Coronary Artery Disease with Dr. Ben Weitz: Rational Wellness Podcast 377

Dr. Ben Weitz discusses Coronary Artery Disease at the Functional Medicine Discussion Group meeting on August 22, 2024.  This was the first annual Dr. Howard Elkin Memorial Integrative Cardiology Lecture.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 

 

Podcast Highlights

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Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz:  Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast. Thank you everybody for attending a Functional Medicine Discussion Group of Santa Monica. And our next month we have Dr. Tom O’Brien who will be speaking on Tuesday the 24th, so that should be really exciting. He’s a great speaker he’s spoken with us before, he has a new presentation he wants to talk about so definitely put that on your calendar.

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Integrative Therapeutics is our sponsor for this evening. So I want to thank them for sponsoring another one of our meetings. And if you’re not familiar with their products, they’re one of the few professional lines of supplements that we carry in our office. And they have a number of great products for every condition, including cardiovascular.  We use their berberine regularly. They have several highly advanced forms of curcumin, Their latest one is Curalieve and it’s super highly absorbable. So that’s a great product at one capsule twice a day is easy to take. It’s super effective. Lowering inflammation.

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I want to say tonight there’s some good news and there’s some bad news.  So the good news has to do with me. I don’t know if everybody’s aware, but I fell and fractured my femur on Halloween night and had surgery the next day. And unfortunately it wasn’t healing because there was a gap between the bones after the surgery. And so it was diagnosed as a non union, but I can now say that it has healed.  The mic’s not working? Okay. I’ve got to keep my mic on. Keep it close to my mouth. Okay. Thank you, Bernie. I’ll just repeat the good news is that it’s about me. I fell and fractured my femur, and it wasn’t healing. I have a non union. And I was told I needed another surgery, but in the functional medicine world, we believe in the ability of the body to heal itself.  And so I wasn’t going to accept that. So I came up with a plan. I scoured research showing that a drug called Forteo, which simulates new bone cells helps healing of non-union fractures. And I started taking injections of Forteo, I also used Human Growth Hormone two IUs a day, and I started using a bone stimulator, and I did that for four months, along with, of course, all the supplements, 10,000 IUs, Vitamin D, 45mg MK4, Boron, Calcium, Magnesium, Strontium, Collagen, Glucosamine and I can now say that my hip is healed.  Yay! So, thank you. I’m really happy.

The bad news is that our friend and colleague, Dr. Howard Elkin unfortunately passed away on August 1st.  He used to come to our meetings regularly, he worked at my office one day a week for about a year. He was a great integrative cardiologist.  He also did prescribe bioidentical hormones and trying to find another cardiologist to send his patients.  There was nobody like Howard. So very sad. So I’m dedicating this talk to Howard Elkin. So this is the first annual Howard, Dr. Howard Elkin Memorial Talk on Integrative Cardiology. So let’s get started here. This is Howard’s book.

And so the goals of the presentation are number one to get you to understand more about what is coronary artery disease, how does plaque form, and what happens when you have a myocardial infarction.  Number two is to understand the testing and in particular, advanced lipid testing. And we’re also going to talk about some of the direct testing.  We have somebody from Cleerly Health to talk about the CT Angiogram with Artificial Intelligence, which is the latest test that allows you non-invasively to see exactly what’s happening inside the arteries.  And then I’m going to focus on some of the approaches to treating coronary artery disease with an emphasis on diet and supplements.

So heart disease continues to be the number one killer in the United States and coronary artery disease is the number one cause of heart disease. Over 800,000 people in the U.S. suffer a heart attack every year. And heart disease is still the number one killer in women as well.  It’s common for women to be fearful about breast cancer, but the number of women that die from breast cancer on average is a fraction of the number of women who die from cardiovascular disease.  So, that should be the focus for preventative medicine.

Coronary artery disease has to do with disease in the arteries that supply the heart and these are four of the main arteries that supply the heart. And this artery right there is the Left Anterior Descending artery. And that artery supplies over half of the heart muscle.  And if that artery becomes completely clogged by a heart attack, you’re most likely not going to make it. They call that the widow maker. Alright. So, what happens in coronary artery disease is that the arteries become lined with plaque and plaque is composed partially of oxidized cholesterol, as well as inflammatory cells, white blood cells, etc.

But what usually leads to a heart attack or a myocardial infarction is not that the arteries become more and more closed until they’re fully closed. 75 percent of the time what happens is that the plaque ruptures, it breaks open and forms a clot. And so the mere presence of cholesterol does not mean that you’re going to have plaque buildup.  The most significant factor is that the plaque becomes oxidized and or inflamed. So looking at markers of oxidation and inflammation are super important.

So let’s see, the endothelial lining of the arteries. So the inside of the arteries is called the endothelium. And we think that is where a lot of the action happens. And there’s a lot of focus in the research on the health of the endothelium. And there’s several things. [Hey, Johnny.] There’s a number of things we can do to improve the health of the endothelium.

Okay, so here is a slide about the endothelium. So the endothelium is this one, [Hi Roxane], is this one cell lining of the inside of the arteries. And if the endothelium is not working properly, we call that endothelial dysfunction. And what that will mean is that typically you’ll get less nitric oxide production.  Nitric Oxide is one of the key players in heart disease. Having good Nitric Oxide production reduces hypertension, improves the health of the arteries, and it’s super important. And here’s a finger-like lining of the endothelium, those little finger-like projections. That’s called the glycocalyx. The glycocalyx is composed of glycoproteins and proteoglycans.  And the health of the glycocalyx is super important in understanding what’s going on.

So, here’s an example of plaque inside the arteries. And so on the left side we have you see the plaque and if the plaque rushes, it looks something like that, and this is where you have a calcium fibrous cap like a [00:09:00] plaque. And so, most people are concerned about having calcium in the arteries.  It turns out that if you have plaque in your arteries, it’s bad. If that plaque is covered by calcium, it’s more likely to be stable, and stable plaque is less likely to lead to a myocardial infarction. So I have a short video here, just in case you don’t understand this. The heart pumps blood to the body through a complex network of arteries.

With the exception of the coronary arteries, which nourish the heart itself, most arteries transport oxygen rich blood away from the heart.  Let’s see. 1, Cancer, 2, and 0. I’d be like, what’s happening to me? It’s a tragedy. Trouble? Wait a minute. What do you think the sound holds up to? The heart pumps blood to the body through a complex network of [00:10:00] arteries.

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Let’s take a turn. Circulating in the blood are red blood cells, white blood cells, nutrients, and other life sustaining substances. Cholesterol and other fatty substances also circulate in the blood. Over time, these substances can be deposited in the artery walls, a condition called atherosclerosis. The deposited cholesterol, or plaque, can build up over time, causing hardening and narrowing of the otherwise smooth [00:11:00] artery walls.

When the walls of the artery become narrowed and hardened, blood flow is restricted. As the plaque accumulates, the buildup can become unstable and may break off or rupture. A condition called thrombosis results when blood starts to coagulate or clump together at the site of the rupture, similar to the way blood clots to stop bleeding from a pipe.

A blockage or thrombus can grow larger, further restricting the flow of blood. The thrombus is also in danger of breaking from the site and traveling through the arteries. The blockage caused by a thrombus can be life threatening. A blockage in the coronary arteries may cause a heart attack. While a blockage in a cerebral artery may cause a stroke.

Blockage in one of the major arteries of the body can prevent blood flow to an extremity or organ. Causing pain and tissue damage to the area.[00:12:00]

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Great. That was pretty interesting.  So, in order to control inflammation and oxidation, this is a list of supplements from Dr. Mark Houston’s book.  By the way, this is one of the best books about coronary artery disease. I don’t know if you know Dr. Mark Houston, but I’ve studied a bunch with him, and he is one of the premier teachers of cardiovascular medicine.  He teaches for A4M.  This [book] is called The Truth About Heart Disease. But, yeah, this is all about coronary artery disease. There’s actually a lot of supplements, I probably take almost all of them, and here’s a list of the top anti oxidant foods I could go through all of those.

Okay, so Yeah. Okay, so the top list that I choose, these are the examples for someone familiar with Can you just hold that for a second? [00:13:00] Oh yeah, sure. There you go. And human stuff. Sorry. Annatto.  Yeah, it’s interesting how beans are so high in antioxidant. Beans are really super healthy, even though Dr. Gundry says they’re not.

As long as they’re properly cooked, and if you undercook your beans, you’ll know it. So, high blood pressure, obviously it’s a super risk factor for coronary heart disease. Smoking, everybody knows about. Cholesterol, dyslipidemia, insulin resistance, diabetes. If you have diabetes, you have three times the risk of heart attack.  I’m going to focus more and just talk about some of the other factors, but diabetes is super important. Insulin resistance, it’s in the stages of a heart attack. [00:14:00] Needs to be addressed. This is about inactivity and obesity.

Now, this is a list that not everybody thinks about, so I’m going to spend a little more time on this.  So, uric acid is a very important marker. Significantly increases risk of coronary artery disease. It’s typically not measured by most doctors. We do it.  I run a lot of panels to Vibrant America, and we always look at uric acid. Dr. David Perlmutter has really emphasized the importance of uric acid as a metabolic marker and not just as a marker for gout.  We have fibrinogen, fibrinogen is an important marker to look at, increases risk of clotting, the blood gets thicker, that increases your risk.  Elevated iron and ferritin.  I did a podcast with a doctor from, wrote a book about Hemachromatosis, and 30% of population has at least one gene that makes them more likely to store iron.  But guess what?  We have no idea because iron doesn’t get measured on most patients. I had a patient who was being treated for anemia was because their, he, because their hematocrit and their hemoglobin were high [meant to say low]. And they put him on iron.  Nobody ever measured the iron. He doesn’t need iron.  He was having a problem. He’s a painter. He was having a problem with lead toxicity, which was blocking his iron. So giving him more iron was never going to fix it.

I had a couple of women, a mother and a daughter, they’re both vegan, they have high iron and ferritin but nobody measured it.  They’re vegan, everybody assumed that they needed iron, but they’re storing iron, so start measuring iron, do a whole iron panel on all your patients, you’re going to find a number of patients that need to reduce their iron, and here’s some strategies for reducing the iron. For one thing, high dose curcumin, there’s a number of things you can do.

Sleep, is super important.

Homocysteine. How many industry measure homocysteine? Okay. Homocysteine is a inflammatory marker in blood, separate from cholesterol. It significantly increases your risk of heart disease. According to Dr. Houston, risk starts when homocysteine is above 5.  Yes, most of the labs say it should be under 12. Now, after 12, it really shoots up. We usually try to get it below 8. Getting it down to 5 is hard, but it’s interesting. So, homocysteine is super important. The way you get it down is with specific B vitamins.

For Thyroid anything that causes inflammation, I put low hormones because we know that having proper good levels of hormones is super important for health.  Anything that causes inflammation such as chronic infections, toxins mold, it turns out [00:17:00] that Dr. Elkin, the day he was moving out of his house because he had mold. Addisalice, so that could be an inflammatory trigger micronutrient deficiencies, gut health, Dr. Elkin regularly ran stool tests on his cardiovascular patients, everybody thought he was crazy, but it’s super important, we all know, especially in functional medicine, it all starts in the gut.

Alright, so the controversy about cholesterol, and we have Johnny Bowden in the back of the room who wrote The Great Cholesterol Myth. And so, it’s a question whether cholesterol itself is a factor. Most of the studies indicate that it’s only when cholesterol becomes oxidized or when there’s inflammation in the arteries that cholesterol really becomes a problem.

Cholesterol is essential for all these functions in the body. It’s essential for producing. Our sex hormones, it’s important for brain health there’s a whole series of nutrients that won’t get produced, you don’t have sufficient levels of cholesterol, it’s how our body makes vitamin D from the sun it’s no wonder patients in Southern California, I, we measure vitamin D all the time, it’s amazing how many people come in who get plenty of sun and they still have low vitamin D. And one of the reasons could be because everybody’s trying to get their cholesterol down so much.

So, oxidation, inflammation interestingly, just to throw something into controversy, and I’m not going to make any conclusions about it, but, we debate what should be the best level of LDL cholesterol, and we’re going to talk about my LDL is.  itself, not necessarily the best marker, but there was a study done recently, University of Pittsburgh, and they found that the patients who are least likely to die of heart disease had LDL [00:19:00] cholesterol in a range of, while it was long term, it was 20 or more, not just heart disease. They had cut LDLC in the range of 100 to 189.  So, there’s still things we probably don’t know about this whole situation. Yeah. Bernie . I was going into small . Yes, absolutely. Which is rich. Oh, the small particle is the one you have to worry about. I mean, is that Bridge point to C. Okay. So, we’re gonna talk about this, but the most doctors, most cardiologists run what’s called the Basic Lipid Profile.

And that means total cholesterol, estimated LDL, what they call LDL C. They just go, it’s about this much LDL. They don’t count the particles of HDL and triglycerides. And it’s wonderfully inadequate. [00:20:00] It’s really malpractice that they’re not running a advanced lipid profile, and that’s where we can come in as functional medicine practitioners.

And, in fact, if you start running the advanced lipid profiles, and we’ll talk about that soon, as well as some of the other advanced steps I have a good relationship with my primary care doctor, and sometimes we run these advanced lipids on his patients, and I share the information with him. I help the patients with the nutritional approach, but Sure.  He can’t run those panels because the insurance companies come after him. And, I know it’s criminal. It’s crazy that we let insurance companies run our health care system. It’s really not good for us. So, you can run these advanced lipid panels and you’ll save the patients money. Because if they get sent on insurance to run an advanced lipid profile and it’s not covered, they’ll get charged thousands of dollars.[00:21:00]

Whereas we can get a really good advanced lipid profile for you. We use Vibrant America and so we can do advanced lipids, hormones, thyroid nutrients and get it done for four or five hundred dollars. Okay. So we just talked about the basic lipid profile and even cardiologists are not running it even though they should and the reason why is insurance coverage and time.  So they just run the basic lipid profile.

Okay, so what is the Advanced Lipid Profile? Well, there’s a number of specialty labs that offer Advanced Lipid Profiles. Howard, Dr. Elkin, he often ran either Boston Heart or Cleveland Heart. And all of these labs have special parts of their tests that the other labs don’t have.  They’ve developed a proprietary testing. I’ll [00:22:00] show you a few examples of Advanced Lipid Profiles so you can get a better idea of how to interpret some of these. All right. So the Advanced Lipid Profile typically will look at not just LDL, not just total cholesterol and estimated LDL, but it’s going to look at LDL particle number and particle size.  So it’s the small dense LDL that puts you at biggest risk. Lately, a marker that has become more popular is ApoB. Peter Attia says it’s the only one you need to look at and it’ll determine your risk. I’m going to show you a slide later on, on somebody that Howard tested who had a Cleveland Heart Lab, had totally normal ApoB, but is at a lot of risk, because they had a lot of small dense LDL, and other inflammatory markers.  So, I’m going to basically be arguing that there’s not one marker that’s best. We need to look at a number of markers. Other tests that you want to look at, Oxidized LDL, Lp-PLAC, and MPO. Those are all markers for inflammation inside the arteries. So inflammation is the key, as we know there’s so many different diseases, and it’s certainly the case with Coronary artery disease.

Lp(a).  How many of you test for Lp(a)?  Everybody should be getting testing for Lp, little a. I’ve had arguments with primary care doctors. No, it’s hereditary. You can test for it while they’re in the process of developing drugs for Lp(a). And once those drugs are out in a few years, everybody’s going to test for it.  But now, they don’t want to test for it because they don’t know what they can do about it. But there are things that we could do, and we’ll talk about that. Vitamin D, Omega 3 is super important, Coenzyme Q10, ADMA is a marker for nitric oxide status. Not everybody [00:24:00] offers that. Unfortunately, Vibrant doesn’t offer it.

TMAO is a controversial marker. I don’t share anything about that. There’s this doctor at Cleveland Clinic, Stanley Hazen. It just seems like every six months he comes out with some other study, trying to tell us that everything we, we think is good is actually bad. And so, TMAO is this marker that’s supposedly correlated with heart disease.  Do you know what the biggest source of TMAO is? Fish. We know how important fish is for health. TMAO is formed from either L carnitine or choline. So it recommends not eating foods that have choline or L carnitine. Do you know how important L carnitine is for the heart? Do you know how important choline is for the brain?  So, I’m very skeptical of TMAO as a marker, but there’s something to it.

Okay genetics, I’m not really going to comment about this. This is a panel that Dr. Mark Houston developed with Vibrant America, and these are all, you can get this whole panel done from Vibrant. These are important markers, so you see ApoE, you’ve probably heard of ApoE3, ApoE4, that’s a risk for Alzheimer’s, but also for cardiovascular disease.

Alright, Lp little a. Lp little a is a particularly atherogenic, sticky LDL particles, It’s super important. It puts you at higher risk for heart disease. The trainer from The Biggest Loser, he had a massive heart attack and this was his only risk factor that they could find.  So, if you have elevated levels of Lp(a) above 30, especially above 50, you definitely have to address it. So it’s important to know that. What can you do about Lp(a)?  Statins actually raise Lp(a). This is more common in African Americans. PCSK9 inhibitors, these are injectable drugs that lower cholesterol, and they can lower Lp(a) 20-30%.  Like niacin, it’s very effective at lowering Lp(a) 20-30%.  So we use a controllable release of niacin and niacin has fallen out of favor from doctors because of some, quite frankly, bad studies, but niacin is very effective when used in proper dosages as part of a nutritional program and I’ve seen patients where their Lp(a) will drop 50 percent just with niacin.  L-Carnitine, 10-20 percent reduction in Lp(a), CoEnzymeQ10 can help, Ground Flaxseeds.  Then there’s this Linus Pauling strategy. We don’t know, I don’t think there’s any human studies, I think it comes from animal studies, but this Progeny of Dr. Pauling, somehow it came out of his research on vitamin C, the combination of vitamin C, Proline, and Lysine, and he had an Lp one way for binding to the artery walls where it don’t qualify.  So that’s another strategy. Dr. Joel Kahn, I don’t know if you’re familiar with him, he’s an integrative cardiologist in Michigan. He wrote a whole book about Lp(a). I did an interview with him, so you can check out my interview with Dr. Kahn on my podcast, Rational Wellness. Oh, Dr. Joel Kahn, KAHN. He has a weekly podcast, truly good.

Homocysteine, you mentioned Homocysteine. There’s fundamentals of B vitamins, they exclude ethylated B vitamins and trimethylglycine can lower hopelessness in most patients by emptying. [00:28:00] You might have to use two or three capsules a day, but just keep experimenting.  You can usually get it down. Sometimes adding extra TMG, Trimethylglycine, can be beneficial if it doesn’t come down to split the B vitamins. Oh, a lot of the companies have formulas specifically related to this. ApoB testing, so Peter Attia says this is all you need. There’s one ApoB particle for every LDL particle.

Wait, go back one sec. Yeah, sorry. Sorry. You know what, I’m happy to share my slides with everybody. Great. Yeah. Yeah. Absolutely. Uh, so, we talked about LDL particle number, that’s the LDLp, that’s where they actually count the number of LDL particles, as opposed to estimating it, [00:29:00] and it’s the small dense LDL particles that are more likely to penetrate through the wall of the artery and become part of a plaque.

Um, heart attack symptoms. Any sort of pain in the upper extremity can be a symptom of a heart attack. So for big patients, I’m thinking something else is going on. They’re having neck pain or shoulder pain. And 45 percent of all heart attacks are silent. Shortness of breath.  Once again, I’m not a cardiologist as you all know, so I’m trying to focus on the things that We can make a difference with, which are, the traditional natural things. Uh, so, these are his forms of stress testing. I’ll go about the EKG treadmill test. And there’s a couple of other forms of stress testing.[00:30:00]

And and now we have direct artery testing. So, there’s something called coronary calcium scan. Are you familiar with that? So, it’s an easy test to send your patients with. A lot of them are guessing whether or not they have heart disease. According to your calcium scan, you can get it for two, three hundred bucks.  It may not be covered by insurance, but a lot of the labs offer it. And it will give you an idea of how much calcified plaque you have in your arteries. Yeah calcium is bad, but what’s worse is soft plaque. So, soft plaque is more vulnerable to break off and lead to a myocardial infarction. Thank you. Now, traditionally, cardiologists have run what’s called cardiac catheterization, also known as an angiogram and this is where they run a catheter through the leg through the arteries of the heart, visualize it, and they, that’s been done for a number of years.  One of the problems with that test is that they have the same patient get tested by different cardiologists. One of them says it’s a 30 percent block, one of them says it’s a 50 percent block. So we now have a more advanced test, which is the CT angiogram with artificial intelligence. And that’s who can we help.  So we have a representative who who’s then come up to tell us a little bit about the Cleerly Health scan.

Edan:  Awesome. This is fine. Perfect. This. Okay? Perfect. Can you guys all hear me without the mic? I’m a little loud. Yeah. Okay.  Good evening, everyone. My name is Edan. I’m actually your point of contact here for All Things Cleerly. I live here in Venice Beach. Dr. Howard Elkin actually was a big user of ours.  When I heard of his passing, it was actually pretty tough. I used to use the Martins Fair. Might be better. Yeah. When when I heard the news about Dr. Elkin, it was actually a pretty big blow to us. We do a case review for most of our patients for the providers, pretty much every single patient you send through.  We do a case review with our medical team. We had an extra view with Dr. Elkin on Monday before I found out, so it was a tough blow for us, but I’m going to spend the next eight or so minutes just [00:33:00] talking to you guys about Cleerly and then if you guys have any questions after the fact, I’ve got my cars as well, so we can chat about it, but a little bit about the company, so our founder, his name is Dr. Min and he’s a cardiologist by trade.  He focused on research for most of his career. And realized in finding his, in all of his findings that he had a chance to really, hopefully change the world. And so, he started the company with the intent to create a world without heart attacks, which as you guys all know is no small feat. But Dr. Min likes to say that if we’re successful in our endeavor, it’ll be a silent revolution, whereby the number one killer in the world simply drops to number two.  Number 3, so on and so forth. So he’s very humble in his pursuit, and the individuals within the organization, we all strive to be the same. And in order to do so, we follow in the footsteps of cancer prevention. So if you can recall back in the day before there was an emphasis on the prevention of cancer, an individual, a patient, would walk into the doctor’s office with a sign or a symptom, and by then we’d know it’d be a little bit too late.  Thus began the revolution for the prevention of cancer, and in [00:34:00] today’s day and age, If you combine all of the deaths associated with all of the cancers, they amount to less deaths than cardiovascular. Now the reason behind that is because the tools that we currently had simply didn’t shed enough light into what we needed to know.  For example, if you ran an advanced lipid panel such as the one that Dr. Weitz was talking about, it’ll give you a lot of amazing information about your patient’s blood chemistry. Let’s say the patient had elevated lipids and you were to work on lowering those lipids through natural supplementation, lifestyle modifications, or pharmacological pursuits.  And you were successful in lowering those lipids. The question becomes, okay, well, what’s going on within the coronary tree, right? We now hear all about these high ketogenic diets, right? So heavy lipids and their lipids are through the sky. But I can tell you so many cases of individuals that run their clear, these are clear, these are clean.

So it isn’t, like, to your point, it isn’t 100 percent about the cholesterol and about the magnesium as well. Similarly, if you were to run a calcium score, A calcium score will tell you [00:35:00] how much stable plaque there is, and to Dr. Weitz’s point it’s not necessarily just about the calcified plaque, it’s more so about the soft plaque.

So enter Cleerly, we’re the company that can talk to you all about the different types of plaque, where it is, and how much of it there is. Now we’ve come to understand that there are three different types of plaque. The first is your calcified plaque, which in our software would be denoted as aluminum, this is just your calcium, but you’d get out of a calcium score.  The second is non calcified plaque, which in the software looks like it’s yellow plaque. This is slightly softer than the calcified plaque, slightly more at risk for rupture. And then the third type of plaque is called, it’s just a fancy term for the lowest type, lowest density or the softest plaque, that’s called low density, non calcified plaque.  And so this stuff is the really, really dangerous stuff. We’re based in research and so we currently have unpublished data that suggests that just one cubic millimeter of this stuff increases your risk for an event threefold. [00:36:00] So consider a person that has a hundred cubic millimeters of total plaque, right?

All three plaque types. That’s considered a stage one patient, which we’ve talked to you about, which is pretty Low, but if they just have one cubic millimeter of that to be the low density stuff that increases your risks.  That’s basically actually all I wanted to do on the slides Most of this talks a little bit more about the company and how to actually obtain the results But just know that from a resource perspective we focus on education first and foremost So we want you to understand when you get these reports you understand number one what they mean What to do about them from a medical therapy perspective all the options available and when to follow up So we’re not the type of organization that just kind of throws something at you and says, Hey, good luck, figure it out.

We literally walk you through and every single patient that you send our way, we actually set up a 30 minute Zoom session to talk to you about the results of those patients. So just know that you always feel supported. If that’s the gist do you have a couple of minutes maybe for questions? Yeah. Yeah.[00:37:00]

Any questions? Sure. So a doctor in Valley mentioned to me, Brad mentioned that I have Ibogaine, it can contaminate, literally, short of wells in my patients. And I said, Oh, there’s something called Heart Something. And I’m saying that to make you look at that list, but I’m sure you’re aware of the competitors and I’m just so curious what the difference is.

I love that you brought that up. So, what your doctor was referring to was HeartFlow? Yes. HeartFlow is a company that evaluates flow, otherwise known as FFR. FFR is used in order to determine what’s called ischemia. And so, from a, Prevention perspective, if a patient is already ischemic, the answer is the cath lab, right?  But from a functional medicine and preventative perspective, we’re trying to get it, catch the disease before they need to get to the cath lab. And unfortunately over 52 percent of heart attacks are in asymptomatic patients. And so if we’re really going to work on stopping it or preventing it before we [00:38:00] even get to the Cath Lab.  Plaque is what you look at first. Once you look at the plaque, if there’s a stenosis that’s greater than 40%, we call it the gray zone, between 40 and 90 percent stenosis, that’s called the gray zone. The question is, are those plaques that comprise of 40 to 90 percent stenosis in one of the vessels, are those ischemic?  And does that patient then need to go to the Cath Lab? Now there’s more and more evidence that show that stenting lesions, depending on what type of lesion they are, don’t necessarily prove to actually improve anything other than symptoms. And so people are starting to move away from sending patients to the cath lab and intervening through stents and or CABG.

Because the fact of the matter is, it may just alleviate symptoms for patients that are experiencing symptoms, but it doesn’t actually improve things. The things that does improve is natural supplementation, pharmacological pursuits if needed, and then just lifestyle. Lifestyle is the biggest thing. The last thing I’ll add to that is it’s been 10 years since [00:39:00] FFRCT has come out and cardiovascular disease has not improved.

Hey, so when lifestyle is spot free, it may be reattacked, re approved. What’s the time exactly? It really will. Now, it’s interesting. I say this anecdotally. Because it’s difficult to put it in from a study perspective however, we can give you example after example of individuals that may be slightly overweight and, or simply aren’t exercising, or aren’t getting enough sleep, or aren’t, or are just too high stress, they’ll obtain it clearly, they’ll obtain it clearly a year later after losing 30 pounds, or whatever it might be, and the amount of Maybe not necessarily plaque transformation, more so maybe just the slowdown of actual plaque formation.

Is there anything else you should be aware of? I would assume so. I don’t know 100% the answer to that question 100%, but I would assume so. If you’re not getting good sleep, then it’s going to be affecting the [00:40:00] cardiovascular. Yes. So, what locations do this test? So, another, another great question. So, from a Southern California perspective, we’re very, very lucky.  We’ve got a ton, from Santa Monica, to Beverly Hills, to Torrance, all the way down the coast into San Diego. So, again, that would be a great question. Just reach out to me, say, Hey, I have a patient in this location, where do I go? None of the out of hits, though, right? We do have, we have we have Northridge, Westlake Woodland Hills, got a lot of spots.

Yes. Can you talk to us about her background, too? Sure. And she told me that she cares about it. We’re close. We’re hoping. Yeah, we’re really, really close. We’re hoping by January 1st. Yeah. Lots of questions, but how much time do we have left? Maybe, maybe we’ll take the rest of the questions offline?

We’ll check. Let’s get started. Sounds good. Of course. Thank you. Let me get this up. I do. That much. Do you guys have this [00:41:00] list of evidence each who had plaque reversal? Yes, we have. I will tell you that amongst the blockbuster pharmacological pursuits that the doctor just spoke about anecdotally, PCSK9 inhibitors.

Okay. So your Repatha and then you’re new with Veo. The PCSK nine inhibitors are pretty much the only medications out there right now. that people are seeing actual regression in disease. Once you have the indices, currently with what we know, regression is not the goal. Transformation is the goal.  It all starts off as soft black, or transform it into the calcite. Do you get regression? Do you get the start? Yes. That potential solution.  Oh, thank you so much.

Dr. Weitz:  Okay, great. So, there’s a couple of tests that some doctors like Dr. Mark Houston I mentioned him, he’s my mentor he uses a test called EndoPat to measure endothelial function. And there’s also one man using for his office called Pulse Weight Velocity. And then another test that’s often done is Carotid Ultrasound.  And there’s actually two different tests. There’s the Carotid Artery Ultrasound, and there’s also the Carotid Intermedial Thickness. The ultrasound better predicts events but the Carotid Intermedial Thickness can better measure the thickness of the plaque but it’s measuring it’s measuring the the artery in the neck, not the artery in the heart.

So, anyway, so here is an advanced lipid profile, so we’re doing good on time. Really happy. I think, I hope I have been talking too fast. Okay, great. So, this is a Boston Heart. This is one of my patients. [00:43:00] So you can see here where there’s LDL-P, which is the particle number and small dense LDL. These are both somewhat elevated.

We still, there’s a lot of controversy as it relates to HDL. So HDL is a, so-called good cholesterol. And the reason why it’s called the good cholesterol is that ideally, HDL can do reverse cholesterol transport. So, once the cholesterol in the body is produced in the liver, and then some of it makes its way into the artery, the HDL can take the cholesterol from the artery, bring it back to the liver, which is reverse cholesterol transport.  But, it’s, we’re still trying to figure out, how do we know that the HDL is doing what it’s supposed to do, and just having a higher HDL doesn’t necessarily mean that it’s going to happen. Having low HDL is not good. So, one way to look at it is to ook at HDL particle size. The latest data seems to show that all the different HDL particle sizes can be beneficial.  So Cleveland has a test for HDL functionality, so that may be the direction we need to go.  Boston Heart uniquely has this test that looks at whether or not you’re a cholesterol absorber or a cholesterol producer. So here we have a patient who’s a high cholesterol absorber. So this can help you with your strategy potentially.  So, for example, on a natural front, you could use Berberine or you could use plant sterols, which help the block cholesterol. If the person’s a cholesterol producer, then you want to think more about red yeast rice, tocotrienols, and some other compounds on the drug front. If they’re a cholesterol producer, you should be thinking about Statins, PCSK9 inhibitors.  If they’re a cholesterol absorber, you can think about Zetia.

So, some of these are other markers. This is 5 percent of markers for inflammation in your arteries. So we always want to look at HsCRP, this marker, LpPLA2, and MPO, myeloperoxidase. Interestingly, we had a number of patients with mild COVID. We found a lot of patients with elevated MPO.

And I think this is a marker of inflammation. That occurred as a result of inflammatory, so, obviously looking at glucose and insulin.  I know a lot of doctors don’t look at insulin, but it’s so important. If you’re managing your glucose, but you’re having to use a lot of insulin, obviously you’re developing insulin insensitivity.

Here are a few genetic markers, so, this patient had a one copy of Apo E4, and that put him at risk. This is actually a guy who came into a really good chain, at 40 years old he was fortunately following I think what’s wrong, nutritional program for him, which was he was doing more of a Keto Paleo type of diet and he pulled a group of coffee, and he ended up having a heart attack at 40.  Yeah, it wasn’t a severe heart attack, but, it was a wake up call. And so, ApoE4 probably is one of the risk factors. This is a test to see if you can tolerate satins or if they’ll be effective.

Omega 3s, everybody should be measuring Omega 3. We try to get the Omega 3 index above 10. I myself, I take 6 grams of DHA a day.  I take it with tocotrienols to prevent the oxidation of the polyunsaturated fat. Let’s see.

And I have Q10, HOMO 6, HOMO 12. So this is a panel we run for Vibrant Health. It doesn’t have all the markers we want. They don’t have LDL P. They don’t have a few of the other things I would like to have. But, Vibrant Labs, Vibrant America Lab, I don’t feel familiar with them. Like, they’re a great lab for functional medicine practitioners because they’re kind of a one stop shop.  There’s not much you can’t get from them. They have some great toxin tests, they have all the gluten sensitivity tests. I put together a panel, I have set up a male panel, a female panel, and then we modify it. And so, this is the advanced lipids.  This is the inflammatory markers right there, so you can see this patient has [00:48:00] elevated homocysteine and IHS CRP, that should be below 1. Unfortunately, they don’t have Lp, but Lae, Lp, or a small Nth Lp out, so that’s good. Insulin resistance, you can see that here with insulin 16, they have hemoglobin, you can see 6.

2,  full fiber, more hormones but I’m not going to talk about all this. Uric acid, we’re always looking at uric acid dispersing it to the Lp, uric acid. So, There are a bunch of natural supplements that can help lower uric acid. According to David Perlmutter, if you want to get your uric acid below 5. 5, So, technically over 7, it tends to increase significantly your risk of gout. That’s probably what you’ve heard your [00:49:00] cat say, mentioned before.

IGF 1, that’s an interesting part of SOFR 1. In Japanese, IGF 1 is agropoxy for growth hormone. So, you don’t want your IGF 1 to be too low. But we supported this model long ago. If your IGF 1 is too high, And that increases your risk of cancer. But, his view is not one I necessarily agree with all of it.

He also recommends a lower protein intake. But, he said, Zach, you want to keep the IGF 1 below 175. Make a trace. And so, this is a core area Janssen scan. This is something that’s a live plant. A live plant. We don’t make everything there.

This is one of Howard’s slides, I think so his patients, as you [00:50:00] can see, they have a lot of inflammation, HSCRP, they don’t have enough nitric oxide they have a lot of slow hits, LDL, low HDL, so this person really is at a lot of risk, so it’s looking at all these different factors, not just one thing, and when it comes to ApoB, They have a perfectly healthy able P of 59.

So if, we’re gonna follow Peter Attia’s recommendation for just focus on ApoB, but unfortunately it’s not enough. We need to look at more markers. So that’s one should be all want that very high homelessness needs. So this really has a lot of risk.

And this is part of by, in the heartland, we got people to translate these, [00:51:00] to get into the operative machine. Now you can see it even slower. But it was changing so much now. So that’s one H2, Camp, Spinetop, and Chinkosan. Okay, how do we reduce Cardiac Coronary Heart Disease? So, from a lifestyle perspective we’re obviously stop smoking, healthy diet, and we’ll talk about some of the ideas of what the most heart helping diet is. Exercise, everybody should be exercising, everybody should be doing some form of resistance training, everybody should be doing cardiovascular training, everybody should be doing stretching, everybody should be doing balance training.

You’ve got to reduce the [00:52:00] visceral adipose tissue around the heart and the organs, that’s most associated with cardiovascular disease. Sleep, super important. Gasting is beneficial. Hormones I’ve become a believer in that we should try to have optimal levels of hormones. And I do think that the research shows that when you take bioidentical hormones, you’re healthier.

Or as you can see, I am a specialist for cardiovascular risk it’s a reason why we can have a lower risk of heart disease a bit later on and increase the depth of that cause. What about testosterone? Well, there’s some controversy about it, but A lot of the data seems to show that testosterone, say as long as you carefully monitor, the thing that can happen with testosterone is you start producing too many red blood cells, hemoglobin, and that goes out.

If that happens, your blood gets thick and stickier. And that’s not a [00:53:00] good thing. So everybody takes testosterone monitors in. But I think for men if everything else is healthy, you can have a good testosterone level later into life. For example, I’m 66 and my testosterone level is 1000. So I never take testosterone.

Alright, so we have the modified Mediterranean diet. Mediterranean Diets. I think it has a lot of research to be done in why it’s a Mediterranean diet. Extra virgin olive oil, super beneficial for cardiovascular health. Of course you gotta get Duplain. Olive oil, and that’s a whole thing. I had a whole podcast about how to select the right olive oil.

It’s been penetrating diet, I have to say. It’s lots of vegetables, fruits, legumes, even though I’m not touching them, do you see it? No. Fish, is red wine beneficial for the [00:54:00] heart? Generally don’t think it is. But for a while, it was the French Herodotes, I think. Drink a lot of wine, have healthy hearts, and it gives the benefit that the Red Queen, Red Wine, can increase HDL levels.

So, right now, everybody seems to be down on Red and White Maybe, maybe there’s some benefits by consuming a lot of alcohol, I mean, the poor folio diet, there’s several studies using this particular diet as a way to reduce risk of cardiovascular disease, and it has specific components. that have been known to help have more favorable lipids, and those are specifically soy plants, cereals, nuts, and soluble fiber.

Soluble fiber was a big thing for a while when you had to eat oatmeal because of soluble fiber. I do think that fiber is super important. It’s [00:55:00] probably not because of the fiber, and by the way, this is coming directly from Dr. Musi, because the fiber belongs onto the cholesterol and T synaptic system, but rather the fiber has a beneficial effect on the microbiome.

that decreases our risk for heart disease. And we’re learning more and more about the importance of the microbiome. For example, the most popular drug for diabetes is Hormin. And how does that Hormin work? You can figure it out. And a lot of the data seems to be pointing out that Hormin has a positive effect on the microbiome.

And, by the way, Berberine is a natural version of that Hormin. And it works largely through the microbiome. Lower carb diet can be beneficial especially for patients with insulin resistance and diabetes. There’s some data on vegetarian diet and, a lot of people swear by vegetarian diet [00:56:00] and for some patients it’s going to be the best choice for them.

I’m trying not to get beat up by eating something when I get out of here. I’m just kidding.  So, when it comes to overall dietary recommendations, we certainly want to avoid sugar and high glycemic carbohydrates. So those are carbohydrates that cause a huge spike in blood sugar, things like bread, cookies, etc. etc. Ultra processed foods. Somehow we came from junk foods, processed foods, now it’s ultra processed.  Like, ultra processed foods are not good. Despite the fact that the U. S. Dietary Guidelines, the folks that made the U. S. Dietary Guidelines came out with something poor like several months ago saying, there’s no food, and ultra processed foods are not healthy. Okay formula of all health a number of foods that will help to manage [00:57:00] livings.

We know that nuts are super beneficial. There’s a few plants that I use. I have a whole bunch of different nuts. Almonds, pecans, walnuts. Walnuts also have some, magnesium in them. Nuts and seeds are super beneficial. I like to add flax seeds. Thanks. Buy the flaxseeds organic and store it in the fridge or freezer and grind it yourself.

Because flaxseed oil is very highly oxidizable, just like fish oil is, so you don’t want to buy random flaxseeds. And they’re most likely to be oxidized because it’s been stored for a while. But Flaxseeds are super beneficial for a lot of things. So, in, so, in the functional medicine world, there is some doctors that have written some books about sodium, say, There’s nothing to worry about with sodium salt, it’s not a risk factor, eat sodium, eat plenty [00:58:00] of sodium according to Dr. Houston, who I trust, salt is absolutely harmful to the vascular system, and generally speaking, we want to keep our sodium down, and we want to keep our potassium and our magnesium up, and it’s not just because it’s Increases blood pressure, but it damages the arteries, makes the arteries stiffer. This is coming from Dr. Houston. I’ve seen some data on him as well. I trust what he’s saying. So, we want to make sure you’re getting lots of potassium and magnesium. Potassium, shoot for at least 5 grams a day, and probably at least 1 gram a day of magnesium. Keep your blood pressure low.

What about eating fat? I can’t necessarily solve all these controversies, but Trans fats, for sure, we know are [00:59:00] not good. Don’t eat trans fats. Omega 3s, we know are good. Monounsaturated oils, like olive oil, we know are good. Everything in between, there’s a question that’s up. The data seems to show a modest amount of ants is healthy on a weekly basis.

What about coconut oil? I think a lot of us in the functional medicine world feel that coconut oil is a healthy oil. I know when I was cooking my vegetables with coconut oil, my small pants helped me out a lot. So I stopped, I switched to avocado oil and variety cooking, according to Dr. Houston, coconut oil is not good and the reason why is because it has long chain saturated fat.

So, what about saturated fat? That’s the big controversy. Saturated fat ban was being contributed to heart disease. Well, [01:00:00] it depends. Saturated fat actually is there’s a number of types of saturated fat. So here are saturated fats with 12 or more carbon chains that are known as long chains. Saturated fats.  Those are more correlated with heart disease. Medium gene, 12 12 carbons or less, and extreme gene saturated fats are not associated with heart disease. So, what happens when you take patients and you say, Let’s remove the saturated fats and let’s substitute something else. So when you substitute polyunsaturated fats, the risk of heart disease seems to go down.  When you substitute carbohydrates, especially refined carbohydrates, the risk tends to go up. There’s going to be meetings that are not going to be happening. Epidemical might be the way to [01:01:00] speak at them. I’m done. He has plenty of medications, it’s carb rich, and we have prescribed medications, but we need to be aware of them. Fibrates are drugs that were popular, they’re not that popular, my understanding is, among cardiologists but it’s a way to reduce cholesterol. Most of the cardiologists are going to be recommending statins to start with.  There’s water soluble, fat soluble statins, That sodium or statins seem to be more effective and better tolerated, generally speaking. So, those are Suprastat, Crestor, and Propastat. Zetia is a drug, I mentioned it before, it helps block cholesterol absorption. It doesn’t have the side effects the potential side effects of statins.

So, Zetia is a drug that can either be added to a statin, or patients who are intolerant to a [01:02:00] statin, don’t want to take a statin, and still want to take a medication you can do a combination of Bempedoic Acid, which is the neurospinal neurostruts, that helps the lower lipids, and combine that with Xetia, and get a really good effect.

Problem with endodermal gassing is that it’s expected to be very nutritious and useful for recovery. Of course, aspirin. We know that clotting is a factor, so, I think thinner blood is probably good, like, which would be two things, so, taking an aspirin, which is recommended for everybody, like, some patients have bleeding, and so it’s not good for them, so, not an idea. From a natural perspective, if you take enough fish oil, I do prevent adrenals, uh, you blood is likely to be thinner, take a [01:03:00] lot of curing as well.

Uh, you can use that kinase, hydrokinase, natural blood thinners, uh, so everybody’s talking about GLP 1 agonists like Ozembic. And, uh, everybody’s thinking of the weight loss, as you saw Oprah last night, looks like a totally different person. Um, they, they really work for weight loss. What are the side effects going to be?

I think there’s going to be a huge number of side effects because of slow GI motility. That’s one of the ways that they, uh, help with weight loss because people don’t get hungry because it sits in their stomach. Uh, so. We’ve, I know in my practice, we’ve treated a lot of patients for gastrointestinal problems, like SIBO, reflux, and decreased motility is a big problem, [01:04:00] so, uh, Dr. Pimentel has said that testing patients for SIBO, or on these drugs, is just, uh, is horrible. The microbiome is all messed up. We used to do IV chelation. It’s still done in some clinics. It’s a way to naturally reduce your cholesterol levels. Um, but I don’t think it’s done that often anymore. Did you see, um, here at CNN’s most recent article, it was talking about, which surprised me, how he, and I guess it was supported by evidence, I don’t remember the exact quote, but that PCSK 9 inhibitors and statins.

He was supporting young. Oh, a hundred percent. I guess he did. Peter Dean says, uh, he said on what this podcast said, we, you get your, uh, your a OB above 40 or like your LVL below 30 will eliminate cardiovascular [01:05:00] disease and doing it, whatever means necessary, which means stat, PCSK nine inhibitors, et cetera.

So, I showed you a slide where a person had a good April 8th, but they had a lot of small events, they had a lot of information, so it’s, in my opinion, it’s the whole picture. It’s not just one market. It’s, it, it takes one, just one market. Alright, Stats, uh, um, so, uh, Stats, uh,

I think in a functional medicine world, we tend to think that statins are absolutely the worst thing in the world, and everybody has side effects. Um, I know a number of doctors will say that 20 percent of their patients are on statins and muscle pain. Uh, according to studies by the big pharma, [01:06:00] it’s like 1%.

It’s definitely 1 in 1%. Uh, I don’t know if it’s 20%, it depends. Uh, there are studies where they give people a placebo instead of a statin and they get muscle pain. Uh, so, it’s hard to say, but there are definitely a percentage of patients who are intolerant to statins. They usually can tolerate Red Yeast Rice and other agents.

Um, one of the things that is happening still is they actually stabilize plaques. They dry out some of their cholesterol, they tend to calcify them. So, as I mentioned, I think a lot of us see calcium and all my god, that’s the worst thing in the world. But, uh, a stable plaque gets better than a soft plaque.

So, That may be one of the mechanisms by which statins are beneficial. Uh, I, I actually heard the, [01:07:00] uh, with the doctor from your company, uh, Joel Kahn’s podcast, and he was saying you can’t reverse plaque, but that if you, uh, calcify it, it will look smaller, and, and that’s what’s really happening. According to Dr. Busey, you can’t reverse plaque, and there’s a number of studies that have shown it, and, and that’s what’s happening. Uh, I guess we’ll, we’ll keep working it and find out. Um, for sure, SACWIS inhibits quite a number of nutrients that won’t be produced along that pathway in that SACWIS blot. We all know about CoQ10, so everybody who’s on the SAC should be taking CoQ10, absolutely.

CoQ10 is super beneficial to the heart. And often in higher dosages, Joel Kahn on his podcast said that, on average, he is prescribing his patients 400 and sometimes 800 milligrams a day of OQ10. [01:08:00] Um, it also can be in sex, also can be in production by eating, maybe some fats, so Trinols, Carnitine, 5K, um, medical interventions.

Thank you. As we heard earlier, neither stents nor bypass surgery, if the patient is stable. So if the patient’s got a blockage in the midst of an event, they open up the artery with a stent, that’s different. But if the patient is stable, they get a stent, they get a coronary bypass surgery, it doesn’t reduce your risk of death.

Alright, here we go. This is good stuff. You wanna take a picture of this slide? I got several of some rice. It, the same pathway. It’s often [01:09:00] un under, uh, underused, uh, under dose. So I just had a patient in my office yesterday. Uh, he was intolerant to, uh, stat. His cardiologist put him on Reggie’s rice, but they put him on 1200 milligrams.

You’ve got to do at least 24 milligrams a day if you want it to be beneficial. Sometimes it’s 48, that’s taken at night. And that’s usually when they prescribe the sac as well. Tocotrienols, when taken with Red Yeast Rice or a statin actually improves the effect. Are you familiar with tocotrienols? Tocotrienols are a form of vitamin E and vitamin E is a family that includes tocopherols and tocotrienols.  So tocotrienols have some unique properties. [01:10:00] So I’m a big believer in Toco tree. And why Statin at night? Um, because body tends to produce together, tends to produce cholesterol at night.

Um, Niacin, as I mentioned, Niacin is maize nutrient that has all these benefits for cardiovascular health. So, Niacin is one of the few ingredients, as I mentioned, you can lower Lp, but why? It can increase HDL. It’s one of the few things that can take LDL particle and make it bigger. We use modest doses, just like 500 milligrams, and at that level, you You know, there’s very few potential side effects.

It was common for Cardiologists to prescribe niacin. Typically, they would be using 2 grams, sometimes 3 grams. And at that [01:11:00] level, sometimes there are some side effects. Of course at any level you might get some flushing, but flushing is not harmful. Plant sterols are another good supplement that inhibits cholesterol absorption that will do one than three grams a day.

Berberine is an amazing supplement for cardiovascular health. One of the few things that has been shown to reverse plaque you, but studies, uh, and as I mentioned, , uh, natural metformin. It’s also a natural PCSK9 inhibitor. This study showed a 3.2 percent reversal of plaque in 4 months. Just think of Berkeley. Citrus Bergamot is another one to add.

If you have a patient on Red Yeast Rice and you’re not getting an amount of improvement, you want to add Citrus Bergamot, Omega 3 fish oils, [01:12:00] super important. Um, despite some of the studies that are coming out of the New England Journal of Medicine or the AMA Journal, ever notice that Um, there’s like a hundred studies that have come out over the last several years on the benefits of fish oil.  But the two that show that fish oil is not beneficial or harmful, those are the ones published in the New England Journal of Medicine. So, I think there’s just overwhelming evidence that omega 3 fats are beneficial.

Question:  What do you think of krill versus a combination of fish?

Dr. Weitz:  So, my understanding is, is most of the data supports a sufficient amount of Omega 3.  At least 2 grams a day. You wouldn’t have to take like 25 krill capsules to get 2 grams. So, unless you, unless you want to take that much, I say get a good quality, high dose of fish oil, 1, 000 milligrams, [01:13:00] tributyls, or more. Raman Sulfate or Fucoidan Sulfate, so those are seaweeds that are included in specific supplements that can help to support the glycocalyx of the endothelium.  And so, one of them is called Arteriosil is a very popular one. EndoGel is pro regenerative.  Regenovasc, these are, uh, supplements that specifically are going to reduce your risk of coronary artery disease, help significantly with blood pressure. You also want to include a nitric oxide stimulator.  Those are super important for blood pressure as well. I mentioned the importance of the glycocalyx producing nitric oxide. Nitric oxide is a gas that’s produced for a short period of time. We can use things like L Citrulline, [01:14:00] beet root extract and some other things that stimulate nitric oxide. Glucosamine sulfate.  Glucosamine sulfate and chondroitin sulfate. These are popular joint supplements that have been shown to support the glycocalyx. So I mentioned the glycocalyx as opposed to proteoglycans. And it turns out there’s three or four studies showing significant reduction in risk. Look at this: 39 percent reduction in all cause mortality, 65 percent reduction in cardiovascular mortality from taking glucosamine sulfate.  It’s amazing. I don’t know why everybody’s not talking about this. When I saw this study coming out, now there’s another study, there’s another study that came out last year. I emailed Joel Kahn and said, wow, is this real? He goes, [01:15:00] yeah. He goes, there’s three or four other studies. So, put all of your patients on glucosamine sulfate.  Aged garlic. It can reduce soft plaque, it can reduce blood pressure.  And Nattokinas, which is a natural blood thinner.

CoQ10 also helps. It’s, as I mentioned, it helps to lower LDL in the brain, it supports the heart muscle, mitochondria, part of our program to rebuild the patient with heart failure. It includes CoQ10, D ribose, L carnitine, and Iodocybin. Methylated D vitamins to lower homeopathy. Lycopene. improves HDL functionality, Dr. Houston developed a supplement with 20 mg of Lycopene and several nutrients for one of the components. [01:16:00] Uh, we wouldn’t want to use specific nutritional strategies. The lower LDL, LDL A, I think I mentioned, most of these, uh, What do you, what do you do about oxidized Lp? Uh, Yesin helps, so does popocranate.

There’s some supplements on the market that contain popocranate and some other, uh, antioxidants, resveratrol, citric ergomide, zirconianols, curcumin. I don’t do HDL functionality, I just mentioned glycopene, omega 3, and again, it’s a B vitamin.

So, here are some books that I recommend. Dr. Houston’s book. This is Jonathan Bowden’s book. Johnny is right here in our audience. Johnny is a very prolific author. Uh, he’s written like 15 different books. [01:17:00] He wrote this with Dr. Sinatra. Yeah, about a year and a half ago, actually, Johnny, Dr. And Dr. Sinatra’s son and I, we all did a tribute to Dr. Sinatra when he died. We did a podcast together. Um, so here’s a book by Dr. Sinatra. Here’s another book by Dr. Mark Huston. This is Joel Kahn’s book about Lp and LDL. Mark Houston has some amazing articles where he writes. There’s all these different supplements, the Cali Chloroate, warm supplements, uh, Ectoide Pathways.

So, great resource. You can take a course with Dr. Houston, teach us how for you for him. You should definitely do it. Um, so, thank you. Please subscribe to my podcast. Tell your colleagues about these names. We’re very educational. We get great [01:18:00] speakers. Um, and it’s, it’s, Costs nothing. It’s a great way to use your network.  Uh, let’s get back to networking. Time to get back in person and support Integrative therapeutics. Thank you.

Dr. Weitz:  Yeah. Okay. We have to leave unfortunately. Thank you. 

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Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review.  Thank you. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition, and want to prevent chronic problems, and want to promote longevity, [01:24:00] Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310 395 3111 and we can set you up for a consultation for functional medicine.  And I will talk to everybody next week.