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Gynecomastia

Once glandular breast epithelium has formed, to what degree is gynecomastia reversible via weight loss, if at all? What are your thoughts about surgical interventions and SERMs (e.g., tamoxifen) for treatment of gynecomastia? Thanks for all you do.

BDNF

Can you put a deep dive on BDNF in the podcast queue? (unless it already exists, in which case I'm sorry for the ignorant question)

Ultramarathon Running

You have discussed zone 2 training but what do you think about staying in zone 2 for hours and hours? I frequently run ultra race distances (between 50k and 100 miles) . These races last from as short as 5 hours (for a 50k) to 35 hours for a tough 100 miler. Training for these races often entails zone 2 training for as long as 12 hours. My heart rate is in zone 2 for most of the time, with excursions to zone 3 and 4 at times for 30 minutes or so several times during these races. What are the benefits and downsides of this kind of endurance training and racing? I'm a cardiologist and I'm aware of the recent research by Dr. O'Keefe at Mid-America Heart that seems to suggest adverse health effects of this kind of endurance exercise. Is there really an increased risk of atrial fibrillation? Coronary disease? Thank you!

Why Are High Linolec acid oils bad?

Why are omega six polyunsaturated oils so bad even when they reduce LDL cholesterol. Can you do a deep dive into soybean oil, corn oil, safflower oil and the mechanism of how they create damage in the in high amounts especially when they constitute the majority of the diet, like a highly processed diet?

Thoughts on High LDL-P in the absence of all other Risk Factors?

I recently came across a few carnivore bloodwork’s that they posted online one of which included their arterial calcium score, and did advance lipid testing. In these subjects the LDL particle was high but virtually every other respecter was within range. Meaning, CRP was pretty low, uric acid was low, triglycerides were low, HDL was high (For what it’s worth)obviously blood sugar and insulin were pretty stable, IGS one was pretty low, and when you looked at the LDL particle size the small ones were also pretty low. Presumably most of it of the large buoyant on un-glycated it kind. What are your thoughts on a situation like this, would you considere it bad or risky and why? Also one showed their arterial calcium sore and it was 0.