Thanks for sharing this. Just finished reading "Health and Beauty Mastery" - what an eye-opener! This book exposes so many hidden truths about the health industry that no one talks about! I completely changed my habits
I had a CAC score March 15 of this year, I had one completely blocked coronary artery. I had been eating a low carb diet for two years and a type 2 diabetic for 20 years. I had a heart attack a week after my CAC test. Because I was eating healthy and my heart was in shape, I had two stents placed and I have no damage to my heart. My oxygen never went under 98% even though only one Coronary artery was fully functional. I am now on a carnivore diet and hoping it helps both my insulin resistance and diabetes as well as. My last A1C was 5.9 my triglycerides were 87 my HDL 88 and my LDL 179. My cardiologist is freaking out and wanting me to go on Repatha. When I tried to explain to him the three top reasons for heart issues was diabetes, insulin resistance and obesity. Why not help me treat these instead of looking at cholesterol? He looked at me like I was an alien when I asked him to separate my large and small ldl particles. I wish I could find a physician like you.
You 100% need the statins. High LDL is ok so long as you are metabolically healthy, which you are definitely not!!! You’re seriously risking your life. Go on the statins, then do what you can to improve your metabolic health and insulin resistance etc. Only then consider losing the statins
@@vickyburton2434 Once you have plaque, you need statins. Generally a low dose has the same efficacy, but don’t be a fool and go without them. You are the intended candidate.
@@RogerWilcoWTF I take Extended Life Niacin and Omega 3 fatty acid as well as ADK. I will have to pay for tests myself because my physicians are so indoctrinated by one number theory. .
I am 68, in March of 2023 I desided to drop the statins because of of bad side effects. Started Keto and intermittent fasting. Went from 198 lbs to 168. Now I am not taking any meds for cholesterol or high blood pressure. My ldl is below 90. I feel great thanks to doctors like you. Thank you for your great advise!!
Interesting that we as patients must instruct our doctors to do the correct trouble shooting and identify root cause. My doctors will not do it, they become offended if challenged. This is ego, not intelligence. I'm largely Keto and exercise every day for several hours either hiking, biking or just washing a car etc. I'll have to trust I'm good. Thx for all the advice, it changed my life and health.
I'm a 66 yo lifelong runner, cyclist, and exercise nut. Formerly on KETO but now low carb, my doctor recommended the CAC test because my LDL is a little high. I got there to find out it cost $100 out of pocket. Great score of 5.95 but my doctor still thinks I'm gonna die if I don't take statins, which I refused. He claims a higher LDL puts me a higher risk of heart attack.
This helps me stay ahead of any surprise cardio and cerebrovascular events. A dubious CKD (based on eGFR calculated using creatinine rather than cyststin-c) diagnosis, the discovery that a cyst on my pancreas had digested 90% of my pancreas, and hyperhomocystenemia were not events I was anticipating. So now I'm vigilant about vessel and heart health. Your information is very valuable to my vigilance. Thank you!
Great tips! Dr. Cywes, please do a video on strategies to manage emotional and physical stress that is backed by science to help manage cortisol levels etc. The LDL gaslighting gives many of us mental stress. Thanks for your hard work!
Loved to see you mention Rooibos Tea, it is the best. I'm sensitive to caffeine and love Rooibos as a bridge drink for intermittent fasting. Kingfisher Teas Rooibos is best.
@@robertcywes2966I live in Cape Town and a Stellenbosch doctor, Sybrandt Smit, did his studies on green rooibos rea and apparently it is excellent for cardiovascular health and lowers blood pressure.
I had a nuclear medicine stress test where they did not want me to use the treadmill but instead injected me with something that shot my BPM up to 160 in a few seconds. They did not find anything wrong at the time. I was still having symptoms and believed there was a major problem. Several months later I insisted on another nuclear medicine stress test but to their displeasure, I also insisted on the treadmill. That meant the Doctor had to be present during the test. This time as my heart rate was climbing slowly and more naturally I had a MCI. Based on my experiences and many discussions with my cardiologist, I would recommend using the treadmill if possible and also to use the left and right mammary arteries for coronary bypasses since they trend to last longer than a radial artery or a saphenous vein.
For the pharmacological (Regadenoson) nuclear medicine stress test to be accurate you need to stop ALL caffeine containing products for at least 12 hours. Also you need to stop all anti-angina meds (nitrates) prior to the test. Btw the dr should 100% be present when this is done and not only when the treadmill is used.
so sad that an MD does not understand a basic WBC count !!!went back to cardio past cath, ( one of the largest practices in area) was pushing the repatha's since cant take any statins. Told her about the colchicine drug and the name of your video plus had been approved for FDA for cardio use, that got her attention, so tired of MDs treating patients like they are dumb as a bag of rocks. One advantage I do have I was an RN for years and can recognize when the doctors are just going thru the patients like an assembly line. Very refreshing to watch a doctor with compassion and values his patients.
2:50 I love you doc and I recommend you daily. Cardiac stress test does not use a dye. It uses a radioactive tracer typically technetium. The drug we use dilates blood vessels. Lexiscan is trade name and generic regadenoson is used. I believe the more often than occasional increase in heart rate is due to decreased b/p and your body's compensatory mechanism to increase stroke volume. Great work as always!!!
Thanks a lot for your inspiring talks which have helped me a lot so far, by changing my mindset about food and the effects of it on my health. At the age of 80 it nearly feels as if I’ve never had more energy.
Thoughts on the role of ApoB and Lipoprotein(a) as risk factors? Peter Attia seems to be pretty obsessed with reducing ApoB as much as possible, which makes no sense to me. Videos about these topics would be super awesome.
my CAC score went from 30 to 1:10 in three years all because I was taking vitamin D3 without vitamin K2 …started taking K2 twice a day along with magnesium glycinate ,cod liver oil capsules and nattokinase.. I eat a lot of carbs. I did not change my diet and I got my score down to 90 when year later. The CAC test is good, but the best one is the CT angiogram, same scan, but they inject dye into your arteries so they can see the soft plaque and the calcified plaque… If you’re wondering what the cod liver oil cap, and Natto are for .. to keep the clots from forming keep the blood flowing
I have been diabetic type 2 since I was 50 and I am 70 now and I have been doing keto off and on for those 20 years and recently I was pretty strict keto for the last year, and now I am eating a carnivore diet. My blood sugars are still high, and my triglycerides are 138 and my HDL is 43. My TSH is 3.34 which is not a good number for me. I just got over a sinus infection and had taken a Z-Pac antibiotic. I just did blood work yesterday and a few days earlier I had a low grade fever return, but fortunately it didn't turn into a sinus infection again. My HSCRP went up to 1.3 when normally it is at .6. I think the thyroid numbers and the sinus infection affected my numbers. I had a CAC score about 5 years ago and it was 210.
Very helpful information. 58 yr male and my cac score was 605 2 years ago. I have lost 60+ lbs with a locarb keto diet and the information you give is giving me the knowledge to retest and double up my efforts to do my best. Much thanks Dr.
I am in the UK, the Dr’s will not give us any of those tests and most of those tests are only done at specialist labs in the big cities. Don’t move her!
I begin a binge with a frown, a grimace or agonised facial expression, a blind reminiscence of my impalement shock which was unrememberable for 60 years
Awareness buys time, time buys options - until it doesn't. Trillions spend on sick care, an unhealthy population, and a Govt that subsidies; corn, soy, wheat, and rice. Thanks for your awareness.
What about hard plaque vs soft plague? Soft plaque, which appears to be the real risk factor on calcification, does not show up in a CAC score. Wouldn’t a CIMT test prove bettter?
My doctors reacted exactly as you describe. Freaking out about my LDL (highest was 509). The cardiologist was convinced that I would be on his operating table the following week and he'd be cleaning "cottage cheese" out of my veins. That was a year ago. He convinced me to do an expensive CT Angiogram. Calcium score was 0 and they found no evidence of atherosclerosis. And yet THEY ARE STILL PUSHING STATINS! I hate that! I started keto (real food, not gimmicks) 6.5 years ago, and that's when my LDL went up. Covid triggered an autoimmune condition called Lymphocytic Colitis, so I stepped up to carnivore 3.5 years ago. That's when my LDL shot up to the 509 mark. The problem I'm having is that every time I have any issues, the doctors look at me through the lens of "it must be the LDL". For example, following a UTI which turned out to be a staph infection, I had massive leg cramps every night, even after the infection was gone. They wouldn't look at my kidney function. They wanted to do another expensive scan of the veins in my legs, looking for a clot. I refused it. Finally massively increasing my water intake helped the cramping. I still think there is something wrong because I've never had to drink so much water before. It has also been suggested that my LDL could be due to FH, which is asinine because that's a condition that's supposed to occur from birth. I never had "high" LDL till keto. So to prove that I could lower my LDL without a statin, I did a 2 week carb challenge eating plain white rice (a al Nick Norwitz's Oreo study). The rice didn't trigger my colitis, and I did indeed lower my LDL by nearly 50%. But all my other numbers went drastically in the wrong direction. Most concerning was my Cardio CRP which was previously 0 mg/L then shot up to 0.9 mg/L! I had such massive inflammation from that carb challenge, my blood pressure was consistently very high, giving me massive headaches beginning within a few days of the challenge. And, of course, they are still pushing statins. Ever since that challenge, I've had painless numbing sensation in both my legs down to my left big toe, and now at the end of my left ring finger. This latter is very concerning as I'm a harpist and need my fingers! I'm afraid to go to my regular doctors because they will again look at me through the lens of "It must be the LDL". I plan to see a chiropractor first, but if you have any suggestions I very much welcome the input! 💜
youre getting leg cramps and drinking so much water because you dont hyrdrate the same without carbs. you need to up your sodium intake and/or take an electrolyte supplement
There's definitely a connection between carnivore and cramping. There's 1 person a Watched that said a little bit of carbs helps the kidneys and somehow reduces cramping. So take that for what it's worth.
It's impossible to know who to believe. We have accomplished professionals on both sides, both making convincing arguments, conflicting studies... Might as well flip a coin. Also, rising CAC could be soft plaque calcifying, which is ideal.
@@johnsonpaul1914If you’re talking about statins, they’re almost all generics at this point. People need to stop making that argument. I have no idea if low-dose statins reduce risk for people who have a CAC greater than 80 or whatever.
@@johnsonpaul1914I'm speaking with the context of this realm, one of eating correctly. Even in the low carb, no processed food circles, there's a difference in approach and a different path with which pharmaceuticals you'll take when your case has advanced enough. They all recommend drugs when you have crossed certain thresholds.
Where was the part where Peter Attia was wrong? You titled the video that but didn’t mention his name? Peter has talked about calcium scoring before and the importance of it
Rob Cwys I was drinking rooibos while watching your video...even better if you can get your hands on stokkies( raw bulk) which is richer tasting...I'm a cholesterol skeptic and enjoyed all your podcasts...subscribed and ticked.
I had a CAC score test done through a radio promotion. My score was 158.. they kept saying through the promotion that the test was $700 Had a nuclear stress test, and a treadmill stress test, which I passed with flying colors, so they said. Still worried.
Dear Dr. Cywes, While watching this video I ordered the tea you mentioned. I almost thought I was allergic to all tea’s. I am drinking a hot cup right now. Wow, You are so right about this tea. It is so pleasant to drink. Thank you for mentioning it. 👏👏👏
Yes, I second that suggestion. My husband had the same and, while he is 6mos on carnivore, his Dr uses fear and condescension to tell him he is going to make me a widow and that his lipids look terrible. He's looking for another Dr and also would like a consult with Dr. Cywes, if we can afford it. God Bless.
My cardiologist is concerned about the LDL levels but did not test to determine how much of the small or large LDL particles were in the count. He wants me to go on statins because of the stents that were put in after my heart attack. So I was wondering if you could answer this question: Do stents increase the risk of plaque build up at the stent site when LDL is elevated? I'm irritated because neither of the cardiologists I've seen ever did a fasting blood sugar, and I was told the amount of blockage I had was higher than they would have expected considering my cholesterol and triglyceride numbers. The family doctor di that and found I was highly insulin resistant and almost pre diabetic. We discussed my diet and she didn't understand why I was IR. In all fairness to her, the discussion wasn't very in depth and she did want to go more into it on another appointment. I did more research and learned why. Although I didn't eat a lot of sugar, I ate way too many simple carbs, and also ate those carbs too often (mid meal snacks were always some kind of bread). My SubQ fat was low, but I still had a belly. So I dumped the majority of my simple carb intake, cut out sugar entirely, changed my snacking to nuts, and never eat past 6 pm if I can avoid it. In 3 months, I lost 3 inches in my waist but still kept the same subQ level (At 65 I have a visible, but not highly defined 6 pack). Reading the research on this and listening to you and a number of other cardiologists, I realized what the issue had been. Too high of a carb intake and insulin resistance.
@@DingoLingo2 He was hospitalized with Afib and was told his heart was fine. He actually had total blockages in 3 of the main arteries that resulted in a widowmaker. If they had done a heart catheterization, it would have shown the blockages. Advocate for a heart catheterization! He survived, but his heart output is now 25%.
I have total chol at 280 and LDL at 180. Drs of course hype statins. I am 67 and a recovered diabetic on keto-ish low carb diet and eTRE (early time restricted eating) for over 4 years. I have a low Trigs at 70 and high HDL at 99. My Uric Acid is high, not certain why since all other inflammatory markers are low. Anyways, I cannot get a CAC or other test as I live in rural Greece. However, I asked the cardiologist to examine me to see if there are any signs of problems. He did many exams including electrodes, sonogram, and treadmill and said that I am perfectly fine, no need for meds! I wish that I could get the Uric Acid lower, but I have no idea what to do. Eliminating red meat does not seem healthy or feasible for me.
I read somewhere that low Trigs imply that high(er) LDL is the healthy big fluffy kind that transports fats/ketones. Also, that low Trigs imply low inflammation. I am not an expert, so perhaps I am incorrect or over simplifying?
Red meat and saturated fat is good for you. Just stop the carbs, sugars, and seed oils. Ben Bikman(with Ken Berry) ruclips.net/video/DTkzhSCsTD8/видео.html stated in communication that 20 gm of allulose(RX Sugar) daily will dramatically lower your uric acid in a few weeks.
Folks, just because you have a low Ca score does not mean you are without risk. In fact you could be at high risk if you have a significant amount of soft plaque, which is not detectable by a Ca scan.
This is great. All spot on! I remember peter Atillas guest who ended the interview on a note, just eat less calories 🥴. What causes bulging of varicose veins/valve failure. My guess that its arterial inflammation.
The main take away from this video should be: 1) blind faith in authority is the greatest enemy of truth. 2) healthcare is self-care 3) don't be afraid to take charge of you health and advise your MD accordingly
Clearly different experts focus on different things. Dr Cywes is focused here on inflammation. That’s one possible aggravating factor in the development of atherosclerotic cardiovascular disease. Address it if it’s an issue. But many people - me included - have plaques and very low inflammatory markers and uric acid. What then? Address the known potential aggravating factors: hypertension, prediabetes or diabetes, elevated lipids, lack of exercise. What bothers me is when anyone focuses in on one thing when the condition is clearly complex and multifactorial. Then it starts to look like the person has an ax to grind, or is focused on advice that will help some and not others.
I have been true to carnivore since Oct 2022. I am 71and have no symptoms. My Feb '24 CAC was 2770. I take aspirin and other anti-inflammatory supplements in addition to D3 K2 E Co Q10 and others. A CT w/contrast & Cleary analysis showed 80% and 60% stabilized plaque in R&L arteries. I passed my tread mill stress test 4 months ago and my CIMT shows I "passed" but am at high risk. My cardiologist told me several times there is no way to get plaque out of the body. After 14 treatments of EDTA iv chelation therapy, my elevated (but not crazy high) cholesterol numbers dropped dramatically and the bottoms of my feet that have been numb for 8 years have 98% feeling restored, additional proof that EDTA chelation is safe and effective. To date, I've had 24 EDTA treatments and will continue with monthly maintenance treatments for the foreseeable future.. I do weight bearing activities daily. My cardiologist wants me to take statin and a weekly injectable anti-inflammatory that I have declined.
Great choices! I didn't see any vitamin C listed. I am on the Linus Pauling Heart Protocol. I reversed a 660 score by 30% in 20 months. Read Dr. Thomas Levy's book "Stop America's #1 Killer" Proof that the Origin of All Coronary Heart Disease is Clearly Reversible Arterial Scurvy. If you have calcium like you do it is Clearly a vitamin C deficiency.
@@Thomas-1976 I think I can help you. He is on a IV chelation therapy pretty expensive. Myself I'm on an oral chelation. What it does is to remove toxic metals like lead, mercury, and others like calcium which is electricly conductive. Once bound to the chelation material it's just urinated away.
I do not see Peter Attia mentioned in this talk. Why is he mentioned in the title? If you want to disprove Peter Attia then come with facts. Personal attacks are inappropriate. Soft plaque does not show on CAC scores. Lp a level is an indicator of increased risk for CAD. Please indicate where Peter Attia is wrong
What about the CIMT test for soft plaques over the stress test. Or both? Apparently even ppl with a zero CAC are still having heart attacks. Just what I’ve read recently
I appreciate all the information in this video. I actually even subscribed to learn more. However, what is it that Peter has wrong? I find his information very valuable and it has helped me quite a bit in terms of changing my overall health. I feel likeboth what you suggest and what he prescribes can be used in unison.
How do I reach you for a consultation and how much does it cost? I’ve been carnivore for about 4-5 months and low carb for years, yet I cannot lose weight and my A1C has moved into pre-diabetes zone at 5.7. Is my body just running low on insulin!? I’ve been eating a low carb diet for years in order to avoid this…how can this be? My HDL cholesterol is low at 63 but LDL is a 254. Triglycerides are at 91. My fasting glucose is 92. I’ve been eating fat and protein exclusively for 4-5 months. Why is this happening?
Thanks for the Video. Very informative. CAC sees only the hard plaque. What about the Soft Plaque. We are told hard plaque is nowhere near as dangerous as the soft plaque; hard plaque cannot be dislodged to cause heart attack. Whereas soft plaque is very likely to dislodge. So to be accurate, one has to undergo Angiogram rather that CAC. Do you agree with these statements. Thank you.
so my CAC was 420 3 years ago (380 in the LAD). I'm not on statins. My Total cholesterol is around 190, Hdl 55-60, trigs are 70, LDL around 114-130. I'm 74, diabetic with RA on Enbrel which is very effective. Vectra D score is 10. . I recently had a nuclear stress test when I was in the hospital with high heart rate (turned out to be a-flutter - have not had an episode since) - stress test came back negative - no ischemia. HS - CRP .3 . LP(a) score is 9. Most recent ApoB was 105 from October 2023. Retest? Would you suggest another CAC at this point? I walk 3-6 miles a day - eat a keto diet although probably 40 net carbs vs 20. Of course my doctors want me on statins especially since I"m a diabetic but the NNT isn't very encouraging for them . I don't want the. possible harmful side effects (no matter how small the doctors try to tell me the risk is) because I depend on my walking to keep my glucose numbers in range (hba1c of 6.0). And the thought that they could possibly worsen my diabetes.
I started about 15 years ago on 20mg of atorvastatin. I have left bundle branch block and very slightly impaired LV emission....if that's the right way of saying it. 47%. No structural heart issues and no signs of CVD. Had MRI done of heart. Cardiologist and GP over the years have increased my statin dose to 80mg. Of course ldl has reduced. But the side effects particularly since I was on 80mg which is about a year now, are horrendous. Especially tendons and gout and fatigue. I have decided to come off and go keto and exercise more. I know it sounds an extreme thing g to do but talking to my doctor is pointless. All she wants to do is prescribe. What I have noticed is that when I wasn't on statins although my LDL was quite high so was my HDL. Anyway I'm doing my own thing and taking cholesterol tests including Apo B etc privately. I'm in the UK by the way.
This is what we tell people in our support group! Eat the fat first and try to get fat in every bite. Trigger the cholecystokinin to tell the brain "you're full, stop eating!" Listening for that signal is an integral part of the fat adaptation process!
I have high cholesterol and ldl. Low triglycerides and good HDL. CAC scan was 0. I’m not overweight, don’t smoke, or drink. I’m active. Have little stress. My inflammation is low. Uric acid is low. Ferritin is good. I do however have a high apob and higher lp(a). I’m bringing my ldl levels and cholesterol down to basically prove it to my Dr. that these numbers are because of a high fat animal based diet and by simply eating carbs and fiber I’ll be able to bring my numbers down. I’ve already brought them down within a few month but he’s still pushing Lipitor. I keep telling him no. I’m scheduled for an echocardiogram next month, and recheck my lipids in November.
If you are skinny like me with a very low BMI, you may be a lean mass hyperresponder(LMHR) which would have a high apoB because the LDH is normally high. A few carbs should drop the LDH, but the critical ratio is the Triglyceride/HDL which yours is apparently good.. The other test no one seems to talk about is fasting insulin, far more important than fasting sugar, which should be in the single digits. Ben Bikman stresses that hyperinsulinemia is the controlling factor not hyperglycemia, and I agree with him.
@@marksmith2625 Agreed. My CAC is 6, HDL in the 70s, TGL in the 60s, fasting insulin of 2, and very low CRP of 0.47...but my doc pushes statins because my total cholesterol is 240. Robert Lustig MD "Metabolical" will tell you that Total cholesterol is garbage and to throw it out. Funny how my statin-pushing doctor is overweight...and has never heard of a Lean-Mass-Hyper-responder.
My GP does not even like to give me a copy of my blood test results or ECG report. He says he will send it to the cardiologist and asks me why i need it because it's not like I would know how to interpret the numbers, anyway. He is so averse to questions and suggestions that if I were to request that he order the tests recommended here, he himself might have a heart attack. I would have liked to have my bloodwork done by Dr Cywes's lab, but unfortunately, I am outside of the US.
First, send me a bottle of your fountain of water you're taking. Second, I've listened and learned form you and other like docs for years and have confident idea on many of these things. Secondly, I've listened to Attia a handful of times. And his info just doesn't set right with me as it contradicts some things that y'all teach.
Great video! Very concise and informative. One of many of your videos that I saved on my playlist. Do you think metformin is a good anti-inflammatory drug with low side effects? Could you do a video on that? Thank you so much for your continued service.
I have had a heart attack..and I have one stent..I also have CKD.STAGE 3/4...MY Dr. Told me..if I want to go on Dialysis..continue with Colchicine...my choice..
I wish he'd reference studies that suggest what he says. Makes his points questionable, such as carnivore diets being more anti-inflammatory than plant based.
Your theories are popular, but where are the outcome studies to back it up? Statins have literally hundreds of trials showing reduction in events. Can you point to a study supporting any of the interventions you suggested? I believe colchicine has maybe two showing very slight risk reduction, and of course aspirin has been studied over and over again and has inconsistent benefits in the right population. But if I’m growing plaque on CAC, I’m a little uncomfortable relying on anecdote and dogma to stop it.
@@robertcywes2966 The argument from unimpressive ARRs suggests lack of understanding about clinical trials and statistical power. RCTs are not designed to show maximal benefit. Doing so would be a waste of money, labor, and precious time. It’s also unnecessary. Instead, trials are deliberately and carefully powered to detect any benefit. As soon as the intervention separates from placebo, we have confidence the intervention works. By design, then, the ARR will be barely detectable. Once it is detected, the trial is over. When the totality of statin trials is evaluated (26 of them as of 2017), there is a statistically significant and consistent risk reduction that correlates linearly with the degree of LDL-lowering. The same benefit is seen in prospective cohorts and Mendelian randomization. I’m sure you’ve read the consensus statement I’m referring to: PMC5837225 Again, you may demand higher ARR, but as long as we’re constrained by time and resources, you won’t get them. But to my original question, do you have any interventional evidence that lowering inflammation or adopting a low carb diet will improve cardiovascular outcomes?
@@mfkleven Such intervention(a low carb diet trial)wouldn't get funded. pharmaceutical studies get funded. and as soon as some relative risk reduction is seen, the study is abruptly stopped, lest side effects start to show up or the benefits aren't durable. Dr. C's point re: absolute risk is legit.
@@bobtheriault5173 Except that such studies (low carb) have been funded, and none have shown improved cardiac outcomes. Maybe that will change in time, but for now, there’s no evidence to support a low carb diet for heart health. Furthermore, studies are funded all the time without pharma support. Last I counted, plant-based diets boasted at least 25 trials showing lower risk of heart disease-no drugs needed. To your point about stopping trials before side effects manifest, that’s another interesting idea, except that post-marketing studies continue for many years after any new med hits the market. Statin trials, for example, have followed patients for nearly a decade and found, contrary to your conspiracy theory, that side effects don’t accumulate with time, but the cardiovascular benefits do-long after the patent has run out.
I'm surprised that among the initial tests you discuss in this video, that there is no mention of an A1C, insulin or C peptide test. I understand the need to know of the presence of inflammation, but wouldn't you want to confirm the cause of the inflammation with these other tests?
Agreed as well as Triglyceride/HDL. Once insulin sensitivity is determined to exist, then continue with ketogenic or -vore or carnivore diet, cut out seeded oils, and do some form of intermittent fasting.
I've had high total cholesterol and moderately high triglycerides for decades - but good ratio and excellent HDL. At 66 my fasting BG (even after 36 hrs!) is 104. My HbA1c is 4.9, my BP is great and I'm trying to go from keto to carni. Doc wants me on a statin, but there's No Way that's going to happen. Any advice?
You have heart disease and need a statin. Low carb dieters experience 2x more heart attacks than standard american diet, so you don't want to be doing that either.
Speaking as heart attack surviver. Who had high cholesterol 7.2 & high try. The best thing you can do 1. Fasting 2. Don't eat any pork 3. No processed food 4. Reduce sugar 5. Lower stress. Check yr BMI ...the greater waist to chest ratio = higher risk. If, you don't radically make changes YOU WILL HAVE CVD heart attack!
Thanks for sharing this. Just finished reading "Health and Beauty Mastery" - what an eye-opener! This book exposes so many hidden truths about the health industry that no one talks about! I completely changed my habits
I got that, it's one of the best books i've read
Thanks for sharing
Who is the author?
I had a CAC score March 15 of this year, I had one completely blocked coronary artery. I had been eating a low carb diet for two years and a type 2 diabetic for 20 years. I had a heart attack a week after my CAC test. Because I was eating healthy and my heart was in shape, I had two stents placed and I have no damage to my heart. My oxygen never went under 98% even though only one Coronary artery was fully functional. I am now on a carnivore diet and hoping it helps both my insulin resistance and diabetes as well as. My last A1C was 5.9 my triglycerides were 87 my HDL 88 and my LDL 179. My cardiologist is freaking out and wanting me to go on Repatha. When I tried to explain to him the three top reasons for heart issues was diabetes, insulin resistance and obesity. Why not help me treat these instead of looking at cholesterol? He looked at me like I was an alien when I asked him to separate my large and small ldl particles. I wish I could find a physician like you.
If your LDL is above 60 ....you are laying down plaque....that is the reality.
You 100% need the statins. High LDL is ok so long as you are metabolically healthy, which you are definitely not!!! You’re seriously risking your life. Go on the statins, then do what you can to improve your metabolic health and insulin resistance etc. Only then consider losing the statins
@@vickyburton2434 Once you have plaque, you need statins. Generally a low dose has the same efficacy, but don’t be a fool and go without them. You are the intended candidate.
If you have high LDL I would have thought he shout have sought ApoB & Lp(a) test Maybe take some Niacin ( Nicotinic Acid) just in case ...
@@RogerWilcoWTF I take Extended Life Niacin and Omega 3 fatty acid as well as ADK. I will have to pay for tests myself because my physicians are so indoctrinated by one number theory. .
I am 68, in March of 2023 I desided to drop the statins because of of bad side effects. Started Keto and intermittent fasting. Went from 198 lbs to 168. Now I am not taking any meds for cholesterol or high blood pressure. My ldl is below 90. I feel great thanks to doctors like you. Thank you for your great advise!!
Do you keep your ldl solo on a keto diet. Do you keep your saturated fat intake low?
How much is your carbs? And how much is your total fat and within that , saturated fat
Interesting that we as patients must instruct our doctors to do the correct trouble shooting and identify root cause. My doctors will not do it, they become offended if challenged. This is ego, not intelligence. I'm largely Keto and exercise every day for several hours either hiking, biking or just washing a car etc. I'll have to trust I'm good. Thx for all the advice, it changed my life and health.
I'm a 66 yo lifelong runner, cyclist, and exercise nut. Formerly on KETO but now low carb, my doctor recommended the CAC test because my LDL is a little high. I got there to find out it cost $100 out of pocket. Great score of 5.95 but my doctor still thinks I'm gonna die if I don't take statins, which I refused. He claims a higher LDL puts me a higher risk of heart attack.
Simply find another Dr
There is simply NO proof the LDL number means anything.
Yeah except the 100s of studies that say otherwise
@@snakejumper3277 You don’t need to take a statin.
"He claims a higher LDL puts me a higher risk of heart attack."
Risk is a BS.
Association is not a causation!
This helps me stay ahead of any surprise cardio and cerebrovascular events. A dubious CKD (based on eGFR calculated using creatinine rather than cyststin-c) diagnosis, the discovery that a cyst on my pancreas had digested 90% of my pancreas, and hyperhomocystenemia were not events I was anticipating. So now I'm vigilant about vessel and heart health. Your information is very valuable to my vigilance. Thank you!
Great tips! Dr. Cywes, please do a video on strategies to manage emotional and physical stress that is backed by science to help manage cortisol levels etc. The LDL gaslighting gives many of us mental stress. Thanks for your hard work!
He has them key word search his videos
Exercise
Spend time in your parasympathetic state. Yoga. Meditation. Yoga Nidra ( for sleep).
You totally rock! Thanks for you honesty and intelligence.
I’d love to see you debate Dr Attia.
Loved to see you mention Rooibos Tea, it is the best. I'm sensitive to caffeine and love Rooibos as a bridge drink for intermittent fasting. Kingfisher Teas Rooibos is best.
It is. My night time bridge
@@robertcywes2966I live in Cape Town and a Stellenbosch doctor, Sybrandt Smit, did his studies on green rooibos rea and apparently it is excellent for cardiovascular health and lowers blood pressure.
I had a nuclear medicine stress test where they did not want me to use the treadmill but instead injected me with something that shot my BPM up to 160 in a few seconds. They did not find anything wrong at the time. I was still having symptoms and believed there was a major problem. Several months later I insisted on another nuclear medicine stress test but to their displeasure, I also insisted on the treadmill. That meant the Doctor had to be present during the test. This time as my heart rate was climbing slowly and more naturally I had a MCI.
Based on my experiences and many discussions with my cardiologist, I would recommend using the treadmill if possible and also to use the left and right mammary arteries for coronary bypasses since they trend to last longer than a radial artery or a saphenous vein.
Thanks for this suggestion. I’ll look into to it! Stay well!
For the pharmacological (Regadenoson) nuclear medicine stress test to be accurate you need to stop ALL caffeine containing products for at least 12 hours. Also you need to stop all anti-angina meds (nitrates) prior to the test. Btw the dr should 100% be present when this is done and not only when the treadmill is used.
@@lfk53no kidding? To my knowledge, my cardiologist was not present.
Thank you for putting this info out into the universe! I’m only 27 but already taking precautions on what I eat!
Prevention always better than cure
number 1 thing is avoid the bad seed oils at all costs. there are many vids on the bad seeds oils to avoid
so sad that an MD does not understand a basic WBC count !!!went back to cardio past cath, ( one of the largest practices in area) was pushing the repatha's since cant take any statins. Told her about the colchicine drug and the name of your video plus had been approved for FDA for cardio use, that got her attention, so tired of MDs treating patients like they are dumb as a bag of rocks. One advantage I do have I was an RN for years and can recognize when the doctors are just going thru the patients like an assembly line. Very refreshing to watch a doctor with compassion and values his patients.
2:50
I love you doc and I recommend you daily. Cardiac stress test does not use a dye. It uses a radioactive tracer typically technetium. The drug we use dilates blood vessels. Lexiscan is trade name and generic regadenoson is used. I believe the more often than occasional increase in heart rate is due to decreased b/p and your body's compensatory mechanism to increase stroke volume. Great work as always!!!
Great! Thanks for ur precision.
Hopefully, this will help many people cut through all the medical dogma.
Thanks a lot for your inspiring talks which have helped me a lot so far, by changing my mindset about food and the effects of it on my health. At the age of 80 it nearly feels as if I’ve never had more energy.
Thoughts on the role of ApoB and Lipoprotein(a) as risk factors? Peter Attia seems to be pretty obsessed with reducing ApoB as much as possible, which makes no sense to me. Videos about these topics would be super awesome.
my CAC score went from 30 to 1:10 in three years all because I was taking vitamin D3 without vitamin K2 …started taking K2 twice a day along with magnesium glycinate ,cod liver oil capsules and nattokinase.. I eat a lot of carbs. I did not change my diet and I got my score down to 90 when year later. The CAC test is good, but the best one is the CT angiogram, same scan, but they inject dye into your arteries so they can see the soft plaque and the calcified plaque… If you’re wondering what the cod liver oil cap, and Natto are for .. to keep the clots from forming keep the blood flowing
Very reassuring and helpful after watching videos with doctors loudly denouncing the carnivore diet as dangerous without hesitation! With thanks!
I have been diabetic type 2 since I was 50 and I am 70 now and I have been doing keto off and on for those 20 years and recently I was pretty strict keto for the last year, and now I am eating a carnivore diet. My blood sugars are still high, and my triglycerides are 138 and my HDL is 43. My TSH is 3.34 which is not a good number for me. I just got over a sinus infection and had taken a Z-Pac antibiotic. I just did blood work yesterday and a few days earlier I had a low grade fever return, but fortunately it didn't turn into a sinus infection again. My HSCRP went up to 1.3 when normally it is at .6. I think the thyroid numbers and the sinus infection affected my numbers. I had a CAC score about 5 years ago and it was 210.
Very helpful information. 58 yr male and my cac score was 605 2 years ago. I have lost 60+ lbs with a locarb keto diet and the information you give is giving me the knowledge to retest and double up my efforts to do my best. Much thanks Dr.
I am in the UK, the Dr’s will not give us any of those tests and most of those tests are only done at specialist labs in the big cities. Don’t move her!
The NHS is state funded and money is at the heart of it. Go and get them privately?
I begin a binge with a frown, a grimace or agonised facial expression, a blind reminiscence of my impalement shock which was unrememberable for 60 years
Awareness buys time, time buys options - until it doesn't. Trillions spend on sick care, an unhealthy population, and a Govt that subsidies; corn, soy, wheat, and rice. Thanks for your awareness.
Apolipoprotein A1/Apolipoprotein B (Apo A1/Apo B) are risk markers. Get them checked it’s not that expensive
And Lipoprotein a
What about hard plaque vs soft plague? Soft plaque, which appears to be the real risk factor on calcification, does not show up in a CAC score. Wouldn’t a CIMT test prove bettter?
Thank you for this information. It helps me decide next steps for my husband. He will be getting a calcium score before he gets a nuclear stress test.
My doctors reacted exactly as you describe. Freaking out about my LDL (highest was 509). The cardiologist was convinced that I would be on his operating table the following week and he'd be cleaning "cottage cheese" out of my veins. That was a year ago. He convinced me to do an expensive CT Angiogram. Calcium score was 0 and they found no evidence of atherosclerosis. And yet THEY ARE STILL PUSHING STATINS! I hate that!
I started keto (real food, not gimmicks) 6.5 years ago, and that's when my LDL went up. Covid triggered an autoimmune condition called Lymphocytic Colitis, so I stepped up to carnivore 3.5 years ago. That's when my LDL shot up to the 509 mark. The problem I'm having is that every time I have any issues, the doctors look at me through the lens of "it must be the LDL".
For example, following a UTI which turned out to be a staph infection, I had massive leg cramps every night, even after the infection was gone. They wouldn't look at my kidney function. They wanted to do another expensive scan of the veins in my legs, looking for a clot. I refused it. Finally massively increasing my water intake helped the cramping. I still think there is something wrong because I've never had to drink so much water before.
It has also been suggested that my LDL could be due to FH, which is asinine because that's a condition that's supposed to occur from birth. I never had "high" LDL till keto. So to prove that I could lower my LDL without a statin, I did a 2 week carb challenge eating plain white rice (a al Nick Norwitz's Oreo study). The rice didn't trigger my colitis, and I did indeed lower my LDL by nearly 50%. But all my other numbers went drastically in the wrong direction. Most concerning was my Cardio CRP which was previously 0 mg/L then shot up to 0.9 mg/L! I had such massive inflammation from that carb challenge, my blood pressure was consistently very high, giving me massive headaches beginning within a few days of the challenge. And, of course, they are still pushing statins.
Ever since that challenge, I've had painless numbing sensation in both my legs down to my left big toe, and now at the end of my left ring finger. This latter is very concerning as I'm a harpist and need my fingers! I'm afraid to go to my regular doctors because they will again look at me through the lens of "It must be the LDL". I plan to see a chiropractor first, but if you have any suggestions I very much welcome the input! 💜
Your case is so complex. need to consult a bio-chemist not a regular doctor.
You should definitely consult a different doc or consult Dr Cywes. Not here in the comments, but getting an actual appointment ASAP.
youre getting leg cramps and drinking so much water because you dont hyrdrate the same without carbs. you need to up your sodium intake and/or take an electrolyte supplement
There's definitely a connection between carnivore and cramping. There's 1 person a Watched that said a little bit of carbs helps the kidneys and somehow reduces cramping. So take that for what it's worth.
I hope you find a doctor that will listen to your concerns and get you a kidney test. You could pay for the test but many people can't afford it.
Fantastic chat Dr. Cywes!
It's impossible to know who to believe. We have accomplished professionals on both sides, both making convincing arguments, conflicting studies... Might as well flip a coin. Also, rising CAC could be soft plaque calcifying, which is ideal.
Not when you follow the money of big pharma and the processed "food" manufacturers
@@johnsonpaul1914If you’re talking about statins, they’re almost all generics at this point. People need to stop making that argument. I have no idea if low-dose statins reduce risk for people who have a CAC greater than 80 or whatever.
@@johnsonpaul1914I'm speaking with the context of this realm, one of eating correctly. Even in the low carb, no processed food circles, there's a difference in approach and a different path with which pharmaceuticals you'll take when your case has advanced enough. They all recommend drugs when you have crossed certain thresholds.
Attia is a clown when compared to Rob Cywes. Just my opinion.
It’s pretty simple. Why would you listen to a RUclips doctor. Also why would you take health advice from someone that is clearly overweight.
Great explanation of the tests needed for evaluation and reasoning for them.
Where was the part where Peter Attia was wrong? You titled the video that but didn’t mention his name? Peter has talked about calcium scoring before and the importance of it
I like Peter Attia, but I agree about him being misguided about cholesterol causing CVD.
My CAC went from 02 to 92 in 5 yrs. Thanks for the advice of the nuclear stress test.
There is no need for personal attack. Present your evidence and leave it to the public.
Rob Cwys I was drinking rooibos while watching your video...even better if you can get your hands on stokkies( raw bulk) which is richer tasting...I'm a cholesterol skeptic and enjoyed all your podcasts...subscribed and ticked.
I had a CAC score test done through a radio promotion. My score was 158.. they kept saying through the promotion that the test was $700
Had a nuclear stress test, and a treadmill stress test, which I passed with flying colors, so they said.
Still worried.
Dear Dr. Cywes,
While watching this video I ordered the tea you mentioned. I almost thought I was allergic to all tea’s. I am drinking a hot cup right now. Wow,
You are so right about this tea. It is so pleasant to drink. Thank you for mentioning it. 👏👏👏
What kind of tea ? Thanks
I would love for you to do a video addressing strategies for people that have already had a heart attack or a CABG surgery.
Great idea
Yes, I second that suggestion. My husband had the same and, while he is 6mos on carnivore, his Dr uses fear and condescension to tell him he is going to make me a widow and that his lipids look terrible. He's looking for another Dr and also would like a consult with Dr. Cywes, if we can afford it. God Bless.
Ya, no one talks about this. It's all "before" this happens, but nothing about AFTER it happens
First time in my life being proud of getting a zero.
My cardiologist is concerned about the LDL levels but did not test to determine how much of the small or large LDL particles were in the count. He wants me to go on statins because of the stents that were put in after my heart attack. So I was wondering if you could answer this question: Do stents increase the risk of plaque build up at the stent site when LDL is elevated?
I'm irritated because neither of the cardiologists I've seen ever did a fasting blood sugar, and I was told the amount of blockage I had was higher than they would have expected considering my cholesterol and triglyceride numbers. The family doctor di that and found I was highly insulin resistant and almost pre diabetic. We discussed my diet and she didn't understand why I was IR. In all fairness to her, the discussion wasn't very in depth and she did want to go more into it on another appointment. I did more research and learned why. Although I didn't eat a lot of sugar, I ate way too many simple carbs, and also ate those carbs too often (mid meal snacks were always some kind of bread). My SubQ fat was low, but I still had a belly. So I dumped the majority of my simple carb intake, cut out sugar entirely, changed my snacking to nuts, and never eat past 6 pm if I can avoid it. In 3 months, I lost 3 inches in my waist but still kept the same subQ level (At 65 I have a visible, but not highly defined 6 pack). Reading the research on this and listening to you and a number of other cardiologists, I realized what the issue had been. Too high of a carb intake and insulin resistance.
i think you are on the right track.
look into fatty liver disease connection to insulin resistance
My husband had a major heart attack one month after having a nuclear stress test. He was told his heart was in great shape.
What was it that the stress test did not pick up on? I'm supposed to have one in a few days.
Was he fully vaccinated?
@@DingoLingo2 maybe his triglycerides were high
@@DingoLingo2 He was hospitalized with Afib and was told his heart was fine. He actually had total blockages in 3 of the main arteries that resulted in a widowmaker. If they had done a heart catheterization, it would have shown the blockages. Advocate for a heart catheterization! He survived, but his heart output is now 25%.
@@CraigMoxey-b1g Nonsmoker, nondiabetic, not overweight, not vaccinated. High triglycerides for most of his adult life.
I have total chol at 280 and LDL at 180. Drs of course hype statins. I am 67 and a recovered diabetic on keto-ish low carb diet and eTRE (early time restricted eating) for over 4 years. I have a low Trigs at 70 and high HDL at 99. My Uric Acid is high, not certain why since all other inflammatory markers are low. Anyways, I cannot get a CAC or other test as I live in rural Greece. However, I asked the cardiologist to examine me to see if there are any signs of problems. He did many exams including electrodes, sonogram, and treadmill and said that I am perfectly fine, no need for meds! I wish that I could get the Uric Acid lower, but I have no idea what to do. Eliminating red meat does not seem healthy or feasible for me.
I read somewhere that low Trigs imply that high(er) LDL is the healthy big fluffy kind that transports fats/ketones. Also, that low Trigs imply low inflammation. I am not an expert, so perhaps I am incorrect or over simplifying?
High fat carnivorebased
@@robertcywes2966 Thank you for responding!
Red meat and saturated fat is good for you. Just stop the carbs, sugars, and seed oils. Ben Bikman(with Ken Berry) ruclips.net/video/DTkzhSCsTD8/видео.html stated in communication that 20 gm of allulose(RX Sugar) daily will dramatically lower your uric acid in a few weeks.
Check the book "Nature wants us to be fat". Richard Johnson talks a lot about uric acid in that book, very insightful.
No more coffee?
Noooo!
I love the video you made about the benefits of coffee.
Folks, just because you have a low Ca score does not mean you are without risk. In fact you could be at high risk if you have a significant amount of soft plaque, which is not detectable by a Ca scan.
Exactly!
Get a CIMT test
@@RUclipsdisco yup, that’s the only way to tell.
@@RUclipsdiscoWhat is this test?
@@darscassel It’s a coronary calcium scan (CAC test).
This information tracks with other sources of "truth" or "unbiased medicine" & I commend Dr Cywes for his efforts
But CAC only measures hard plaque which is not a good measure. The soft plaque is what causes cardiac incidents.
This is great. All spot on! I remember peter Atillas guest who ended the interview on a note, just eat less calories 🥴. What causes bulging of varicose veins/valve failure. My guess that its arterial inflammation.
The main take away from this video should be:
1) blind faith in authority is the greatest enemy of truth.
2) healthcare is self-care
3) don't be afraid to take charge of you health and advise your MD accordingly
Very clear thinking. Statins are usually not the answer. Our Australian doctors also (incorrectly) freak out over high cholesterol.
My CT was 0 and I get new strokes…. No vegetable oil, nearly no carbs, no suger! LOT of meat and butter. Exercice and meditate. Not overweight.
How long were you on this no carb diet
Plant your diet in such a way that will be beneficial, also do not forget to add Arjuna tea in your diet to keep heart health.
Clearly different experts focus on different things. Dr Cywes is focused here on inflammation. That’s one possible aggravating factor in the development of atherosclerotic cardiovascular disease. Address it if it’s an issue. But many people - me included - have plaques and very low inflammatory markers and uric acid. What then? Address the known potential aggravating factors: hypertension, prediabetes or diabetes, elevated lipids, lack of exercise. What bothers me is when anyone focuses in on one thing when the condition is clearly complex and multifactorial. Then it starts to look like the person has an ax to grind, or is focused on advice that will help some and not others.
Everything u mentioned = inflammation😊
OMG. Second error. ANA is antinuclear antibody NOT antigen! Essentially the opposite. Wow!!
I have been true to carnivore since Oct 2022. I am 71and have no symptoms. My Feb '24 CAC was 2770. I take aspirin and other anti-inflammatory supplements in addition to D3 K2 E Co Q10 and others. A CT w/contrast & Cleary analysis showed 80% and 60% stabilized plaque in R&L arteries. I passed my tread mill stress test 4 months ago and my CIMT shows I "passed" but am at high risk. My cardiologist told me several times there is no way to get plaque out of the body. After 14 treatments of EDTA iv chelation therapy, my elevated (but not crazy high) cholesterol numbers dropped dramatically and the bottoms of my feet that have been numb for 8 years have 98% feeling restored, additional proof that EDTA chelation is safe and effective. To date, I've had 24 EDTA treatments and will continue with monthly maintenance treatments for the foreseeable future.. I do weight bearing activities daily. My cardiologist wants me to take statin and a weekly injectable anti-inflammatory that I have declined.
Great choices! I didn't see any vitamin C listed. I am on the Linus Pauling Heart Protocol. I reversed a 660 score by 30% in 20 months. Read Dr. Thomas Levy's book "Stop America's #1 Killer" Proof that the Origin of All Coronary Heart Disease is Clearly Reversible Arterial Scurvy. If you have calcium like you do it is Clearly a vitamin C deficiency.
What is EDTA chelation therapy, not heard of that before?
@@Thomas-1976 I think I can help you. He is on a IV chelation therapy pretty expensive. Myself I'm on an oral chelation. What it does is to remove toxic metals like lead, mercury, and others like calcium which is electricly conductive. Once bound to the chelation material it's just urinated away.
“Ignore LDL as long as they’re high”. Are you sure you’ve got that right?
I do not see Peter Attia mentioned in this talk. Why is he mentioned in the title? If you want to disprove Peter Attia then come with facts. Personal attacks are inappropriate. Soft plaque does not show on CAC scores. Lp a level is an indicator of increased risk for CAD. Please indicate where Peter Attia is wrong
My thoughts exactly. This is click bait.
Wrong on both counts. Cac is a screening test like a mammogram. Lpa indicates wound healing capacity anywhere in the body...survival advantage
Thanks for making this video. Exactly what I pointed out in Ep 384. Great work!
What about the CIMT test for soft plaques over the stress test. Or both? Apparently even ppl with a zero CAC are still having heart attacks. Just what I’ve read recently
I appreciate all the information in this video. I actually even subscribed to learn more. However, what is it that Peter has wrong? I find his information very valuable and it has helped me quite a bit in terms of changing my overall health. I feel likeboth what you suggest and what he prescribes can be used in unison.
How do I reach you for a consultation and how much does it cost? I’ve been carnivore for about 4-5 months and low carb for years, yet I cannot lose weight and my A1C has moved into pre-diabetes zone at 5.7. Is my body just running low on insulin!? I’ve been eating a low carb diet for years in order to avoid this…how can this be?
My HDL cholesterol is low at 63 but LDL is a 254. Triglycerides are at 91. My fasting glucose is 92. I’ve been eating fat and protein exclusively for 4-5 months. Why is this happening?
Your fasting is excellent. 1ac can be flawed. Try an OGTt.
LADA or 1.5 is something I’m looking into.
C peptide test
I wonder where the magical CACS score of 80 has suddenly come from.
Me. 3pts of mine needed stents at 80
Thanks for the Video. Very informative. CAC sees only the hard plaque. What about the Soft Plaque. We are told hard plaque is nowhere near as dangerous as the soft plaque; hard plaque cannot be dislodged to cause heart attack. Whereas soft plaque is very likely to dislodge. So to be accurate, one has to undergo Angiogram rather that CAC. Do you agree with these statements. Thank you.
Better test is CIMT to detect soft plaque and Fibrinogen
I'm curious also what he thinks of this test. I've never heard him mention it surprisingly
Thank you so much for this video! Now I know how to approach my doctor and what to ask for. Prayers to you Doctor C 🙏
so my CAC was 420 3 years ago (380 in the LAD). I'm not on statins. My Total cholesterol is around 190, Hdl 55-60, trigs are 70, LDL around 114-130. I'm 74, diabetic with RA on Enbrel which is very effective. Vectra D score is 10. . I recently had a nuclear stress test when I was in the hospital with high heart rate (turned out to be a-flutter - have not had an episode since) - stress test came back negative - no ischemia. HS - CRP .3 . LP(a) score is 9. Most recent ApoB was 105 from October 2023. Retest? Would you suggest another CAC at this point? I walk 3-6 miles a day - eat a keto diet although probably 40 net carbs vs 20. Of course my doctors want me on statins especially since I"m a diabetic but the NNT isn't very encouraging for them . I don't want the. possible harmful side effects (no matter how small the doctors try to tell me the risk is) because I depend on my walking to keep my glucose numbers in range (hba1c of 6.0). And the thought that they could possibly worsen my diabetes.
I started about 15 years ago on 20mg of atorvastatin. I have left bundle branch block and very slightly impaired LV emission....if that's the right way of saying it. 47%. No structural heart issues and no signs of CVD. Had MRI done of heart. Cardiologist and GP over the years have increased my statin dose to 80mg. Of course ldl has reduced. But the side effects particularly since I was on 80mg which is about a year now, are horrendous. Especially tendons and gout and fatigue. I have decided to come off and go keto and exercise more. I know it sounds an extreme thing g to do but talking to my doctor is pointless. All she wants to do is prescribe. What I have noticed is that when I wasn't on statins although my LDL was quite high so was my HDL. Anyway I'm doing my own thing and taking cholesterol tests including Apo B etc privately. I'm in the UK by the way.
Wow that was a long post 😀
Do you recommend quitting coffee?
This is what we tell people in our support group! Eat the fat first and try to get fat in every bite. Trigger the cholecystokinin to tell the brain "you're full, stop eating!" Listening for that signal is an integral part of the fat adaptation process!
Thank you greatly Dr!
It’s my understanding if you “donate blood”, which I’ve done lowers cholesterol. It lowered mine several points after donating blood.
Irrelevant sadly
It definitely reduces iron levels in your blood as I donated blood to reduce my Ferritin level.
@@Thomas-1976 My cholesterol went down 14 points. Not sure for how long but it did.
Please advise Xi Jinping that if he wants to visit Nunawading he will need to be on the carnivore diet for seven years.
Thank you! Very actionable advice
Thank you doctor!
God Bless You!!
Can I buy the one at the grocery store or do you have a link where you buy yours?
I have high cholesterol and ldl. Low triglycerides and good HDL. CAC scan was 0. I’m not overweight, don’t smoke, or drink. I’m active. Have little stress. My inflammation is low. Uric acid is low. Ferritin is good. I do however have a high apob and higher lp(a). I’m bringing my ldl levels and cholesterol down to basically prove it to my Dr. that these numbers are because of a high fat animal based diet and by simply eating carbs and fiber I’ll be able to bring my numbers down. I’ve already brought them down within a few month but he’s still pushing Lipitor. I keep telling him no. I’m scheduled for an echocardiogram next month, and recheck my lipids in November.
If you are skinny like me with a very low BMI, you may be a lean mass hyperresponder(LMHR) which would have a high apoB because the LDH is normally high. A few carbs should drop the LDH, but the critical ratio is the Triglyceride/HDL which yours is apparently good.. The other test no one seems to talk about is fasting insulin, far more important than fasting sugar, which should be in the single digits. Ben Bikman stresses that hyperinsulinemia is the controlling factor not hyperglycemia, and I agree with him.
@@marksmith2625 Agreed. My CAC is 6, HDL in the 70s, TGL in the 60s, fasting insulin of 2, and very low CRP of 0.47...but my doc pushes statins because my total cholesterol is 240. Robert Lustig MD "Metabolical" will tell you that Total cholesterol is garbage and to throw it out. Funny how my statin-pushing doctor is overweight...and has never heard of a Lean-Mass-Hyper-responder.
A CAC test for 100 Bucks? It’s £500 in the uk……really not accessible.
My GP does not even like to give me a copy of my blood test results or ECG report. He says he will send it to the cardiologist and asks me why i need it because it's not like I would know how to interpret the numbers, anyway. He is so averse to questions and suggestions that if I were to request that he order the tests recommended here, he himself might have a heart attack. I would have liked to have my bloodwork done by Dr Cywes's lab, but unfortunately, I am outside of the US.
Where’s the Dr. Attia part? Surely he didn’t just throw his name out there as clout.
Great advice. Thanks Doc.
Excellent information
would have been very helpful to include the exact things to test for in the video comments.
Dr Cywes you are doing the Lord's work. I can't wait to see where we take this movement in 5-10 years.
Cheers
Thanks. Hopefully it keeps folks away from visiting w the Lord a while longer
First, send me a bottle of your fountain of water you're taking. Second, I've listened and learned form you and other like docs for years and have confident idea on many of these things. Secondly, I've listened to Attia a handful of times. And his info just doesn't set right with me as it contradicts some things that y'all teach.
Thanks but it's the lighting
From what I've gleaned from Attia is that he contradicts himself.
Great video! Very concise and informative. One of many of your videos that I saved on my playlist. Do you think metformin is a good anti-inflammatory drug with low side effects? Could you do a video on that? Thank you so much for your continued service.
Wd not use metformin for its ant inflammation properties
Well...what do you use??@@robertcywes2966
THANK YOU
I have had a heart attack..and I have one stent..I also have CKD.STAGE 3/4...MY Dr. Told me..if I want to go on Dialysis..continue with Colchicine...my choice..
What about Steel Cut Oats? My understanding is they are anti-inflammatory. What is your take on this Doctor Cywes?
No they are not
High insulin
love the content
I wish he'd reference studies that suggest what he says. Makes his points questionable, such as carnivore diets being more anti-inflammatory than plant based.
Well it helps my undrrstanding thank you. Whether it helps with my relationship with my dr is yet to be determined 😊
Thanks, I've been getting CAC scores for about 5 years, going for another one soon. First info about colchisine.
I have a whole video on colchicine
Your theories are popular, but where are the outcome studies to back it up?
Statins have literally hundreds of trials showing reduction in events. Can you point to a study supporting any of the interventions you suggested?
I believe colchicine has maybe two showing very slight risk reduction, and of course aspirin has been studied over and over again and has inconsistent benefits in the right population. But if I’m growing plaque on CAC, I’m a little uncomfortable relying on anecdote and dogma to stop it.
There is no statin study showing significant absolute risk reduction
@@robertcywes2966 The argument from unimpressive ARRs suggests lack of understanding about clinical trials and statistical power. RCTs are not designed to show maximal benefit. Doing so would be a waste of money, labor, and precious time. It’s also unnecessary. Instead, trials are deliberately and carefully powered to detect any benefit. As soon as the intervention separates from placebo, we have confidence the intervention works. By design, then, the ARR will be barely detectable. Once it is detected, the trial is over.
When the totality of statin trials is evaluated (26 of them as of 2017), there is a statistically significant and consistent risk reduction that correlates linearly with the degree of LDL-lowering. The same benefit is seen in prospective cohorts and Mendelian randomization. I’m sure you’ve read the consensus statement I’m referring to: PMC5837225
Again, you may demand higher ARR, but as long as we’re constrained by time and resources, you won’t get them.
But to my original question, do you have any interventional evidence that lowering inflammation or adopting a low carb diet will improve cardiovascular outcomes?
@@mfkleven Such intervention(a low carb diet trial)wouldn't get funded. pharmaceutical studies get funded. and as soon as some relative risk reduction is seen, the study is abruptly stopped, lest side effects start to show up or the benefits aren't durable. Dr. C's point re: absolute risk is legit.
@@bobtheriault5173 Except that such studies (low carb) have been funded, and none have shown improved cardiac outcomes. Maybe that will change in time, but for now, there’s no evidence to support a low carb diet for heart health. Furthermore, studies are funded all the time without pharma support. Last I counted, plant-based diets boasted at least 25 trials showing lower risk of heart disease-no drugs needed.
To your point about stopping trials before side effects manifest, that’s another interesting idea, except that post-marketing studies continue for many years after any new med hits the market. Statin trials, for example, have followed patients for nearly a decade and found, contrary to your conspiracy theory, that side effects don’t accumulate with time, but the cardiovascular benefits do-long after the patent has run out.
I'm surprised that among the initial tests you discuss in this video, that there is no mention of an A1C, insulin or C peptide test. I understand the need to know of the presence of inflammation, but wouldn't you want to confirm the cause of the inflammation with these other tests?
Agreed as well as Triglyceride/HDL. Once insulin sensitivity is determined to exist, then continue with ketogenic or -vore or carnivore diet, cut out seeded oils, and do some form of intermittent fasting.
Attia is a well known egotistical ideologue suffering from the highest form of Dunning-Kruger
Prove it
Sounds like something Bart Kay would say 😂
@@robertbarthel9757 Accusing Attia of Dunning-Kruger is, well, ironic.
I was wondering when you'd show up
And cardio training over recommended
Strongly recommend physical activity of any kind doesn't always have to be high intensity
Thank you!
I've had high total cholesterol and moderately high triglycerides for decades - but good ratio and excellent HDL. At 66 my fasting BG (even after 36 hrs!) is 104. My HbA1c is 4.9, my BP is great and I'm trying to go from keto to carni. Doc wants me on a statin, but there's No Way that's going to happen. Any advice?
Listen to this video
Avoid statins
You have heart disease and need a statin. Low carb dieters experience 2x more heart attacks than standard american diet, so you don't want to be doing that either.
Speaking as heart attack surviver. Who had high cholesterol 7.2 & high try. The best thing you can do 1. Fasting 2. Don't eat any pork 3. No processed food 4. Reduce sugar 5. Lower stress. Check yr BMI ...the greater waist to chest ratio = higher risk. If, you don't radically make changes YOU WILL HAVE CVD heart attack!
Good stuff doc.
Thank you
Thank you
Thank you 💓
Isn’t a CAC only for hard plaque? Aren’t most strokes caused by soft plaque?
CIC score is a screening test it's either positive or negative and no it doesn't necessarily correlate with stroke risk
@robertcywes2966 Hi, I've not heard you talk about CIMT testing, what are your thoughts on it's predictability for risk assessment.
How about Cape Town Rooibos Tea? We thought of you when we found our can again. We smile at you when we drink it.