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1

PCSK9 Inhibitors

I was wondering if Peter could go a little deeper into the topic of PCSK9 inhibitors and how they work vs typical statin use. Any side effects in clinical trials or in his personal use of Repatha.

2

Sglt2 inhibitors and lipase increase

In my practice I occasionally observed a slight elevation in lipase after Initiation of sglt2 inhibitors without signs of pancreatitis. Did you observe something similar and Do you consider this clinically relevant?

1

Creatine and Beta-alanine supplementation

I miss an episode of the AMA commenting on supplementation with creatine and beta-alanine to help performance in physical strength and conditioning activities, in addition to benefits in other physiological systems

1

Diet of children

I would like to suggest that Peter condider doing a podcast on children’s health focusing on diet ans supplements. Has he used any supplements on his children? Is there any recomendation out of the ordinary ones that most pediatritians do?

2

32 Year Old with CAC score of 117

I am 32 years old, and during my teenage years and late twenties I had several really unhealthy years (smoking for 2 years, eating lots of saturated fat, overweight, high blood pressure). About two years ago I change things around with lifestyle diet, cardio, weight lifting, and lifestyle change. In May 2023, my ApoB was 70, Lp(a) was 10, LDL 80, Triglycerides 90, HbA1c 5.5% and these test have remained there for over a year (until now in 2024). By listening to the podcast, I decided this year to get my CAC score done to check about the damage I did in my 20s while I was unhealthy. The results shocked me- my Coronary Artery Calcium Score was 117.7 (with 77.9 LAD; 35.5 RCA). I am honestly terrified, and the first thing I am planning with my Dr is to begin statins to bring my ApoB down to 20-30 mg/dL. What other treatment recommendations might you have for a 32 year old patient with my profile? What other tests would you recommend? Right now my outlook is mostly that of fear (especially because I am so young and have recently become a father), so what would you tell a patient like me to provide them with a more positive outlook?