Good question- I love reading the advanced studies using insulin levels. To get a good reading they check it 3 - 4 times in a 30 min setting … When I try to translate that into the clinic setting, many flaws show up. The insulin is very volatile. It should be checked without getting out of bed - first thing in the morning… not possible for patients to do that. Instead, I use fasting glucose with a fasting ketone. I have the patient check FIRST THING in the morning. Several days of this (at a fraction of the cost of one fasting laboratory insulin) teaches me & the patient far more. Again … wise question. Thank you for asking.
@DoctorBoz it's crazy that many labs don't don't do glucose/ insulin simultaneously. I've literally had to search for my NP (office was unsuccessful) and ended up requesting Labcore to run a GTT and Insulin panel x3. Sadly, there's no code for a draw x4 so I'm stuck with a 3x draw. At least I have a better idea.
Congratulations Dr. Bosworth! As Board Certified Cardiovascular Surgeon I am glad that you provide this excellent information (and explanations) to the public!
Every day gives an opportunity to learn something: in the past the specialty was “Thoracic and Cardiovascular Surgery”. Then Thoracic Surgery became a separate specialty.
Hey Dr. Boz, not sure if you read comments, but your videos are a lifesaver. I tried your 72-hour sardine challenge, and the effects were almost immediate. 35 hours in, I woke up and my vision was so clear, sharp, and bright. And the best part? That annoying floater in my left eye was gone! It had been bugging me for a while, but when I looked for it, it was just... gone! I'm so happy. God bless you.
So, my insulin resistance score was less than 25. I also get my fasting insulin checked every so often along with C-Peptide . They are 3.3 and 1.0 respectively. Keto for about a year and a half. I am a LMHR. TC 390 LDL 280. TRIGS 84, HDL 84, CRP-HS .6. A1C 5.4. I am 76 yo. and living my best life.
@@jenniehu2129You can't because it's a concept, an idea. That isn't to say that it's a false concept. If you were to be insulin resistant you would have ask yourself why. Insulin resistance is downstream from chronically elevated blood glucose. That is something that you can measure and CGMs are readily available now
Heart attack at 49. Now 60. Apoa1 1.94g/l ApoB 0.61 g/l TG 0.7 mmol/L Fasting Insulin 4 HbA1c 5.1 Cleaned up my diet, daily walks and resistance train 4 days per week. Never felt better coming into retirement. No BP meds. Daily asprin
@basstheangelo Yes fasting is an additional benefit but what does one do when they're very thin already (like 10% body fat) & is trying to stay healthy on keto but can't afford to lose weight? Not sure fasting would be the right strategy to use...
@ long fast (18 hours or longer) isn’t just about losing weight. It’s mostly an immune system reset and autophagy. It breaks down damaged and unwanted cells. The process helps in cellular cleansing.
@@cc2020-d4w try doing OMAD (one meal a day). Select the most convenient time to consume all your calories. Do it in just an hour window. After that meal no calories for the next 23 hours. You eat again in the 24th hour. That’s what I do. Make sure you consume no calories for 23 hours straight.
As a man who had a heart attack at 47(12months ago) this gives hope. Cleaned up my diet. Dropped 50 pounds. Trying to get into a better habit of exercise myself.
Dr. Ken Berry would not put that BP as too high. 130/85 is okay according to him. The difficulty with a one-size-fits-all number is that the bigger you are the more pressure you need to get the blood round. And the older you get the more you need.
I heard the same thing from Dr. Suneel Dhand. He said the medical community keeps lowering the blood pressure over the years. He says everybody is different with different body size and mass. I thought it was interesting. I myself my blood pressure is usually around 117 to 121 over 80 to 72. But when it gets too low I get dizzy.
@uuzoo My normal, resting blood pressure is under 110/60. 1am 77. I don't get dizzy. Depending on different factors, different people require different blood pressure to adequately pump blood. And to lower it with medications can cause blood starvation in the body. Get to the root of the problem. What is causing it to be high? Correct that problem. Don't lower it with meds.
@@herbbowler2461 I agree, but finding a clinician that will even attempt to find the root cause...all they want to do is throw a pill at you. If it works, hey...on to the next! I've lived it the last 16 years.
Wow, the explanation at 0:29 about cholesterol and heart disease is mind-blowing! 🤯 The comparison with a pimple makes it so easy to understand. Thank you for breaking this down so clearly! 🙌
Thanks for this helpful video. My doc has called me in because my cholesterol is elevated but I'm healthy weight, exercise daily, eat well, don't smoke and all those other markers you mentioned are normal except I can't find the LPIR on my results - I don't think it was done. I've changed my diet to lower sugar and carbs and increased healthy fats. Before he tries to give me some medication, I'll insist on the LPIR test.
I don't care about the numbers or the doctors. I never see them. My family has been living off our land for generations. We eat a lot of meat, fat and carbs. We also eat lots of fresh fruits and vegetables. We love to drink wine and brandy (home made). We smoke home grown tobacco. Everyone lived well into late 90-ies or even over 100. We are ALL active all of the time. We don't waste time sitting in front of TV, or playing with cell phones. There are always things to be done, and we try to stay on top of them. Human body is not made to be sitting idle, eating unhealthy processed food.
These pundits never describe the individuals lifestyles they are lecturing to. It's inexcusable! The say the sky is falling but never describe who it's falling on‼🤔
Keep researching. You’ll start to find there’s a couple of camps of doctors… group A are the Doctors who study and are in the “know” about TODAY’S statistics and studies, and aren’t interested in selling the lies of big Pharma. Group B are all the typical Doctor’s who don’t keep up and rely on their past training (sometimes decades old) to guide their advice.
Thank you, Dr. Boz for this very informative video. You are teaching science that nobody knows. This info is untraditional in figuring out the major risk factors and predictors of a heart attack . Thank you very much. Keep up the wonderful job, Dr. Boz.❤❤❤
Thank you for sharing the comparison table, Doctor! I’m curious to know more about how the LPIR score is calculated and the associated cost of performing the test.
DR Boz I very much appreciate the information that you share consistently. Where can I get a copy of this risk table? There are so many people on low carb discussion groups talking about their lipid profiles and I would really like to be able to discuss lipids and risk intelligently
Blood pressure at home: 105/65 At the doctors office it was 121/72 because I had been walking for 90 minutes in 12 F wind chill and then I had to climb steps up to the exam room - oh and no time to rest and nothing to rest the arm on at heart level. 😐 Total: 366 Trigs: 40 HDL: 114 LDL: 244 Weight:117 BMI: 20.1 I am a LMHR at 52 y/o. I do a lot of walking. And my resting heart rate is 55.
I would love the blood pressure part explained. I’m not doubting it. We all agree that lifting weights plus HIIT training is good for us but for that whole time our blood pressure rises dramatically. Yes I understand that the exercise lowers the resting blood pressure but I still can’t quite line up how the massively elevated exercise pressures are not more detrimental. I don’t want them to be as I exercise every day but it still doesn’t make perfect sense to me.
@ yes I’m sure it is. But that isn’t really relevant to the fit and healthy trained person. Of course I’m guessing because I have no data in front of me but logically those that are having heart attacks in those circumstances are your average overweight Joe or Jane doing work far beyond his or her fitness level.
@@royc2390 Do you think anyone has ever done a study to see the risk ratio related to ‘average’ blood pressure (as in a persons average for the day, taking in spikes and troughs) rather than resting blood pressure?
@@stevemc2626 That is a very good question that I'd like to know also. I've never seen anything like that yet. If I ever come across such a thing, I'll come back here and post to you.
I'm in a quandry on BP. I have glaucoma in one eye. Low BP, raises pressure in that eye. BP is q135-140,/75-80 eye pressure is 16. While taking BP meds 120/80 was pretty normal, but eye pressure creaped up to 18 to 19 with eye meds. Guess it's what you're willing to chance
A statin study gives placebo to both groups. There is a 1% absolute difference in event rates between the two groups. Should the FDA approve the placebo with the lower event rates?
You missed one of the most important! Remnant cholesterol (RC), the IDL and VLDL. (Non-LDL - LDL) = RC. Target RC < 25. RC is the best predictor of systemic inflammation. I can send you the research. LDL can be very high, but if HDL is high and Triglyc low, your RC could be VERY LOW (low inflammation). And that matters more than LDL. Also, those with very high HDL may have a superior form of HDL (yes, there's more than one kind of HDL) that better clears LDL and keeps the arteries healthy. RC is a better predictor than even CRP!
Well, my uric acid is between 7 and 8, seems heriditary and taking blood pressure medication Olmesartane seems to rather push it up more. No idea, what more to do. Have been doing fasting 18:6 for years and fighting to keep my heart cleanb. No heart attack but 2 stents in my 50s. 13 Years ago. I can't eat a lot of meat, makes me physically sick. Eat porridge, lots of vegetables and salad, but also rice and potatoes. Eyveryone you talk to, you get different advice.
Dr.Boz thank you for this "bird's eye view" of "all the possible" measurements you can make to see if a patient has a high risk of having Cardiovascular disease (CVD) or not. I think certain doctors get very emotional or get carried away with focusing on "just" LDL because they were "selling" their one and only solution. I am one hard patient to convince about high LDL and how that means a greater chance for arteriosclerosis. My relatives are all doctors and we know about the "4s" study etc. Because my family has FH. All doctors are trained to push a solution whether the patient is proven to have CVD or not. Because they get psychologically rewarded the moment LDL is lowered. They feel that they have achieved a great deal. 😅 They are smart, informed etc. So educated!! Wow! Being a doctor is so rewarding mentally. I was supposed to have had a "mini-stroke" but no MRI scanning actually could prove there was a blood clot in my right brain! My Calcium score was very low almost zero about one month afterwards. This test measured calcification in my heart. I probably have epilepsy of an unknown origin as well. Wow these are all uncharted territories for an average doctor.The only visible sign during the stroke incidence was my left side of my body particularly my left arm and left leg was "frozen" or immovable for a day or three after the day of my "stroke."😅 Okay the patient was affected by this sign and decided to take the heavy medicine given right afterwards. Wouldn't you have agreed, just to eliminate the frozenness? I didn't know what atorvastatin 80mg was. I also didn't know all of a sudden I had to be on more than one statins to ensure I was really not going to clot anymore. How could I argue they the doctors were overly concerned? Hey these are the same tribe that tried to sell me real statins from USA 5 years before my incidence of "stroke". And I thought was they just wanted money. Even now under the Ministry of Health in Hong Kong, I don't have to pay for those statins anyway. So why the absolute focus on lowering my LDL with statins? All the other people in my family who are doctors never had a "stroke" that I had to have. 😅
To this day, at least two years after that strange "stroke" my LDL is lowered by a statin but I do not believe my stroke was due to my previous high LDL. It may be some clotting factor. This is reduced by taking a small aspirin. But why has my clotting factor caused a stroke? 😢 Anyone out there really understand these mysterious arteriosclerosis incidences? How about a Nobel prize for the proof? 😅
This is very timely for me, as my dad just passed away this month from a blot clot to his intestines. So my question is: Does this information apply to ANY blot clot (stroke or to the intestines)? Thank you!
Love this. Would love to understand how LDL size plays a factor in this, among other variables not mentioned. Tim Noakes’ studied this. Keep up the great work.
I very much appreciate your video, and I must say, this is ammunition I could use my next consultation with my doctor. However, I do have one issue with your spreadsheet. The light colored columns also have light colored numbers on them, making them unreadable for me, I simply cannot see them. The type of colorblindness I have (deutero-something) pertains to about 75% of all colorblinds. Could you amend the sheet to show dark colored numbers on light colored columns or maybe just all numbers dark colored? I would very much appreciate the effort. Obviously, not necessary to adapt the video, but I do wish I could import the sheet (the end result you show). Maybe in the comments? Thank you very much for making the video!
Note I lowered my lp(a) from 246 to 84 with repatha and niacin 2k. I am high protein moderate fat. Very low carb. My ldl is 10, hdl 70 and tryg 35. I like the combination of driving my ldl down with repatha and essentially keto ish. Best of both worlds. Tested all inflation markers and all very low. No I R. Lost 70 lbs. over 2 years. Keeping it off for 2 since. Balanced approach to addressing all key risk factors. I don’t want a surprise that ldl is in fact bad… to much debate so I took it off the table. And added bonus crushed my lp(a)! Don’t say it can’t be done and be willing to try and retest. Also LP-PLA2 is a great inflammation test along with crp.
Dr quick question. I told my doctor my dad died when he was forty eight of heart attack, my grandfather fifty i have good insurance. He wouldn't even let me get a triglyceride test. I had a fight with him and this is my second doctor so do you do telemedicine?
I have very high LDL, VERY high HDL, low triglycerides, I’m confused!?!? I have high blood pressure, salt sensitivity I guess. I can’t digest meat easily, milk, cheese or anything else that I’d love to eat. I’d love to eat those foods my Dr. doesn’t go into detail. Any suggestions? I’m 78 and a 3 year cancer survivor.
Don't get me wrong, I am not on a ketogenic approach to my nutrition. My HDL is 125, LDL 81 and TRI 25. I do fast. As for my nutrition, I opt to eat clean daily, carbohydrate sources are potatoes, oats, vegetables, and fruit. When it comes to fat, 6 whole eggs and other healthy fats. I am not a doctor; my mom was and that myth to cholesterol she wasn't buying it back in 90s. In fact, she encouraged the consumption of whole eggs and dairy, not just the low-fat ones. Her approach was that trans-fat and bad style of life, be it in nutrition, smoking, alcohol, screw us up. Being Greek, olive oil is something we've had a lot, I don't use it nowadays to be fair, I get my fat elsewhere. To conclude, there are always options to nutrition, and we just must figure out the adjustments we need to take; everything's through trial and error. Thank you for the information.
The insulin resistance score- LPIR is new to me- why don't GPs in Australia do these important tests? My LDL is elevated and my GP wants to start me on statins- I am declining her prescribing and want to stick to lifestyle changes I can control. It is difficult to get more than the standard Medicare testing.
And a high fat diet will ensure you remain insulin resistant, something you won’t notice because of the low carb restriction. Better to reverse the resistance. In other words, regain the capacity for your system to function property with a normal carb intake. Your body doesn’t need disproportionate amounts of protein and fats.
i always thought non-hdl cholesterol was closely related to apob (total cholesterol - hdl cholesterol). and apob value, if high, is directly correlated to a heart attack occurrence. in your diagram you don't consider the possibility. am i wrong?
I have been eating red meat for 9 months. I lowered my lp(a) by 70 points. My hdl went down and triglycerides went up (still in normal range). My crp went down. My insulin levels are normal. From my experience, i feel every body responds differently to a diet. Keep checking your labs as you go (ie.ownyourlabs or anylabtestnow).
Might want to take a gander at Serrapeptase, just for fun. Mechanistic studies demonstrated that SRP significantly inhibited the LPS-induced production of proinflammatory cytokines such as IL-2, IL-1, IL-6, and TNF-α in aortic tissue. Furthermore, it also inhibited LPS-induced oxidative stress in the aortas of mice, whereas the expression and activity of monocyte chemoattractant protein-1 (MCP-1) decreased after SRP treatment. In conclusion, SRP has the ability to reduce LPS-induced vascular inflammation and damage by modulating MCP-1.
The statin will increase your LPa… i also have this issue and have lowered mine from 330 to 180. Im on repatha and vascepa. Pcsk9 is the only real way along with niacin although niacin is very controversial on this…
@ my issue is since being on Repatha for a year, the muscle issues in my legs and lower back have been pretty intense. I searched and saw many have this issue. I’d very much like to stay on Repatha but my goodness, I’m super active at the gym and I’m hurting lately.
@@DylanGemelliBiohackingJust read an article from an athletic doctor who did it with VLCKD. Low carb ketogenic diet who was already on a statin. I’m about to start this . I already do IF.
I agree. I had a tolerable ldl, even though my hdl/ldl ratio was indicating some risk. It wasn’t enough risk to indicate i had a deadly aneurysm that could have popped by now. By the Grace of God i am writing this because i came down with non-covid pneumonia exactly 2 years ago and the chest x-ray exposed it. Doctors were sweating bullets over me because they weren’t confident to operate on me while i was dealing with the pneumonia.
Hi doctor.. I went to Chresteol test yesterday and my doctor told me I’m not required to fast and they told me if I have coffee or tea in the morning that is not a problem. So before the lab test I had coffee and milk drink maybe 3 hrs before the test so today the results is back to my email and my triglycerides was 164 and in the past 10 years my triglycerides never reach a 100 my triglycerides always around 80s So would you recommend me to re check my cholesterol test again and do it fasting this time ??
Picking up on Fructose raisng Uric Acid! Im curious the home remedy of tart cherry claims to lower uric acid. My husband used to take it and swears by it. He no longer has gout because we've been on a ketovore diet for 3 years. Went on this diet due to TBI and needing better brain health for my husband. I know different topic but i love the breakout on labs. You're awesome Dr. Boz!
My husband had a CAC score of 1115. We don't trust the mainstream medical establishment. What would be your suggestion to do next? We now only have whole foods and whole ingredients in our house. No sugar. No seed oils. We're scared but we will never take a statin. Could you tell us what you think he should do next?
Dear Dr. Boz, thank you for all the great info, as always! I got a serious question though. What would you recommend to someone who is trying to eat right, but is experiencing VT, PVCs, when their blood sugar drops low in between meals? No diabetes, no known issues of any kind. Just healthy, lean, active, reducing carbs from keto to carnivore. Any suggestions?
I've been doing ketovore for a year, my cholesterol was high when I started, but now it's in the stratosphere. No more diabetic meds, but very nervous.
Same boat. 6 months of carnivore and OMAD. Down 85 lbs: 24 BMI and BP 100/70. Feel amazing. However bloodwork this week shows triglycerides 177 and LDL 205. Hate to jump back onto a statin now that testosterone has recovered. How to balance the keto benefits and the cholesterol issue?
I have a body mass scale which also tracks my cardiovascular health , the way it does that is by measuring small changes in my weight as my heart beats and using my height to calculate a pulse wave velocity which seems reasonable and my cardiovascular age has been stable at 60 years old and I will soon be 69 years old. I know this just tells me that I have no hardening or calcification of my arteries and that I could have soft plaque build up. It is assumed that we all begin to build up plaque as we get older so if that is true then I would see a hardening of my arteries and an increase in my pulse wave velocity over time but so far it has been stable. I am on a low carb diet and I have a normal BMI and waist circumference also normal blood pressure but I no longer test my blood sugar every morning now I just keep to my diet.
No one seems to know what causes heart attacks. Half of them couldn't have been blockages and the other half are sim[ly assumed to be caused by blockages.
I so agree. Just yesterday I read about this fitness guy, doesn't drink alcohol, eat healthy (no sugars, low carb) exercise A lot and did so his entire life. At 41 he went to the food store after w/o felt great and suddenly went down. He had a heart attack.. Absolutely no factors would point he was at risk. You even read of athletes, professional footballer going down on the pitch with heart attacks too often to be considered rare, and at rather young ages. I feel there's more to it than just blockages that aren't really known or at least talked about. Personally, I think extreme training isn't that benefitial. Marathons, working out 6 days/week and such are a huge strain on body. But what else are we missing?
After being low carb for a year l lost 40 lbs, now normal weight, normal A1C but l know my cholesterol could go up but why did my triglycerides go up also? That worries me very much. I also haven’t had any alcohol in a year.
Wow. That's very interesting. I thought triglycerides were tied to carb intake - the lower the carbs and sugar the lower triglycerides. But everyone's body is different. I've been on a PCSK9 inhibitor for the past year (history of high cholesterol and a stent three years ago) and my triglycerides have consistently been in the mid 20's. However, I've decided to come off of it for 60 days and will be running an NMR to see what happens to my cholesterol and triglyceride numbers. I've been low carb over the course of time I've also been on the PCSK9 inhibitor.
your triglycerides go up because your body is burning fat for energy if you are in a deficit, and the saturated fat stored in our body is broken down and taken TO the liver to be metabolised. If you are eating too much it's because the fat you eat is being taken to the liver for storage as saturated fat. you are eating too much carbohydrate or too much fat or both. exercise in zone two for a good amount of time will reduce it. but don't get a blood test soon after exercise... as the level are high after exercise. 40 minute walk daily and eating within your energy needs should keep them in the good range. too much fat, or carbs (energy overall) will raise them, exercise lowers them but only if it's aerobic (zone two)
@ l think l remember him saying that in the beginning your triglycerides can rise because of circulating out of the liver into bloodstream but my test where done a year later.
Hi Dr. boz, firstly, I love your videos. Keep them coming. Something unusual has happened with my fasting insulin levels over the last few months. About 6 months ago, my fasting insulin level was 9.0. I started doing low-carb, ketogenic diet to lower my triglycerides. After 3 months, my insulin level rose to 15, and now it has reached 18.8. How can insulin levels be going on up if I'm consuming very little carbs, and more importantly, how can I lower it again. Please let me know before I have a heart attack. Thanks.
Your stress hormones may play a role in this process. How is your sleep? Very low carb diet is not for everyone, also excessive fasting. Even psychological stress can contribute to diabetes. Wishing you the best on your health journey.
@ I am not sure how your body will react. Low carb / carnivore diet affected my sleep. Also underlying infection or any source of stress affects glucose and insulin level. I tried to eat more fat etc…. nothing worked and I was feeling unwell. Not overweight but with “cortisol belly”, BMI fluctuates between 19-21. I have no problem with fasting….. now I retrain my body to eat more often. You may try to bring SLOWLY more carbs and check your labs again. Or even better just eat your carbs in the evening and assess your sleep, after a week or two you will know and learn how your body responds. I ordered Dr. Mercola’s new book, he changed his stance on fasting, low carb, high fat diets….Keep your mind open to new ideas. Sicker and older need more time to adapt to changes. Love your body and trust your intuition 🙏🏻
@jolantawozniak2132 thank you for your insight 🙏. It could just be my body not being able to handle ketosis. It prefers glucose for energy. It's a shame. My triglycerides were finally down to 100, even with minimal effort and exercise.
@ Please check Dr. Boz response below to question “why not check fasting insulin level”. I simply love her response. I still will test my fasting insulin level once a year…… without obsessive monitoring.
I'm 66 and have been on keto for about 10 years but with a move to probably 95% carnivore over the last couple. Feel great. All bloods, BMI, BP, etc very good right until my last recent blood test. Over the two years since my previous test, my Total cholesterol has gone from 200 to 440. Everything else still fine. My Dr said statins. I declined. I'm wondering if I'm now in the Lean Mass Hyper Responder category? If so, as I understand it, adding some carbs back should reduce the LDL (but with disadvantages too?). I know that LDL may not be an issue but..... perhaps a more 'balanced' diet may have more balanced results? I'm wary of changing from a diet that has really suited me just because of one aspect of a blood test (if I hadn't had it, I'd still be happy and relaxed) but.... I think I'll have an ApoB test to check particles.
Dr Ken Berry recommended fasting 14-16 hours, no more or no less. He also recommended skipping your workout if you workout in the morning. Skip the blood draw for a few days if you ran in a marathon to let the inflammatory markers to return to normal.
A better alternative to ApoB is to run the NMR lipo profile to determine the real risk of LDL particles by looking at LDL particle count and the small dense particles, particularly. And don't waste your time with BMI. A massively muscular person will have a huge BMI and that's actually good if their body fat content is low. An analysis of percentage body fat is much more reliable. And CRP is enormously inaccurate. It can be turned up with any source of inflammation such as a bad skin rash, A knee injury, recent surgery, or underlying inflammatory arthritis or other inflammatory disease. It's not very accurate at all. Better to use oxidized LDL as a vascular marker for inflammation. Overall, this is is generally all accurate information, especially the components of metabolic syndrome with insulin resistance proving to be very important.
Would love to hear Dr. Boz's comments on long-term carnivores' slightly elevated A1c. It's been postulated that the RBCs of a carnivore live longer, so there's more time for them to get glycated. Perhaps an A1c adjustment should be formulated for the carnivore population?
Thank you Doc, for your Videos. 🥰 How is the risk accessment for people with already badly clogged arteries, if LDL values are ignored? After BS values around 120 in the morning (16h fast) and peaks around 180 after eating, i decided to go carnivore and dropped Atorvastatin. Its now 3 weeks without any carb. I got my bloodwork values today, my doctor called me on the phone. My BS value is now ~90 in the morning. A1C 5,8. Insuline 6.48. Feeling very good, lost weight. . my Doctor meant i should not worry about diabetes, i would´nt experience that because my cholesterine is extreme high. ( Triglicerides102, LDL 156, HDL42) and i will die first to fats. The point is, i already have 5 stents which were caused by undiscovered extreme bloodpressure in the past vor over 10 Years (not an issue anymore).My Doc really escalated, after i told him i went Keto. 😔 sry for german english.
![Dr. Boz [Annette Bosworth, MD]](http://yt3.ggpht.com/wmxkT94LN1N2ujFLA7_YMlEgwZG_rqBnqbjh6BAjMU4gOD-oNLizrcDRL-9WuOoWlzs0_dMyfQ=s48-c-k-c0x00ffffff-no-rj)
Why didn’t you check fasting insulin?
Good question- I love reading the advanced studies using insulin levels. To get a good reading they check it 3 - 4 times in a 30 min setting …
When I try to translate that into the clinic setting, many flaws show up. The insulin is very volatile. It should be checked without getting out of bed - first thing in the morning… not possible for patients to do that.
Instead, I use fasting glucose with a fasting ketone. I have the patient check FIRST THING in the morning. Several days of this (at a fraction of the cost of one fasting laboratory insulin) teaches me & the patient far more.
Again … wise question. Thank you for asking.
@DoctorBoz it's crazy that many labs don't don't do glucose/ insulin simultaneously. I've literally had to search for my NP (office was unsuccessful) and ended up requesting Labcore to run a GTT and Insulin panel x3. Sadly, there's no code for a draw x4 so I'm stuck with a 3x draw. At least I have a better idea.
❤@@DoctorBoz
CAC scan would have been helpful also.
@@DoctorBoz, what ketone & glucose numbers are you looking for? 0.5 and higher, and glucose in the 60s-80s?
Congratulations Dr. Bosworth! As Board Certified Cardiovascular Surgeon I am glad that you provide this excellent information (and explanations) to the public!
Heard of Cardiothorasic surgeon and Vascular Surgeon. Never heard of "Cardiovascular" surgeon in the USA.
Every day gives an opportunity to learn something: in the past the specialty was “Thoracic and Cardiovascular Surgery”. Then Thoracic Surgery became a separate specialty.
What about if you have high Lp(a)? Still okay to have high LDL?
How do you know if someone is a Surgeon?
They will make sure to let you know that 😂
Hey Dr. Boz, not sure if you read comments, but your videos are a lifesaver. I tried your 72-hour sardine challenge, and the effects were almost immediate. 35 hours in, I woke up and my vision was so clear, sharp, and bright. And the best part? That annoying floater in my left eye was gone! It had been bugging me for a while, but when I looked for it, it was just... gone! I'm so happy. God bless you.
I will try this since you have tried it and you are having good results- thanks.
You should!
@@hassanwasim6349what brand of sardines do you buy?
What about sardines and uric acid ?
How many cans did you eat in that period?
My mothers bp was well over 150 her whole life....she passed at 86 and not from heart attack
So, my insulin resistance score was less than 25. I also get my fasting insulin checked every so often along with C-Peptide . They are 3.3 and 1.0 respectively. Keto for about a year and a half. I am a LMHR. TC 390 LDL 280. TRIGS 84, HDL 84, CRP-HS .6. A1C 5.4. I am 76 yo. and living my best life.
It's impossible to measure "insulin resistance" which is a construct
You're not alone. My numbers are similar, just age is less and LDL is higher.
Have you had a coronary calcium scan?
@@jasoncdebussyhow do I check insulin resistance? Thanks!
@@jenniehu2129You can't because it's a concept, an idea. That isn't to say that it's a false concept. If you were to be insulin resistant you would have ask yourself why. Insulin resistance is downstream from chronically elevated blood glucose. That is something that you can measure and CGMs are readily available now
Great presentation and it makes sense. High cholesterol is not the culprit for heart attack but insulin resistance does.
Heart attack at 49. Now 60. Apoa1 1.94g/l ApoB 0.61 g/l TG 0.7 mmol/L Fasting Insulin 4 HbA1c 5.1 Cleaned up my diet, daily walks and resistance train 4 days per week. Never felt better coming into retirement. No BP meds. Daily asprin
You need to do fasting. 18 hours or longer. Autophagy kicks in at 18 hour fast. Autophagy resets everything in your body.
@basstheangelo
Yes fasting is an additional benefit but what does one do when they're very thin already (like 10% body fat) & is trying to stay healthy on keto but can't afford to lose weight? Not sure fasting would be the right strategy to use...
@ long fast (18 hours or longer) isn’t just about losing weight. It’s mostly an immune system reset and autophagy. It breaks down damaged and unwanted cells. The process helps in cellular cleansing.
@@cc2020-d4w try doing OMAD (one meal a day). Select the most convenient time to consume all your calories. Do it in just an hour window. After that meal no calories for the next 23 hours. You eat again in the 24th hour. That’s what I do. Make sure you consume no calories for 23 hours straight.
As a man who had a heart attack at 47(12months ago) this gives hope. Cleaned up my diet. Dropped 50 pounds. Trying to get into a better habit of exercise myself.
Dr. Ken Berry would not put that BP as too high. 130/85 is okay according to him. The difficulty with a one-size-fits-all number is that the bigger you are the more pressure you need to get the blood round. And the older you get the more you need.
Good point
@@chazwyman
Berry doesn't have a clue what the truth is.
I heard the same thing from Dr. Suneel Dhand. He said the medical community keeps lowering the blood pressure over the years. He says everybody is different with different body size and mass. I thought it was interesting. I myself my blood pressure is usually around 117 to 121 over 80 to 72. But when it gets too low I get dizzy.
@uuzoo
My normal, resting blood pressure is under 110/60. 1am 77. I don't get dizzy. Depending on different factors, different people require different blood pressure to adequately pump blood. And to lower it with medications can cause blood starvation in the body. Get to the root of the problem.
What is causing it to be high?
Correct that problem.
Don't lower it with meds.
@@herbbowler2461 I agree, but finding a clinician that will even attempt to find the root cause...all they want to do is throw a pill at you. If it works, hey...on to the next! I've lived it the last 16 years.
Wow, the explanation at 0:29 about cholesterol and heart disease is mind-blowing! 🤯 The comparison with a pimple makes it so easy to understand. Thank you for breaking this down so clearly! 🙌
Thanks for this helpful video. My doc has called me in because my cholesterol is elevated but I'm healthy weight, exercise daily, eat well, don't smoke and all those other markers you mentioned are normal except I can't find the LPIR on my results - I don't think it was done. I've changed my diet to lower sugar and carbs and increased healthy fats. Before he tries to give me some medication, I'll insist on the LPIR test.
What an informative video! Thank you, Dr. Boz!
One of her very best!
I don't care about the numbers or the doctors. I never see them. My family has been living off our land for generations. We eat a lot of meat, fat and carbs. We also eat lots of fresh fruits and vegetables. We love to drink wine and brandy (home made). We smoke home grown tobacco. Everyone lived well into late 90-ies or even over 100. We are ALL active all of the time. We don't waste time sitting in front of TV, or playing with cell phones. There are always things to be done, and we try to stay on top of them. Human body is not made to be sitting idle, eating unhealthy processed food.
These pundits never describe the individuals lifestyles they are lecturing to. It's inexcusable! The say the sky is falling but never describe who it's falling on‼🤔
What a fantastic video. More people need to watch this and be educated ❤
I'm so confused , with all these doctors that contradict each other .😫
Oh no…. I have to use my own discernment. Why can’t everyone just give me all the answers??? 😭
Keep researching. You’ll start to find there’s a couple of camps of doctors… group A are the Doctors who study and are in the “know” about TODAY’S statistics and studies, and aren’t interested in selling the lies of big Pharma. Group B are all the typical Doctor’s who don’t keep up and rely on their past training (sometimes decades old) to guide their advice.
Just walk Excercise eat clean and put God first and everything be ok
I love how you break it down. Very interesting. Thank you.
My LPa went from 70 to 148 on keto! I'm actually terrified. 😢
My blood pressure refuses to go down. My CAC score is 0...I'm super confused.
Thank you, Dr. Boz for this very informative video. You are teaching science that nobody knows. This info is untraditional in figuring out the major risk factors and predictors of a heart attack . Thank you very much. Keep up the wonderful job, Dr. Boz.❤❤❤
Thank you for sharing the comparison table, Doctor! I’m curious to know more about how the LPIR score is calculated and the associated cost of performing the test.
DR Boz I very much appreciate the information that you share consistently.
Where can I get a copy of this risk table?
There are so many people on low carb discussion groups talking about their lipid profiles and I would really like to be able to discuss lipids and risk intelligently
Wonderful doc, great clear delivery. TY
Well done! Very good summary and very clear. Thank you for this!
Blood pressure at home: 105/65
At the doctors office it was 121/72 because I had been walking for 90 minutes in 12 F wind chill and then I had to climb steps up to the exam room - oh and no time to rest and nothing to rest the arm on at heart level. 😐
Total: 366
Trigs: 40
HDL: 114
LDL: 244
Weight:117
BMI: 20.1
I am a LMHR at 52 y/o. I do a lot of walking. And my resting heart rate is 55.
Fantastic tg and hdl!
Are you not afraid with so high LDL?
I mean, just in case
most doctors, nurses, and medical assistances cannot take an accurate blood pressure measurement!
Remarkable stats! Good for you
@@GuitarsAndSynthsRight and I do home monitoring. I won’t let them check it, and I’ve never seen any evidence that pills lower cardio risk.
I would love the blood pressure part explained. I’m not doubting it. We all agree that lifting weights plus HIIT training is good for us but for that whole time our blood pressure rises dramatically. Yes I understand that the exercise lowers the resting blood pressure but I still can’t quite line up how the massively elevated exercise pressures are not more detrimental. I don’t want them to be as I exercise every day but it still doesn’t make perfect sense to me.
That is why there's so many heart attack deaths while shoveling snow.
@ yes I’m sure it is. But that isn’t really relevant to the fit and healthy trained person. Of course I’m guessing because I have no data in front of me but logically those that are having heart attacks in those circumstances are your average overweight Joe or Jane doing work far beyond his or her fitness level.
@@stevemc2626 Assuredly so. Blood pressure spikes(scrubbing) can still be dangerous if there are "pimples" in the lining of arteries.
@@royc2390 Do you think anyone has ever done a study to see the risk ratio related to ‘average’ blood pressure (as in a persons average for the day, taking in spikes and troughs) rather than resting blood pressure?
@@stevemc2626 That is a very good question that I'd like to know also. I've never seen anything like that yet. If I ever come across such a thing, I'll come back here and post to you.
Summary of useful lab tests (& ref ranges): LPIR (
I'm in a quandry on BP. I have glaucoma in one eye. Low BP, raises pressure in that eye. BP is q135-140,/75-80 eye pressure is 16. While taking BP meds 120/80 was pretty normal, but eye pressure creaped up to 18 to 19 with eye meds. Guess it's what you're willing to chance
A patient is on Keto Diet. His HBA1C is 5.2 ,fasting Insulin is 4 ,LDL is 150 and Triglyceride is 170. Why his TG is high?
This is a 5 star video....very well said. TY!!!!
Consider looking at the ratio of triglycerides to HDL as a risk factor.
My ratio is 0.8. Triglycerides 63 mg/dL and HDL 79 mg/dL.
Rewriting the internal medicine books, great Doctor
Dear Dr. Boz really you are doing great for human life well being 😍
A statin study gives placebo to both groups. There is a 1% absolute difference in event rates between the two groups. Should the FDA approve the placebo with the lower event rates?
Unsubstantiated claims, zero reference links. But a ton of links to sell stuff.
Keto propaganda.
Happy Birthday Dr Bosworth!!!
You missed one of the most important! Remnant cholesterol (RC), the IDL and VLDL. (Non-LDL - LDL) = RC. Target RC < 25. RC is the best predictor of systemic inflammation. I can send you the research. LDL can be very high, but if HDL is high and Triglyc low, your RC could be VERY LOW (low inflammation). And that matters more than LDL. Also, those with very high HDL may have a superior form of HDL (yes, there's more than one kind of HDL) that better clears LDL and keeps the arteries healthy. RC is a better predictor than even CRP!
Good information. TG/HDL ratio is also a good predictor of Insulin Resistance. Less than 2 is great.
Well, my uric acid is between 7 and 8, seems heriditary and taking blood pressure medication Olmesartane seems to rather push it up more. No idea, what more to do. Have been doing fasting 18:6 for years and fighting to keep my heart cleanb. No heart attack but 2 stents in my 50s. 13 Years ago. I can't eat a lot of meat, makes me physically sick. Eat porridge, lots of vegetables and salad, but also rice and potatoes. Eyveryone you talk to, you get different advice.
Uric acid is NOT causal in heart disease
Dr.Boz thank you for this "bird's eye view" of "all the possible" measurements you can make to see if a patient has a high risk of having Cardiovascular disease (CVD) or not. I think certain doctors get very emotional or get carried away with focusing on "just" LDL because they were "selling" their one and only solution. I am one hard patient to convince about high LDL and how that means a greater chance for arteriosclerosis. My relatives are all doctors and we know about the "4s" study etc. Because my family has FH. All doctors are trained to push a solution whether the patient is proven to have CVD or not. Because they get psychologically rewarded the moment LDL is lowered. They feel that they have achieved a great deal. 😅 They are smart, informed etc. So educated!! Wow! Being a doctor is so rewarding mentally. I was supposed to have had a "mini-stroke" but no MRI scanning actually could prove there was a blood clot in my right brain! My Calcium score was very low almost zero about one month afterwards. This test measured calcification in my heart. I probably have epilepsy of an unknown origin as well. Wow these are all uncharted territories for an average doctor.The only visible sign during the stroke incidence was my left side of my body particularly my left arm and left leg was "frozen" or immovable for a day or three after the day of my "stroke."😅 Okay the patient was affected by this sign and decided to take the heavy medicine given right afterwards. Wouldn't you have agreed, just to eliminate the frozenness? I didn't know what atorvastatin 80mg was. I also didn't know all of a sudden I had to be on more than one statins to ensure I was really not going to clot anymore. How could I argue they the doctors were overly concerned? Hey these are the same tribe that tried to sell me real statins from USA 5 years before my incidence of "stroke". And I thought was they just wanted money. Even now under the Ministry of Health in Hong Kong, I don't have to pay for those statins anyway. So why the absolute focus on lowering my LDL with statins? All the other people in my family who are doctors never had a "stroke" that I had to have. 😅
To this day, at least two years after that strange "stroke" my LDL is lowered by a statin but I do not believe my stroke was due to my previous high LDL. It may be some clotting factor. This is reduced by taking a small aspirin. But why has my clotting factor caused a stroke? 😢 Anyone out there really understand these mysterious arteriosclerosis incidences? How about a Nobel prize for the proof? 😅
This is very timely for me, as my dad just passed away this month from a blot clot to his intestines. So my question is: Does this information apply to ANY blot clot (stroke or to the intestines)? Thank you!
I use old reading of BP 140 over 90
I found that when I get into the 100teens that I feel very fatigued.
Doctor you're a great at sharing things what is your coronary calcium score?
Zero
Love this. Would love to understand how LDL size plays a factor in this, among other variables not mentioned. Tim Noakes’ studied this. Keep up the great work.
I very much appreciate your video, and I must say, this is ammunition I could use my next consultation with my doctor. However, I do have one issue with your spreadsheet. The light colored columns also have light colored numbers on them, making them unreadable for me, I simply cannot see them. The type of colorblindness I have (deutero-something) pertains to about 75% of all colorblinds. Could you amend the sheet to show dark colored numbers on light colored columns or maybe just all numbers dark colored? I would very much appreciate the effort. Obviously, not necessary to adapt the video, but I do wish I could import the sheet (the end result you show). Maybe in the comments? Thank you very much for making the video!
Note I lowered my lp(a) from 246 to 84 with repatha and niacin 2k. I am high protein moderate fat. Very low carb. My ldl is 10, hdl 70 and tryg 35. I like the combination of driving my ldl down with repatha and essentially keto ish. Best of both worlds. Tested all inflation markers and all very low. No I R. Lost 70 lbs. over 2 years. Keeping it off for 2 since. Balanced approach to addressing all key risk factors. I don’t want a surprise that ldl is in fact bad… to much debate so I took it off the table. And added bonus crushed my lp(a)! Don’t say it can’t be done and be willing to try and retest. Also LP-PLA2 is a great inflammation test along with crp.
LDL only 10??? Super low
Please do a video on menopause, what you eat in a day to stay healthy please. And Hormones.
Cut out on. Juice means fructose, sugars, fried food, Take dryfruit, flaxseed for HDL, and omega 3
Excellent discussion. Loved it.
Dr quick question. I told my doctor my dad died when he was forty eight of heart attack, my grandfather fifty i have good insurance. He wouldn't even let me get a triglyceride test. I had a fight with him and this is my second doctor so do you do telemedicine?
I have very high LDL, VERY high HDL, low triglycerides, I’m confused!?!? I have high blood pressure, salt sensitivity I guess. I can’t digest meat easily, milk, cheese or anything else that I’d love to eat. I’d love to eat those foods my Dr. doesn’t go into detail. Any suggestions? I’m 78 and a 3 year cancer survivor.
Triglyceride/HDL ratio is of utmost importance. Less than 2 is great. You need not worry about your lipid Profile.
Is there a link to download this risk factor spreadsheet? I'm not finding it in the description. Thanks!
Thanks Doc. Picking myself up today 🤷🏻♀️
Outstanding video!
Congrats with this helpful explanation where to look.❤
Don't get me wrong, I am not on a ketogenic approach to my nutrition. My HDL is 125, LDL 81 and TRI 25. I do fast. As for my nutrition, I opt to eat clean daily, carbohydrate sources are potatoes, oats, vegetables, and fruit. When it comes to fat, 6 whole eggs and other healthy fats. I am not a doctor; my mom was and that myth to cholesterol she wasn't buying it back in 90s. In fact, she encouraged the consumption of whole eggs and dairy, not just the low-fat ones. Her approach was that trans-fat and bad style of life, be it in nutrition, smoking, alcohol, screw us up. Being Greek, olive oil is something we've had a lot, I don't use it nowadays to be fair, I get my fat elsewhere. To conclude, there are always options to nutrition, and we just must figure out the adjustments we need to take; everything's through trial and error. Thank you for the information.
The insulin resistance score- LPIR is new to me- why don't GPs in Australia do these important tests? My LDL is elevated and my GP wants to start me on statins- I am declining her prescribing and want to stick to lifestyle changes I can control. It is difficult to get more than the standard Medicare testing.
I need a doctor like Dr. Boz in my neck of the woods. 😍🫀❤️
Do I not have More triglycerides in my blood when I'm fasting and releasing fat into my blood? Please answer.
No when you fast ur levels in the blood decrease because there is no fat in the first place for it to convert to triglycerides
Thanks so much. The video helped me piece things together.
Thank you for this information!!
Anyone know a good private lab in The Netherlands? My doctor doesn't want to do some of these tests.
Hate doctors that don’t do those test
Thank you Dra.for the great information.
And a high fat diet will ensure you remain insulin resistant, something you won’t notice because of the low carb restriction. Better to reverse the resistance. In other words, regain the capacity for your system to function property with a normal carb intake. Your body doesn’t need disproportionate amounts of protein and fats.
very good doc boz....master diseration....
i always thought non-hdl cholesterol was closely related to apob (total cholesterol - hdl cholesterol). and apob value, if high, is directly correlated to a heart attack occurrence. in your diagram you don't consider the possibility. am i wrong?
I have been eating red meat for 9 months. I lowered my lp(a) by 70 points. My hdl went down and triglycerides went up (still in normal range). My crp went down. My insulin levels are normal. From my experience, i feel every body responds differently to a diet. Keep checking your labs as you go (ie.ownyourlabs or anylabtestnow).
Do you take carbohydrate rich diet or alcohol?
No
Thank you Dr Boz. I agree with everything you've said. Interesting to see that we often focus on the wrong metrics.
Inflammation due to the chronically debilitating effect of 'safe and effective'.
Thank you what are you great people eating daily please, thank you❤
Thank you for all your hard work!
I still wonder if elevated BP is a cause or a symptom? And I'm not talking about 160/95, just the 130/80 range.
Might want to take a gander at Serrapeptase, just for fun.
Mechanistic studies demonstrated that SRP significantly inhibited the LPS-induced production of proinflammatory cytokines such as IL-2, IL-1, IL-6, and TNF-α in aortic tissue. Furthermore, it also inhibited LPS-induced oxidative stress in the aortas of mice, whereas the expression and activity of monocyte chemoattractant protein-1 (MCP-1) decreased after SRP treatment. In conclusion, SRP has the ability to reduce LPS-induced vascular inflammation and damage by modulating MCP-1.
For those of us that won the genetic lottery of high Lp(a), what do you advise to lower/control it? Already on a statin + repatha.
The statin will increase your LPa… i also have this issue and have lowered mine from 330 to 180. Im on repatha and vascepa. Pcsk9 is the only real way along with niacin although niacin is very controversial on this…
@ my issue is since being on Repatha for a year, the muscle issues in my legs and lower back have been pretty intense. I searched and saw many have this issue. I’d very much like to stay on Repatha but my goodness, I’m super active at the gym and I’m hurting lately.
@ thats a common issue with statins
@@DylanGemelliBiohackingJust read an article from an athletic doctor who did it with VLCKD. Low carb ketogenic diet who was already on a statin. I’m about to start this . I already do IF.
My GP told me bp under 140 is OK for seniors above 70. Im 77.
1.uric acid and heart disease
2.glucose increase uric acid
3.hemoglobin hbA1C risk of heart disease *
4.BMI risk by 33%
5.cholesterol
6.triglycerides and consumption of carbohydrates
7.bp elevated
8.insulin resistance, rising
I agree. I had a tolerable ldl, even though my hdl/ldl ratio was indicating some risk. It wasn’t enough risk to indicate i had a deadly aneurysm that could have popped by now. By the Grace of God i am writing this because i came down with non-covid pneumonia exactly 2 years ago and the chest x-ray exposed it. Doctors were sweating bullets over me because they weren’t confident to operate on me while i was dealing with the pneumonia.
Hi doctor.. I went to Chresteol test yesterday and my doctor told me I’m not required to fast and they told me if I have coffee or tea in the morning that is not a problem.
So before the lab test I had coffee and milk drink maybe 3 hrs before the test so today the results is back to my email and my triglycerides was 164 and in the past 10 years my triglycerides never reach a 100 my triglycerides always around 80s
So would you recommend me to re check my cholesterol test again and do it fasting this time ??
Picking up on Fructose raisng Uric Acid! Im curious the home remedy of tart cherry claims to lower uric acid. My husband used to take it and swears by it. He no longer has gout because we've been on a ketovore diet for 3 years. Went on this diet due to TBI and needing better brain health for my husband. I know different topic but i love the breakout on labs. You're awesome Dr. Boz!
My husband had a CAC score of 1115. We don't trust the mainstream medical establishment. What would be your suggestion to do next? We now only have whole foods and whole ingredients in our house. No sugar. No seed oils. We're scared but we will never take a statin. Could you tell us what you think he should do next?
Drop all of the ‘healthy’ grains too.
@jima1325 No grains....even ancient grains like millet and quinoa? Do they cause heart disease?
Dear Dr. Boz, thank you for all the great info, as always! I got a serious question though. What would you recommend to someone who is trying to eat right, but is experiencing VT, PVCs, when their blood sugar drops low in between meals? No diabetes, no known issues of any kind. Just healthy, lean, active, reducing carbs from keto to carnivore. Any suggestions?
What about the makeup of LDL - fluffy vs small/dense ?
I've been doing ketovore for a year, my cholesterol was high when I started, but now it's in the stratosphere. No more diabetic meds, but very nervous.
Same boat. 6 months of carnivore and OMAD. Down 85 lbs: 24 BMI and BP 100/70. Feel amazing. However bloodwork this week shows triglycerides 177 and LDL 205. Hate to jump back onto a statin now that testosterone has recovered. How to balance the keto benefits and the cholesterol issue?
@@pghedgesDo you take alcohol regularly?
@@PrasantaDatta-f3gI went from a nightly drinker before carnivore to an average of only one drink every 10-14 days now.
I have a body mass scale which also tracks my cardiovascular health , the way it does that is by measuring small changes in my weight as my heart beats and using my height to calculate a pulse wave velocity which seems reasonable and my cardiovascular age has been stable at 60 years old and I will soon be 69 years old. I know this just tells me that I have no hardening or calcification of my arteries and that I could have soft plaque build up. It is assumed that we all begin to build up plaque as we get older so if that is true then I would see a hardening of my arteries and an increase in my pulse wave velocity over time but so far it has been stable. I am on a low carb diet and I have a normal BMI and waist circumference also normal blood pressure but I no longer test my blood sugar every morning now I just keep to my diet.
Thank you so much for this information. I’m going to see a cardiologist next week and this will be very useful.
No one seems to know what causes heart attacks. Half of them couldn't have been blockages and the other half are sim[ly assumed to be caused by blockages.
I so agree. Just yesterday I read about this fitness guy, doesn't drink alcohol, eat healthy (no sugars, low carb) exercise A lot and did so his entire life. At 41 he went to the food store after w/o felt great and suddenly went down. He had a heart attack.. Absolutely no factors would point he was at risk. You even read of athletes, professional footballer going down on the pitch with heart attacks too often to be considered rare, and at rather young ages. I feel there's more to it than just blockages that aren't really known or at least talked about. Personally, I think extreme training isn't that benefitial. Marathons, working out 6 days/week and such are a huge strain on body. But what else are we missing?
Fantastic video, thanks!
Any idea why my A1-C would be 5.7 even though my Triglycerides are only 42? That seems weird to me.
Great explanation of often overlooked labs. Too bad there wasn't an easier way to measure LPIR.
Hello, is LPIR the same or a replacement for HOMA IR indication?
Thanks
yes and fasting quickly raise UA levels. 😊
After being low carb for a year l lost 40 lbs, now normal weight, normal A1C but l know my cholesterol could go up but why did my triglycerides go up also? That worries me very much. I also haven’t had any alcohol in a year.
Wow. That's very interesting. I thought triglycerides were tied to carb intake - the lower the carbs and sugar the lower triglycerides. But everyone's body is different. I've been on a PCSK9 inhibitor for the past year (history of high cholesterol and a stent three years ago) and my triglycerides have consistently been in the mid 20's. However, I've decided to come off of it for 60 days and will be running an NMR to see what happens to my cholesterol and triglyceride numbers. I've been low carb over the course of time I've also been on the PCSK9 inhibitor.
your triglycerides go up because your body is burning fat for energy if you are in a deficit, and the saturated fat stored in our body is broken down and taken TO the liver to be metabolised. If you are eating too much it's because the fat you eat is being taken to the liver for storage as saturated fat. you are eating too much carbohydrate or too much fat or both. exercise in zone two for a good amount of time will reduce it. but don't get a blood test soon after exercise... as the level are high after exercise. 40 minute walk daily and eating within your energy needs should keep them in the good range. too much fat, or carbs (energy overall) will raise them, exercise lowers them but only if it's aerobic (zone two)
This isn't unheard of. I forget the reasoning...I think Dr Cywes has a video on it
@ l think l remember him saying that in the beginning your triglycerides can rise because of circulating out of the liver into bloodstream but my test where done a year later.
Hi Dr. boz, firstly, I love your videos. Keep them coming.
Something unusual has happened with my fasting insulin levels over the last few months. About 6 months ago, my fasting insulin level was 9.0. I started doing low-carb, ketogenic diet to lower my triglycerides. After 3 months, my insulin level rose to 15, and now it has reached 18.8. How can insulin levels be going on up if I'm consuming very little carbs, and more importantly, how can I lower it again. Please let me know before I have a heart attack. Thanks.
Your stress hormones may play a role in this process. How is your sleep? Very low carb diet is not for everyone, also excessive fasting. Even psychological stress can contribute to diabetes. Wishing you the best on your health journey.
@jolantawozniak2132 sleep isn't the best. So if I eat carbs again my insulin level should return to normal?
@ I am not sure how your body will react. Low carb / carnivore diet affected my sleep. Also underlying infection or any source of stress affects glucose and insulin level. I tried to eat more fat etc…. nothing worked and I was feeling unwell. Not overweight but with “cortisol belly”, BMI fluctuates between 19-21. I have no problem with fasting….. now I retrain my body to eat more often. You may try to bring SLOWLY more carbs and check your labs again. Or even better just eat your carbs in the evening and assess your sleep, after a week or two you will know and learn how your body responds. I ordered Dr. Mercola’s new book, he changed his stance on fasting, low carb, high fat diets….Keep your mind open to new ideas. Sicker and older need more time to adapt to changes. Love your body and trust your intuition 🙏🏻
@jolantawozniak2132 thank you for your insight 🙏.
It could just be my body not being able to handle ketosis. It prefers glucose for energy. It's a shame. My triglycerides were finally down to 100, even with minimal effort and exercise.
@ Please check Dr. Boz response below to question “why not check fasting insulin level”. I simply love her response. I still will test my fasting insulin level once a year…… without obsessive monitoring.
I'm 66 and have been on keto for about 10 years but with a move to probably 95% carnivore over the last couple. Feel great. All bloods, BMI, BP, etc very good right until my last recent blood test. Over the two years since my previous test, my Total cholesterol has gone from 200 to 440. Everything else still fine. My Dr said statins. I declined. I'm wondering if I'm now in the Lean Mass Hyper Responder category? If so, as I understand it, adding some carbs back should reduce the LDL (but with disadvantages too?). I know that LDL may not be an issue but..... perhaps a more 'balanced' diet may have more balanced results? I'm wary of changing from a diet that has really suited me just because of one aspect of a blood test (if I hadn't had it, I'd still be happy and relaxed) but.... I think I'll have an ApoB test to check particles.
FYI, I'm now on Crestor 10mg once per week and after 3 months have seen TC, LDL fall by 30%.
Simply brilliant
❓ OMAD works I agree but if I'm going in for blood test should I or will it help if I fast 24 hours or more before the blood test?
Dr Ken Berry recommended fasting 14-16 hours, no more or no less. He also recommended skipping your workout if you workout in the morning. Skip the blood draw for a few days if you ran in a marathon to let the inflammatory markers to return to normal.
I have heart acne?
A better alternative to ApoB is to run the NMR lipo profile to determine the real risk of LDL particles by looking at LDL particle count and the small dense particles, particularly.
And don't waste your time with BMI. A massively muscular person will have a huge BMI and that's actually good if their body fat content is low. An analysis of percentage body fat is much more reliable.
And CRP is enormously inaccurate. It can be turned up with any source of inflammation such as a bad skin rash, A knee injury, recent surgery, or underlying inflammatory arthritis or other inflammatory disease. It's not very accurate at all. Better to use oxidized LDL as a vascular marker for inflammation.
Overall, this is is generally all accurate information, especially the components of metabolic syndrome with insulin resistance proving to be very important.
Any consideration for potassium to lower blood pressure?
So are you saying that you can be insulin resistance cause by pathological thoughts
These is a great video. But one question! Where do those odds/probability figures come from?
Thanks!
Great info. What about checking Myeloperoxidase? I understand it's much more of an indicator than CRP. PLAC or PULs test also which is LpPLA2
Would love to hear Dr. Boz's comments on long-term carnivores' slightly elevated A1c. It's been postulated that the RBCs of a carnivore live longer, so there's more time for them to get glycated. Perhaps an A1c adjustment should be formulated for the carnivore population?
Thank you Doc, for your Videos. 🥰
How is the risk accessment for people with already badly clogged arteries, if LDL values are ignored?
After BS values around 120 in the morning (16h fast) and peaks around 180 after eating, i decided to go carnivore and dropped Atorvastatin. Its now 3 weeks without any carb. I got my bloodwork values today, my doctor called me on the phone.
My BS value is now ~90 in the morning. A1C 5,8. Insuline 6.48. Feeling very good, lost weight. . my Doctor meant i should not worry about diabetes, i would´nt experience that because my cholesterine is extreme high. ( Triglicerides102, LDL 156, HDL42) and i will die first to fats. The point is, i already have 5 stents which were caused by undiscovered extreme bloodpressure in the past vor over 10 Years (not an issue anymore).My Doc really escalated, after i told him i went Keto. 😔 sry for german english.