May 5, 2025 • 29 mins
Think your cholesterol is fine? Think again.
In this eye-opening episode, Dr. Michael Richman, a world-class cardiothoracic surgeon and lipidology expert, breaks down why standard cholesterol tests are dangerously outdated—and what your doctor may not be telling you.
Even if your LDL, HDL, and total cholesterol appear “normal,” you could still be at high risk for a heart attack. Why? Because the real threat isn't your cholesterol level—it's how that cholesterol is transported in your blood.
🎯 Here’s what you’ll learn:
Why over 50% of first heart attacks result in sudden death
How athletes, vegans, and people with “perfect” labs are still dying
What traditional cholesterol tests miss entirely
The role of lipoproteins (the “cars” of cholesterol) and why they matter more
What tests to ask your doctor for (advanced lipoprotein testing, Lp(a), ApoB)
Why genetics are more important than diet
The shocking truth about statins and brain health (spoiler: they don’t cause dementia—they help prevent it)
Why even top cardiologists take lipid-lowering meds—even if their numbers are “normal”
This episode isn’t fear-mongering—it’s about empowering you with knowledge that could literally save your life.
Resources Mentioned:
👉 PaladinMDs.com — Watch the animated video on how cholesterol enters the artery wall
👉 Look up: “ASTEROID Study” & “METEOR Study” for plaque stabilization with statins
👉 Ask your provider about advanced lipoprotein testing (covered by insurance & Medicare)
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
Okay, hello everybody.
How are you doing today, Dr.
Richmond?
SPEAKER_01 (00:04):
Morning, Mike.
SPEAKER_00 (00:05):
Okay, so today we're going to talk about probably the
most important thing that we cantalk about, and that's why I
wanted to start us off withthis.
And it just so happens that mypartner is a cardiothoracic
surgeon, and he's been doinglipid management for 20 years.
He's also on the editorial boardof the Journal of Clinical
Lipidology, which is a premiumpeer-reviewed lipid journal.
(00:27):
And the reason why I think thisis so important is the number of
people that die from heartdisease every year is
astronomical.
And if you look at the numbers20 years ago and the numbers
today, it really hasn't changedthat much, which is amazing.
If you think about all thisstuff, all the diets and all the
(00:48):
stuff we do, it hasn't reallychanged that much.
And, you know, still being anactive surgeon and treating
people and, you I still amamazed at how many people are
still dying from this.
And the other thing that shouldscare all of us is I know a
bunch of people, normal calcium,zero calcium score, they
(01:09):
exercise, they work out, theyjog.
Some of them also had CT NGOsand they all say, oh, my lipids
are fine, my cholesterol isfine, and they die.
So why are these people dying?
You know, on a personal note, mycardiologist referred me to
lipid management doctor.
And it just so happens Dr.
(01:30):
Richmond is one.
So for me, it was easy and I didmy testing.
And this is something that Iwant everyone to know.
And I've been telling friendsand patients this, and I'm a
surgeon and I still wasn't thatup to date on this.
So without further ado, I'mgoing to let my Dr.
Richmond come in and share hiswealth of knowledge.
SPEAKER_01 (01:51):
Thank you.
Thank you.
So just a little background,expand on what he said.
So statistics are a littlebehind.
So in 2021, there were 938,000cardiovascular deaths.
That's stroke, heart attack,peripheral vascular disease.
In the year 2000, there wereover 950,000.
(02:12):
So that makes anywhere between35% and 39% of all deaths in the
United States are due tocardiovascular disease.
So like I tell people, when youdrive by a cemetery, every one
and third tombstone is acardiovascular death.
And it's amazing.
It's frightening.
So today's topic, really, if youwant to get down to it, is...
(02:35):
Why are lipid measurementsfalling short?
In other words, what are wedoing wrong with cholesterol?
And then once we figure thatout, what can we do to improve
our testing, our risk factorscoring to give people extra
life?
Because Believe me, I did apresentation that we'll refer to
(02:59):
at some point.
How does a heart surgeon preventa heart attack?
But, you know, a littlebackground, like Dr.
Fiorillo said, I'm a heartsurgeon.
So a cardiologist is anon-surgeon.
A cardiac surgeon is a surgeon.
I'm the one who opens up thechest.
And one day in 2000, I want tosay 2005, I was doing a bypass.
(03:20):
And I thought to myself, I don'teven know how arteries get
blocked.
I know how to fix them.
but I don't even know howarteries get blocked.
So one of the leading lipidexperts happens to be in New
Jersey and I called him up onthe phone and I introduced
myself and he hung up on me.
Typical Jersey, right?
Hung up on me.
Thought it was a joke and Icalled him back and I said,
(03:46):
listen, I'm a cardiac surgeon onthe West Coast.
And I said, I need to learneverything about lipidology
because there's no formaltraining in it.
And I spent the next year yearreally learning everything and
reading everything andultimately getting myself on the
editorial board of the LipidJournal, then was asked to write
with him in another academician,Lipid and Lipoprotein
(04:07):
Guidelines, how to managepeople.
SPEAKER_00 (04:11):
Mike, people don't understand, just to jump in real
quick, people just go bycholesterol and now a lot of
people's HDL, LDL, see a lot ofPeople short saying, oh, my
ratio is good.
So we'll talk about that.
But people just think, oh, I'mgood.
My cholesterol is good.
And we don't want, most peoplethat die of a heart attack
probably have good cholesterolis the point.
(04:32):
So Mike's going to extrapolateon.
It's not just getting yournumber and saying, okay, I'm
good.
My cholesterol is good.
I'm not going to have a heartattack.
SPEAKER_01 (04:40):
Expanding on that.
Okay.
So we gave a little backgroundwith the numbers.
Atherosclerosis.
is the deposition ofcholesterol-laden plaque within
the artery wall.
And if Brian, if you can showthat first picture, I'd
appreciate it.
Okay, so that is an artery cutend on.
(05:04):
And the big part, the pink part,That's called the lumen of the
artery, and that's where theblood flows.
And then the artery wall hasthree layers, that really thin
layer is called the intima.
And then where that yellow is,that's the media, that's the
muscular layer.
So when you feel your pulse inyour wrists, that's because the
(05:24):
muscle's pumping.
And then you have somethingcalled the adventitia.
And if you notice, thecholesterol plaque is inside
that first layer.
It's not where the blood flows.
And that's key.
That's what people don'tunderstand.
Doctors don't even understandthat, if you can believe that.
So somehow the cholesterol hasgot to go into the wall of the
(05:45):
artery.
And when a blockage occurs, soit occurs from the inside of the
wall and pushes and blocks andnarrows.
So that's calledatherosclerosis.
And atherosclerosis is endemic.
It's been around since the...
The dawn of time.
(06:05):
So how do we know that?
Well, in 2013, a mummy study waspublished, which is really
interesting.
So they did CT scanning of thecoronary arteries of 137
mummies.
And these included mummies thatspanned 4,000 years.
And one group of them was fromSouth America, vegan only.
(06:27):
And they found across the board34% of the mummies had
significant atherosclerosis,including women and children
mummies who were vegan.
So that debunks the myth rightthere that atherosclerosis is a
disease of white men who smokeand go to Dairy Queen.
And then if you look at theautopsy studies of the U.S.
(06:50):
dead in the Korean War, inVietnam, in Gulf War, in
Afghanistan, upwards of 60% ofmen between 18 and 35 had
significant, I'm not talking 30,but over 50% blockages.
So this starts in birth.
(07:11):
And if you don't get a handle onit, when you're young, it's a
progressive disease.
And I'll ask Mike right here,okay?
And we'll see if he gets theanswer right, because even
though he's smart as can be,doctors don't know this.
What is the first sign in mostpeople that they're having a
heart attack?
SPEAKER_00 (07:31):
Well, what we're all taught is pain, right?
When you tell me it's not, butwe're all taught pain in the
chest radiating to the arm.
SPEAKER_01 (07:38):
Right.
So the first sign is 50% ofpeople is sudden death.
You're dead.
You're dead.
That's the threat.
SPEAKER_00 (07:44):
And listen, and this is why we're doing this.
This is what scares people,right?
People are dropping dead.
And I think we all know peoplethat it's happened to.
And, oh, my friend runs, youknow, three miles a day and he's
dead.
the next day.
So yeah, 100%.
We want to know what's insideour artery.
And, you know.
Okay, so
SPEAKER_01 (08:03):
moving along.
So the five major risk factorsfor cardiovascular disease, so
in other words, blockages, areage.
We all get old.
Can't change your age.
Smoking, high cholesterol, type2 diabetes.
I'll say a word about that.
There's 93 million people in theUnited States that are
(08:23):
pre-diabetic.
28 million diabetics.
All pre-diabetics and diabeticshave abnormal lipid panels.
Okay.
Cholesterol testing.
And then the final one is highblood pressure.
But what is the thing that Ididn't say?
This is why I don't dotraditional risk factor scoring
is because they don't mentiongenetics and everything is
(08:45):
related.
And everything is related toyour genetics.
So when people say, oh, you'relow risk, you're moderate risk,
you're high risk.
I just want you to think aboutit logically and intuitively.
So if Mike said to me, Michael,I don't smoke.
I'm not going to divulge his agesomewhere in the 50s.
I don't have high bloodpressure.
(09:07):
I think I don't have highcholesterol and I know I don't
have diabetes.
But my dad died at 55 of a heartattack and his uncle died.
at 58 of a stroke intuitively.
Do you think he's low risk?
And the answer is no.
Absolutely not.
But we base everything on thisantiquated, stupid risk factor
(09:27):
scoring.
And if you look at theFramingham risk factor scoring,
there's two points that nobodyeven, you can't be diabetic.
to be accurately risk factorscored in the United States, and
you can't have coronary arterydisease.
Well, we know that coronaryartery disease is an epidemic,
so clearly we're not adequatelyrisk factor scoring people,
(09:52):
okay?
So what can we do to enhance theprobability of identifying
everybody?
And that's what we're talkingabout today is how do we
properly test people?
Because we do a hundred
SPEAKER_00 (10:05):
questions in today's day because people are spending
a lot of money going tolongevity centers and places and
doing prophylactic tests likeangiograms and calcium scores.
And we're not saying that's awaste of money or a waste of
time, but people do need to knowthat that's not the end all be
all.
SPEAKER_01 (10:25):
Kind of is a waste of money and kind of waste of
time.
But that's from a heart surgeon.
But that's for a future show.
But OK, so we're doing 125 to135 million cholesterol tests a
year.
Still, it's the number onekiller.
OK, and now here's the fun part.
OK, so cholesterol, regardlessof what all you people think.
(10:48):
80% of your cholesterol in yourbody is genetic.
20% is dietary.
Most cholesterol is made in yourliver and in your small
intestine based on your genes.
So in other words, you cannotdiet away your cholesterol.
Okay, we make about 800 to 1200milligrams a day in our body and
we eat maybe 200 to 400milligrams.
(11:12):
And of that, you absorb throughyour intestine about 8%.
So I have vegans, who theircholesterols are disasters.
Because remember,
SPEAKER_00 (11:21):
you can't...
Mike, that's a really goodpoint.
People do not realize it's verydifficult to lower your numbers
by just diet.
Very hard.
SPEAKER_01 (11:30):
Yeah, almost impossible, you know?
So, okay, so we're doing allthese cholesterol testing.
And we know that if you look atthe Framingham study, which was
26 years, if you compare peoplewho have heart attacks and who
don't, have heart attacks,there's an 80% overlap of
(11:51):
cholesterol levels.
In other words, if you look atsomebody's cholesterol level,
the people who had heart attacksand the people who didn't have
heart attacks, 80% of themoverlap.
So in other words, the way we'redoing it, you're looking at
them, all bets are off.
Waste of time.
So what is the answer?
How does a heart surgeon preventthe heart attack?
Well, first of all, The wholelipid hypothesis, and Mike knows
(12:17):
because you see all over theinternet every day, these fools,
for lack of a better word, sayeat as much cholesterol as you
want.
It's good for you.
So in 1909, a guy by the name ofAnshakov in Eastern Europe, who
was in the Imperial Army,force-fed rabbits cholesterol
and sunflower oil and inducedrapid atherosclerosis, so
(12:41):
blockages.
And then was able to identify inthe wall of the artery, these
cells that come in and coalescetogether and form cholesterol
plaques.
So 1909, we're in 2025.
And there's people that arestill arguing against biology.
And we've realized over theyears, and this is my little
(13:03):
demo thing.
This is from an Italianrestaurant.
And this is balsamic.
Sorry about that.
Let me put it in the middle.
This is balsamic vinegar andolive oil.
So when you get regular testing,you know they do a total
cholesterol.
They do an LDL cholesterol,which is your bad cholesterol.
(13:25):
They do an HDL cholesterol,which is your good cholesterol.
And they do a triglycerides.
First, a little bit about totalcholesterol, which Mike didn't
even know.
And remember, I didn't evenknow.
And we both went to med school.
There has never been written oneguideline that says you're
supposed to look at your totalcholesterol.
Yet everybody walks around andsays, oh, my doctor said my
(13:46):
total cholesterol is less than200.
I'm in good shape.
Or my total cholesterol is above200.
I'm in bad shape.
That's never written into oneguideline.
OK, so block that out.
So what do we look at?
Unfortunately, we look at LDL-C,which is your bad cholesterol,
which I refer to as the people.
(14:09):
So I made this analogy yearsago, the Richmond analogy.
And the analogy is, if you thinkof people on a highway, so think
of an artery.
If you think of people on ahighway, is it the number of
cars that cause a blockage orthe number of people in the car
that cause a blockage or atraffic jam?
(14:31):
Answer, Mike?
SPEAKER_00 (14:32):
Number of cars.
SPEAKER_01 (14:34):
Correct.
Well, we measure the number ofpeople.
So regular cholesterol testing,all they do is they're taking
and they're measuring the amountof liquid cholesterol in 100
cc's of blood.
And what does that tell you?
That tells you absolutelynothing.
Because if I turn this on theside right here and I say to
(14:55):
you, whoops, if I say to you,get, oh, it's hard.
Sorry, guys, I'm moving.
If I say to you, mix the oil andthe blood.
You can't because they're notsoluble in each other.
So what the body does is itpackages the cholesterol in
cars, round cars, to allow it totravel where it needs to go and
(15:18):
where it doesn't need to go.
So in 1967, Dr.
Friedrichsen wrote in the NewEngland Journal of Medicine,
atherosclerosis, I'mparaphrasing, is a disease of
cars.
It's a disease of what we calllipoproteins.
It is not a cholesterol disease.
It's not a people-in-the-cardisease, okay?
(15:39):
And that's key.
So we measure the people in thecars, but we've known since the
early 60s, actually 50s, thatthese cars drive the cholesterol
into the wall of the artery,just like we showed you that
picture.
Yet, Very few people understandit and very few people do.
SPEAKER_00 (15:59):
And I think that's why you're starting to see some
people saying cholesterol is notbad for you and and saying, you
know, these numbers are fine.
And and there's a lot of thatnow on social media.
And that's probably why, becausein a way, there's some truth to
that, too.
SPEAKER_01 (16:14):
Right.
OK, so if we're measuring onehundred and twenty five million
people, same number of peopleare dying, 50 percent of people.
First sign is they're droppingdead.
The CDC says 50% of people whosurvive a heart attack and make
it to the emergency room havenormal cholesterol.
As soon as you do what's calledadvanced lipoprotein testing,
(16:36):
you realize they don't.
And all diabetics andpre-diabetics, their cholesterol
looks fairly normal on a regularpanel.
And as soon as you do advancedlipoprotein testing, where
you're actually doing an MRI ofthe blood, covered by insurance,
covered by Medicare,FDA-approved, You're measuring
the lipoproteins.
(16:58):
When you measure lipoproteins,you identify every single person
at risk and miss nobody.
So how do we reduce?
I mean, I wish this would be astaple in the health care system
mandatory for everybody.
So how would we reducecardiovascular events in death?
Number one.
(17:18):
Identify everybody.
So if you do lipoprotein testingon everybody, you will identify
every single person at risk andmiss nobody.
Now, nobody will argue with thiswho knows the field, okay?
The second thing is once youidentify somebody, okay, at
least you've provided theservice.
If you don't want treatment andyou want to try voodoo, God
(17:40):
bless you.
You know, yes, you needmedicines.
And Mike's not going to denythat, you know, like you can't
diet yourself away.
But the problem is if you don'tidentify people, how do you give
them that option?
And everybody does come around.
Believe me, they diet, they trythis diet, that diet, and
(18:01):
ultimately they realize, oh myGod, I can't diet this away.
And it is the number one killer.
And I've got to do somethingabout it.
So lipoprotein testing.
Is
SPEAKER_00 (18:14):
the answer there?
For people listening who havecardiologists, or even if you
don't, ask your cardiologist.
Advanced lipoprotein testing.
That was something new to me,too, just over the last few
years.
So, very important takeaway.
SPEAKER_01 (18:28):
You know, and so on my website, there is, and I'll
give you the website address.
If you go up on the top, it sayslipid consultation.
You scroll down, there's afantastic animation of...
that screenshot that I showedyou of an animation, how a
lipoprotein gets into the wallof the artery and how
(18:49):
atherosclerosis occurs.
Okay.
And that's www.paladinmds.com.
That's P-A-L-A-D-I-N-M-D-S.com.
And I want everybody to go watchthat video because once you see
it, it crystallizes.
And how does a particle get intothe wall of the artery?
Well, inside the artery wall,inside that first layer are
(19:13):
holes called pores, P-O-R-E-S,like pores on your face.
And if you remember frombiology, diffusion, which you
may think is osmosis, but it'sdiffusion, and it's stuff in
life flows from where there's alot to a little.
So if you have a lot of cars onthe highway running through your
(19:34):
blood vessel, They go throughthe wall of the artery where
they get eaten up and theybecome an atherosclerotic
plaque.
Okay, Brian, show the secondpicture.
Okay, so there's theatherosclerotic plaque.
Now you'll hear a term calledangina or angina.
(19:56):
So let's talk about classicangina.
So as the plaque gets bigger, inother words, It pushes from the
bottom up, pushing the wall up.
When you get a 50% blockage, aperson says, okay, I have chest
pain, shortness of breath,fatigue with heavy activity.
(20:18):
Then it gets to 75% and it'swith moderate activity.
Then it gets 90, it's withminimal activity.
And then 99%, it's at rest.
Now, if this occurs slowly, youcan follow them and you can
track them and you canintervene.
However, it's the plaques likethis that are 10%, that are 20%,
(20:39):
that have zero calcium, that areyoung, that are immature, that
are constantly changing shape,that rupture.
See this plaque ruptured righthere?
And then the red thing is ablood clot.
So now your body sends what'scalled platelets to block the
crack because the plaqueruptured.
But the problem is it fills theentire artery wall and blocks
(21:02):
blood flow.
dead before you hit the ground.
SPEAKER_00 (21:05):
So this is the person with the zero calcium
score that is running, going tothe gym, working out, and dies
from a sudden heart attack intheir sleep or after activity.
So this is the scary part thatwe all want to know what's going
on in our heart, right?
What's going on in here?
We don't know.
SPEAKER_01 (21:25):
And these are the guys, like Mike said, Joe
Schmoe, Ran a half marathon onSunday, felt great on a Monday.
I mean, felt great on a Sundaynight, got up Monday morning and
hit the ground is dead.
And everybody's like, oh, myGod, his cholesterol is normal.
No, it's not.
Because we know that 50 percentof people who have normal
(21:46):
cholesterol don't.
So the whole thing is this is adisease that starts in
childhood.
The only thing we can do is stopprogression or slow progression.
We can't.
regardless of what you hear onthe internet.
And please believe me, I'vededicated my life to this.
There's nothing that causesregression.
(22:07):
In other words, makes the plaquego away to an appreciable
extent.
Yes, people will say that.
And I'm going to get scientificright now because Mike and I
like to be evidence-based.
So there's two studies.
One's called the Meteor Studyand the other's called the
Asteroid Study.
And that's using high-doseresuvastatin, which is a statin.
(22:28):
And they put an ultrasound downinto the coronary artery and
then another one up into thecarotid artery.
And they measured the plaquevolume, which is the
three-dimensional plaque volume.
The problem was is none of thosepeople had significant
blockages.
They were 20% or 30%, so theydidn't block blood flow.
(22:48):
And yes, one of them found, Ithink, an 8% reduction in
overall volume of the plaque,and the other one was like an
11% reduction.
But if they didn't limit bloodflow, it's irrelevant.
And they also didn't look at howmany people died or didn't die.
So what statins do, besideslowering your cholesterol, is
(23:09):
they stabilize plaques.
They make those plaques, likeyou saw in that video, less
likely to break.
And to me, that's the money.
If your cholesterol isborderline, still, I don't know
one cardiologist or one cardiacsurgeon that doesn't take
medicine.
Because if you can stabilizethat plaque and keep it from
(23:29):
breaking, that's the best thingthat we can do to prevent sudden
death.
SPEAKER_00 (23:34):
And Mike, that's another very good point is the
whole statin talk.
We could almost do another talkas statins, which we will at
some point.
But all the sudden statins aresuch a bad rep with a lot of
people.
And I personally know, Peoplethat are stopping statins, they
think, you know, it's loweringmy testosterone.
I don't feel good on them.
(23:55):
It's causing dementia.
Which
SPEAKER_01 (23:56):
is a myth, as you know.
SPEAKER_00 (23:59):
One thing that I talked to you, I was somewhere
and everyone was talking about,hey, we got to stop statins.
Get off them.
I knew people that were gettingoff because they think it was
causing early onset Alzheimer'sor dementia.
And it's quite the opposite.
And when we really dove into it,all the studies show that it
actually decreases Alzheimer'sand dementia risks in well
(24:21):
peer-reviewed journals.
So the whole stat and talk,we're not going to bore you with
that today.
SPEAKER_01 (24:26):
Well, I mean, we can say one little thing.
So right when Mike and I figuredthis out, I sent him.
So there's a new meta-analysisin the Journal of Alzheimer's
Disease, 50% Five studies,randomized studies, 7 million
people.
They had a reduction of 24%all-cause dementia, 21% in
Alzheimer's.
(24:46):
We've known this as cardiacsurrogates for a long time.
And what people also don'tunderstand is the brain
cholesterol does not mix withthe total body cholesterol.
So these lipoproteins, thesecards, turn over every three
days.
So that's why when we'remeasuring lipoproteins, You
don't have to fast for yourblood test because you're
(25:07):
measuring the transportvehicles.
But your brain cholesterol lastsfrom six months to five years,
and it doesn't mix with thebody's cholesterol.
So when people are saying itlowers your cholesterol in your
brain, it does not, number one,because yes, every cell does
need cholesterol.
But actually, the number onecause of dementia is vascular
(25:30):
dementia.
are mini strokes caused byatherosclerosis in the small
brain arteries.
So that's why the best we've gotright now is to lower your
cholesterol aggressively.
But if you're not identifiedproperly, right, Mike, you can
talk about yourself.
SPEAKER_00 (25:48):
A hundred percent.
Someone like myself, no familyhistory.
My numbers are marginally high.
I've always exercised and workedout.
And I'm on a statin.
And When I looked into it, Idon't want to take anything.
I don't like taking anything, tobe honest with you.
But the studies don't lie.
And these are real studies.
(26:09):
So that's another takeawaypoint.
Besides all the studies we'retalking about, besides the
lipid, now we have statins.
And these are all stuff we'retelling you, not because they're
our opinion.
And this is why we're doing thispodcast.
This is peer-reviewed journals.
This is studies on thousands ofpeople.
SPEAKER_01 (26:29):
Millions.
There's no drug that has beenstudied more than statin.
First statin was developed in1983.
The guys who won the Nobel Prizein medicine in 1965, two
doctors, discovered how to getrid of lipoprotein particles.
In other words, That's what ledto statins, that statins
(26:52):
increase the number of parkingspots in your liver for these
lipoproteins to go and bindthere, to go and park and can't
get out.
And then you go to the bathroomand you get rid of them.
So but, you know, there's somuch more to lipid management.
Some people need two drugs,three, but we're not talking
about that.
What we're talking about is howdo you identify every single
(27:13):
person at risk?
SPEAKER_00 (27:15):
So I think, Mike, I think this is a really good
intro and a really good start.
And I think people hopefullylearned a little bit today.
And I think see yourcardiologist.
And even if you don't have anyfamily history, it's good to
know what's going on in here.
You know, maybe it makes yousleep a little bit better at
night doing some of these stuffand getting some knowledge.
(27:36):
But I think this is a reallygood intro.
And I think we're going to talkmore, a lot more about this in
the future among so many othertopics.
But this is exciting stuff.
And it's great to have an expertlike you on here and And as we
go on and do more podcasts,we're going to try and bring on
experts in every field if wecan.
And we're really going to tryand make it fun and exciting and
(27:57):
brief.
So we don't bore you, but wewant to hit the major topics.
And you can always reach out tous individually.
If you're lipids, you know,Mike's the guy for that.
And that was great.
SPEAKER_01 (28:08):
Please, please, you know, if I can say, please just
do yourself a favor and go watchthe video, the animated narrated
video that I made with actuallyone of my patients.
He did because that's what hedoes.
He used to work for Fox.
Um, and, um, the narrated videobecause you want to see how
(28:30):
biology works how the particlesactually get into the wall of
the artery because that'llcrystallize everything because
you want to be able to tell yourfriends family and you want to
understand it okay that you knowthat's number one and then also
like mike said please understandthat what you hear and you see
on the internet okay there isnot one doctor there was a just
(28:54):
a quick anecdote and there was aNational Geographic from 2007,
which I've entitled The Heart,and it journeys somebody's whole
thing who had multiple heartattacks to needing a heart
transplant.
And they interviewed all thecardiologists at the Cleveland
Clinic, which is like thepremier place.
There's not one cardiologistthat doesn't take medicine,
okay?
Because we say we have nointention of dying of the
(29:18):
disease that we treat, okay?
So please believe us that whatyou hear on the internet is not
true.
that cholesterol is not good foryou.
It is not good for you.
SPEAKER_00 (29:31):
Awesome.
Okay.
SPEAKER_01 (29:34):
Right.
And remember, when it comes toyour health, the truth matters
because we're all about thetruth.
SPEAKER_00 (29:41):
All right, everyone.
Stay healthy, my friends.
Till next time.
SPEAKER_01 (29:44):
All right.
Thank you.
Okay, hello everybody.
How are you doing today, Dr.
Richmond?
SPEAKER_01 (00:04):
Morning, Mike.
SPEAKER_00 (00:05):
Okay, so today we're going to talk about probably the
most important thing that we cantalk about, and that's why I
wanted to start us off withthis.
And it just so happens that mypartner is a cardiothoracic
surgeon, and he's been doinglipid management for 20 years.
He's also on the editorial boardof the Journal of Clinical
Lipidology, which is a premiumpeer-reviewed lipid journal.
(00:27):
And the reason why I think thisis so important is the number of
people that die from heartdisease every year is
astronomical.
And if you look at the numbers20 years ago and the numbers
today, it really hasn't changedthat much, which is amazing.
If you think about all thisstuff, all the diets and all the
(00:48):
stuff we do, it hasn't reallychanged that much.
And, you know, still being anactive surgeon and treating
people and, you I still amamazed at how many people are
still dying from this.
And the other thing that shouldscare all of us is I know a
bunch of people, normal calcium,zero calcium score, they
(01:09):
exercise, they work out, theyjog.
Some of them also had CT NGOsand they all say, oh, my lipids
are fine, my cholesterol isfine, and they die.
So why are these people dying?
You know, on a personal note, mycardiologist referred me to
lipid management doctor.
And it just so happens Dr.
(01:30):
Richmond is one.
So for me, it was easy and I didmy testing.
And this is something that Iwant everyone to know.
And I've been telling friendsand patients this, and I'm a
surgeon and I still wasn't thatup to date on this.
So without further ado, I'mgoing to let my Dr.
Richmond come in and share hiswealth of knowledge.
SPEAKER_01 (01:51):
Thank you.
Thank you.
So just a little background,expand on what he said.
So statistics are a littlebehind.
So in 2021, there were 938,000cardiovascular deaths.
That's stroke, heart attack,peripheral vascular disease.
In the year 2000, there wereover 950,000.
(02:12):
So that makes anywhere between35% and 39% of all deaths in the
United States are due tocardiovascular disease.
So like I tell people, when youdrive by a cemetery, every one
and third tombstone is acardiovascular death.
And it's amazing.
It's frightening.
So today's topic, really, if youwant to get down to it, is...
(02:35):
Why are lipid measurementsfalling short?
In other words, what are wedoing wrong with cholesterol?
And then once we figure thatout, what can we do to improve
our testing, our risk factorscoring to give people extra
life?
Because Believe me, I did apresentation that we'll refer to
(02:59):
at some point.
How does a heart surgeon preventa heart attack?
But, you know, a littlebackground, like Dr.
Fiorillo said, I'm a heartsurgeon.
So a cardiologist is anon-surgeon.
A cardiac surgeon is a surgeon.
I'm the one who opens up thechest.
And one day in 2000, I want tosay 2005, I was doing a bypass.
(03:20):
And I thought to myself, I don'teven know how arteries get
blocked.
I know how to fix them.
but I don't even know howarteries get blocked.
So one of the leading lipidexperts happens to be in New
Jersey and I called him up onthe phone and I introduced
myself and he hung up on me.
Typical Jersey, right?
Hung up on me.
Thought it was a joke and Icalled him back and I said,
(03:46):
listen, I'm a cardiac surgeon onthe West Coast.
And I said, I need to learneverything about lipidology
because there's no formaltraining in it.
And I spent the next year yearreally learning everything and
reading everything andultimately getting myself on the
editorial board of the LipidJournal, then was asked to write
with him in another academician,Lipid and Lipoprotein
(04:07):
Guidelines, how to managepeople.
SPEAKER_00 (04:11):
Mike, people don't understand, just to jump in real
quick, people just go bycholesterol and now a lot of
people's HDL, LDL, see a lot ofPeople short saying, oh, my
ratio is good.
So we'll talk about that.
But people just think, oh, I'mgood.
My cholesterol is good.
And we don't want, most peoplethat die of a heart attack
probably have good cholesterolis the point.
(04:32):
So Mike's going to extrapolateon.
It's not just getting yournumber and saying, okay, I'm
good.
My cholesterol is good.
I'm not going to have a heartattack.
SPEAKER_01 (04:40):
Expanding on that.
Okay.
So we gave a little backgroundwith the numbers.
Atherosclerosis.
is the deposition ofcholesterol-laden plaque within
the artery wall.
And if Brian, if you can showthat first picture, I'd
appreciate it.
Okay, so that is an artery cutend on.
(05:04):
And the big part, the pink part,That's called the lumen of the
artery, and that's where theblood flows.
And then the artery wall hasthree layers, that really thin
layer is called the intima.
And then where that yellow is,that's the media, that's the
muscular layer.
So when you feel your pulse inyour wrists, that's because the
(05:24):
muscle's pumping.
And then you have somethingcalled the adventitia.
And if you notice, thecholesterol plaque is inside
that first layer.
It's not where the blood flows.
And that's key.
That's what people don'tunderstand.
Doctors don't even understandthat, if you can believe that.
So somehow the cholesterol hasgot to go into the wall of the
(05:45):
artery.
And when a blockage occurs, soit occurs from the inside of the
wall and pushes and blocks andnarrows.
So that's calledatherosclerosis.
And atherosclerosis is endemic.
It's been around since the...
The dawn of time.
(06:05):
So how do we know that?
Well, in 2013, a mummy study waspublished, which is really
interesting.
So they did CT scanning of thecoronary arteries of 137
mummies.
And these included mummies thatspanned 4,000 years.
And one group of them was fromSouth America, vegan only.
(06:27):
And they found across the board34% of the mummies had
significant atherosclerosis,including women and children
mummies who were vegan.
So that debunks the myth rightthere that atherosclerosis is a
disease of white men who smokeand go to Dairy Queen.
And then if you look at theautopsy studies of the U.S.
(06:50):
dead in the Korean War, inVietnam, in Gulf War, in
Afghanistan, upwards of 60% ofmen between 18 and 35 had
significant, I'm not talking 30,but over 50% blockages.
So this starts in birth.
(07:11):
And if you don't get a handle onit, when you're young, it's a
progressive disease.
And I'll ask Mike right here,okay?
And we'll see if he gets theanswer right, because even
though he's smart as can be,doctors don't know this.
What is the first sign in mostpeople that they're having a
heart attack?
SPEAKER_00 (07:31):
Well, what we're all taught is pain, right?
When you tell me it's not, butwe're all taught pain in the
chest radiating to the arm.
SPEAKER_01 (07:38):
Right.
So the first sign is 50% ofpeople is sudden death.
You're dead.
You're dead.
That's the threat.
SPEAKER_00 (07:44):
And listen, and this is why we're doing this.
This is what scares people,right?
People are dropping dead.
And I think we all know peoplethat it's happened to.
And, oh, my friend runs, youknow, three miles a day and he's
dead.
the next day.
So yeah, 100%.
We want to know what's insideour artery.
And, you know.
Okay, so
SPEAKER_01 (08:03):
moving along.
So the five major risk factorsfor cardiovascular disease, so
in other words, blockages, areage.
We all get old.
Can't change your age.
Smoking, high cholesterol, type2 diabetes.
I'll say a word about that.
There's 93 million people in theUnited States that are
(08:23):
pre-diabetic.
28 million diabetics.
All pre-diabetics and diabeticshave abnormal lipid panels.
Okay.
Cholesterol testing.
And then the final one is highblood pressure.
But what is the thing that Ididn't say?
This is why I don't dotraditional risk factor scoring
is because they don't mentiongenetics and everything is
(08:45):
related.
And everything is related toyour genetics.
So when people say, oh, you'relow risk, you're moderate risk,
you're high risk.
I just want you to think aboutit logically and intuitively.
So if Mike said to me, Michael,I don't smoke.
I'm not going to divulge his agesomewhere in the 50s.
I don't have high bloodpressure.
(09:07):
I think I don't have highcholesterol and I know I don't
have diabetes.
But my dad died at 55 of a heartattack and his uncle died.
at 58 of a stroke intuitively.
Do you think he's low risk?
And the answer is no.
Absolutely not.
But we base everything on thisantiquated, stupid risk factor
(09:27):
scoring.
And if you look at theFramingham risk factor scoring,
there's two points that nobodyeven, you can't be diabetic.
to be accurately risk factorscored in the United States, and
you can't have coronary arterydisease.
Well, we know that coronaryartery disease is an epidemic,
so clearly we're not adequatelyrisk factor scoring people,
(09:52):
okay?
So what can we do to enhance theprobability of identifying
everybody?
And that's what we're talkingabout today is how do we
properly test people?
Because we do a hundred
SPEAKER_00 (10:05):
questions in today's day because people are spending
a lot of money going tolongevity centers and places and
doing prophylactic tests likeangiograms and calcium scores.
And we're not saying that's awaste of money or a waste of
time, but people do need to knowthat that's not the end all be
all.
SPEAKER_01 (10:25):
Kind of is a waste of money and kind of waste of
time.
But that's from a heart surgeon.
But that's for a future show.
But OK, so we're doing 125 to135 million cholesterol tests a
year.
Still, it's the number onekiller.
OK, and now here's the fun part.
OK, so cholesterol, regardlessof what all you people think.
(10:48):
80% of your cholesterol in yourbody is genetic.
20% is dietary.
Most cholesterol is made in yourliver and in your small
intestine based on your genes.
So in other words, you cannotdiet away your cholesterol.
Okay, we make about 800 to 1200milligrams a day in our body and
we eat maybe 200 to 400milligrams.
(11:12):
And of that, you absorb throughyour intestine about 8%.
So I have vegans, who theircholesterols are disasters.
Because remember,
SPEAKER_00 (11:21):
you can't...
Mike, that's a really goodpoint.
People do not realize it's verydifficult to lower your numbers
by just diet.
Very hard.
SPEAKER_01 (11:30):
Yeah, almost impossible, you know?
So, okay, so we're doing allthese cholesterol testing.
And we know that if you look atthe Framingham study, which was
26 years, if you compare peoplewho have heart attacks and who
don't, have heart attacks,there's an 80% overlap of
(11:51):
cholesterol levels.
In other words, if you look atsomebody's cholesterol level,
the people who had heart attacksand the people who didn't have
heart attacks, 80% of themoverlap.
So in other words, the way we'redoing it, you're looking at
them, all bets are off.
Waste of time.
So what is the answer?
How does a heart surgeon preventthe heart attack?
Well, first of all, The wholelipid hypothesis, and Mike knows
(12:17):
because you see all over theinternet every day, these fools,
for lack of a better word, sayeat as much cholesterol as you
want.
It's good for you.
So in 1909, a guy by the name ofAnshakov in Eastern Europe, who
was in the Imperial Army,force-fed rabbits cholesterol
and sunflower oil and inducedrapid atherosclerosis, so
(12:41):
blockages.
And then was able to identify inthe wall of the artery, these
cells that come in and coalescetogether and form cholesterol
plaques.
So 1909, we're in 2025.
And there's people that arestill arguing against biology.
And we've realized over theyears, and this is my little
(13:03):
demo thing.
This is from an Italianrestaurant.
And this is balsamic.
Sorry about that.
Let me put it in the middle.
This is balsamic vinegar andolive oil.
So when you get regular testing,you know they do a total
cholesterol.
They do an LDL cholesterol,which is your bad cholesterol.
(13:25):
They do an HDL cholesterol,which is your good cholesterol.
And they do a triglycerides.
First, a little bit about totalcholesterol, which Mike didn't
even know.
And remember, I didn't evenknow.
And we both went to med school.
There has never been written oneguideline that says you're
supposed to look at your totalcholesterol.
Yet everybody walks around andsays, oh, my doctor said my
(13:46):
total cholesterol is less than200.
I'm in good shape.
Or my total cholesterol is above200.
I'm in bad shape.
That's never written into oneguideline.
OK, so block that out.
So what do we look at?
Unfortunately, we look at LDL-C,which is your bad cholesterol,
which I refer to as the people.
(14:09):
So I made this analogy yearsago, the Richmond analogy.
And the analogy is, if you thinkof people on a highway, so think
of an artery.
If you think of people on ahighway, is it the number of
cars that cause a blockage orthe number of people in the car
that cause a blockage or atraffic jam?
(14:31):
Answer, Mike?
SPEAKER_00 (14:32):
Number of cars.
SPEAKER_01 (14:34):
Correct.
Well, we measure the number ofpeople.
So regular cholesterol testing,all they do is they're taking
and they're measuring the amountof liquid cholesterol in 100
cc's of blood.
And what does that tell you?
That tells you absolutelynothing.
Because if I turn this on theside right here and I say to
(14:55):
you, whoops, if I say to you,get, oh, it's hard.
Sorry, guys, I'm moving.
If I say to you, mix the oil andthe blood.
You can't because they're notsoluble in each other.
So what the body does is itpackages the cholesterol in
cars, round cars, to allow it totravel where it needs to go and
(15:18):
where it doesn't need to go.
So in 1967, Dr.
Friedrichsen wrote in the NewEngland Journal of Medicine,
atherosclerosis, I'mparaphrasing, is a disease of
cars.
It's a disease of what we calllipoproteins.
It is not a cholesterol disease.
It's not a people-in-the-cardisease, okay?
(15:39):
And that's key.
So we measure the people in thecars, but we've known since the
early 60s, actually 50s, thatthese cars drive the cholesterol
into the wall of the artery,just like we showed you that
picture.
Yet, Very few people understandit and very few people do.
SPEAKER_00 (15:59):
And I think that's why you're starting to see some
people saying cholesterol is notbad for you and and saying, you
know, these numbers are fine.
And and there's a lot of thatnow on social media.
And that's probably why, becausein a way, there's some truth to
that, too.
SPEAKER_01 (16:14):
Right.
OK, so if we're measuring onehundred and twenty five million
people, same number of peopleare dying, 50 percent of people.
First sign is they're droppingdead.
The CDC says 50% of people whosurvive a heart attack and make
it to the emergency room havenormal cholesterol.
As soon as you do what's calledadvanced lipoprotein testing,
(16:36):
you realize they don't.
And all diabetics andpre-diabetics, their cholesterol
looks fairly normal on a regularpanel.
And as soon as you do advancedlipoprotein testing, where
you're actually doing an MRI ofthe blood, covered by insurance,
covered by Medicare,FDA-approved, You're measuring
the lipoproteins.
(16:58):
When you measure lipoproteins,you identify every single person
at risk and miss nobody.
So how do we reduce?
I mean, I wish this would be astaple in the health care system
mandatory for everybody.
So how would we reducecardiovascular events in death?
Number one.
(17:18):
Identify everybody.
So if you do lipoprotein testingon everybody, you will identify
every single person at risk andmiss nobody.
Now, nobody will argue with thiswho knows the field, okay?
The second thing is once youidentify somebody, okay, at
least you've provided theservice.
If you don't want treatment andyou want to try voodoo, God
(17:40):
bless you.
You know, yes, you needmedicines.
And Mike's not going to denythat, you know, like you can't
diet yourself away.
But the problem is if you don'tidentify people, how do you give
them that option?
And everybody does come around.
Believe me, they diet, they trythis diet, that diet, and
(18:01):
ultimately they realize, oh myGod, I can't diet this away.
And it is the number one killer.
And I've got to do somethingabout it.
So lipoprotein testing.
Is
SPEAKER_00 (18:14):
the answer there?
For people listening who havecardiologists, or even if you
don't, ask your cardiologist.
Advanced lipoprotein testing.
That was something new to me,too, just over the last few
years.
So, very important takeaway.
SPEAKER_01 (18:28):
You know, and so on my website, there is, and I'll
give you the website address.
If you go up on the top, it sayslipid consultation.
You scroll down, there's afantastic animation of...
that screenshot that I showedyou of an animation, how a
lipoprotein gets into the wallof the artery and how
(18:49):
atherosclerosis occurs.
Okay.
And that's www.paladinmds.com.
That's P-A-L-A-D-I-N-M-D-S.com.
And I want everybody to go watchthat video because once you see
it, it crystallizes.
And how does a particle get intothe wall of the artery?
Well, inside the artery wall,inside that first layer are
(19:13):
holes called pores, P-O-R-E-S,like pores on your face.
And if you remember frombiology, diffusion, which you
may think is osmosis, but it'sdiffusion, and it's stuff in
life flows from where there's alot to a little.
So if you have a lot of cars onthe highway running through your
(19:34):
blood vessel, They go throughthe wall of the artery where
they get eaten up and theybecome an atherosclerotic
plaque.
Okay, Brian, show the secondpicture.
Okay, so there's theatherosclerotic plaque.
Now you'll hear a term calledangina or angina.
(19:56):
So let's talk about classicangina.
So as the plaque gets bigger, inother words, It pushes from the
bottom up, pushing the wall up.
When you get a 50% blockage, aperson says, okay, I have chest
pain, shortness of breath,fatigue with heavy activity.
(20:18):
Then it gets to 75% and it'swith moderate activity.
Then it gets 90, it's withminimal activity.
And then 99%, it's at rest.
Now, if this occurs slowly, youcan follow them and you can
track them and you canintervene.
However, it's the plaques likethis that are 10%, that are 20%,
(20:39):
that have zero calcium, that areyoung, that are immature, that
are constantly changing shape,that rupture.
See this plaque ruptured righthere?
And then the red thing is ablood clot.
So now your body sends what'scalled platelets to block the
crack because the plaqueruptured.
But the problem is it fills theentire artery wall and blocks
(21:02):
blood flow.
dead before you hit the ground.
SPEAKER_00 (21:05):
So this is the person with the zero calcium
score that is running, going tothe gym, working out, and dies
from a sudden heart attack intheir sleep or after activity.
So this is the scary part thatwe all want to know what's going
on in our heart, right?
What's going on in here?
We don't know.
SPEAKER_01 (21:25):
And these are the guys, like Mike said, Joe
Schmoe, Ran a half marathon onSunday, felt great on a Monday.
I mean, felt great on a Sundaynight, got up Monday morning and
hit the ground is dead.
And everybody's like, oh, myGod, his cholesterol is normal.
No, it's not.
Because we know that 50 percentof people who have normal
(21:46):
cholesterol don't.
So the whole thing is this is adisease that starts in
childhood.
The only thing we can do is stopprogression or slow progression.
We can't.
regardless of what you hear onthe internet.
And please believe me, I'vededicated my life to this.
There's nothing that causesregression.
(22:07):
In other words, makes the plaquego away to an appreciable
extent.
Yes, people will say that.
And I'm going to get scientificright now because Mike and I
like to be evidence-based.
So there's two studies.
One's called the Meteor Studyand the other's called the
Asteroid Study.
And that's using high-doseresuvastatin, which is a statin.
(22:28):
And they put an ultrasound downinto the coronary artery and
then another one up into thecarotid artery.
And they measured the plaquevolume, which is the
three-dimensional plaque volume.
The problem was is none of thosepeople had significant
blockages.
They were 20% or 30%, so theydidn't block blood flow.
(22:48):
And yes, one of them found, Ithink, an 8% reduction in
overall volume of the plaque,and the other one was like an
11% reduction.
But if they didn't limit bloodflow, it's irrelevant.
And they also didn't look at howmany people died or didn't die.
So what statins do, besideslowering your cholesterol, is
(23:09):
they stabilize plaques.
They make those plaques, likeyou saw in that video, less
likely to break.
And to me, that's the money.
If your cholesterol isborderline, still, I don't know
one cardiologist or one cardiacsurgeon that doesn't take
medicine.
Because if you can stabilizethat plaque and keep it from
(23:29):
breaking, that's the best thingthat we can do to prevent sudden
death.
SPEAKER_00 (23:34):
And Mike, that's another very good point is the
whole statin talk.
We could almost do another talkas statins, which we will at
some point.
But all the sudden statins aresuch a bad rep with a lot of
people.
And I personally know, Peoplethat are stopping statins, they
think, you know, it's loweringmy testosterone.
I don't feel good on them.
(23:55):
It's causing dementia.
Which
SPEAKER_01 (23:56):
is a myth, as you know.
SPEAKER_00 (23:59):
One thing that I talked to you, I was somewhere
and everyone was talking about,hey, we got to stop statins.
Get off them.
I knew people that were gettingoff because they think it was
causing early onset Alzheimer'sor dementia.
And it's quite the opposite.
And when we really dove into it,all the studies show that it
actually decreases Alzheimer'sand dementia risks in well
(24:21):
peer-reviewed journals.
So the whole stat and talk,we're not going to bore you with
that today.
SPEAKER_01 (24:26):
Well, I mean, we can say one little thing.
So right when Mike and I figuredthis out, I sent him.
So there's a new meta-analysisin the Journal of Alzheimer's
Disease, 50% Five studies,randomized studies, 7 million
people.
They had a reduction of 24%all-cause dementia, 21% in
Alzheimer's.
(24:46):
We've known this as cardiacsurrogates for a long time.
And what people also don'tunderstand is the brain
cholesterol does not mix withthe total body cholesterol.
So these lipoproteins, thesecards, turn over every three
days.
So that's why when we'remeasuring lipoproteins, You
don't have to fast for yourblood test because you're
(25:07):
measuring the transportvehicles.
But your brain cholesterol lastsfrom six months to five years,
and it doesn't mix with thebody's cholesterol.
So when people are saying itlowers your cholesterol in your
brain, it does not, number one,because yes, every cell does
need cholesterol.
But actually, the number onecause of dementia is vascular
(25:30):
dementia.
are mini strokes caused byatherosclerosis in the small
brain arteries.
So that's why the best we've gotright now is to lower your
cholesterol aggressively.
But if you're not identifiedproperly, right, Mike, you can
talk about yourself.
SPEAKER_00 (25:48):
A hundred percent.
Someone like myself, no familyhistory.
My numbers are marginally high.
I've always exercised and workedout.
And I'm on a statin.
And When I looked into it, Idon't want to take anything.
I don't like taking anything, tobe honest with you.
But the studies don't lie.
And these are real studies.
(26:09):
So that's another takeawaypoint.
Besides all the studies we'retalking about, besides the
lipid, now we have statins.
And these are all stuff we'retelling you, not because they're
our opinion.
And this is why we're doing thispodcast.
This is peer-reviewed journals.
This is studies on thousands ofpeople.
SPEAKER_01 (26:29):
Millions.
There's no drug that has beenstudied more than statin.
First statin was developed in1983.
The guys who won the Nobel Prizein medicine in 1965, two
doctors, discovered how to getrid of lipoprotein particles.
In other words, That's what ledto statins, that statins
(26:52):
increase the number of parkingspots in your liver for these
lipoproteins to go and bindthere, to go and park and can't
get out.
And then you go to the bathroomand you get rid of them.
So but, you know, there's somuch more to lipid management.
Some people need two drugs,three, but we're not talking
about that.
What we're talking about is howdo you identify every single
(27:13):
person at risk?
SPEAKER_00 (27:15):
So I think, Mike, I think this is a really good
intro and a really good start.
And I think people hopefullylearned a little bit today.
And I think see yourcardiologist.
And even if you don't have anyfamily history, it's good to
know what's going on in here.
You know, maybe it makes yousleep a little bit better at
night doing some of these stuffand getting some knowledge.
(27:36):
But I think this is a reallygood intro.
And I think we're going to talkmore, a lot more about this in
the future among so many othertopics.
But this is exciting stuff.
And it's great to have an expertlike you on here and And as we
go on and do more podcasts,we're going to try and bring on
experts in every field if wecan.
And we're really going to tryand make it fun and exciting and
(27:57):
brief.
So we don't bore you, but wewant to hit the major topics.
And you can always reach out tous individually.
If you're lipids, you know,Mike's the guy for that.
And that was great.
SPEAKER_01 (28:08):
Please, please, you know, if I can say, please just
do yourself a favor and go watchthe video, the animated narrated
video that I made with actuallyone of my patients.
He did because that's what hedoes.
He used to work for Fox.
Um, and, um, the narrated videobecause you want to see how
(28:30):
biology works how the particlesactually get into the wall of
the artery because that'llcrystallize everything because
you want to be able to tell yourfriends family and you want to
understand it okay that you knowthat's number one and then also
like mike said please understandthat what you hear and you see
on the internet okay there isnot one doctor there was a just
(28:54):
a quick anecdote and there was aNational Geographic from 2007,
which I've entitled The Heart,and it journeys somebody's whole
thing who had multiple heartattacks to needing a heart
transplant.
And they interviewed all thecardiologists at the Cleveland
Clinic, which is like thepremier place.
There's not one cardiologistthat doesn't take medicine,
okay?
Because we say we have nointention of dying of the
(29:18):
disease that we treat, okay?
So please believe us that whatyou hear on the internet is not
true.
that cholesterol is not good foryou.
It is not good for you.
SPEAKER_00 (29:31):
Awesome.
Okay.
SPEAKER_01 (29:34):
Right.
And remember, when it comes toyour health, the truth matters
because we're all about thetruth.
SPEAKER_00 (29:41):
All right, everyone.
Stay healthy, my friends.
Till next time.
SPEAKER_01 (29:44):
All right.
Thank you.
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