Thyroid expert on podcast?
Hi Peter and team, is there a plan to have a thyroid expert on the podcast anytime soon? I feel thyroid is the topic that has never been really covered but is arguably involved in all metabolic processes. Fasting, ApoB levels, glucose utilization, fat storage and so much more is all thyroid dependent. Its a complicated topic where the activation of T4->T3 at the tissue level seems to play an important role (is serum T3 a good proxy of how much T3 is in the tissue/cell?). Apparently some people are hypothyroid at the tissue level with typical symptoms (tired, constipated, high ApoB, gaining weight etc) but at the lab level they are euthyroid with low normal values. Any plans to shed light on thyroid and go deep? Thanks a lot!
Decoding everything
So many conversations on the podcast take us right to the edge of having tools to become more effective in managing our own health. The 8 question list Peter talked about on the most recent AMA is an example. Most patient figure it out themselves when they go through these, BUT, they are one example and not in the show note. Here's the dilemma, I live in NYC and none of my docs know what I'm talking about when I talk about APOB or APOE or Rapamyacin. Yes, I need a more enlightened circle of HCP but they don't even know who to refer me to. I have paid to get all my health data, but then I get stuck having no professional to have a discussion with. I know Peter's waiting list is massive. Okay no problem but over the past year I have listened to all 4 years of the podcast, I'm on metformin, I wear a CGM, I've lost 60 lbs, gotten all my vitals into the green zone, created my own exercise program, but I feel lost. What if there was a higher level of membership where we got more insights, more access, etc. I would pay 10x the amount of membership. The doctor has convinced me and I'm here wondering what else can I do and am what I'm doing is most effective. He's talked about how frustrated he is the level of practice among doctor, well I'm on the receiving end of these and looking for any direction I can get! Thanks, clearly, I'm a fan. Keep it up.
Protein Amount for overweight or obese individuals
For people over 40 to get adequate protein, the podcast suggests a goal of 1.2 to 1.6 g/kg. However, if someone is obese, would that amount be based on their total weight, their ideal body weight (ie BMI of 25), or lean body weight measured by DEXA? If it is based on their total weight, the protein amounts get fairly high for obese individuals. Thanks
Difficulty getting apo(b) tested due to cost, and age
Hi Peter, I'm wondering if you could speak to the process of working with a doctor to get apo(b) levels tested, and what we might expect? I found the notes you gave on getting DEXA scans (how frequently to test, expected price, how to make the Medicine 3.0 argument) incredibly helpful, would love similar suggestions for apo(b). I've spoken to two primary care doctors now about getting a look at my apo(b) levels given my family history of high LDL-C levels, and my own LDL-C level of 160 at 25 years old. Given my age, bringing up a more prevention oriented approach has been difficult. The doctors I've spoken to so far have routinely hinted that it's highly unlikely any insurance companies would cover a lipid panel. In your experience, is cost a prohibiting factor in getting tested for abo(b), or do you think the apprehension is more attributable to a default to Medicine 2.0? You've made the importance of apo(b) clear; would just love a few notes on the experiences one might go through while trying to get those levels tested.
DEXA Scan - No VAT Being Provided
I finally obtained a DEXA scan and while I was pleased to see that they provided an AMLI value, I was supposed to find out that they do NOT provide a VAT value. After calling the lab to discuss this with them, they stated that they no longer provide that data, as they felt it was not accurate. Can you calculate or approximate VAT based on other data (such as Android/Gynoid values) provided in the report? As a reference, I was scanned with a GE Healthcare, Lunar Prodigy Primo system. As a follow-up, can you make available an EXCEL based, or high quality Nomogram so that members can download and plot their results more accurately than trying to approximate on the ones included in your show notes?