Dr Ford Brewer - PrevMed

A Patient came to me recently that had been evaluated for high Fibrinogen in the past. I usually get labs if a patient requests them. But I don't routinely follow fibrinogen. This video tells why. It also goes into the history of fibrinogen. I was discovered to be a risk over 30 years ago, in studies like Framingham.

Here's a link: https://pubmed.ncbi.nlm.nih.gov/3626001/

Other studies, such as an Annals of Epidemiology study, continued to show risk. This one actually showed some independent nature of the risk: https://www.sciencedirect.com/science/article/abs/pii/1047279792900958

Several LEI ( Life Extension Institute) articles were published after these indicating major risk factors. I quoted one, which gave an indicator of both management (aspirin, vits A, C and E, ) and of course, smoking cessation, weight loss, and management of blood pressure.

Finally, we covered an interesting article showing overlap of plaque imaging studies and fibrinogen:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282270/

I come from a family that used to eat too much - of everything. My dad had a BMI over 35 most of his life. At age 19, I was 35 pounds over my current 155. I had a surprisingly bad result at age 57. It motivated me to make a few changes. This included finally breaking down & taking a statin, changing my BP meds, dropping 10 pounds, and going low carb. My arterial age dropped from 73 years to 52. I got focused on a full-time activity as Chief Science Officer for Physician Partners, a Medicare Advantage pioneer, bringing prevention to Medicare, and from there to other forms of insurance medicine. I traveled every week, ate out too much, and gained 10 pounds. I also gained 5 years of arterial age. I have lost most of the 10 pounds, but that's only been over the past 3 months. My CIMT, if it responds, will take a few more months to do so.

This is our weekly YouTube Live event. I start off by covering dysfunctional HDL and the many functions of HDL. We also got questions about K2, like whether it really does make sure that D3 works correctly. We talked about whether LDL is really good or bad. And we talked about Rapamycin, mTOR, fasting & autophagy.

Julie had a serious Vitamin D3 overdose, with toxicity. She shared a short version of her story 3 weeks ago. This is the full interview video. It includes her original reason for coming to see us: cardiovascular risk evaluation due to an inflammatory disease called Still's Disease.

How does LDL get into the artery wall to cause plaque? Many of us used to say that it was damage or holes in the intima - the single-cell lining of the artery wall. Dr. Philip Shaul of UT Southwestern just published an article in Nature magazine indicating that LDL is actually transported through the endothelial cell. The specific enzymes are DOCK4 and SR-B1.

This is a general public coverage of the article in Medical Xpress. https://medicalxpress.com/news/2019-04-bad-cholesterol-artery-walls.html

This is the link to the actual Nature Magazine article. https://www.nature.com/articles/s41586-019-1140-4/figures/4

What is the impact? It doesn't change much about our understanding of the causes of heart attack & stroke (CV inflammation). or the causes of CV inflammation ( prediabetes, insulin resistance, smoking Lp(a), etc.) But it does create a major opportunity in understanding the specific metabolic pathway associated with LDL deposition in the artery wall. And knowledge of specific metabolic pathways is potentially very powerful - it can lead to prevention and treatment mechanisms previously unknown.

There is no question that middle-aged men in Eastern Finland that use the sauna more also live longer. There is, however, a lot of debate re: whether the sauna use causes it or something else. The "something else" might be cardiovascular fitness & conditioning. Is it that having CV fitness increases your sauna use by putting you in the gym more, and making it possible for you to remain comfortable in 175 degrees F heat?

So is it the heat shock proteins and FOXO3, as stated by Rhonda Patrick? or the association with fitness as stated by multiple letters to the editor of JAMA, who published a key article on this in 2015? Here's the 2015 article:

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2130724

My hunch is that it's both. The same articles published a follow-up analysis article in 2018. Unfortunately, the follow-up analysis wasn't published in JAMA Internal Medicine. I'm thinking that's because this analysis (multivariate analysis) should have been done on the 2015 study, but wasn't. Whatever happened re: the submissions and editorial judging, the follow-up indicates my hunch is right:

https://pubmed.ncbi.nlm.nih.gov/29551418/

Prolon Day 5 - Last day! Since the nap at noon on day 3, I have felt great! no fatigue or hunger. This is my Prolon Experience on a YouTube Live video discussion format.

We typically overtreat using surgery and medications when lifestyle changes are better. What's happening with ablation for atrial fibrillation as well. Ablation is a surgical procedure often recommended without investigation of common causes of procedure failure, like genetics & sleep apnea. This video covers the basic mechanics of atrial fib, ablation & failed ablation. Then we cover an early study showing the increased failure rate for OSA ( Obstructive Sleep Apnea). Here's the link:

https://pubmed.ncbi.nlm.nih.gov/20488856/

Penn Jillette didn't like potatoes. He lost 100 pounds in 84 days basically eating nothing but potatoes. No butter, salt, or pepper. They were cooked - with the skin. According to Penn, "magicians are professional liars. Anyone that takes medical advice from a Las Vegas magician is stupid and deserves to die..."

There is a lot more to the potato diet than you might think. It's not very elegant in terms of macronutrients and glycemic characteristics - and immediate biochemistry/biomarkers. But pictures don't lie so well. Look at the results. He's had major improvement in his blood pressure, longevity, and quality of life."