My Doctor's Response to Apo E Lipid Panel Request
Hi Peter, I listened your recent podcast with Dr. Huberman and was particularly interested in the discussion about how Apo E is an excellent indicator of future cardiovascular health. So much so that I asked my doctor for a lipid panel that includes this marker (my previous lipid panel did not include Apo E, only LDL, HDL, and triglycerides). To my surprise, my doctor pushed back. After a few back and forth messages, the last message from my doctor went as follows: "Your original lipid panel did indicate normal values. You are not considered high risk, based on your paternal grandfather's history of heart disease, and your father's history of hypertension. I like to practice evidence based medicine, therefore will not order this test. I hope you can understand." A few questions for you: 1. Is this backwards thinking on the part of my doctor? I understand what he means by "evidence based"; however, from my perspective this is a REactive approach to my health vs a PROactive approach which I am trying to implement. 2. Is it possible to approximate my Apo E based on my triglyceride, LDL, and/or HDL levels? 3. Is this good reason to look for a new doctor? Thank you
Zone 2 - breaking threashold slightly
Dear Peter, I have a lactate meter and find it still quite difficult to stay in zone 2. Sometimes I end with a lactate value of 5, but perceived effort is very low. Why does it make such a difference for the cell to not break the 2 mmol/l? I understand that the mitochondria will not keep up with the release of lactate, but does that really matter when you stay/end slightly above threshold? Would the cell not continue to do the same rate metabolizing lactate when you stay/end slightly above the threshold? Thank you!
Vein, Atery, Capillary health Deep Dive Impacts endothelium and small changes of circluatory health leads to brain health
Covert Strokes, White Matter Hyperintensities, Cerebral Small Vessel Disease, aside from the obvious : BP, Atherosclerotic Plaques, Understanding How vein , capillary and arterial health can lead to the literal infancy of a cascade of breakdowns which present as WMH, the NOT NORMAL normal part of aging not enough physicans are talking about. Some think it is related to VEIN health and the lack of emptying of Cerebral venous back up= increasing wmh . Why is this not addressed PRIOR to them becoming SEVERE! and the ramifications of this "normal aging" lie.
Higher protien intake in elite athlete causing very high BUN
Hello, I've seen your discussions and posts about protien intake, and a consistent theme seems to be targeting about .8-1 g/lb of protien. I'm a small guy (120 lbs at most) and an elite endurance athlete, and have been targeting 100-120 g of protien per day, with 20-40g of that being collagen protien supplements. However, in my quarterly blood draws, I've been seeing my BUN consistently very high for 2 years now (28-32), even when measuring at different times of day and ensuring excellent hydration status. No other biomarkers indicate anything other than healthy robust kidneys. After some experimentation and very frequent blood draws, the only way I can get BUN even close to a normal range (low 20s) is a very low protien diet. How do you balance kindey health with a higher protien intake needed to hold up against elite level endurance training?