#03 - Ron Krauss, M.D.: a deep dive into heart disease
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- Опубликовано: 28 сен 2024
- Original release date: 7/2/2018
Whenever I’m stumped on a patient case, or in my thinking about lipids, Dr. Ron Krauss is one of the first people I turn to for insight. I’m not alone. Ron is recognized globally for his research into lipidology and has worn many hats in his career, including clinician, lipidologist, nutrition, genetics, and drug researcher. He received both his undergraduate and medical degrees from Harvard and is board certified in internal medicine, endocrinology, and metabolism. He’s currently the senior scientist and director of atherosclerosis research at Children’s Hospital in Oakland.
My hope is that both the curious patient and the physician can get a lot out of this episode by being more informed about dyslipidemia and the interventions used to reduce the risk of atherosclerotic disease, cerebrovascular disease, and peripheral vascular disease.
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The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 10 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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This podcast is at least 5 standard deviations above the mean... in terms of real world applicable clinical knowledge that isn’t just interesting but will actually make a difference and literally save lives... I’ll make sure to share this podcast with all my classmates and professors when I start medical school this fall...
What about the study on pub med that says statins raise LP (a)
same here !
Wow, Christmas has come early this year. Now I only need to find the time to listen to this stuff.
Please interview Dr. Stephanie Seneff at MIT. She has a different view of statins. I take one now, but very aware that two family members suffer major memory problems. They, however, cannot remember how it was to be normal, they cannot remember how many things they forgot, so they don’t think they have a problem. I view aggressive statin use as family destroyers.
Unless your HDL is very low and triglycerides are very high statins won’t do crap and no research supports the use of statins to even prevent heart disease except with those of metabolic disorder stated above. No use for healthy people that just eat healthy, therefore eating healthy and avoid taking medication seems logical rather than risking dementia like family members
Notice how they sidestepped alzheimers? My dad was a neurologist. He hated statins, was positive they caused dementia. Of course, the cardiologist argued that it was the cvd that caused the dementia in their mutual patient and not the statin. My dad disagreed. If you're the patient, i guess you have to choose between your head and your heart.
@@sarah29880 hello Sarah - very curious your opinion when diagnosed with very high cholesterol ( propably genetic) as diet is generally healthy what would you suggest ? As was told by the doctor it may cause diabetes and fatty liver? Would you say any medication? Or maybe low carb diet and fasting? Regards M
@@NAKMUAYACADEMY lower fat high carbs, loads of milk-ray peat style, I stopped carnivore because constant ketosis and fasting increases cortisol in the body and higher carbs lowers body stress 👍💕
@@NAKMUAYACADEMYI am also a nutritionist. I would NEVER recommend a high carb diet and would encourage fasting by all means. Your longevity goal should be to reduce insulin spikes. Listen to Dr. Jason Fung on RUclips. He can help you understand the principle. Also read his books. Everyone’s genetics are different and some thrive on carnivore and keto but you can never go wrong eating Whole Foods while avoiding the high carb foods and processed foods. Wear a CGM and you can filter out the foods that are your enemy. Good luck!
Perfect timing! Listening now while shoveling snow. Your content is always of such high-quality. I always learn so much. Thank you for sharing knowledge that empowers your listeners to better health, and better health decisions.
Needs subtitles for us deaf coots.
Just came across this channel. First let me say that after 40 years in healthcare your credibility greatly increased when I saw that in 2018, according to CMS open payments, you only took $125.00 from Amgen Inc. most MDs ir DOs out here are in big pharmas back pocket. Very well done but it stll seems as though physicians still throw stones in the dark hoping to hit the target without regard to what happens if they miss. We will never have good research as long as companies that stand to benefit fund those studies. Sorry but bias is built into the protocol.
I really wish this podcast didn't require a masters in biology to have any clue what they're talking about.
Just know your anatomy and some amount of physiology and you'll be halfway across the bridge of understanding. Peter pauses himself and guests often enough to explain issues many of us may not know.
@@danielevans5864 So what you're saying is: the solution to not knowing that their talking about is to get educated in what they're talking about. Wow. Truly brilliant insight there, mate. You should be a life coach or a podcast host. Imagine how many people you could help get out of debt by advising them to make more money. Or even simple things like advising that people eat to solve their hunger issues. Your brilliant insights could change the world.
@@scottk1525 Don't be so bitter. All education and knowledge is best measured on a spectrum. I was .merely mentioning the prerequisite subjects one needs to first understand before comprehending pathophysiology and therapeutics.
Be kind to yourself and breathe in peace.
Just ask your doctor to add Apo B and LP (a ) to your next test. If they are high, come back here for more info.
@@metemad Thanks. That doesn't help at all.
I quote "there is a lot to learn on how statines have effects on biology, that could impact health" ... / ... " it is in part because we have such a large population doing this experiment" (taking statines over 40 years..) !
I am curious also to learn. Thank you but I think: should my home be on fire, i would be very thankful towards the firemen AND would learn how to avoid repeated fires in the future.. might it take some time, the firemen help bridge the crisis... BUT would I resign to having my whole life firemen trying to extinguish the fire in my house.. ?
Am I wrong here? Statins are used to lower LDL; LDL size has a major effect on arterial damage/repair (small particles are bad); so, lowering LDL will reduce small particle numbers. BUT, diet change will reduce LDL particle size within about a week, will raise HDL and lower Trigs. The only side effects of diet change are more energy, mind clarity and weight loss. So why the hell would you take a statin if these two options where presented to you?
Exactly. A doctor might say statins can cause arterial plaques to stabilize and become less prone to rupture and cause a heart attach or stroke. Or that they provide an anti inflammatory effect. A ketogenic diet will fix your HDL, Trigs and also be anti inflammatory. Some people would prefer to take a statin then eat a domino’s pizza, I guess.
@@robdoubleyou4918 And what always gets forgotten is that statins seem to provide some protection against future events, but don't change the chances of death. So they must be increasing the chances of dying from something else, which is the opposite of dietary change.
Particle size doesn't matter when controlled for particle count.If you're asking why drugs are chosen as opposed to lifestyle change it's because it's a sad reality is that most people won't even make minimal changes in diet, especially when pills are available.
@@lianjohnston461 I wouldn't worry about high total LDL if the size breakdown showed low amounts of small (older) particles. I've seen quite a lot of low carb advocates say that LDL can go up on low carb, but the particle size dramatically changes, and it's the small ones that do the damage.
My subtle point about choices of diet was that most people are not presented with the alternatives I mentioned, by healthcare professionals. Patients go along with the fallacy that medication cures you. All the drugs do is manage symptoms, or maybe swap one way to die with another.
@@matthewstroud4294 particle size seems to matter but residence time of particles matters more. Spouse took zetia and ldlc lowered, but small dense particles doubled and went from pattern A to B. Yet cardiologist said it's okay, we only care about total particles because that's what the research says is probative.
Doctors know zero about diet. Notice how fat and unhealthy they are too? Most of them don't believe diet csn do anything. I notice our vet asks as a first question what are you feeding your pet but the human doctors are ibstead reaching for their prescription pad.
OUTSTANDING interview! So grateful that you have shared it Dr Attia. Multiple insights can be gleaned from this brilliant man Dr Ron Krauss and yourself.
01:20 .. statines and myalgia.. energetic dysfunction muscles... Ubiquinol / ubiquinone (wiki) CoQ10 related to Mitochondrial Electron transport chain ETC complexes I and II, prot. cytochrome b, Q-cycle redox.
Thank you Peter for all you do in sharing your (and your guests) knowledge to help people understand how to improve their health and make sense of complicated topics like ASCVD. There is far too much noise in the health and wellness media and I have found your channel to be extremely helpful in cutting through all the crap and getting to the root of the issues. It has helped me immensely and I am very grateful for it, so again, thank you.
Preaching to a choir who is either too young to have an issue, or an older audience who eats and lives well.
My husband, on the other hand would never sit through this. He will reach for his Lipitor, then head out to Burger King for lunch. 😕
I get where you are coming from. I've been both the young guy who didn't have any issues and didn't even care if he did. I've been the fat guy who felt like crap. And now I am the skinny guy who eats well and runs 80 miles a week for FUN. I owe my transformation to folks like Dr Attia. Anyway, enough about me. I just want to plant a seed if I can. While your husband will never sit through this, you did (I assume). And now you have the power to get into his head, armed with knowledge. Talk to him about what you've learned. Point out examples of what not to do when you're out in public if you catch my drift. Show him what sort of sh!t is in processed food. The list goes on on what you could do. Maybe he will be receptive, maybe not. But you can try. I did the same thing with my folks a few years back. My Mother was quite receptive and what she learned changed her life. She lost a ton of weight and looks great! My Father on the other hand, while he learned a little, is very stubborn and addicted to his horrible lifestyle. But I still made a difference. You can too! I hope this all came out right! I wish you luck!
New findings (July 2021) regarding statins as risk for dementia have indicated on only Lescol and Pravachol are not implicated.
Do you have a link to that study ?
@@BigJack512 Not 3 months later. Once I mentally file a medical fact I disregard from whom I read it. But you can trust me. I'm a pharmacist.
thanks God for smart doctors!
My LDL-P: 1523 mmol/L, LDL-C:178 mg/dl, HDL: 104 mg/dl, triglyceride: 46 mg/dl, LDL size: 21.9 pattern A. Hgb A1C 5.3. My PCP wants me take statin to lower my LDL. I’m not sure if I should take it. Any suggestions will be appreciated. Thanks 🙏
second opinion
I asked to get a calcium score test. It is not covered by insurance, but it was the best $125 I spent last year. The score was 6 and I am 60. My pcp does not talk about statin anymore. He asks me what I have been doing and eating.
That's pretty high. There may be something wrong with your HDL particles as well, your hdlc is over 100.. they may not be returning to your liver.
I would prob start a statin if I were you. If PSCK9 offered /covered that would be good too.
U rock!
Does the bandaid cause the cut ? Did the firemen cause the fire?
I think a higher proportion of firemen commit arson compared to general population. :-)