Incipient heart failure
You have talked a lot about heart disease but not specifically heart failure. I am a heathy 77 year old, not on a statin because my numbers are excellent with a plant based diet, exercise daily (zone 2, zone 5, resistant training), hike a lot, etc. Within the last year I have picked up symptoms of heart failure. Cardiologist put me on Jardiance (not sure what it does) and said to come back in a year. Would you specifically address heart failure and the best strategies to slow it down or even reverse it, perhaps in a Drive episode? Thanks
Links between male hormones & lipids
Dear Peter, I am very curious to know whether there are known associations between the lipid metabolism and the male hormonal system. More specifically, I try to answer the question whether they should be treated separately, or where there is an approach that encompasses both. The personal context is one of high cholesterol (high LDL and high LP(a) – with good levels of HDL and Triglycerides) and low male hormones (low testosterone, low estradiol). My lipidologist recommends an approach, very close to yours, i.e. massively reducing apo(b) – but has no input as to my hormonal situation. Can high cholesterol be associated with low testosterone? And are there explanations out there for such links? Thank you!
Harmful Effects of Nicotine
The AMA on nicotine seems to contradict studies done on the substance. With the prevalence of NRT products in the market perhaps another look is warranted? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553893/
Current/On-going Alzheimer’s studies
I would love to see an episode evaluating the various clinical trials currently being conducted on Alzheimer’s disease (such as AHEAD and Trailblazer). I am in the evaluation stage of participation in the AHEAD study. My father died from Alzheimer’s complications at 84 (I believe he was diagnosed in his mid to late 70s. He was a heavy smoker, but otherwise fairly healthy other than high cholesterol). I recently got my PET scan and genetic testing results, mild to intermediate level of amyloid plaques in my brain and APOE3 and 4 genetic profile. I am a healthy almost 62 yr. old retired woman. The only Rx I had been taking is 10 mg. Crestor, although I have now switched to 1/2 t./day of Amla powder. I take a multivitamin for vegans (Complement), 600 mg. calcium (my doctor recommended this due to osteopenia), vitamin C and 10 mg. Zyrtec daily. I have followed a no sugar, no flour diet (Bright Line Eating) since 2020 and lost 40 lbs. (started at 221, now 181), but am still about 25 lbs. overweight at 5’7” (still working on it). My bloodwork is all normal. I have been mostly Whole Foods Plant Based (with the exception of an ounce of cheese a few days per week) for about 10 years. Before that I was pescatarian for about 20 years, vegetarian for about 10 years before that, and grew up eating a Mediterranean diet (both of my parents came to the US from Italy). I work out 5-6 days per week. I have not decided whether I want to take the next step in the study which would be monthly infusions (1/3 get placebo, 2/3 get LEQEMBI). I’ve read about potential side effects of brain edema and micro hemorrhages, which concern me. Although reducing plaques may be good, it may not actually do enough to address Alzheimer’s risk. I found a 2017 Mayo Clinic study that seems to suggest the drugs that target only amyloid plaques, like LEQEMBI, may not be complex enough to treat or cure AD. There are a couple more tests, an MRI and a tau PET scan coming up, then I will need to make a decision on the infusions. I would like to help advance the science, but not if I am risking serious side effects for very little gain for not only myself but for science as well since it seems like this research may have already been done. I do believe in the power of a healthy lifestyle, and think that may be my best bet. I’ve read about potential neuro protective affects of citicoline, so I plan to start taking a supplement of about 1000 mg/day. Thank you for your work and especially for focusing on prevention of disease, something sadly lacking in our current medical establishment. This is a huge gift to the world and to the fight against chronic diseases. I would appreciate any thoughts you have on the AHEAD study (and other studies, specifically for Alzheimer’s) and risk vs. benefit of participation. Thank you!