bring the data & studies to support your assertions and counter arguments. It’s a beautiful thing. I’m counting on people like you to change the medical world for the better for us all if they don’t crush you first. They are coming at you and you did an excellent and bold job pushing back. Keep at it my friend and thank you for doing so.
Deeply appreciated!
@@aliciastanley5582 I agree Alicia
You make it so clear that only an MD can misunderstand it!
Funny. In all seriousness, I don't know how I can be more clear. I hope you found my "accusations" at 9:00 minutes and beyond well reasoned, if quite direct.
@@nicknorwitzPhD Paraphrasing, "Here's the published research; I've cited it for you more than once; you're not only ignoring it, you're claiming that it doesn't exist. Therefore, you're just flat wrong." How much more well-reasoned could you have been?
Laughed out loud.
Lame Norton isn’t a MD
@@robbanks1436 Yeah I was wrong LOL
Solid intro. Thanks for not wasting my time. The doctors making mistakes publicly, need to be called out and given a polite opportunity to retract or correct. And if they persist, they must be held accountable. Maybe create a LMHR Disinformation Hall of Shame.
"The doctors making mistakes publicly, need to be called out and given a polite opportunity to retract or correct. And if they persist, they must be held accountable." 100% agree.
Don’t quit Nick! We need doctors like you to explain this stuff. And yes ..we can learn more from doctors on RUclips because our doctors don’t care to take the time to learn or want to bother to explain things to us. I have absolutely zero faith in mainstream medicine anymore.
Your frustration is long overdue and frankly surprising it's taken this long to surface. Don't allow these nay sayers get to you the work you do is so needed and appreciated. Only with clear verifiable and unbiased data can we learn and understand what the facts are. The false data is getting so bad that many people don't believe anything a MD has to say.
You are so right about that. My distrust for standard medicine has been growing in leaps and bounds as I see it reflecting more ignorance, corruption, and greed all the time. So very sad for our country. Yet, I still have hope but we all must speak out and confront them. We need a country-wide organization that represents medical patients on a whole range of issues with an education arm to make the public aware of things and organize those that have concern,a lobbying arm of keto and carnivore people and other Americans who want to see more transparency, functional doctors in insurance networks, naturopathic doctors, real supplement accountability, a quarterly magazine to educate members of our organization of new upcoming issues and old ones not adequately addressed. And more.
"getting so bad that many people don't believe anything a MD" ... that's - sorta' - what I'm so afraid of and pointing out ... when egos are so large they can't see their own clear misinformation, it gets called out, and discredits the community ... dangerous situation
This vid should be watched by everyone in medical school. What a great presentation. For me, as a non-scientist, non- medical person, such a presentation helps me spot and learn to identify the useless crap in arguments.
no way
Thank you. Appreciate it.
It wont be watched in medical school because its pseudoscience. In the end you should be glad that people actually saving your life when you get stroke/Heart attack or whatever due to poor life choices werent educated on pseudoscience.
Your integrity and clarity is sky high. Loyal to the scientific endeavor. Great work.
Thank you very much!!!
I actually think that his integrity is very suspect. He says nothing about all of the carnivore doctors that say that LDL-C is meaningless and cite LMHR as the justification for their proposition. I don’t think he’s a charlatan in the same way that they are but birds of a feather.
@@davidzip8841 why is Nick responsible for any of those folks? How does “Birds of a feather” apply when Nick takes bgreat pains to distinguish his view from others?
Regarding Dayspring and others mentioned here, this is human ego on full display. This represents the inability to backtrack and say, maybe I was wrong or what I believed was possibly wrong. The curiosity has left the building. To Nick and team, nicely done and very necessary.
Even those who are Dayspring fans can't deny his arrogance is a bit "much," and there are some examples here where he's clearly speaking as an expert on something he hasn't taken the time to properly research. That may sound arrogant coming from me, but for those who watch the video in full, I think it's undeniable. Doesn't mean he isn't smart and informed on other matters or in general, but... here... on this specific topic...
They will continue to attack you, you are young, intelligent, not willing to simplify follow, but actually have a scientific mind that looks for facts. This goes against their rules. Please stay strong, the world needs you and you are being an positive role model for others like you. At this point in human history when society has lost all trust in the medical profession, you are a ray of hope.
☀️☀️☀️☀️☀️
You are a delight to listen to. This 73 year old ASD woman loves to geek out with you. I am carnivore with high ldl.
Well love that you love to geek out with me. Will never say no to that, irrespective of your dietary preferences :).
@@nicknorwitzPhD I help clients with metabolic health issues. I always send them your vids.
I’m content to let you scientists fight out the truth about LMHR’s and LDL. Thank you for your work. Meanwhile, I will continue to live my life in the healed condition from day-by-day agonising IBS (and many other issues) Fatty meat ,eggs and a little fish for me👍
I completely understand where you are coming from, per my commentary about my own background mentioned just after 9 min into this video and covered/disclosed elsewhere.
I went full Carnivore in December 2023 and I have lost 35lbs in 3 months to get to my target weight. I wanted to be healthy again and get away from Carbs. I am now off all my blood pressure meds, I feel young again. My Migraine headaches are gone and now I'm on a Keto Diet. My Doctor was concerned but she had been on a Keto diet for 3 years and understood. She wanted to do an EKG and blood work as she was concerned. I just went on Medicare and physicals are not a thing. So I have no idea what my numbers are but damn I feel good now. I wake up in the morning and feel like a million bucks. When I was eating the IC it diet I always felt lethargic. Once my Doc saw my blood pressure she told me to quit my meds. I'm happy and won't change a thing. 😄
That's an encouraging personal story for me Annette and congratulations on your success. That's a situation I can relate to personally having gone keto six months ago to address an IBS (SIBO) condition that developped as a result of a food poisoning instance. However, I have suffered a relapse of my symptoms three weeks ago, so I'm not completely out of the woods yet.
@@JesusMartinez-mk6fc I certainly don’t have all the answers and am forever ‘tweeting’ and experimenting with what I eat. I don’t think my gut is totally healed, but am sure I am more comfortable eating high fat / low fibre foods. I’ve spent years and years trying to discover why eating food ends up causing me gut pain, all the whole trying to eat ‘healthily’ according to nutrition advisors and guidelines. Good luck with your journey.
I respect people who say “I don’t know” because most of them will persevere in finding out. Science is all about finding out. I am intensely interested in learning more. Thanks NN.
You're welcome!
Keep it up, Nick!
Here is why. They're scared! A lifelong career in what you believed is wrong is a huge mountain to climb if motivated to do so.
As I battle with my PCP who thinks I'm going to drop dead of a heart attack despite all the metabolic improvements I have made. I think of her position being governed by protocols established with outdated studies, if she changes her position what are the liability implications of patients, insurance and big pharma contracts.
So keep it up! That mountain needs to be climbed! ❤
LMHR is a very specific phenotype for which high LDL may have a different implication. NN is not seeking to disprove the entirety of the lipidology field. This is a specific case. Many of you need to slow your roll.
I just dropped all my meds because my doctor is annoying and I don’t want to talk about it anymore. They don’t deserve my time or money. He’s fat and I’m not. Who should be telling who how to eat?
Fantastic job! Too many are "Don't confuse we with the facts! My mind is already made up!" and or their ego wont let them change their stance on the subject. If this video does not work, keep doing what you and Dave are doing and move forward and ignore the peanut gallery.
Yes! Thank you!
I have high HDL, high LDL, trig below 70, BMI 21. I am not worried about high LDL because on balance of all risk factors (obesity, high blood pressure, UPF intake, prediabetes - all now reduced/resolved) I would rather have high LDL than multiple other factors with a much higher association with CVD. My LDL is way up, but my blood pressure is way way down. Along with GERD, arthritis, sleep apnea, depression, psoriasis, all resolved.
People who say it cannot be done, should not interrupt those who are doing it
True
Absolutely brilliant Nick! Very nuanced, polite, yet challenging to detractors. Well done!
Thanks for this. And thanks for listening
Thank you, Nick, for this Clear Restatement of your position and current science! Carry on!
I will carry on. People are finding surprisingly hard to beat down 😅
Kudos. You are encouraging intelligent, unbiased discussions in the hope it will lead to better health outcomes for both individuals and the general population.
Thanks 😊
Its difficult to get someone to understand something when their job depends on them not understanding it.
I'm not sure I'd ascribe the intent to mislead to all these cases... in many I think it's as simple as ignorance. It's hard to know intent
Exactly!!!
Dr Nick, first and foremost, your presentation skills are quite incredible 👏🏽 I misclicked and ended up at this video, but I stuck around because the clarity of your explanations. Very impressive. LMHR doesn't apply to me as my LDL is in the late 50s (I've been whole foods plant based for years), but I do find the concept very interesting. It's a massive departure from traditional views on LDL, but ultimately what matters is not whether or not something makes peers happy/unhappy, but whether or not something is part of a quest for truth. Whilst I'll never be doing low carb myself, I do find the LMHR theory very interesting. I genuinely hope that further LMHR studies happen in the future 🙏🏽
Recognizing the tremendous knowledge of the functional need of the human body for LDL, and how the levels of LDL respond to varying dietary and health factors, I believe that we should agree that LDL is a very important, indeed a critical component of overall health.
Great delivery of forward thinking arguments for the new sciences of cholesterol and lipidology. Keep presenting the data and studies, the medical world will be changing finally, and you will be one of the pioneers for this along with many others. Thank you for all the work you do!
Thanks a million
It seems to me that jealousy makes people nasty. Keep it up Nicolas. You are doing excellent work.
Thank you very much!
Thank you for such a clear and concise overview of the disperate position that your detractors have taken. It clearly show them up for what they are. Keep up the superb work you do.
Thank you kindly
Well-crafted address to set the record straight! I think I've watched every video on your channel. I appreciate your diligence and rigor!
Thank you so much :). I appreciate it!
An entirely logical response which is easy to follow and understand. Well done, Nick. I'm glad you took the time to produce this piece as it helps many who are influenced by this specific misinformation. The misinformation is resultant from either ignorance, ego, monetary reasons or a combination. But whatever the reason, it's harmful of them to mislead. I hope you keep us informed of any responses by those individuals. Thanks.
Appreciate this. It’s sounding like I achieved my goal and I hold out hope, especially for Layne and Dayspring
Thank you for a science logic based argument. Excited to see your voice rise because you are greatly needed in this world.
More to come! And thanks!
Conversation and debate are not dead despite what you see in colleges. These individuals, Doctors, should be amenable to an open discussion regarding this very important topic. They are hiding in plain sight and it’s quite obvious why. Keep up the outstanding work. Thank you
Thank you for watching, evaluating and engaging openly and honestly
This was awesome. Clear, to the point, unflinching. Much needed in this medical / industrial complex. Bravo!
You’re welcome
You should have 10X more subscribers. Your content is far more grounded in intelligence, as well as critical , discerning, and nuanced thinking than anyone else in this space! You're pushing back at something that you said you're beginning to find frustrating. Well I find it (the willful ignorance and misleading and misinforming criticisms) infuriating. I am SO glad that someone of your intelligence and intellectual honesty is weighing in on this topic.
"You should have 10X more subscribers. Your content is far more grounded in intelligence, as well as critical , discerning, and nuanced thinking than anyone else in this space!" You're making my day!
I totally agree 100%! Nick is amazing and I'm so grateful to have found his channel.
Thank you for all that you do for the LMHR community 💖💖💖
Thank you for what you’re doing. I worked in the medical industry for over 40 years, and saw exactly what your fighting against. Please don’t stop, we need to get the information out. ❤
Best video ever! Finally someone who stands up against the corrupt mainstream doctors! 👍👍
Glad you liked the video ☺️…
It is clearly corruption when doctors choose their easy paycheck from the drug companies over their patients lives.
If low carb sends TG and HDL in the right direction, it will NOT be far-fetched to assume the LDL is equally in the right direction. The problem arose because LDL has been labeled "bad cholesterol " by the medical community. The nuances in the case of LMHR should be considered. It is well-known that inflammation is at the root of many diseases including cardiovascular and metabolic ones. Does cholesterol, a saturated lipid, cause inflammation? Saturated lipids do not have bonds that enable reactions and hence unable to cause inflammation.
Interesting perspective. Dayspring hereby labels you “LDL Denier and Heretic”.
"The nuances in the case of LMHR should be considered." - With this, I agree fully.
We should ignore the last 100 plus years of science?
@@danielmccarthyy Actually Dayspring hasn't called me anything directly. He has historically avoided any engagements with me in any form. It's an interesting behavior pattern.
@@northerncoloradotransparen1454 Please elaborate.
I see your motives, you are unbiased. Stay on track, I’m cheering you on, my personal low carb experience is exactly as you describe, my metrics did the same as you describe.
Such refreshing nuance and clear speaking and thinking.
Cheers
7:00 excellent re Journal of Lipidology piece. Hopefully in show notes. Otherwise I will get it and read. very much appreciate your being cautiously optimistic.
Tyvm
Amazing video Nic! Sometimes a man has to do what he doesn't like but he does it because it's necessary. Congratulations! You've always been quite clear and nuanced in all your videos. This video was no exception and dare I say, you've taking it up quite a huge notch. This video is super clear, transparent and nuanced and a bulletproof response that draws the line on the sand to those opposing critics - most of which I've watched unfairly ridicule you - and that are not only perpetrating a disservice to the scientific community but to the advancement of learning and science. Keep up the groundbreaking work! 👏🏆👏
Appreciate that Jesus.
I really appreciate this opportunity to hear you explain .... Wonderful keep your 🏒 on the ice.....
You are my favorite nerd to watch & I watch a lot of them. You are engaging, respectful, knowledgeable and come across so genuine and educated. You know youre shit and you stand up for yourself against some major assholes (Layne). Thankful for your content! 👏🏽
Thanks 😊
This might be my most liked post you have done.
Very clear on what your goal is and your view. And how a few doctors are either ignorant or are “well let’s say not being completely honest”.
Thank you
Glad you enjoyed it and thought it had value.
It's good to see this all in one place. I've bookmarked this one.
Sweet!
Thank you for your research. May you be blessed.
Thanks! I feel that way most days
This is the kind of videos I want to see! Even better, if we could gather all these people in a room and make a podcast of the discussion. We understand the subject is nuanced and we have a lot of unknowns, however in a discussions between opposing forces the new research directions will be decided. Thanks for this video, I hope the people mentioned will respond to it in a meaningful and constructive manner.
I’m glad you are keeping this. Attia seems to be misusing his position by simply parroting Dayspring. & it's obvious that Daysprimg is not listening. Hopefully they will see their errors, correct them, & move on.
Nope… he’s not listening 🙉
Thank you for the work y'all are doing, and for making the effort to inform us, which mainstream medical would never do!! I am a hyper-responder.
There are more and more LMHR (or there are more and more being noticed...)... awareness is generally good imho
Stuff like this makes me appreciate how people like Dr Mike handle disagreement.
Thanks for slowing down your speaking tempo. For us layman trying to learn it is helpful.
You are welcome
@@nicknorwitzPhDMostly for french people 😉
You gave us, in the past, how to eat and lower our ldl, which I appreciated.
I did. Thanks for noticing.
Great presentation and happy you kept your calm
Thanks... I wonder what % of viewers agree?
I love your pursuit of truth. It comes across in your vids. This is the kind of world I want to live in where actual science drives the narrative. That said, there are those “professionals” with their version of truth which, I think, is more an expression of position, ego and righteousness than it is of observable facts and ground truth. We are seeing an upwelling of that in recent years.
Maybe the best way to deal with this is to just maintain YOUR position of truth and let those who resonate with truth find you, and let those who resonate with ego find them. Both are OK, but I just know the kind of world I want to live in.
Very nicely put
I am a Lean Mass Hyper-Responders. My LDL 196 HDL106 Tri 32 Total testosterone 842 at almost 50 years old and I am in the best shape of my life. My metabolic biomarkers are optimal as well. I believe my results are not hurting my cardiovascular system and it is keeping me healthier. I have been practicing IF Restricted window 20 hours for over 4 years and I eat healthy fats and low carbs faithfully. I have changed my DNA expression/ epigenetics.
THANK YOU SOOOO much for this refreshing video!! I am one of your superfans!!!!
AWE! You're making my heart melt 😉
@@nicknorwitzPhD Is that a good thing for metabolic health?😜
@@sunshinemama9143 A molten heart... don't think so... is there a med for that?
Thanks for the video. I could understand it as a layman. Looking forward to more research on LMHR as I am on keto diet and fasting.
Finally someone honest and most importantly - non biased and prejudiced .
Appreciate it :).
This is a very clear hypothesis; maybe that's why some doctors can't grasp it?
What if I make into a music video?
@@nicknorwitzPhD tiktok dances are popular with Doctors and nurses....
@@nicknorwitzPhDBe sure it doesn’t have more than 3 chords.
A closed minded Doctor can be critically dangerous. Their egos are shameful. Thank you, Nick. Keep up the good fight!
🥊🥊🥊
I needed this. I am up and down as to what to do with my extremely high LDL and ApoB I am this category for sure. My doctor is having a melt down.
Nick, Great video! Love your approach. LDL being part of a causal chain is supported by scientific studies is an accurate statement, and yet so so much more can be said and is yet to be understood. I think what is missing in so so much of this debate is an evolutionary biology perspective, and a broader perspective that goes beyond the lipid energy model. VLDL, LDL, HDL are fundamental to our physiology.. they are mechanistic in that they have roles to perform in a complex system for which the lipid energy model sheds some light on. LDL also plays a role in the immune system. LDL is also essential for ferrying "building blocks" of fat and cholesterol used in the construction of cell membranes. A discussion that limits LDL to just being part of a causal chain while accurate as you have carefully explained is and can be misleading. As you point out.. high LDL being a normal physiological response does not actually make it casual in any way. As a principle in the case of CVD and plaque we should be highly suspect of the idea that such a fundamental component like LDL which the body makes for so so many processes would in any way be the root of the problem.. or casual. I'm sure you will respond by correcting me with a definition of casual that I am not considering... but my point is that someone needs to start describing LDL in a very very different light.. because it does so so so much more than just participate in the energy lipid model and being part of the bodies repair response to damage in our arteries. I feel like we are still very much caught up in the false debate using the Fire and fireman analogy... People keep seeing firemen at the scene of a fire and then blame the firemen. While you are focused on an energy model, LDL is participating in a damage control model as well. It is participating in a construction model as well.. and there is really no discussion of that here about all those other models. I believe that in that repair process high LD may yet take on new meanings when considering that or immune response etc etc etc. No where do I here any discussion of oxidized LDL. Maybe consider broadening the discussion about full scope of LDL to respond to all the naysayers.. like Rhonda Patrick. Maybe they need to be educated about more than just LMHR and the lipid energy model...
This is a good video. Rational. Calmly presented. Nuanced. Subbed.
Welcome aboard!
I don’t even understand the debate. Let’s just say hypothetically that the lmhr cohort is at risk, what’s the solution? It’s obviously not the standard diet and pharmaceutical protocols because that’s clearly not working for the majority of people.
The debate is that there are a group of individuals that hate keto/carnivore and will deny any evidence of positive health outcomes from those dietary patterns. They will frame any study suggesting such as a scam and pseudoscience and any attempt to convey or discuss the nuanced science as grift.
Basically, they think the LMHR phenotype, the Lipid Energy Model, and all of Nick and team's work and literature is made up, pseudoscience grift.
One sweet potatoe per day is ,apparently, sufficient to prevent ldl elevating further in lmhr's. The carbs would partially decrease ketogenesis and its therapeutic affects , though.
the majority of people don't actually follow the recommended diets, they eat the SAD diet
Maybe the problem is you cannot teach an old dog (Dayspring, for example) new tricks. I recently met with 3 different cardiologists in a hospital after experiencing a new (relatively minor) angina episode. I've been eating low carb and more animal-based for about 5 years, and the stricter I've become, the higher my cholesterol has risen. I'm lean and similar to an LMHR but not quite (LDL-C 250 mg/dL, HDL 55 mg/dL, Trigs 75 mg/dL). I did have a triple bypass in 2016. Now, 8 years later, all 3 cardiologists felt my current angina was from my elevated cholesterol. I introduced the LMHR concept to all 3 cardiologists. They weren't interested in hearing what I had to say but I told them anyway. I ended up getting a 64-Slice CT angiogram that revealed all my bypasses were open and clear. I sometimes wonder whether they found out about my good looking CT angiogram and what they thought of it. My guess is they never followed up to see and just moved on to their next patient, carrying on with their standard beliefs. I did get some feedback from my family doctor, however. He's more familiar with me than the other cardiologists because I've been his patient for about 10 years. He knows I don't take a statin and never will. He reviewed my CT angiogram results and agreed that they revealed my bypasses were all looking great. Then he said... are you ready for this?... he said I should take a statin to lower my cholesterol. Ouch! NOTE: The general consensus is that the angina I experienced was likely on old, "native" artery that was getting tight and blocking blood flow to a small region of my heart. The angina has gone away now, maybe on its own or in part because I am now taking baby aspirin and a low-dose beta blocker (which can help alleviate angina).
" I introduced the LMHR concept to all 3 cardiologists. They weren't interested in hearing what I had to say " ... that's unfortunate. Irrespective of what their perceptions might be, the fact that a patient walks away with the notion that his doctor's are close minded to learning more is... telling
@@nicknorwitzPhD Yes, it's "telling" and it's pretty darn common. And yet quite a few doctors I follow changed their entire paradigm of treatment simply because a single patient told the doctor what they did and the doctor listened. A few that come to mind are Dr. David Unwin, Dr. Brian Mowll, and Dr. Steven Gundry (patient Big Ed).
Chris McCaskill was having (yet another!) go (yesterday) at the (in his opinion) “limited” scope of your LMHR research study results / findings once again yesterday. This division of thought / belief / re LDL doesn’t seem to be going away anytime soon!
I like Chris as a person. He's coming from a different angle. I texted him this AM aim to follow by encouraging him to watch and engage on this video and the topics covered herein. I realize it's going to stir emotions, but I hope the net effect of the discussion that arises is productive. I am optimistic. I feel like I was direct, but fair.
@@nicknorwitzPhD That’s brilliant Nick. Let’s hope these silly social-media driven diet divisions and associated cherry--picked science data can be steadily outclassed by such courteous, intelligent debate.
You're winning. And it's obvious to all, lay, professional, does not matter. Slowly but surely, a massive paradigm shift is in motion and we're winning; humanity is winning. There's still a ton more to go, much more fighting, keep up the good fight.
Thanks! We need and will have our metabolic health revolution
4:17 min: "LDL particles ApoB containing particles are part of the causal pathway of ASCVD. They are necessary but not sufficient to drive ASCVD."
From what I've gathered, the mainstream (cardiologist / lipidologist) view on ASCVD is that LDL particles (ApoB) are causal, necessary AND sufficient.
In discussions on why the high concentration of LDL particles (over time) is sufficient (ie, other driving factors not necessary), it's explained that hypotheses on (pre) oxidised LDL, (pre) injury (mechanical, chemical etc), (pre) inflammation, & so on, in the development of atherosclerosis, were found not to be substantiated (after 2 to 3 decades of research). Ie, these factors were not necessary as precursors in the development of ASCVD.
At some point, could you elaborate more on why you don't share the view re. LDL particles (ApoB) being sufficient in the development of ASCVD?
I imagine you may be referencing something else.
Thank you for the work you are doing.
My pleasure!
Thanks Nick appreciate your candor.
Always!
THANK YOU! Been Carnivore for 14 weeks. Just got a thyroid & lipid panel (NOT fasting) and the numbers freaked me out! I've never cared about cholesterol until getting my results today! 617 total, LDL 456, HDL 111- BUT TG: 210... although I had just eaten 2 eggs/3 pcs bacon & coffee with protein powder. Should I be concerned? (I'm hypothyroid, menopause & 10 lbs overweight)
Thank You! I am still obese, yet a LMHR by the numbers! BMI does affect our phenotype, but DOES NOT define it. Hoping to soon be an actually LEAN, LMHR, but know this current research direction is currently applicable to me, too.
When will a study be designed, not just to determine LDL-atherosclerosis risk, but also to explicitly compare the budding LMHR data to current/historical BMI, changes in BMI and current/historical athleticism! I strongly hypothesize/believe that my historical high athleticism may have been causal to having this very specific phenotype with keto!
Do you agree with cardiovascular researcher, Dr. Malcolm Kendrick, that LDL particles, whether LARGE FLUFFY or small dense, cannot/do not damage the coronary glycocalyx and endothelium? So, no matter how many LDL's a person has floating around, there can be no atherosclerosis UNLESS something else (INSULIN RESISTANCE with high glucose) has first damaged the coronary intimal lining.
NO WAY
@@northerncoloradotransparen1454 You are obviously an expert. Care to elaborate on your comment? Is large fluffy a problem? Is LDL always a problem irrelevant of size? Is there never anything else involved?
5:55 The fact that very high LDL particles is a physiological response that’s possibly unique hasn’t yet convinced me that the ultimate result, elevated apoB, somehow functions in a different manner.
Ie, HOW apoB ends up elevated is not yet clearly associated with any difference as to WHAT happens as a result, whether LDL receptor defect or massive ketone driven production of apoB containing particles by the hepatocytes.
Reduced sub endothelial deposition, if that is in fact the case (still looking to see whether arterial dilation - which maintains lumen diameter- the first stage in plaque deposition, not stenosis, has been ruled out) would have to be explained by different phenomena such as resistance to sub endothelial deposition or higher subendothelial efflux vs influx (maybe a combo?)
Btw - shout out to @RealDaveFeldman for collegial exchange which hopefully we can continue here
3:30 - maybe you will mention it but it’s now fairly well established that hepatocytes also directly produce LDL particles. So not all LDL particles are a result of Lipo protein lipase associated transformation of VLDL to LDL.
Also haven’t seen any functional HDL study to show that the HDL particles in LMHR are ideally functional.
Nick, I've met Dave a few times. He applies more caveats to his position than a teenager trying to explain a scratch on the family car!
I have been one of those Carnivores: "I don't care about My LDL. It was 200 when I was 19, and it's 250 now that I am low-carb. I am NOT a LMHR. My wife appears to be!" But she has a CAC of ZERO. And the doctor no longer threatens her with a statin (She is like 360+ LDL, normal weight, not low-carb, but usually in ketosis!).
Part of the problem... Doctors have lied to us about SO MANY THINGS. Our trust is gone. And as a layperson, I do see your results and I think "It doesn't matter... Blaming LDL for the plaque is like blaming firemen for fires, or scabs for cuts!"
But the more I listen, the more nuanced this becomes. It's almost like the message needs to be: "LMHRs: We don't know if it is safe. And even if our studies show that it is/might be... It does NOT say anything about High Cholesterol in NON-LMHRs. Or in unhealthy people eating a SAD diet. And it will PROVE NOTHING other than what the LIMITED data will show us for a small sample size of people!".
These studies are interesting because CONFUSION about why something isn't doing what you expect (think particle physics), it usually means you are on the verge of discovering something (a new particle, or in LMHRs... a different reason for LDL).
Finally, Malcom Kendricks has some numbers about statins. 30yrs of statins might add 2-3 days of extra life... Are they worth the side-effects?
"He applies more caveats to his position than a teenager trying to explain a scratch on the family car!" -- LOL!
I see people like NN and DF as explorers. Rather than denigrating them, real scientists should be cheering them on.
I agree… not that I’m biased or anything 😂
Hurts them to lose those easy kickbacks from big pharma. That corruption won’t fall easily.
@@nicknorwitzPhD Just keep doing what engineers do. Figure stuff out.
Love a classy clap back 😬🙌🏾
👏👏👏
Thank you for treating this in a sane and logically consistent way. To be honest I've stopped listening to Layne after initially listening to his work intently. The loudness wasn't being helpful. So I'm instead going back to the papers and trying to read carefully.
Good for you! Hopefully you feel I can do better
Best video yet. Unfortunately, air tight, irrefutable spiciness in regard to many not willing to address new information is fully necessary.
Necessary but not sufficient
Nuanced medicine doesn’t fit into a one size fits all treatment algorithm. Most docs really don’t understand this stuff to begin with and rely on treatment algorithms to come up with a plan.
Keep up the good work. Fan of your channel.
In light of the precision of measure necessary in the communication of the hypothetical LMHR concept, all studies and the conversation in general, whenever possible, should immediately shift to apoB not LDL-C.
LDL cholesterol is a crude estimate of apoB (ie ldl cholesterol it’s only one of three factors that determines LDL particle number, certainly in individuals, but even in group studies, particularly smaller groups studied like this.
ApoB is gold standard. Plenty of evidence re discordance between LDL cholesterol and apoB especially, but not exclusively, in the insulin resistant
Play by play - ie moving on to minute 3
I was wondering your views on the following case study:
Takemura et al. 2024,
"The impact of dietary fat type on lipid profiles in lean mass hyper‐responder phenotype"
Clin Case Rep. 2024 Feb; 12(2) e8485.
Note, the patient did not have the LMHR triad of high HDL-C & low TG, had the inverse (had high LDL-C and high TG in response to a ketogenic diet, but lean (BMI 23). HDL-C remained low (heavy smoker)). What was interesting is that high TG levels dropped in response to switching from high saturated fat to unsaturated fat ketogenic diet, although LDL-C remained high. It wasn't until carbohydrates were introduced that LDL-C dropped to normal range, yet TG levels remained relatively unchanged from the unsaturated fat ketogenic diet levels.
Interesting all the different individual variables and responses to diets.
Dr Nick, always enjoy your videos. Straight and to the point! Once you have solved all of the world's cholesterol problems 😉, would you consider doing a video on MTHFR? I recently found out I have the heterozygus gene mutation and am in the process of doing research. It's hard because there are very few people I trust to provide good information on this topic. You would be the perfect resource!
This is the first time I’ve heard that LMHRs do not need to be thin. I’m 86kg and have lost some weight on a ketogenic diet over the last twelve months. My ldl has continued to rise, latest is 194. My HDL is 74 and triglycerides are 42. So I don’t quite meet the three criteria, and if I trust my doctor, I’m unlikely to do so as he has prescribed rosuvastatin. I went keto after my bp went up and I had a cac score of 253, possibly due to prescription of calcium tablets for osteoporosis and a high carb/ low fat diet. I’m 68, and looking forward to hearing more about this topic.
As a LMHR genotype, I have been cautious. While I am in ketosis for a significant portion of every 24 hour period; due to IF; during my feeding window, I eat significantly more carbs than someone on a ketogenic diet would.
The results are
Non-HDL: 214
HDL: 60
Trig: 100
So in my current state I don't match the phenotype, however, I am definitely the genotype and if I were on a strict ketogenic diet (rather than diurnally transitory keto), I'd be something like:
Non HDL: 300+
HDL: >80
Trig:
LMHR is not a genotype
@@nicknorwitzPhD yes, i realize that. More correctly stated, I am of a genotype (and have the environmental conditioning) that is compatible with expression of the LMHR phenotype. The evidence of this is that if I consume a strict ketogenic diet I have the triad, and I am able to accurately modulate the magnitude of the variables in the triad by varying my carbohydrate intake.
My father was extremely lean so was my maternal grandfather. My son is 5'9" 108 lbs and I am 6'1" 135 lbs. I used to he on a high carb crap diet and my LDL was absolutely fine according to my doctor, but all my other markers were horrible. Now, on a low carb diet (~50g/day) every one of my other labs (besides non HDL cholesterol) are *perfect*.
Thanks for making this. It was very clarifying and I hope everyone watches it. I understand better your issues with Thomas Dayspring and for me, I hear nonstop that you and Dave have proved that Ken Berry is right and the idea that high cholesterol can be harmful is a lie (quoted from his best-selling book). I think it was an important clarification to hear you say that LDL can be associated with increasing risks of heart disease.
Thanks for your words Chris. Question: can you actually point me to where Ken says that high cholesterol is never harmful?
@@nicknorwitzPhD Yes, chapter 5 of his best-selling book leaves absolutely no doubt. He makes it clear higher is better. Here's just one quote: "the published fact that most patients who have a heart attack have a cholesterol level of less than 200." No mention of FH. Just mentions that it's a lie and we'll look back on the cholesterol theory of heart disease with shame and embarrassment.
@@Viva-Longevity Haven't read his book. If there is a video (esp from the past year) where he or Shawn or any major low carb influencer says explicitly "LDL doesn't matter" in heart disease and you can provide a link, I'm happy to try to be a voice of nuance and reason.
@@nicknorwitzPhD They're all over the Internet, no? They go further to say higher LDL is better. If you're up for a game of whack-a-mole, you can start with Chaffee. ruclips.net/video/fpiRxen9gNk/видео.htmlsi=G4bu5LKIzY8nRvPA
@@nicknorwitzPhD I responded with a link but I guess RUclips didn't like the link and deleted it?
👏👏👏so good!! Grateful for your very important work!!
Thank you too!
I enjoyed your careful breakdown of exactly why the meme that doctor posted was inappropriate and does a disservice to anyone who sees it and society at large. It’s like I paid someone to articulate using only logic why I’m feeling a certain way
Thanks so much for this clear discussion. I will re-listen for sure and watch your other videos. I have been off and on keto/carnivore for over a year - recently in Feb - shifting to a Primal approach with carbs @50 g. Recent bloodwork has me meeting your criteria- LMHR and my Dr wants me on statins. I am not ‘lean’ with about 10 lbs to lose - 😂acknowledge that you are clear what the criteria are. My gamma GT was elevated as well. So more research to do. Sigh. I feel great eating low carb high fat.
Thank you Nick! We support your selfless search for our optimal health while encountering the falsehoods & closedmindedness from obvious big pharma advocates. Keep up the awesome work!
Not sure on their motives. Could just be ignorance. Could be ego defense. Doesn’t really matter. Data and logic are data and logic
Could you do an explanatory video about the “ normal “ population please. You explain things so well.
I am not capable of understanding the technical papers and my Dr does not explain.
Quite happy that I am in no way a lean mass anything but I do need to be keto for T2 diabetes.
Stay tuned for my conversation with @theProof (Simon Hill). I hope we will cover the distinction about LDL/ApoB in the "normal" population vs LMHR in depth, approaching it from new angles with new articulations. I'm counting on him to "push me" there.
@@nicknorwitzPhD Looking forward to that discussion, I am relieved when two people from opposing views are able to sit together and talk science. You rarely ever see that, unfortunately..
Thank you for your presentations & for providing links to the papers. I asked another RUclipsr to provide links to her cited studies. She gave me the excuse that she can’t because RUclips frowns on this practice. She asked me to email her. I now assume she has nothing to back up her video presentation on hormones. Thanks for being honest & informative!
You are so welcome! 🤗
Low carb is low sugar -> low stimulation of glp-1 and therefore less stimulation of glp-1 receptor on the lymphatic sensory neurons where there is less stimulation of TRPV1 on the neurolymphocrine system defined in the 2020 Berkeley study. This leads to less stimulation of insulin and less stimulation of TRPV1 by insulin leading to less glucose metabolism and mitochondrial production of ROS and less lipid oxidation and peroxidation.
Additionally on a normal carbohydrate diet both TRPV1 and TRPV4 are up-regulated and increase NO and vascular relaxation but also changes the endothelial intercellular junctions and leads to a weaker endothelial layer that breaks in atherosclerosis. You will see increase in TRPV4 and klf4 in active atherosclerosis.
@@stellasternchen wow, please ck out TRP channels particularly sugar glp-1, glp-1 receptor and TRPV1 insulin stimulation and mitochondrial function.
Here’s a start:
2020 Berkeley study
Reveals the neurolymphocrine system. Are you familiar with how this works?
Glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide stimulate release of substance P from TRPV1- and TRPA1-expressing sensory nerves
Here’s how insulin stimulates TRPV1 and TRPV1 puts glucose into the cell independent of the insulin receptor
2021
TRPV1 Activation by Capsaicin Mediates Glucose Oxidation and ATP Production Independent of Insulin Signalling in Mouse Skeletal Muscle Cells
TRPV1 increases ROS in mitochondria
2020
TRPV1 and mitochondrial dysfunction
TRPV1 Channel: A Noxious Signal Transducer That Affects Mitochondrial Function
Drs. Julius and Patapoutian shared the 2021 Nobel Prize first their discovery of TRPV1 and Piezo 1 in humans.
These channels are highly conserved in our systems since the prokaryotic level of evolution in the kingdom of Animalia and are essential to life in our system. The more you learn about them the more amazed you will be at their ability to respond to multiple stimuli and each other in every cell in our bodies.
Thank you for all you do!
My pleasure!
all of this drama over something in which there are no guarantees. I truly appreciate your scientific curiosity Dr. Norwitz.
you're welcome!
LMHR...that's me! Carnivore 6 months...heart attack 2 months in. Still down the rabbit hole of testing. CHC next week. Thinking I should decrease red meat and have more variety.
Good video. I like that you point out, and are ultimately motivated by, the need for an accurate assessment of the pros and cons of carb restriction. The list of pros is getting pretty extensive, from mental health and bowel problems, to it's success reversing the conditions of the great epidemic of our times in obesity and metabolic syndrome. The primary con with respect to individual health has always been "but it might sometimes raise your LDL". People who are seeing benefit are rightly motivated to put that assumption under the microscope and tease out the intricacies with an open mind. The establishment response to that questioning strikes me as knee-jerk, irrational and anti-science as the examples you put forward demonstrate. It's evidence, in my mind, of some deeper ideological commitment being threatened.
6:25 Maybe other people have been making such an argument, but it seems like a strawman to me. I certainly don’t think it’s a “abnormal” response to have super high cholesterol in the face of a very high saturated fat and dietary cholesterol intake. can you point out who has been saying that it’s an abnormal response to have very high LDL on keto when one is lean? Or did I miss something?
Excellent explanations, concise, with references and evidence. Exactly how good science should be discussed and conducted. Thanks Nick!
Appreciate it!
Great video. I'm not a lean mass hyper responder, but if I stayed on carnivore long enough, I probably would get there since a lot of my numbers are Pretty Close. I have a lot of patients Who I work with to help them with Weight loss and I go through their blood work to tell them where I think they can change things up. And what's going on with your body. Most doctors refused to do a fasting insulin and tell the person starts having prediabetes. I find this very annoying. You can have a great fasting, insulin and a great A1C. And your insulin Could be through the roof.
I do appreciate fasting insulin data...hard to "bio hack" if you don't "bio track"
I find it shocking the number of people that think measuring glucose is a suitable proxy for insulin: they think low glucose means low insulin. How many of these people have good glucose/A1c and sky high insulin???
from what I gather high insulin in the short term isn't associated with problems though, only long term elevated insulin is.
@@descai10 Many people are getting long term elevated insulin. That's the point. They are measuring good glucose but don't realise their insulin is often high, to keep glucose lower. Eating carbs (sugar) 6 times a day with meals and snacks is 6 spikes of both glucose and insulin. For most people that is constantly high insulin and that will catch up with them.
I'm guilty of believing the LMHR group was pushing high LDL-c was "ok". My fault. YES, agree no one is pushing or should be pushing it is ok. Agree, we don't yet know what we don't know. Agree with all things case by case, person by person.
Good reply 😊😊😊