Lead and Your Heart: Why “Normal” Isn’t Optimal
Let’s talk about Lead….everyone knows it damages children’s brains but what about adults? In 2018 Bruce Lanphear’s group followed over 14 thousand Americans for 19 years and found those with high concentrations had 70 percent higher risk of dying from cardiovascular disease and about twice the risk of dying from ischemic heart disease compared to […]
Giving Blood to Lower PFAS: Answering the Objections
A lot of people read my post about donating blood or plasma to reduce PFAS. A few of the comments caught my eye. Comment 1: Aren’t you just handing your PFAS to the person who gets your blood like a hot potato? Well, the thing is…. Everyone already has PFAS. In the NHANES study, PFAS […]
Can Donating Blood Lower Your Forever Chemicals? What the Only Randomized Trial Found
Patients ask me about toxins more than they used to. Mold, heavy metals, microplastics, and increasingly the forever chemicals called PFAS. The key is avoidance of these, eating fiber and taking regular saunas. Now, we have a new option for PFAS. What PFAS are Per and polyfluoroalkyl substances are a family of several thousand synthetic […]
Is LDL the Wrong Target? What FOURIER and SPARCL Really Showed
Maybe LDL is the wrong target. Look at the curve from the FOURIER trial, we reduced LDL from 92 to 30. If LDL were the villain everyone thought then why are the results so….weak? FOURIER primary endpoint, evolocumab vs placebo. The y axis runs to 100 percent. What FOURIER showed 11.3 percent had a heart […]
The Triglyceride-to-HDL Ratio: The Heart Risk Number Your Lab Doesn’t Report
If you have had a cholesterol test, you already own the single most useful number in preventive cardiology. You just have to calculate it yourself: triglycerides divided by HDL cholesterol. As a cardiologist, I check the triglyceride HDL ratio before I look at LDL, and in this article I will explain why, how to interpret […]
The Anti-Fatigue Factor: What a 1951 Liver Experiment Teaches Us About Whole Food Supplements
In 1951, a nutrition researcher gave rats every vitamin science knew about and then dropped them into cold water. They quit in thirteen minutes. The rats that had been fed liver were still swimming two hours later. That experiment is the best answer I have to the question patients ask me constantly: why don’t you […]
Can Persistent AFib Convert Without Ablation? A Case From My Practice
“Is ablation my only real option?” It’s the question I hear most often in second-opinion consults for persistent atrial fibrillation. For most of my career as a cardiac electrophysiologist, my honest answer was that once AFib becomes persistent, the realistic choices are the conventional ones: control the rate, suppress the rhythm with medication, or ablate. […]
The Screening Cascade: How a Calcium Scan Becomes a Stent You Never Needed
It usually starts with good intentions. A patient with no symptoms — or stable, predictable symptoms — gets a coronary artery calcium (CAC) scan “just to know.” The score comes back elevated. Nobody sleeps well after a four-digit calcium score. What happens next follows a script I have watched for twenty-five years. The elevated score […]
Excess Niacin, NAD Boosters, and Heart Disease Risk: What New Research Shows
Niacin — vitamin B3 — has a long history in cardiology. For decades we prescribed it to raise HDL and lower LDL. The numbers moved. Then the outcome trials came back: no fewer heart attacks, no fewer deaths. Niacin quietly fell out of favor, and most of us moved on without asking the obvious question […]
ApoB vs LDL Cholesterol: The Number Your Doctor Probably Isn’t Ordering
Most people have been trained to watch one number. Their LDL cholesterol goes up, and they worry. It goes down, and they relax. I think that’s the wrong number to watch. Atherosclerosis isn’t caused by cholesterol floating loose in the blood. It’s caused by particles carrying cholesterol getting stuck in the artery wall. Every one […]