PCSK9 inhibitors for all!
PCSK9 inhibitors seem like a wonder drug. If price was not a factor, what would the downside be of starting on a once a month injection of a PCSK9 inhibitor for someone in their 30's? It seems like this would be the most efficient and easiest for patient compliance solution to ASCVD.
Thyroid, T3, T4 and TSH
Dr. Attia -- thank you so much for episode #256 -- Exploring thyroid, adrenal and sex hormones. Great explanation on the thyroid and how it works.... I am currently taking Levothyroxine, as I have been diagnosed with Hypothyroidism. In the most recent labs - my TSH was elevated, so I was asked to check with my PCP for more evaluation. The latest lab results are a bit confusing TSH -- is 5.740 T4 -- is 1.64 -- which appears to be in the upper range..? T3 - is 2.1 -- which seems to be in the lower range... I am taking T4, which is the inactive hormone, but this is already elevated. The dose I am currently taking is 75 mcg -- 6 x a week. The doctor says to increase the dose to 7 times a week. It seems that taking more of what is already elevated it is not going to solve the problem. Lab readings for RT3 were not requested....Maybe it should have been requested, as it looks like T4 maybe converted into RT3..? Should I be switching to a medication that contains T3 and T4?
Use of HRT after breast cancer diagnosis.
Dear Peter Attia. I´m a Norwegian epidemiologist and GP working with women who suffer from menopausal symptoms. My first choice of combined systemic HRT is Estradiol patches/cream/gel and micronized progesterone. As far as I can read the literature there is now more or less an agreement that modern transdermal estrogen and micronized progesterone do not increase the risk of breast cancer. And, here comes my question; if modern preparations are safe for peri/postmenopausal women, why are they contraindicated in women with a breast cancer diagnosis? And what about estrogen-only preparation for women without a uterus? The contraindications of local estrogen preparations are even more mysterious for me since the systemic effects are low. I have heard and read your episodes about HRT after breast cancer, but I can not see you have discussed modern preparation. Many women suffer a lot during and after BC treatment and have a low quality of life for years. I think we underestimate the suffering. I have in vain been waiting for the updated analysis of the Stockholm and HABIT trial, in the hope it would give some answers about long-term effects of HRT use after BC on BC and total mortality. The long-term effect after HRT use in WHI did not show a difference in either breast cancer-specific mortality or all-cause mortality between the treatment and placebo groups after 18 years of follow-up. Do you give HRT to women who suffer from menopausal symptoms after BC?
EMF exposure
At levels we're typically exposed to is there any evidence that EMF is affecting our health? If not, is it because it hasn't been studied well? Or is there proof of it's safety? I really want a sleep eight. And although I haven't went full tin hat wearing - unplug the wifi at night, keep cell phones out of the bedroom - I'm still reluctant to bring in yet another device. Between my smartwatch, oura ring, and wireless ear buds I'm already pretty bluetoothed up for the day.