Insulin Resistance, Inflammation and Cardiovascular Disease – Lab Screening & Webinar

Okay, so is that live Clede? I am ready. So there’s a day. So this
would wait. I’m gonna go ahead and start then. So we’ve had more fun and games
with the software for the YouTube live event today. This time, one of my videos came up and we could not find where it’s coming from
and sure enough we closed that everything and it was still going
ahead. So there’s a ghost in the machine. What I’d like to do is just give you a
couple of updates on what we’re doing in terms of activities. Tomorrow I’m headed
down to AAOSH American Academy of Oral Systemic Health professionals.
It’s gonna be a group of about 3 to 5 hundred individuals, most of them are
dentists and their staff, um, folks that are very much in touch with the fact
that having periodontal disease is a risk factor for cardiovascular
inflammation and therefore for heart attack and stroke. There will also be a
large group of docs there as well. Docs that are into prevention and functional
medicine. So looking forward to seeing that crowd. I’ve already had
several of them acknowledged our email and let me know they would be there. We have good attendance for the upcoming Louisville event, that’s in two
weeks. And we have I think we’re beyond the sale component, you know
the first ten for the webinar series. Again I’ll talk a little bit more about
the webinar series here and actually provide you some of the information from
the webinar series. I was talking with a lady last week and asked her about it.
She and her husband were interested in getting a CIMT. I asked, “Well do you
know if you have inflammation? Or do you know if you have insulin
resistance?” She said, “Well he does. We don’t know if I do.” And I said, “Well, why
do you not join the webinar. You can get the testing there. That’s what it’s for.”
And she said, “Well, the webinar… we’re not really sure why we’d want to do the
webinar. We get so much free information from you on the channel.” And I said, “I
know, I’ve had this conversation at multiple people. We’ve been… we’ve not
been very clear about what the webinar is. The folks that have figured it out
though have acknowledged and understand. It’s a great way to get testing.”
So what we’re doing is we’re… here’s the history on it… well let me just say this
what we’re doing is we’re offering the cardiovascular inflammation test (the
panel) through Quest through our relationship with Quest because we have
found out that they’re no longer offering it direct to patients. In
addition, while we’re offering that we’re also offering – testing for the most
common causes of inflammation, which we all know is insulin resistance. So most
of our docs don’t know to dig any deeper than a hemoglobin A1c or perhaps
a fasting blood glucose. But there’s so much more that you can do. OGTT (oral
glucose tolerance test) where you fast for eight hours, take a blood sugar, drink,
some sugar, then take another blood sugar test one hour later and two
hours later. We also in addition… to that… add insulin testing at zero fasting, one
hour, and two hours. And that gives us a lot of very very interesting information.
For example, we get a lot of people that have fairly normal hemoglobin A1c but
they have out of normal OGTTs. We actually… now that we’re able to get
insulin values, we actually get about one once per month. We’ll get somebody who’s
got a normal OGTT but their insulin values are out of whack sometimes,
taking twice as much insulin to keep that blood sugar in a good space.
So bottom line is sometimes it’s okay to guess but when you’re worried about
whether or not when you don’t know if you have cardiovascular inflammation or
not or insulin resistance, don’t guess. Go ahead and test. So we’ve taught
thousands of people how to get this. Quest stopped offering the CV
inflammation panel to the customer and that’s what we’re doing. We’re working to
help. As we’ve discussed in the past, inflammation is a big, big deal. I
mean it’s something that was listed on the cover of TIME magazine,
the surprising link between inflammation, heart attacks, cancer, Alzheimer’s, and
other disease, and what you can do to fight it. If you look at this next
image, cardiology in interventions inflammation for the cardiologists. The
standards committees of medicine still understand very clearly that
inflammation is a big deal including inflammation for the cardiologist. But
here we are in 2019, and we don’t have really good guy that’s in that space. You
know you want to know when that Time magazine article was. 2004. So we’ve been
diddling with this for about 15 years. I personally would have decided not to
wait for the standards committees. I know there
probably going to get around to where they need to be in a good place, but
they’re not there yet. So I’m getting cardiovascular inflammation testing in that panel that we’re talking about and I’m offering it to patients.
And again, we’re offering it to folks in the webinar series. Just as a
clarification on the two things that we’re talking about. First of all, we’ll
we’ll start at the heart and lung. I’m in the heart and a large artery areas then
we’ll go down a little bit deeper to two areas, two layers: the intima and the
media. It gets a lot more complicated than that but we’re going to skip these
extra layers and we’ll talk a little bit about what’s called the glycocalyx. This
is a couple of different three different images of it. The one in the top right
here is an actual picture from a cross-section of a tiny arterial and/or
capillary where you see these hairy appendages coming out. That is the
glycocalyx. The purple image here is a is a diagram of it and this picture below
is an again another actual picture. See over here is an injured glycocalyx. So
let’s go take a quick look at that before we do let’s just take a quick
digression one of the things we worry about with this process
inflammation and insulin resistance. It’s something like diabetic retinopathy
and you may say, “Well Ford, you’re getting ahead of yourself.” And I would say, “No.” As we’ve talked, we’ve discussed many times the school public health and a
UCLA has demonstrated that half of adults 30 years and older have insulin
resistance or full-blown diabetes. But the point that I’m going to make
here in this next slide is that even diabetic retinopathy is not just a
disease that happens after your diagnosis of full-blown disease. There
have been multiple studies which look at this issue. And here’s the point.
Retinopathy is defined by microaneurysms or worse, lesions in at least one eye was
present in 39 percent of men and 35 percent of women at the time of
diagnosis of type 2 diabetes. So let me go back and connect a couple of dots
here. You’re saying, “Well, you know I don’t know if I’ve got internal resistance.” Not again. Half of adults… a third to a half of adults have insulin resistance.
And you’re saying, “Well, maybe that’s not a problem.” And I’m saying, “Hmm, we clearly
know that that creates plaque. It burns your glycocalyx. It sets you up for
inflammation and therefore a risk for heart attack and stroke.” And if you’re
still not quite believing that, that having insulin resistance is damaging. If
you’re like that guy (I can’t remember his name), the author of the article
saying that insulin resistance or pre-diabetes was a dubious diagnosis. He
obviously was not aware of the science. You get injury to your body when
you have insulin resistance. So wanted to give a couple of examples of the testing
that we’re talking about. This is my inflammation panel from I don’t see that.. Oct 19 2015 I’ve had
some since then but that was the that was the image that I had available. I
wanted to just show this. One of the problems that we have with Quest is
that even though Quest is a National Lab, they will give us different formats. This
is the simplest, easiest. Only time I’ve ever gotten all of the inflamation panel
in one section on the report. The information panel includes
myeloperoxidase, Lp-PLA2 activity, high sensitivity CRP (C-reactive protein), and
microalbumin creatinine ratio. Again very briefly, the first two are actual
enzymes released by our immune system when our immune system is attacking
plaque in our arteries artery walls. CRP is a protein made by the liver and
reaction to inflammation. And the microalbumin creatinine ratio
is an actual measurement of how much protein the intima is letting through… is
letting pass through. So here’s the thing. If that glycocalyx is injured, then the
intima is injured, and it’s likely to let protein through the filter in the kidney
into the urine. So those are the brief and maybe overly quick summaries of the
type of information we’re looking at with the inflammation panel. Why don’t we
just look at one thing. A lot of people that do look at cardiovascular
inflammation do look at one thing and they look just at C-reactive protein.
Here’s a reason quick example way too many false positives with just
C-reactive protein alone. If I were to give a hundred people a flu shot today,
about two-thirds of them would have a positive C-reactive protein two days
from now. So again, that’s the reason we don’t just look at one number, one lab.
Couple of other quick examples. This individual, for example, has a very good
very desirable (I’m jealous) OGTT. A fasting specimen glucose in the
80s, the one-hour specimen of 114, the two-hour specimen back down to 72. Again
mine would not mine doesn’t come out that way. Here’s another example, this
is an individual that was very very sharp or is very sharp individual in
terms of what’s going on here and said to me, “My blood sugar is fine. My doc
checks it every year and I check up on him. Dr. Brewer, I know you focus on this.”
I will humor you and go ahead and get this is a version of a Kraft insulin
survey. So here’s what we see with the Kraft insulin survey for this individual
who was told he had no blood sugar problems and knew that himself. Fasting
came in in the 80s (which is good). 1/2 hour, all the way up over 212. At one
hour, continued to climb that 257. Two hours, at 291. Three hours, back finally
back down to 168. And again that’s why I say don’t guess test and for sure the
just relying on hemoglobin A1c and fasting blood sugar is a guess. As you
see in this individual, for insulin values corresponding to these at fasting,
we wanted to be below 5 business good there you don’t want them to have to go
over 50 for optimum blood sugar management and you want him to get back
to less 10 or less at four. Obviously this individual was struggling or his
pancreas was struggling to keep up with that challenge. This just gives those of
you who remember the video there is a popular video, it’s where I covered the
different patterns that you see on a Kraft insulin survey in terms of
insulin and blood sugar. Here’s the thing. Here’s a normal one, the
starting at 80, peaking at about 120, and then coming down within a couple of
hours. Insulin starting below five, peaking up,
and this one peaked at eighty, optimum would be 50 or less, and then going back
down. Pattern two, you get some delayed response. Pattern three, you get further
delayed response (3a). Pattern 3b, further delay. Pattern 4, you see the
blood sugars are getting up around 250 and insulin values are getting up around
250 as well. Pattern 5 is the one that helps click for a lot of folks and
that’s where somebody’s got full-blown diabetes. Their body’s not
producing insulin anymore at that point. Gonna cover a couple of other points.
Again those of you who’ve who keep up with the comments on the channel know
that every few weeks, we’ll get somebody that says, “Yeah, I got the OGTT,
the insulin survey, and I’m not only insulin resistant, prediabetic.
I have full-blown diabetes. And why on earth is my doc not know that well?”
Here’s a national survey of primary care physicians knowledge, practices, and
perceptions on prediabetes. Bottom line is docs… what I think one of the
comments they made was that less than 30 okay. Only 36 percent of PCPs refer
patients to diabetes prevention, lifestyle change. And here’s the thing. If
you think that those physicians are actually doing a full-blown lifestyle
coaching with those patients or wake up no they’re not. The average visit for
primary care is about seven minutes so you can’t do lifestyle management in
that time period. That survey went on to ask the docs, “Well what do you think
the problem is?” And the docs basically said, “Look, the patients aren’t motivated
to make these lifestyle changes so I don’t
go there now.” Before we beat up on the docs, there’s a lot of truth to that. A
lot of your docs will typically come out of training, be very aggressive with
helping train patients, educate patients in terms of managing their lifestyle.
After a few hundred patients saying, “Yeah yeah, I still don’t want to do it.” You
sort of wear out on that issue. So this is not just a doctor issue but it ends
up becoming a systems issue. It’s the doc. It’s the systems, the insurance
companies don’t pay for spending that kind of time with patients. And sure
enough, it’s the patients as well. So it’s easy to blame it on the docs It’s easy
to blame it on the insurance company. It’s easy to blame on the other two if
depending on which one you are. Bottom line is this is important information
and we need to again get started looking at this. This is another version of the
inflammation panel. This shows something to be aware of. This
is a male’s inflammation. The lab test itself says that they were normal
because microalbumin creatinine was less than thirty. The lab test normals
themselves are really looking for kidney disease microalbuminuria is what we’re
looking for. Anything above six to eight for a male microalbumin creatinine
ratio is risk for cardiovascular disease. I’m just gonna click through a couple of
others and then we’ll back out and start taking some questions. This is what you
want to happen. This is the patient progress. Pardon the blurring on this
image, it was there, I couldn’t fix it, but this is somebody who was having some
problems. As you can see had two and three positive problems with
cardiovascular inflammation. He saw this. He started working on it with me, started
working on his lifestyle, and in most cases it involves losing some weight. And
as you see now his current numbers, he’s got that inflammation down. So I’m gonna
go back and show… go back out and see what we have in terms of questions and
comments. And I’m gonna move that over there so we
okay. RobTO7 good morning Doc. Goodworld hello. And if you guys could go ahead and
start hitting me with some of the comments and questions that you may have.
C LEar good morning first time I’ve been able to catch you live what does it
mean if insulin number one is nine point five. The standards would say, “Well that
insulin of nine point five on fasting is a good number.” I would tell you it’s not
optimum. It’s an acceptable number but it’s not optimum. You want your fasting
insulin to be less than five hundred. And 147DegreesWest good morning sun is not up yet in Alaska. That’s what I was thinking you’re there in Alaska it
is eleven 24-hour time you’re probably what five time zones away. Thanks for
joining we were happy to see you here. Peggy Johnson what about stevia and
erythritol because that’s how I eat any sweets I eat them every day. Okay so
that’s a great question and let me just take a few minutes and talk about the
non-nutritive sweeteners story back thirty years ago. About the only
thing that was available was saccharin. There were there was a huge scare about
saccharin causing cancer specifically bladder cancer because it happened in
mice the even 30 years ago there were those of us who looked at that and said
hmm you really don’t have a significant record of increased risk of of bladder cancer in humans with saccharin
and you go back and you look at the the mouse data the lab of the lab mouse data
and they were basically given the the mouse what an equivalent to up to the
human would be would be about a pickup truck full a hoof saccharin every day so
we still don’t know the answer in terms of humans if we gave if we had any human
that actually took a pickup truck full of saccharin every day it may cause
can’t bladder cancer for that human I just I don’t expect that that study’s
gonna be done anytime soon but let’s go to another view of this there’s clearly
evidence that non-nutritive sweeteners do impact the gut biome there’s been
reported on that a couple of years ago it was some research that came out of
Israel and the gut biome is very very important
they’ve done studies which demonstrate look if you if you transfer the gut
biome of someone that has insulin resistance or diabetes to lab animals
and even to to other humans it’s it’s been shown you will greatly increase
that the recipients risk of developing insulin resistance and or diabetes so
there is something to the gut biome and insulin resistance or diabetes as well
as there is too many other health determinants
now one other side to this non-nutritive sweeteners third that saccharin was 30
years ago now you’ve got a ton of things just an update I will tell you that
there’s been significant research indicating challenges with with all of
the non-nutritive sweeteners that I’m aware of at least in terms of gut biome
issues that’s obviously not as hard a an
outcome as full-blown cancer oh but you still do see that you haven’t seen them
or at least I haven’t seen them in terms of the science any significant evidence
that you’re going that you get that from stevia so here’s my personal read on it
I do use stevia and I’m not concerned at all about stevia I’m more concerned
about any of the others the the yellow packets the pink packets which are
saccharin the several of the others now things like monk fruit actually have
sugar in them erythritol is a is actually a pretty good one it’s
expensive and you don’t and for that reason you don’t see it used a lot
couple of other points about the non-nutritive sweeteners I’ve been a
non-nutritive sweeteners attact for a major part of my life I’ve gotten sick
of it one of the things I’ve started doing is is putting um Gymnema Gymnema
in my morning coffee I’ve got videos and what else I put in my morning coffee
both gymnema is no it’s an old it’s an ancient Ayurvedic medicine known
as the “sugar killer” and what it actually does is it it coats the sugar taste
receptors in the back of your tongue and palate so you it’s true and I I can tell
it by drinking or putting some Gymnema in your mouth then you go try to to
ingest something sweet whether it’s a non-nutritive sweeteners or sugar and it
just doesn’t taste the same I’ve had it out of my whole life I’ve tried multiple
times to decrease my non-nutritive sweeteners addiction I’m making
significant progress now good old-fashioned three
thousand-year-old Gymnema or maybe it’s a thousand years old that it’s a very
old intervention let me just say one last thing about non-nutritive
sweeteners before we move on you’ll see a lot of research about out this is oh
you gained weight with non-nutritive sweeteners you get diabetes with
non-nutritive sweeteners etc etc those are environmental studies meaning you
look at people that are using it and you take people that are using non-nutritive
sweeteners and then you look to see um how many people in each population users
and non-users have diabetes or obesity or you can do it the other way and look
at people that have diabetes or obesity versus controls and then looking
non-nutritive sweeteners use clearly guess what you’re going to see you’re
going to see non-nutritive sweeteners use linked with people that have
diabetes or insulin because they don’t want to take sugar in with people that
are obese because they’re trying to cut back on their calorie intake let’s go
back so you’re always going to see that in the science when you do say that on a
specific study look for that bias because that is a study bias that really
doesn’t mean anything in terms of the non-nutritive sweeteners themselves
final point on non-nutritive sweeteners now move on look at the diabetic
population look at Richard K. Bernstein he’s the godfather of diabetic self-care
he still uses non-nutritive sweeteners a lot recommends them and despite having
full-blown very brittle diabetes in his 30s and using non-nutritive sweeteners
up through his 80s he did not have a problem and all he did all his life was
manage other diabetics and did not see problems with
um non-nutritive sweeteners so yes there’s some soft signals that
non-nutritive sweeteners are a problem they’re very soft and even those soft
signal and they had to do with again gut biome kind of stuff they don’t have to
do with diabetes the the signals I’ve seen in the in their search regarding
diabetes and obesity again very very unclear not not something I would worry
about at all because of the bias issue overall it can be good to be taking a
chemical and so I’m trying to I continue to try to work on mine on my own
non-nutritive sweeteners addiction okay so Peggy Johnson whereabouts stevia and
erythritol okay I talked about those of any of the non-nutritive sweeteners
stevia and erythritol by far the best Edward K. O’Brien thanks Dr. Brewer for
very informative blood panel and CIMT review and consult yesterday well thank
you for sharing that via laptop video highly recommend folks thank you very
much Mr. O’Brien had one of the major things that I continue to run into is
that people just can’t wrap their head around I can actually see a doc through
remote means the they can get comfortable with doing other things
remotely but they really have a challenge with this thank you again so
much for sharing that Peggy Johnson thank you so much Doctor. Kinpatu good
morning Kinpatu my morning fasting blood glucose is a hundred and five but
my mid-day is lower 80s in postprandial is well controlled one thirty at peak
returns to 80s within two hours what does this imply Kin for our events
like we’re having the boot camp event we had a couple more people register for the
boot camp event in Louisville past couple of days by the way and at any of
these events will start the mornings with morning blood sugar testing you
know just finger stick testing this time I’m bringing a couple of insulin buttons
or not insulin buttons Libre buttons freestyle Libre buttons which will hand
out we’ve done that a couple of times in the past that’s very popular as well we
will typically see 10 to 20% of attendees will have what’s called the
“dawn effect” and that’s what you’re describing there where you have a high
blood sugar fasting in the morning but it drops after eating you know most
people think it’s gonna be low coming in and then I’m gonna eat something eat
breakfast and it’s gonna go up again with 10 to 20 percent of us that’s not
what happens we come in high we eat something and it goes low now what
causes that it’s called the dawn effect dawn dawn is the time of day dawn and
it’s got to do with cortisol we have what’s called a diurnal or a Circadian
just like everything else in our body in terms of metabolism we have a circadian
pattern for cortisol cortisol is like a long-acting version of epinephrine it’s
made by the adrenal glands it causes our blood sugar to go up it’s like
epinephrine it’s sort of fight or flight it gets the human body ready for action
and about 3 to 7 o’clock each morning almost all humans have an increase in
our cortisol level that is what leads to the higher fasting blood sugar and then
for those people who actually drop their blood sugar after they eat what’s going
on there is they they get an inch in response to their to their breakfast
and then that insulin response causes them to drop their blood sugar
great great question Kinpatu thank you for raising it again looks very much
like classic dawn effect now a lot of people get really concerned about hip
when they have the dawn effect I can tell you I think there’s maybe a little
bit more more heat than light more emotion than it’s probably warranted yes
I you should pay attention when you have done effect but here’s the thing when
you’re looking at burning your glycocalyx you’re looking at having
blood sugars of 140 and above for hour after hour after hour each day most
people that have done effect never get over like you can can put they get in
the high 90s 105 110 something like that and then usually after the their first
meal it drops back down so I don’t really think you’re getting a lot of
damage to your glycocalyx and your arteries from a from a dawn effect if
somebody does know that if you’ve seen any scientific evidence that you do I’d
be very interested to see it because I just don’t okay RobT07 Doc I asked my
GP about testing from myeloperoxidase and L-PLA2 and the tests
weren’t even available to order I asked a specialist who didn’t have them either
CRP was okay well Rob thank you again for raising that issue that’s why I
raised that’s why I covered again what I covered today were that’s the purpose
for what we’ve been calling the webinar series it’s a it’s a cardiovascular
inflammation test panel series is what it is and that’s exactly again while
we’re making that available just to another come come in on the story there
what happened was we do everything can to make to-do patient directed care
may make medicine available to patients sometimes it forces patients to think
more than they want to but again if you’re not if you’re one of these people
that just wants to walk in spend seven minutes with the doc the doc tells you
what they think you ought to do and then you walk out and do it this is you’re
not going to spend much time on this channel the folks that that watch this
channel think about this get into the details and want to start doing some of
this themselves and so we were telling people how to get inflammation panels it
was self directed care we aired a video on how to do that I guess about three or
four months ago and it was an old video it was something that was in the
cardiovascular inflammation course and we started getting feedback people got
very interested and excited about it they went to quests and they found out
Quest is no longer offering the inflammation panel to to direct patient
so again that’s why we’re doing it with the the webinar series and like I said
I’m obviously not the greatest marketer I would have thought to call it
something else Peggy Johnson what should I do about my
gut biome then well it’s a good question a couple of comments one of the most
important things you can do is eat a probiotic or a probiotic type food like
sauerkraut kimchi I hesitate I don’t ever recommend yogurt
to people because even that yogurt that hasn’t had tons of sugar added usually
still has significant sugar I personally supplement with
supplemental probiotics in a sauerkraut I don’t like kimchi and I used to try oh
what was that it was a sort of a liquid yogurt thing made in Russia I used to do
that but it had too many carbs as well but I will do supplements that I
purchased that have probiotics in it and I’ll eat sauerkraut about ain’t at least
one or two servings of sauerkraut a day so that’s a much higher frequency of
sauerkraut and why do I do I’ll let again I’m looking at for my gut biome
I still do take some some non-nutritive sweeteners so that’s one of the places
where I worried about that maybe the damage that those some of those diet
soft drinks occasionally make on on my gut biome and that’s why I push the
probiotics Erik Janse Dr. Brewer do you believe atherosclerosis can develop for
people that are very insulin sensitive are not insulin resistant and do not
have hypercholesterolemia with these people what could be the cause you know
it’s very interesting Eric I actually see that quite often in my patient
population and it’s like you know they get good OGTT good insulin numbers in
it’s slight but they have plaque and in fact I’ve got more patients than not
having that these days and guess where that’s coming from
my next question is okay did you lose 30 pounds sometime over the over the past
and the answer is always yes I did so what happens is people lives control
their lifestyle they gain way too much weight they know it that added body fat
mass drives insulin resistance they find out like they’ll have you know they’ll
get a motivator like a family member will die from a heart attack or they’ll
get a positive calcium score and they’ll say you know what
I’ve got to get focused they’ll lose 30 pounds and they’ll then come to see me
and I’ll say look you’ve lost 30 pounds you’ve you’re back to where you need to
be you’re not insulin resistant at this point what can I do for you and they
always say the same thing yeah I’ve lost 30 pounds but there’s
still a lot more I can do and I want to continue to dial it in and I just wanted
some consultation on that and that’s my favorite kind of patient to see that’s
about 80% of my patients now one of the patients I saw last week had lost a
hundred pounds and knew he had about 30 more to go and I actually suspect that
he had a little bit more than 30 to go but what I usually we’re often
unrealistic regarding how much weight we need to lose but that’s okay there’s a
thing called the jump test you take your shirt off and you jump in front of a
mirror and everything that bounces is fat so once you get down you lose that
30 pounds I tell them to go ahead and do the jump test and typically I almost
without fail they’ll come back and they say yeah I still got some saddlebags I
needed to lose a little bit more 30 was not quite enough okay Bart Robinson
enjoy listening to you as always thanks Bart I appreciate that
Peggy Johnson thanks again you’re the best thank you very much
Raymond Rogers and we’re gonna be cutting off in just a second guys unless unless
we get some more questions in we’re trying to keep it significantly less
than an hour preferably closer to half an hour to improve the the ability for
people to do uptake on looking at the the reviews Raymond Rogers will take
first round of Repatha today LDL is 95 and had a stent put in a couple of weeks
ago and the pacemaker thank you very much for sharing that Raymond and good
luck with your Repatha good luck with your LDL and good luck with your stent
and pacemaker Thank You Johnson Wow lots of sauerkraut laughing yeah I hate
sauerkraut you know you do something for for 30 days and you sort of
excuse me usually acquire a taste for it I still hate sauerkraut
I still hate that natto stuff I’m put meadow powder in that morning coffee as
well and it’s just like I don’t think I’m ever gonna get it to acquire a taste
for those 127DegreesWest make crack slow to it up from kimchi also nicer in
the winter make crack slow I don’t know what crack slow is
that’s it man that sounds like a good opportunity for a joke Peggy Johnson can
you give the name of the best sauerkraut brand no I cannot I just used I’m cheap
and I’ve got a Kroger about a mile from me and Kroger has this look just a
no-name brand and sent a jar about that big so uh I will stay stocked up on it
obviously it’s got its own bacterial colonies in it so storage is not gonna
be a problem then I have a container in my refrigerator and I’ll just open that
container when I get when I finish that container I’ll go to the to the the
cupboard take the jar open the jar up and fill up that container again for
more sauerkraut and again it’s it’s a no-name if anybody has a recommendation
on brand of sauerkraut I’d be very open to it and if you find a brand of
sauerkraut that actually tastes good that would be wonderful Raymond Rodgers has to LDL get oh hello
should LDL get that that’s a I’m gonna actually just take take a whack at that
LDL issue hello should I get and then we’re gonna wrap up that’s like so many
things in science and healthcare and for heart attack and stroke prevention
that’s being debated right now as well there are folks that will say well
here’s the stain let me start with the standards then I’ll go to the guys that
are on either end of the standard and then I’ll give my view of it so the
standards used to be like 130 then down to 100 a few years ago then they said
now at the standard is you know 70 or below for LDL there are there are people that would say nope you
know what we’ve done and they’re talking about the PCSK9 and inhibitors the PCSK9 there’s
been three studies that have come out with the PCSK9 inhibitors which dropped
the LDL levels as low as into the 20s
they said they actually got improved risk going that low there and they also said look we’re very
much aware of this impression and the literature that there’s a lot of
problems with having low LDL increased risk for senility brain fog etc but
we’re not seeing it in the twenties just wanted to let you know and I’ve reviewed
those studies that even though they said that that data is really weak so that’s
the guys that’s the standards the guys that would say go low and in fact I’ve
got a patient I did a video on him he he wanted to go that lower route the and if
you’re interested in looking it up you can find it it says LDL of 29 and he’s
happy and I understand fully where he’s coming from he’s got you know as you’ll
see if you watch the video he’s got some extra risks and you got to try to figure
out what the what the science is actually saying I paste I basically will
give patients what I know about the science consult with them on that tell
them what I would do and then they make their choices that’s the way medicine
should be now let that’s the lower end of the spectrum there are people that
would say higher is better I can’t remember the name he’s a he’s a
cardiologist I think is of Indian descent that’s doing a lot of stuff in
quoting a lot of research on the internet indicating that higher LDL
levels are better I haven’t gotten too deep into hit the science he’s quoting but I will say that yes he’s focusing on
wanting to get it higher so I’ve told you the standards on LDL the guys that
are saying low the guys they’re saying high I’ll give you my version I don’t
think you think LDL matters nearly as much as we used to think and here’s the
thing I think once you start understanding that image and that
mechanism that we described in the very beginning of the of the discussion it begins to make more
sense look if you’re if you have burnt your glycocalyx your glycocalyx is
what’s what keeps that LDL that oxidized LDL from penetrating into the wall of
the artery and that’s what plaque is it’s oxidized LDL that’s why all docs
for 50 years or more have been focused on LDL they you look at plaque in
people’s arteries people that have died of heart attack and stroke you analyze
it it’s LDL oxidized LDL so the thought was decreased that LDL concentration let
me tell you I’ve got given what I do you can imagine I’ve got a lot of people
that have familial hypercholesterolemia and I’ve got several videos on that as
well I can tell you what I see I don’t see significant risk people are
not having huge numbers of heart attacks with most FH patients I will say this
though a a heterozygous patient here’s well let me just say this here’s where
the risk comes in if they gain 30 pounds and start getting insulin resistant if
they start hitting their 50s and 60s and start getting insulin resistant they
tend to have less less margin of safety than other folks that’s when they start
having their heart attacks and strokes now people that have what we call
homozygous in other words they had a familial hypercholesterolemia gene from
their mom and one from their dad those folks do have heart attacks and strokes
in their 20s so LDL does matter there’s no question
that it does matter I think it matters so much less than then we’ve tended to
think and it’s still programmed into the standards of medicine I appreciate the
the interest we’ve got a lot of people in here today and again we’re yet Nadia
Ali thank you 147DegreesWest not Ali
It’s the cardiologist that’s out there that’s talking about try to get your LDL
up again thank you very much for your interest today we’ve had a lot of
attendance and we’ll be looking forward to seeing you next time bye-bye

12 thoughts on “Insulin Resistance, Inflammation and Cardiovascular Disease – Lab Screening & Webinar

  1. Dr Brewer. I take 1000 mg of extended release metformin twice a day to control sugar levels (prediabetis). I exercise every third day which includes CrossFit training and weight lifting. Recently I learned that metformin is harmful to mitochondria so some, like David Sinclair, do not take metformin on exercise days. What do you suggest?

  2. dentists are first in line to prevent heart disease because of the direct connection between the gum disease gin..v and heart disease. thank you for enlightenment.

  3. i cut down carbs and sugar and cut out oils my triglycerides came down and HDL up but my fasting blood sugar was 78 and now is 100 .isn't it unusual ? i am planing to get a insulin test and ogtt . any suggestions good doctor? thank you

  4. Just after college I had a short term job at a canning factory. Hard work, but I learned some things. One is that canning is a way to process foods to kill bacteria, which it does well. Some spores might survive, but nearly all bacteria is killed and the product stays clear of bacteria if the pressure is properly established by the vacuum created.
    When one buys sauerkraut in a jar in the shelf, one is buying canned product, free of bacteria. Refrigerated cold-pack sauerkraut is likely to have live bacteria.
    So my question is are you eating sauerkraut because of the acidity and the fiber? Those are present in canned products. But if you are eating it for bacteria, I would think that one should make it at home and refrigerate it after it is in the right condition, eating properly fermented. Or eat refrigerated product. Am I misunderstanding this?

  5. Dentist told me today that my gums are much improved since last cleaning 3 months ago. I have been strict carnivore for the last 3 months coincidentally ;>)

  6. Dr. Brewer, Use the tiniest bit of artificial sweetner to your sauer kraut. TINY IS KEY. It TRANFORMS it into something you will look forward to eating everyday. At least it did for me.

  7. Dr Brewer, sounds like you are eating the wrong kind sauerkraut. It comes in the refrigerator section. It needs to fermented and with live bacteria. Sounds like you maybe buying the pasturized kraut. Look for it at the health food store until you recognize brands. Mine has Probiotic right on the label. Look for yogurts, cultured and fermented foods that state live cultures. These will taste better. Sandor Katz has great videos on YouTube for making these items homemade. It's not too hard. Enjoy your videos. Thank you.

    Homemade natto made from black beans is great. It is slimy but I had it to other food and it disappears in taste. I think it is the soybean that must taste bad but I have never tried it. It is very simple to make.

  8. For @Robt07 who said his doc said inflammation panel wasn't available…sometimes docs say a test isn't available when they mean it isn't covered by your insurance. Explain that you're willing to pay out of pocket and you may get a different answer.

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