Dr Ford Brewer - PrevMed

50-60 people viewing this channel each day have FH (Familial Hypercholesterolemia). But only between 1 to 6 actually know it. FH is seen in 1 of every 200-250 people. That's far more than MS or Cystic Fibrosis, yet most of us have never heard of it.

And FH is lethal. With the fact that it's so under-recognized, we need to raise awareness. This video covers the CASCADE study, a study of the patterns of recognition & treatment of FH in the US.

Reverse T3 is a hot topic on YT. There are plenty of docs talking about how they use it. They imply - or state emphatically - that docs not using it is "behind the times", "not keeping up". Reverse T3 is real. It's a variation of thyroid hormone. And it truly is an inactivated version of the thyroid hormone. In addition, it is also increases during several conditions.

Two of those conditions are often mentioned by the "new age" Youtube docs:

1. malnutrition, or decreased caloric intake. In fact, this does appear to be a key mechanism for slowing Basal Metabolic Rate; and

2. During significant illness, as in hospital ICU-related illness. Direct T3 might be only slightly depressed, or not low at all. However, the Reverse T3 is clearly elevated, and the patient is clearly hypothyroid by the clinical condition - or symptoms.

Reverse T3 is also elevated in 2 other states: 1. during fetal development (high T3 is destructive of fetal development); and 2. with large hemangiomas - ( the D3 de-iodinase enzyme is found in high concentrations in hemangioma tissue.

The following link is a great source for learning the basics and history of Reverse T2 as well as thyroid science.

https://www.ccjm.org/#

Does all this mean that Reverse T3 is real and that high values are key to a diagnosis for your fatigue? Not so fast - the theory is good. But these things have been knowing for years - if not decades. At this point, however, the scientific evidence gets thin. The jury really is still out on this issue. I have used reverse T3, mostly at the request of patients. But I'd not recommend using reverse T3 levels to prescribe medications.

And the fortunate part is this - most docs, no matter how vocal they are about reverse T3, use it to recommend lifestyle changes - not medications.

If you have the common genetic variant Haptoglobin 2, your risk of heart disease is 3 to 5 times higher. We discuss a couple of articles that describe the structure, function, and amount of increased risk. One is from Cahill et al in the journal JACC 2015: https://pubmed.ncbi.nlm.nih.gov/26483103/

We also use some images from Brad Bale & Amy Doneen. And finally some images from D'Alessio Fasano re: leaky gut & zonulin, haptoglobin2.

This topic came up due to a recent Jl of Immunology article indicating there are more functions for Haptoglobin than just cleaning up oxidized hemoglobin.

https://www.jimmunol.org/content/early/2018/09/06/jimmunol.1800508?with-ds=yes

Here's my old video on the topic. It has more detail: https://www.youtube.com/watch?v=tCDRXh0aomo&t=1s

Diagnostic Accuracy & Physician Confidence - This study in JAMA indicates that docs miss a lot more than you'd think: almost half of the "easy" cases, and over 90% of the hard ones. Really? Was it young/inexperienced docs? or poorly trained? Nope. These were good docs, a cross-section of physicians today.

Were the cases too hard? Were there mistaken core assumptions in this study that would render the findings useless? As a career medical director/CMO and epidemiologist, I"m not at all surprised. And I'm not ready to say I'm the exception, the only doc that ever got it all right. In fact, I've begun to wonder how often some of my heroes (like William Osler) actually got it right...

We go into details on the article in this video.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1731967

USA TODAY published an article on the front page of the January 31, 2019 issue titled: "Study: Half of Americans Have Heart Disease". This is true. That's 121.5 million Americans or 48.5 %. The majority of that group (about 40% of the 48.5%) have high blood pressure alone. That's a major jump from previous numbers. Why? It's due to a change in the standard definition of high blood pressure. That happened due to the JNC(standards committee) announcement of November 2017.

I'm personally frustrated that it took 14 years to make that change. The latest previous definition was 2003. They used higher numbers to define the cut point for high blood pressure (140/90). The discussion after the 2003 JNC went like this, "There was a case to define it lower. But we expect the next JNC in 2 years to make that change if it turns out valid." The problem? It wasn't 2 years later. It was 14 years.

This is a group of the AHA (American Heart Association) and ACC (American College of Cardiology).

https://www.usatoday.com/story/news/health/2019/01/31/heart-disease-nearly-half-u-s-adults-have-it-study-finds/2729955002/

https://professional.heart.org/professional/ScienceNews/UCM_496965_2017-Hypertension-Clinical-Guidelines.jsp

Doug Thompson DDS is a dentist specializing in detecting and treating the oral manifestations of systemic inflammation. He founded and runs the Wellness Dentistry Network. He recorded his own biomarkers as a result of his experience with Prolon, (Valter Longo's Fasting Mimicking Diet). He shares this experience.

This video covers CycloDextrin. It's a new medication that dissolves cholesterol crystals. And it stimulates LXR -related genes. It's actually been shown clearly in lab mouse models to dissolve plaque. It hasn't been used in humans yet. But it has been shown to stop human immune cells from attacking plaque, again by the LXR pathway.