May 27, 2026 • 41 mins
- Listen Saturday mornings at 8 as Dr. Msonthi Levine discusses medical issues and takes your calls on News Talk 560 KLVI. Dr Levine is board certified in Internal Medicine and Geriatrics. His office is located at 3080 Milam in Beaumont, Texas. He can be reached at 409-347-3621.
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Episode Transcript
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Speaker 1 (00:00):
All right, welcome in and that radio listeners Southeast Texas,
welcome to another edition of the Doctor Levine Medical Hour.
Hopefully having a wonderful Saturday morning. If you haven't looked outside,
it looks like hurricane season out there with all the
rain and the wind and treated limbs are down. Man,
(00:20):
it just looks like it does when it's in September
October area in this area. So man, big rainy day
to day, good day to stay in sad, list to
some good radio, and take care of business inside the house. Anyway.
Phone lines are open. We're here every Saturday morning normally
(00:40):
if there's no vacation, answer your phone call. Is trying
to help you understand what is good for you, what's
good for your family to as the theme song says,
stay alive as long as possible, and just hell this possible?
Remember we don't. And it's a drag. I have to
go to the hospital and the offices of doctors all
(01:02):
the time and take a sacamedge with you out all
the time. It's a drag. Who wants to do that?
So you have to do your part though, to stay alive.
It's no longer automatic as you get older, when you're younger,
you can do all that stuff. You can eat whatever
you want to drink or whatever you want, nothing happens.
You can stay up all night, you can go to
(01:24):
work with minimal sleep. I mean, just your body is
strong and you can just tolerate all this abuse. But
as you get older, just the aging process kicks in.
And that is again I want to let everyone know
that process is real, you know, getting older, it's a real,
real process. I know sometimes patients get a little perturbed
(01:47):
at doctors when they say, well, I mean you're such
and such age. You know that, you know, they want
to believe it's got to be something else. I mean,
stop just saying that. Let's look into something else, which
we need to do, right. I mean, I think there
can be so much overlap with these diseases. We only
have so many physical symptoms that we have. We have,
(02:08):
you know, about ten physical complaints that typically takes her
about ninety nine percent of the physical diseases out there
that we deal with only ten, Right, and it's up
to your practitioner to figure out which out of the
hundreds of diseases out there is the one that's bothering you.
(02:31):
So it can be tough sometimes, so just be patient
what it's out there and work with this, and we'll
work with you, and we'll do our best to get
your answer as fast as possible. That certainly is our
goal every time we interact with you, is to have
the right answer. The first visit gets you on the
(02:53):
right medication. It works, it's a success for everybody, for
the practitioner as well as for the patient. I mean
that is our primary goal every day, is to try
and discover what it is that's bothering you and gets
you better as fast as possible. But it just doesn't
work out like that on every single case. There are
(03:17):
cases that we just don't know what is wrong, even
though we've tried this. We've tried that, we've been through
our wave of diagnostic testing and maybe a lot of
laboratory work, and we still just don't have a clue
as to what is causing the physical symptom. Frustrating, frustrating
(03:41):
certainly for both parties involved. But it happens every day,
and I've tried to remind listeners that you have to
be open to being reassessed, especially if you go in
and talk with your provider or you go to a
minor care and you are a hospital, maybe you've been hospitalized,
(04:01):
and you were there for a few days. You got
a lot of testing, and you get all these sheets
of paper with these diagnosses on it. But once you
get home a few days later, things don't get better.
Maybe they slide backwards, you get worse, maybe you get
some new physical complaints. You know, you have to go
back in and get reassessed. Whether you would like to
(04:23):
be reevaluated by a different team of doctors or the
same doctors, it's certainly up to you, but I think
you have to have an open mind about that. That's unfortunately,
how sometimes these diseases get found is getting reassessed at
a later date. Just the diseases can mature, as I say,
we'll get that a lot with connective tissue diseases, diseases
(04:45):
like lupus or matarathritis, and just a lot of other
diseases are like that. There's sort of a day one
presentation of diseases and just you're not getting a whole
lot of physical complaints. You know, things are off put,
can't put your finger on it. It's going to require
you know, several more days of just monitoring a lot
(05:06):
of times we do that there in the hospital with
patients who get admitted. That's a big reason a lot
of times to get placed in the observatory facility, if
you will, which we call the hospital the modern American hospital,
the observatory facility, right, because a lot of what we're
(05:27):
doing is just watching you. Right. We're taking your vital signs,
we are monitoring your heart function, we are monitoring your physiology,
if you will, by checking your blood work. We're checking
your kidney function, your bone marrow function, your electrolytes. It
really paints a picture for health care providers in terms
(05:49):
of what is going on with your human body. And
all of that information allows healthcare providers who are trained
to make a diet noses about a hospitalized patient to
help them sort of fine tune their impression about what
it is or what it's not. And again, so a
(06:11):
lot of patients once they get in the hospital are
ready to go, but a lot of times we just
want to watch you and sort of see what happens,
and that will allow us to make the right diagnosis.
So just be patient with is, have an open mind
about it, and we'll work together to try and figure
out what is wrong with you. But it is a
(06:33):
messy outside. A good day to stay inside and just
hang out with your family, clean up the house, get
to those house chores that you've been getting to a
lot of times. It's just driving around in this sort
of weather. It's dangerous as well, and it's just kind
of better to hang out. Now they have all these
sort of home services where you can order this and
(06:53):
order that, and you don't necessarily have to leave your house,
So maybe that's it's a good day to do that.
But again, if you haven't had your vaccines, go out
and get those. We have a lot more on the
market now, whether you get from your doctor's office, get
it from your pharmacy, we don't care. Just go out
and get that. The immune system is at work every day.
(07:17):
But again, aging getting older doesn't work as well. We
hear so much about heart attacks and strokes and dementia.
We talked about that a little bit a couple of
weeks ago. And infections are huge, huge, huge issues as
one gets older, whether it be pneumonia or a bladder
(07:38):
infection or bloodstream infection which we call back to remia.
That is very, very common. Just because we get what
we call immuno compromised as we get older. So these
vaccines really are targeting certain organisms that are common in
(07:59):
this age category. It's not a complete complete protection, but
again we're targeting certain organisms that appear to have a
very common occurrence in the older population or as you
get older, and getting these vaccines in will just again
(08:19):
boost your immune system, remind your immune system how to work. Again.
Your immune systems kind of like a military just kind
of on standby in case it needs to defend its
land or its body. It's on standby. So you want
to have as much artillery as possible, and that's basically
(08:40):
what vaccines allow you to do is develop your artillery
and the different options you can defend yourself if you
do get an invasion by an organism, whether it be
a virus or a bacteria, and keep the severity of
the disease to a minimum. Oh often you hear about
(09:02):
loved ones, family members going into the hospital a week ago.
They were doing fun, right, they were driving, they were
cutting the grass, they were just taking care of themselves,
just going through life, no problems, and then within twenty
four hours, forty eight hours, I mean, they are fighting
(09:22):
for their lives. They're on breathing machines, they're on medicines
to keep their heart working and their vascular their blood vessels,
their blood pressure up. I mean, this stuff can happen very,
very rapidly with these infections. So vaccines really help decreasing severity,
giving you protection, keeping you out of that hospital so
(09:45):
that you don't have to fight for your life like that.
I know that it's frustrating talking to patients. I think
there's an assumption, if I get a vaccine I did,
I should never get sick. It should protect me like that,
And I think that's the idea put in general. Again,
it doesn't work out that way, but it does. It
does in my experience what I see decrease the severity
(10:10):
of infection. It's all you're trying to do, because again,
getting older, you're just more vulnerable. You're weaker. Your body
doesn't heal as well, it doesn't protect itself as well,
it doesn't like a lot of physiological stress, which we
call sepsis, that term that you're becoming more familiar with
in the general population against Sepsis is a medical term
(10:32):
we use to describe what happens to the human body
when it gets infected, your heart rate might go up,
your auction level might fall, you might get some fever,
your laboratory work will look a certain way, and we
can see that picture and it alerts us to the
fact that maybe there's some active infection and we sort
(10:53):
of need to get on top of it as soon
as possible. Again, because if that sepsis engine keeps hump
and it gets worse and it accelerates, it can cause
some damage to the human body. To although the vital
organs like your brain and your heart, and your kidney
and your liver, which is what we see a lot
when patients develop what we call sepsis, it can cause
(11:17):
what we call multi organ failure, and the more organs
that is failing at one time unable to sustain that
for a very long period of time, and sometimes patients
just sort of lose the fight, lose the battle, the
physiological battle of acute medical crises. And it is sort
(11:39):
of a surprise or a shock when family members see that.
But again, this stuff happens every single day. It's again,
like anything else, you need to be strong in order
to withstand a physiological stress, and just unfortunate, a lot
of us are not at that level when we get
older for various reasons, and we need as much protection
(12:02):
as possible. So go get your vaccines today. Well, let
it drive a little bit and then you can go.
And certainly, as I've mentioned to you, try to prioritize
eating that good diet, a lot of vegetables and don't
drink sugar. Phone lines are open eight nine six kov
I want one hundred and three to three zero Kalva.
(12:22):
We'll go on our first break, be back in two minutes.
All right, welcome back to the doctor p Metica. Our
phone line to open. Eight nine six kova I won
one hundred three three zero kio v I chatting And
(12:46):
just a very very wet Saturday morning. Good time to
stay inside, hang out with the fam, watch some games,
order out, yes, and not driving this wet, wet Well,
unless you're going to get your vaccine, of course, then
you have permission to do that. Wouldn't that be cool
if you could order your vaccines at home? Right, you
(13:08):
could go to a website and someone will come out
to your house and give your vaccine shot. That would
be so awesome. Or if they were tablets or pills capsules, right,
your vaccine capsule that would be awesome as well. But
we're not there yet, but we might be there again.
There's a whole industry that's in the background working on
(13:30):
vaccines and trying to work on the technology make it faster, cleaner,
more efficient, and we've come a long way. It's been
some conversation about the position we at right now with vaccines.
Every time you wake up, there's a new vaccine, there's
a variant, and you got to go get a booster,
and you hear a lot about that. Sometimes I can
(13:52):
little confuse myself, but certainly work with your healthcare provider
or your pharmacy, which has taken over that respect responsibility,
to become a partner in that responsibility and providing those vaccines,
which I think is a win win for everyone involved.
And unfortunately a lot of patients are using the pharmacy
every single day to get their prescriptions, fill their prescriptions,
(14:16):
and they're already there anyway, just like you go into
your doctor's office, your healthcare provider's office, that you're already
there anyway when I just go ahead and get your
injection so you don't get Stepsis Rocky from bomat. How
can we help you.
Speaker 2 (14:30):
Hey, good morning, the first time called her. I've really
had a question in your opinion thoughts on the injections
pep tide injections, any opinions on that? What's your thoughts?
Are all pep tide injections?
Speaker 1 (14:45):
Just and yeah, rockey, thanks for that question. Just to
be clear, peptide injections are you referring to like a
g LP one injection, like a zimpic or with govi
or what? Do you have a name brand of a
medication well for peptides?
Speaker 2 (15:00):
Well, yeah, sorry, it's not none of those. It's kind
of like a recovery. It's got different ones than a recovery.
Speaker 1 (15:09):
Okay, it's not a prescription medication. It's something you might
get from a different healthcare provider or how do you
get it?
Speaker 2 (15:18):
Yeah, that's correct, absolutely all right.
Speaker 1 (15:20):
And so the idea is that this peptide is supposed
to help you recover faster if your exercise or provides
some strength or endurance with exercising. Is that correct?
Speaker 2 (15:32):
Correct? That is correct?
Speaker 1 (15:34):
Is it supposed to help in any other way help
you live longer, control.
Speaker 2 (15:39):
Appetite, immation, arthritis, inflammation, and things of that nature. Recover
Look quicker as we get older.
Speaker 1 (15:47):
Yeah, I guess you can tell. I can expert on peptide,
but I have heard conversations about peptides. Again, everyone is
looking to feel good, look good, and live as long
as possible. And I think every year there's sort of
a new ingredient, to new injection, a new supplement that
(16:08):
might sort of be the one that can help all
of Americans feel the way they want to feel. And
I guess the peptide category is the newest, latest, and greatest.
My position normally on these sort of supplements, if you will,
is that it's worth a try to see if it
helps you. Just like with prescription medications, they've been studied,
(16:32):
they've been efty approved, but when we put it into
the open market, the open world, if you will, every body,
every person has a different reaction to these medications, and
you may not get the reaction that you're looking for.
But I think if you're suffering with your physical health,
then you want to feel better that these peptides can
(16:53):
be an option for you. As long as you agree
with the risks of taking this product and you're working
with a healthcare provider that has a knowledge of this product.
I think it can be something that a person can
try as an option to make them feel well. You know,
try it for a few months and see how you do.
But it's not going to work for everybody, but you
(17:15):
know it's worth to try. I mean, creating that was
something that was very popular for a while. There's this
typically again always something every year or so where this
is sort of the new latest version of the magic peel,
if you will, that's going to you know, fix all
of our elements. And just unfortunately that our body is
(17:35):
so complex, it's multi layered that normally it's it's not
going to be one just one little supplement that's going
to fix everything. It's normally collection of things that you
have to do on a regular basis to feel well.
You know, you got to eat well, you have to
sleep well, you have to not drink sugar, you can't smoke,
(17:56):
you can't drink alcohol, so you got to have to
write genet eggs and it's several things that sort of
need to be in place. It's not just going to
be about let me get this in one injection and
inject it and it solves all of our problems. Now
for some it works that way, right, but for most
of us, it's not going to be that easy, but
(18:16):
I think it can be a good option to try
if you're in that position and you're looking to feel better.
Speaker 2 (18:21):
Yes, sir, well, I certainly appreciate you taking my call
and I enjoy your program. Thanks a lot.
Speaker 1 (18:26):
Well, I appreciate it, Rocky, And you stay safe out
there and be aware of the wet weather and drive safely.
We don't want any accidents out there. But all of
the dietary supplements out there, the peptot category, it's it's
brand new. Having read a lot about it, again, a
lot of these, as the color mentioned, a lot of
(18:47):
these substances are available to you sort of directly without
the involvement of a healthcare provider, licensed medical provider, and
you can sort of get your hands on these things
yourself and again do your own reason and I don't
have a problem with that. I really really don't have
(19:09):
a problem with that as a healthcare provider, just because again,
doing your own investigation, I think is a wonderful way
to try and figure out what works for you. A
lot of times your health care provider he or she
is not able to research this at length, right, but
(19:31):
in your leisure with the aid of the Internet, I mean,
just the information highway like that, all that information is
available to you. You can certainly do your own homework
and then bring that to your healthcare provider and both
of you can look at it to determine if it's
right for you, and then you try it. And it's
like all these other medicines that we prescribe that you
(19:54):
need a prescription for a lot of this is sort
of a trial to see if it's going to work
for you. For blood pressure, for diabetes, for high cholesterol,
for depression, for headaches, for rashes, for joint pain. I mean,
just all of us in these situations are trying these
(20:14):
medications as a trial to see if it's going to
help you. In general, the medications we prescribe have a
sort of low toxicity level. Otherwise, most practitioners just don't
prescribe it because they don't want the toxicity impact of
the medication. They normally don't recommend high toxicity medications to
(20:36):
their patients because they just don't want the risk of
it harming their patients, so they just don't write for it,
or there's a conversation about it before it's handed to
the patient that hey, this is the risk. Do you
want to accept the risk? Yes or no? Yes, Okay,
I'm gonna write it. I'm a document that I talk
to you just because hey, yeah, it's it's high risk.
(20:57):
Something might happen. Same thing with the pepti category. Certainly
if it's you don't need a prescription for the product.
You have to do your own research and figure out
for yourself if you're willing to expose your body to
this new product. Whoever makes it, the name of it,
the manufacturer of I'm sure there's probably different manufacturers out there.
(21:19):
Which one is the best one, which one is the
right one? A lot of that information, again is unknown
as these products hit the market just because of the
laws of the land. You know, if it's a certain
type of food supplement or a certain type of what
we call nutraceutical, it doesn't require the type of intense
(21:40):
testing that prescription medications require. So a lot of that
information or so just sort of what is the expectation
of medication is really not known for each particular product.
I know a lot of patients like, but what's the
best product? You know, between this one and that one?
Which is the best We want the best for ourselves.
(22:03):
And a lot of times these what they call head
to head studies, they're just not out there just because
it's it's a lengthy process, it's an expensive process, and
it's a risky process, right these pharmaceutical companies, I mean
this boils down to a lot of what they call
market share, and the more market share you have, obviously
(22:26):
things go a lot better for you if your product
is in the market and it's the most prescribed products.
So if you potentially do some study and it finds
out that your product is not so good and it's
the other guy's product, and that might get out and
who wants that, right, So a lot of these head
to head studies are just not done, so we never
(22:47):
know which one is the strongest, are the best. Again,
as I've mentioned to you, doctors are their own sort
of investigators and healthcare providers and those practitioners pas do
their own sort of mental investigation with the medicines that
they are prescribing every single day for all their patients,
and they sort of see what happens for them in
(23:11):
terms of which products bring success, which products don't bring success,
which products have the high callback rate, which products cost
the most and I get phone calls back. Yeah, sort
of have a mental idea about that, and that influences
the medicines that you prescribe, which is why you can
(23:32):
go to one doctor and get this for blood pressure,
you go down the street for the same blood pressure,
the same lab results, and they're giving you something different.
And unfortunately, that is where we're at right now in
terms of prescribing. It's all about the habit and what
you've been exposed to, what your experience has taught you.
(23:53):
Even though we read the same books, take the same tests,
just our personal experiences going to dictate how we sort
of manage our patients. And unfortunately that's just the way
it is. But thankfully, like I said, get reassessed. Whether
it's by the same doctor, different doctor, doesn't matter. You
(24:13):
deserve to get a second opinion. You're just trying to
get information, just trying to feel well. And if a
peptide is right for you, if it makes you feel well,
how can anyone argue with that? You feel tired, you
have headaches, You want to have more endurance, you want
to sleep better, you want to mentally feel more stable.
(24:35):
You're looking for the answer, the magic ingredient if you will.
And I think again, it's just how our mind works.
We want to try and keep it simple. Just what
can I do one of two things I can do
to make it pretty easy for me, simple, straightforward. I
don't have to do a whole lot. And again the
peptide category. Again I don't know a whole lot about it,
(24:57):
but it is out there. Is my a good solution
for you. But do your own homework, try it out
for a few months. Make sure you don't break the
bank with it, because a lot of times these products
are I mean they're normally in the hundreds range per month.
And again, just do a limited evaluation on your own
and see if it works for it, and if it
(25:17):
does doesn't cause any problems, Hey, maybe that's the right
thing for you. Phone lines are open eight on six
kalo if you out win one hundred and three to
three zero Okay, I'll be back in two minutes. All right,
welcome back to Talk of the Medica. Our phone lines
(25:38):
are open eight on six ko if you out one
one hundred three three zero O kof yea. I talking
with you on a very very wet Saturday morning, So
be careful out there. If you're driving drives slow, you'll
get there eventually. Just don't want any accidents. One thing
that's happened in the past couple of months is the
cholesterol guidelines for all healthcare providers sort of changed, and
(26:04):
I thought I would just give a brief understanding of that.
It might explain to you maybe some prescribing habits that
might change from your provider in the next several weeks
to months. And as you know, like I said, most
doctors like myself, priminent care physicians on the front lines,
we have sort of this collection of guidelines that have
(26:28):
been put together by experts in the medical field. They've
looked at all the latest research and they pump out
these guidelines that we can kind of go to in
reference on most diseases that we're treating. You may be
familiar with this if you've had cancer, and no matter
where you go M. D. Anderson here locally here in Beaumont, Texas,
(26:52):
the guidelines in terms of how to treat these diseases
or very strict, the most strict I've really seen in
all of medicine in terms of treating cancer. But cholesterol guidelines, again,
it's changing all the time about every few years we
get better or the latest update on the guidelines, and
(27:13):
it sort of tells doctors what you should be doing
with your patients as it pertains to cholesterol. As we
all know, cholesterol is one of the identified risk factors
for cardiovascular disease, right. That's the big problem in our country,
that plaque that gets in those blood vessels and causes
(27:34):
what we call stenosis or narrowing and causes the little
blood clots to form, which we call thrombus, and in
belize a risk factor for that is the development of plaque,
And we have risk factors for that. High cholesterol, it's
one of them. So it's one thing we focus on
a lot when we see patients. We're always checking the cholesterol.
(27:56):
So they sort of came out with the latest guidelines
a few months ago, thought I would just sort of briefly,
superficially explain kind of what they are recommending to healthcare
providers so you can kind of maybe figure out why
certain things are happening. And the bottom line with my
(28:16):
understanding of this is that they basically want cholesterol, high
cholesterol treated sooner and more aggressively in anyone who might
have a risk factor for cardiovascular disease, and so that
means that when you're provider checks your cholesterol, you might
(28:40):
start getting prescribed a cholesterol medication a lot sooner than
you would have maybe two or three years ago. Again,
because the guidelines are just based on the latest information.
As basically stand a man, if we can keep that
cholesterol down to a minimum, then plaque has no chance
(29:01):
to develop. And even if you've already had an event,
Let's say you've already had the stroke, you've already had
the heart attack. Maybe you've had some X rays and
some ultrasounds of your carotid artery and your doctor has
picked up some plaque in your carotid artery. Maybe they've
looked at the blood vessels in your legs and they've
(29:22):
picked up some plaque development in your legs. If there's
any evidence or presence of plaque that is known to
the provider, and you can assume you have plaque if
you've had a stroke or heart attack, right that, you
know you're the patient that necessitates the most aggressive form
(29:43):
of cholesterol management that we know, and we want the
cholesterol to be pretty low. And their new target right
now is fifty five what we call LDL the bad cholesterol.
You've heard of that, right, anytime you get your straw profile.
A lot of patients are looking at their own information.
Now now that there's patient portals and you can go
(30:07):
on your website and look at your labs and your
X ray reports. The LDL, which is called the bad cholesterol,
tends to be what we call more orthrogenic, meaning it
tends to generate more plaque. The higher the level it
tends to undo that. As compared to the HDL type
(30:27):
of cholesterol, which is considered the good cholesterol. You want
that to be as high as possible because it tends
to defend you against plaque development. So basically, if you
look at your cholesterol profile, you want the LDL number
to be as low as possible. I guess as close
to seventy as you would like it to be, a
(30:50):
below one hundred, and you want the HDL cholesterol to
be in the fifty sixty seventy range. So one up,
one down. That's really the ratio that you would like.
But most of us, unfortunately again because of our habits,
were not bad people just trying to make it out there.
But again a lot of the food items and beverage
(31:13):
items in our presence, the food items and beverage items
that we consume on a regular basis, because it's available,
it's cheap, we like it, it tastes good. I grew
up drinking it. I grew up eating it. Why is
it now poison? I don't understand that everybody in my
family drinks that. Everybody in my family eats it. It's being
advertised everywhere, It's wherever I go, It's there in front
(31:35):
of my face. I mean, how can this be poison? Right? So,
because of our consumption of those ultra processed products, normally
the HDL is low and the LDL is high. That
is the chemical reaction of consuming those type of food
(31:58):
and beverage items to make you more apt to form
plaque as a result of the chemical reaction of these
products that you're drinking every day and that you're eating
every day. So most Americans' cholesterol profile is more likely
to cause plaque. But the pharmaceutical company they have taken
(32:24):
care of that. Right. We now have more cholesterol medications
than I've ever had access to to help patients get
their cholesterol down to an LDL of fifty five. Right,
you've had a heart attack, you've had a stroke. They
want the LDL down to fifty five, and that's the
(32:46):
lowest it's ever been recommended to get. Seventy was a
few years ago, and most providers like, how are we
going to get there to seventy? We know how this works, right,
It's hard to get patients to seventy. It really is
just by diet alone. It's kind of hard. So you
(33:07):
normally need a pharmaceutical product to get it down to seventy.
Now they want it down to fifty five. Again, this
is for those patients who've had the strokes or heart attacks.
They have a lot of vascular disease already established. This
is for that patient. So now we have several more
(33:27):
cholesterol medicines other than the one you're familiar with, the
statin category, right, The lipiatur zo core semastat been out
for many years and really a great category, one of
those super duper category of medicines that doctors use every day,
very popular. That has helped Americans and doctors control plaque
(33:52):
development and stabilize cardiovascular risk. But again, side effect issues
come into play. Costs come into play. Sometimes just the
potency of the drug, even though you're taking the highest dose.
Again because of your genetics, because of how your body
interacts interacts with these drugs, we can't get your cholesterol
(34:19):
to what they call target. Right, there's a target that
we're looking for. And again the previous target was seventy.
We want the LDL to be seven. Again, I'm talking
about high risk. You've already had strokes and heart attacks.
These are considered high risk patients for secondary events. We're
trying to prevent another event from happening. They want that
(34:42):
cholesterol to be fifty five fifty five, so that means, primarily,
in my opinion, you might need to be on more
than one cholesterol medication. And normally that's what that means.
You're gonna need to be on at least probably two
or Again, we now have all these options, you might
be on three cholesterol medications. Again, not for everybody, not
(35:06):
general population is probably going to be for a small
segment of our patients, probably thirty five percent of our
patients would probably need to be on two or even
three cholesterol medicines to get to goal of fifty five.
And again, you've had this struck heart attack. We don't
want nothing else to happen. That's always a patient's concern
when they've had the big event in the hospital. What
(35:27):
can we do so that this won't happen again? There
you go, get that LDL down. The fifty five phone
lines are open eight nine six kV ot won one
hundred three three zero ko Yeah, I'll be back in
our last segment. All right, welcome back to the doctor.
(35:53):
We meta. Our phone lines are open eight nine to
six kalvy ot won one hundred three three zero Kova.
I Remember, if there's a topic you'd like me to discussed,
just call my office four nine three four seven three
six two one, or you can call the radio station
and leave that topic and we'll be more than happy
to talk about it. Remember, this is the genesis of
(36:13):
the show, just to try to make this thing as
easy and simple and straightforward for you as possible. It's
complicated out there to figure out what is good what
is bad a lot of times, and we're just trying
to make it simple again. We discussed the category of peptides,
these nutraceutical dietary supplement that you can get for yourself
(36:34):
to see if it can help you feel better, work
out better, have more endurance, it's the sort of the
latest category that they've discovered. The human body is a
very complex chemistry machine, and there's just all these different
areas that can be tweaked or augmented or influenced, and
the peptide category is sort of the latest on the
(36:55):
market to see if it will help you. Homer and
placement therapy has been very popular for many years. It's
the same idea, right, it just don't feel good. I
want to feel better, I want to have more strength,
I want to look a certain way, I want to
skin look better. I don't want to be tired. The
list is pretty long, so how can I do that?
So hormone replacement therapy is another way to do that,
(37:18):
And you can look at peptides kind of as a
hormone sort of replacement or augmenter that you can take
that can sort of increase or decrease certain levels of
certain hormones that then tell your body to do X
or Y. So it's sort of the idea, right, We're
always sort of playing around with our bodies and trying
to figure out what works. It's nothing wrong with it
(37:40):
most of the time. It's relatively safe. Again, no matter
what product that you consume, you get from your provider,
you get it over the counter yourself. Just be aware
and be ready for the risks of taking any sort
of product for a polling period of time. Most of
the stuff is pretty benign. Again, most these companies that
are producing these products, they don't want to any pr nightmares,
(38:02):
any politic relations nightmares, not in the environment that we
in where if anything goes wrong, I mean very rapidly,
the public knows about it. So again that's not good
for business. So a lot of times they don't want
to put a product out there that they know is
sort of toxic. They know it's not a good product.
So most of the time, but the most part it's
(38:23):
a good product. It's not going to change any I'm sorry,
it's not going to hurt most people. The risk is low,
and so they introduce to the market. But at the
end of the day, you kind of have to do
your own investigation and try it out see if it
works for you. And again, I just spend a lot
of time talking about cholesterol management just so you know,
moving forward, you might be prescribed to cholesterol medicine even faster.
(38:49):
And again, there's two different categories, right what they call
primary prevention and secondary prevention. Primary is when nothing has
happened to you and your healthcare provider is trying to
prevent any event from happening to you. Secondary is when
something's happened. You've been to the Hospel, you have this stroke,
and we don't want a second crisis to happen. So
the dosing of the medicines, the type of medicines are
(39:11):
different for both of those categories, but based on the
current cholesterol guidelines. Again, another risk factor for cardiovascal disease
that we look at all the time. We want the
numbers lower and lower and lower, and we want the
medicines on board sooner and sooner and sooner. Again, we
have better risk calculators, yes, risk calculators that your provider
(39:33):
can plug in some basic information and kind of figure
out your risk. And if the risk is high enough,
then a lot of times you warrant a cholesterol management
from a pharmaceutical product such as a statin or the
list of other medicines that are out there that are
now on the market to help lower your cholesterol other
(39:53):
than eat right and be physically active and don't drink
sugar because those activities tend to make your cholesterol profile
more what we call athrogenic, meaning it's going to form
plaque given time if you continue down this road. So
that's why diet is number one. But a lot of
(40:14):
times we would need a little help from a pharmaceutical friend,
and that can be a statin category on top of
the other three categories that are now on the market
that helps which were not available. So it is possible
that for cholesterol alone, you might be on two or
three medicines on top of your blood pressure medicines, on
(40:36):
top of your diabetes medicines. Ugh, I don't like it
any more than you do, to be honest with you.
Just I guess been in the game over twenty years,
and really it's upsetting when a person walks in having
to take all of those medications like that. Just I
feel for that patient because that's expensive and that's time consuming. Right,
(40:59):
your whole day is just about taking these meds, But
a lot of times it's just about cleaning up that
diet and eating food items and drinking food items that
do not generate inflammation in your system. Inflammation is a
big plaque producer as well, and the diet has a
(41:19):
lot to do with it anyway and draw your weekend.
Stay dry, don't drink and drive. We'll see you guys
next week. Take
All right, welcome in and that radio listeners Southeast Texas,
welcome to another edition of the Doctor Levine Medical Hour.
Hopefully having a wonderful Saturday morning. If you haven't looked outside,
it looks like hurricane season out there with all the
rain and the wind and treated limbs are down. Man,
(00:20):
it just looks like it does when it's in September
October area in this area. So man, big rainy day
to day, good day to stay in sad, list to
some good radio, and take care of business inside the house. Anyway.
Phone lines are open. We're here every Saturday morning normally
(00:40):
if there's no vacation, answer your phone call. Is trying
to help you understand what is good for you, what's
good for your family to as the theme song says,
stay alive as long as possible, and just hell this possible?
Remember we don't. And it's a drag. I have to
go to the hospital and the offices of doctors all
(01:02):
the time and take a sacamedge with you out all
the time. It's a drag. Who wants to do that?
So you have to do your part though, to stay alive.
It's no longer automatic as you get older, when you're younger,
you can do all that stuff. You can eat whatever
you want to drink or whatever you want, nothing happens.
You can stay up all night, you can go to
(01:24):
work with minimal sleep. I mean, just your body is
strong and you can just tolerate all this abuse. But
as you get older, just the aging process kicks in.
And that is again I want to let everyone know
that process is real, you know, getting older, it's a real,
real process. I know sometimes patients get a little perturbed
(01:47):
at doctors when they say, well, I mean you're such
and such age. You know that, you know, they want
to believe it's got to be something else. I mean,
stop just saying that. Let's look into something else, which
we need to do, right. I mean, I think there
can be so much overlap with these diseases. We only
have so many physical symptoms that we have. We have,
(02:08):
you know, about ten physical complaints that typically takes her
about ninety nine percent of the physical diseases out there
that we deal with only ten, Right, and it's up
to your practitioner to figure out which out of the
hundreds of diseases out there is the one that's bothering you.
(02:31):
So it can be tough sometimes, so just be patient
what it's out there and work with this, and we'll
work with you, and we'll do our best to get
your answer as fast as possible. That certainly is our
goal every time we interact with you, is to have
the right answer. The first visit gets you on the
(02:53):
right medication. It works, it's a success for everybody, for
the practitioner as well as for the patient. I mean
that is our primary goal every day, is to try
and discover what it is that's bothering you and gets
you better as fast as possible. But it just doesn't
work out like that on every single case. There are
(03:17):
cases that we just don't know what is wrong, even
though we've tried this. We've tried that, we've been through
our wave of diagnostic testing and maybe a lot of
laboratory work, and we still just don't have a clue
as to what is causing the physical symptom. Frustrating, frustrating
(03:41):
certainly for both parties involved. But it happens every day,
and I've tried to remind listeners that you have to
be open to being reassessed, especially if you go in
and talk with your provider or you go to a
minor care and you are a hospital, maybe you've been hospitalized,
(04:01):
and you were there for a few days. You got
a lot of testing, and you get all these sheets
of paper with these diagnosses on it. But once you
get home a few days later, things don't get better.
Maybe they slide backwards, you get worse, maybe you get
some new physical complaints. You know, you have to go
back in and get reassessed. Whether you would like to
(04:23):
be reevaluated by a different team of doctors or the
same doctors, it's certainly up to you, but I think
you have to have an open mind about that. That's unfortunately,
how sometimes these diseases get found is getting reassessed at
a later date. Just the diseases can mature, as I say,
we'll get that a lot with connective tissue diseases, diseases
(04:45):
like lupus or matarathritis, and just a lot of other
diseases are like that. There's sort of a day one
presentation of diseases and just you're not getting a whole
lot of physical complaints. You know, things are off put,
can't put your finger on it. It's going to require
you know, several more days of just monitoring a lot
(05:06):
of times we do that there in the hospital with
patients who get admitted. That's a big reason a lot
of times to get placed in the observatory facility, if
you will, which we call the hospital the modern American hospital,
the observatory facility, right, because a lot of what we're
(05:27):
doing is just watching you. Right. We're taking your vital signs,
we are monitoring your heart function, we are monitoring your physiology,
if you will, by checking your blood work. We're checking
your kidney function, your bone marrow function, your electrolytes. It
really paints a picture for health care providers in terms
(05:49):
of what is going on with your human body. And
all of that information allows healthcare providers who are trained
to make a diet noses about a hospitalized patient to
help them sort of fine tune their impression about what
it is or what it's not. And again, so a
(06:11):
lot of patients once they get in the hospital are
ready to go, but a lot of times we just
want to watch you and sort of see what happens,
and that will allow us to make the right diagnosis.
So just be patient with is, have an open mind
about it, and we'll work together to try and figure
out what is wrong with you. But it is a
(06:33):
messy outside. A good day to stay inside and just
hang out with your family, clean up the house, get
to those house chores that you've been getting to a
lot of times. It's just driving around in this sort
of weather. It's dangerous as well, and it's just kind
of better to hang out. Now they have all these
sort of home services where you can order this and
(06:53):
order that, and you don't necessarily have to leave your house,
So maybe that's it's a good day to do that.
But again, if you haven't had your vaccines, go out
and get those. We have a lot more on the
market now, whether you get from your doctor's office, get
it from your pharmacy, we don't care. Just go out
and get that. The immune system is at work every day.
(07:17):
But again, aging getting older doesn't work as well. We
hear so much about heart attacks and strokes and dementia.
We talked about that a little bit a couple of
weeks ago. And infections are huge, huge, huge issues as
one gets older, whether it be pneumonia or a bladder
(07:38):
infection or bloodstream infection which we call back to remia.
That is very, very common. Just because we get what
we call immuno compromised as we get older. So these
vaccines really are targeting certain organisms that are common in
(07:59):
this age category. It's not a complete complete protection, but
again we're targeting certain organisms that appear to have a
very common occurrence in the older population or as you
get older, and getting these vaccines in will just again
(08:19):
boost your immune system, remind your immune system how to work. Again.
Your immune systems kind of like a military just kind
of on standby in case it needs to defend its
land or its body. It's on standby. So you want
to have as much artillery as possible, and that's basically
(08:40):
what vaccines allow you to do is develop your artillery
and the different options you can defend yourself if you
do get an invasion by an organism, whether it be
a virus or a bacteria, and keep the severity of
the disease to a minimum. Oh often you hear about
(09:02):
loved ones, family members going into the hospital a week ago.
They were doing fun, right, they were driving, they were
cutting the grass, they were just taking care of themselves,
just going through life, no problems, and then within twenty
four hours, forty eight hours, I mean, they are fighting
(09:22):
for their lives. They're on breathing machines, they're on medicines
to keep their heart working and their vascular their blood vessels,
their blood pressure up. I mean, this stuff can happen very,
very rapidly with these infections. So vaccines really help decreasing severity,
giving you protection, keeping you out of that hospital so
(09:45):
that you don't have to fight for your life like that.
I know that it's frustrating talking to patients. I think
there's an assumption, if I get a vaccine I did,
I should never get sick. It should protect me like that,
And I think that's the idea put in general. Again,
it doesn't work out that way, but it does. It
does in my experience what I see decrease the severity
(10:10):
of infection. It's all you're trying to do, because again,
getting older, you're just more vulnerable. You're weaker. Your body
doesn't heal as well, it doesn't protect itself as well,
it doesn't like a lot of physiological stress, which we
call sepsis, that term that you're becoming more familiar with
in the general population against Sepsis is a medical term
(10:32):
we use to describe what happens to the human body
when it gets infected, your heart rate might go up,
your auction level might fall, you might get some fever,
your laboratory work will look a certain way, and we
can see that picture and it alerts us to the
fact that maybe there's some active infection and we sort
(10:53):
of need to get on top of it as soon
as possible. Again, because if that sepsis engine keeps hump
and it gets worse and it accelerates, it can cause
some damage to the human body. To although the vital
organs like your brain and your heart, and your kidney
and your liver, which is what we see a lot
when patients develop what we call sepsis, it can cause
(11:17):
what we call multi organ failure, and the more organs
that is failing at one time unable to sustain that
for a very long period of time, and sometimes patients
just sort of lose the fight, lose the battle, the
physiological battle of acute medical crises. And it is sort
(11:39):
of a surprise or a shock when family members see that.
But again, this stuff happens every single day. It's again,
like anything else, you need to be strong in order
to withstand a physiological stress, and just unfortunate, a lot
of us are not at that level when we get
older for various reasons, and we need as much protection
(12:02):
as possible. So go get your vaccines today. Well, let
it drive a little bit and then you can go.
And certainly, as I've mentioned to you, try to prioritize
eating that good diet, a lot of vegetables and don't
drink sugar. Phone lines are open eight nine six kov
I want one hundred and three to three zero Kalva.
(12:22):
We'll go on our first break, be back in two minutes.
All right, welcome back to the doctor p Metica. Our
phone line to open. Eight nine six kova I won
one hundred three three zero kio v I chatting And
(12:46):
just a very very wet Saturday morning. Good time to
stay inside, hang out with the fam, watch some games,
order out, yes, and not driving this wet, wet Well,
unless you're going to get your vaccine, of course, then
you have permission to do that. Wouldn't that be cool
if you could order your vaccines at home? Right, you
(13:08):
could go to a website and someone will come out
to your house and give your vaccine shot. That would
be so awesome. Or if they were tablets or pills capsules, right,
your vaccine capsule that would be awesome as well. But
we're not there yet, but we might be there again.
There's a whole industry that's in the background working on
(13:30):
vaccines and trying to work on the technology make it faster, cleaner,
more efficient, and we've come a long way. It's been
some conversation about the position we at right now with vaccines.
Every time you wake up, there's a new vaccine, there's
a variant, and you got to go get a booster,
and you hear a lot about that. Sometimes I can
(13:52):
little confuse myself, but certainly work with your healthcare provider
or your pharmacy, which has taken over that respect responsibility,
to become a partner in that responsibility and providing those vaccines,
which I think is a win win for everyone involved.
And unfortunately a lot of patients are using the pharmacy
every single day to get their prescriptions, fill their prescriptions,
(14:16):
and they're already there anyway, just like you go into
your doctor's office, your healthcare provider's office, that you're already
there anyway when I just go ahead and get your
injection so you don't get Stepsis Rocky from bomat. How
can we help you.
Speaker 2 (14:30):
Hey, good morning, the first time called her. I've really
had a question in your opinion thoughts on the injections
pep tide injections, any opinions on that? What's your thoughts?
Are all pep tide injections?
Speaker 1 (14:45):
Just and yeah, rockey, thanks for that question. Just to
be clear, peptide injections are you referring to like a
g LP one injection, like a zimpic or with govi
or what? Do you have a name brand of a
medication well for peptides?
Speaker 2 (15:00):
Well, yeah, sorry, it's not none of those. It's kind
of like a recovery. It's got different ones than a recovery.
Speaker 1 (15:09):
Okay, it's not a prescription medication. It's something you might
get from a different healthcare provider or how do you
get it?
Speaker 2 (15:18):
Yeah, that's correct, absolutely all right.
Speaker 1 (15:20):
And so the idea is that this peptide is supposed
to help you recover faster if your exercise or provides
some strength or endurance with exercising. Is that correct?
Speaker 2 (15:32):
Correct? That is correct?
Speaker 1 (15:34):
Is it supposed to help in any other way help
you live longer, control.
Speaker 2 (15:39):
Appetite, immation, arthritis, inflammation, and things of that nature. Recover
Look quicker as we get older.
Speaker 1 (15:47):
Yeah, I guess you can tell. I can expert on peptide,
but I have heard conversations about peptides. Again, everyone is
looking to feel good, look good, and live as long
as possible. And I think every year there's sort of
a new ingredient, to new injection, a new supplement that
(16:08):
might sort of be the one that can help all
of Americans feel the way they want to feel. And
I guess the peptide category is the newest, latest, and greatest.
My position normally on these sort of supplements, if you will,
is that it's worth a try to see if it
helps you. Just like with prescription medications, they've been studied,
(16:32):
they've been efty approved, but when we put it into
the open market, the open world, if you will, every body,
every person has a different reaction to these medications, and
you may not get the reaction that you're looking for.
But I think if you're suffering with your physical health,
then you want to feel better that these peptides can
(16:53):
be an option for you. As long as you agree
with the risks of taking this product and you're working
with a healthcare provider that has a knowledge of this product.
I think it can be something that a person can
try as an option to make them feel well. You know,
try it for a few months and see how you do.
But it's not going to work for everybody, but you
(17:15):
know it's worth to try. I mean, creating that was
something that was very popular for a while. There's this
typically again always something every year or so where this
is sort of the new latest version of the magic peel,
if you will, that's going to you know, fix all
of our elements. And just unfortunately that our body is
(17:35):
so complex, it's multi layered that normally it's it's not
going to be one just one little supplement that's going
to fix everything. It's normally collection of things that you
have to do on a regular basis to feel well.
You know, you got to eat well, you have to
sleep well, you have to not drink sugar, you can't smoke,
(17:56):
you can't drink alcohol, so you got to have to
write genet eggs and it's several things that sort of
need to be in place. It's not just going to
be about let me get this in one injection and
inject it and it solves all of our problems. Now
for some it works that way, right, but for most
of us, it's not going to be that easy, but
(18:16):
I think it can be a good option to try
if you're in that position and you're looking to feel better.
Speaker 2 (18:21):
Yes, sir, well, I certainly appreciate you taking my call
and I enjoy your program. Thanks a lot.
Speaker 1 (18:26):
Well, I appreciate it, Rocky, And you stay safe out
there and be aware of the wet weather and drive safely.
We don't want any accidents out there. But all of
the dietary supplements out there, the peptot category, it's it's
brand new. Having read a lot about it, again, a
lot of these, as the color mentioned, a lot of
(18:47):
these substances are available to you sort of directly without
the involvement of a healthcare provider, licensed medical provider, and
you can sort of get your hands on these things
yourself and again do your own reason and I don't
have a problem with that. I really really don't have
(19:09):
a problem with that as a healthcare provider, just because again,
doing your own investigation, I think is a wonderful way
to try and figure out what works for you. A
lot of times your health care provider he or she
is not able to research this at length, right, but
(19:31):
in your leisure with the aid of the Internet, I mean,
just the information highway like that, all that information is
available to you. You can certainly do your own homework
and then bring that to your healthcare provider and both
of you can look at it to determine if it's
right for you, and then you try it. And it's
like all these other medicines that we prescribe that you
(19:54):
need a prescription for a lot of this is sort
of a trial to see if it's going to work
for you. For blood pressure, for diabetes, for high cholesterol,
for depression, for headaches, for rashes, for joint pain. I mean,
just all of us in these situations are trying these
(20:14):
medications as a trial to see if it's going to
help you. In general, the medications we prescribe have a
sort of low toxicity level. Otherwise, most practitioners just don't
prescribe it because they don't want the toxicity impact of
the medication. They normally don't recommend high toxicity medications to
(20:36):
their patients because they just don't want the risk of
it harming their patients, so they just don't write for it,
or there's a conversation about it before it's handed to
the patient that hey, this is the risk. Do you
want to accept the risk? Yes or no? Yes, Okay,
I'm gonna write it. I'm a document that I talk
to you just because hey, yeah, it's it's high risk.
(20:57):
Something might happen. Same thing with the pepti category. Certainly
if it's you don't need a prescription for the product.
You have to do your own research and figure out
for yourself if you're willing to expose your body to
this new product. Whoever makes it, the name of it,
the manufacturer of I'm sure there's probably different manufacturers out there.
(21:19):
Which one is the best one, which one is the
right one? A lot of that information, again is unknown
as these products hit the market just because of the
laws of the land. You know, if it's a certain
type of food supplement or a certain type of what
we call nutraceutical, it doesn't require the type of intense
(21:40):
testing that prescription medications require. So a lot of that
information or so just sort of what is the expectation
of medication is really not known for each particular product.
I know a lot of patients like, but what's the
best product? You know, between this one and that one?
Which is the best We want the best for ourselves.
(22:03):
And a lot of times these what they call head
to head studies, they're just not out there just because
it's it's a lengthy process, it's an expensive process, and
it's a risky process, right these pharmaceutical companies, I mean
this boils down to a lot of what they call
market share, and the more market share you have, obviously
(22:26):
things go a lot better for you if your product
is in the market and it's the most prescribed products.
So if you potentially do some study and it finds
out that your product is not so good and it's
the other guy's product, and that might get out and
who wants that, right, So a lot of these head
to head studies are just not done, so we never
(22:47):
know which one is the strongest, are the best. Again,
as I've mentioned to you, doctors are their own sort
of investigators and healthcare providers and those practitioners pas do
their own sort of mental investigation with the medicines that
they are prescribing every single day for all their patients,
and they sort of see what happens for them in
(23:11):
terms of which products bring success, which products don't bring success,
which products have the high callback rate, which products cost
the most and I get phone calls back. Yeah, sort
of have a mental idea about that, and that influences
the medicines that you prescribe, which is why you can
(23:32):
go to one doctor and get this for blood pressure,
you go down the street for the same blood pressure,
the same lab results, and they're giving you something different.
And unfortunately, that is where we're at right now in
terms of prescribing. It's all about the habit and what
you've been exposed to, what your experience has taught you.
(23:53):
Even though we read the same books, take the same tests,
just our personal experiences going to dictate how we sort
of manage our patients. And unfortunately that's just the way
it is. But thankfully, like I said, get reassessed. Whether
it's by the same doctor, different doctor, doesn't matter. You
(24:13):
deserve to get a second opinion. You're just trying to
get information, just trying to feel well. And if a
peptide is right for you, if it makes you feel well,
how can anyone argue with that? You feel tired, you
have headaches, You want to have more endurance, you want
to sleep better, you want to mentally feel more stable.
(24:35):
You're looking for the answer, the magic ingredient if you will.
And I think again, it's just how our mind works.
We want to try and keep it simple. Just what
can I do one of two things I can do
to make it pretty easy for me, simple, straightforward. I
don't have to do a whole lot. And again the
peptide category. Again I don't know a whole lot about it,
(24:57):
but it is out there. Is my a good solution
for you. But do your own homework, try it out
for a few months. Make sure you don't break the
bank with it, because a lot of times these products
are I mean they're normally in the hundreds range per month.
And again, just do a limited evaluation on your own
and see if it works for it, and if it
(25:17):
does doesn't cause any problems, Hey, maybe that's the right
thing for you. Phone lines are open eight on six
kalo if you out win one hundred and three to
three zero Okay, I'll be back in two minutes. All right,
welcome back to Talk of the Medica. Our phone lines
(25:38):
are open eight on six ko if you out one
one hundred three three zero O kof yea. I talking
with you on a very very wet Saturday morning, So
be careful out there. If you're driving drives slow, you'll
get there eventually. Just don't want any accidents. One thing
that's happened in the past couple of months is the
cholesterol guidelines for all healthcare providers sort of changed, and
(26:04):
I thought I would just give a brief understanding of that.
It might explain to you maybe some prescribing habits that
might change from your provider in the next several weeks
to months. And as you know, like I said, most
doctors like myself, priminent care physicians on the front lines,
we have sort of this collection of guidelines that have
(26:28):
been put together by experts in the medical field. They've
looked at all the latest research and they pump out
these guidelines that we can kind of go to in
reference on most diseases that we're treating. You may be
familiar with this if you've had cancer, and no matter
where you go M. D. Anderson here locally here in Beaumont, Texas,
(26:52):
the guidelines in terms of how to treat these diseases
or very strict, the most strict I've really seen in
all of medicine in terms of treating cancer. But cholesterol guidelines, again,
it's changing all the time about every few years we
get better or the latest update on the guidelines, and
(27:13):
it sort of tells doctors what you should be doing
with your patients as it pertains to cholesterol. As we
all know, cholesterol is one of the identified risk factors
for cardiovascular disease, right. That's the big problem in our country,
that plaque that gets in those blood vessels and causes
(27:34):
what we call stenosis or narrowing and causes the little
blood clots to form, which we call thrombus, and in
belize a risk factor for that is the development of plaque,
And we have risk factors for that. High cholesterol, it's
one of them. So it's one thing we focus on
a lot when we see patients. We're always checking the cholesterol.
(27:56):
So they sort of came out with the latest guidelines
a few months ago, thought I would just sort of briefly,
superficially explain kind of what they are recommending to healthcare
providers so you can kind of maybe figure out why
certain things are happening. And the bottom line with my
(28:16):
understanding of this is that they basically want cholesterol, high
cholesterol treated sooner and more aggressively in anyone who might
have a risk factor for cardiovascular disease, and so that
means that when you're provider checks your cholesterol, you might
(28:40):
start getting prescribed a cholesterol medication a lot sooner than
you would have maybe two or three years ago. Again,
because the guidelines are just based on the latest information.
As basically stand a man, if we can keep that
cholesterol down to a minimum, then plaque has no chance
(29:01):
to develop. And even if you've already had an event,
Let's say you've already had the stroke, you've already had
the heart attack. Maybe you've had some X rays and
some ultrasounds of your carotid artery and your doctor has
picked up some plaque in your carotid artery. Maybe they've
looked at the blood vessels in your legs and they've
(29:22):
picked up some plaque development in your legs. If there's
any evidence or presence of plaque that is known to
the provider, and you can assume you have plaque if
you've had a stroke or heart attack, right that, you
know you're the patient that necessitates the most aggressive form
(29:43):
of cholesterol management that we know, and we want the
cholesterol to be pretty low. And their new target right
now is fifty five what we call LDL the bad cholesterol.
You've heard of that, right, anytime you get your straw profile.
A lot of patients are looking at their own information.
Now now that there's patient portals and you can go
(30:07):
on your website and look at your labs and your
X ray reports. The LDL, which is called the bad cholesterol,
tends to be what we call more orthrogenic, meaning it
tends to generate more plaque. The higher the level it
tends to undo that. As compared to the HDL type
(30:27):
of cholesterol, which is considered the good cholesterol. You want
that to be as high as possible because it tends
to defend you against plaque development. So basically, if you
look at your cholesterol profile, you want the LDL number
to be as low as possible. I guess as close
to seventy as you would like it to be, a
(30:50):
below one hundred, and you want the HDL cholesterol to
be in the fifty sixty seventy range. So one up,
one down. That's really the ratio that you would like.
But most of us, unfortunately again because of our habits,
were not bad people just trying to make it out there.
But again a lot of the food items and beverage
(31:13):
items in our presence, the food items and beverage items
that we consume on a regular basis, because it's available,
it's cheap, we like it, it tastes good. I grew
up drinking it. I grew up eating it. Why is
it now poison? I don't understand that everybody in my
family drinks that. Everybody in my family eats it. It's being
advertised everywhere, It's wherever I go, It's there in front
(31:35):
of my face. I mean, how can this be poison? Right? So,
because of our consumption of those ultra processed products, normally
the HDL is low and the LDL is high. That
is the chemical reaction of consuming those type of food
(31:58):
and beverage items to make you more apt to form
plaque as a result of the chemical reaction of these
products that you're drinking every day and that you're eating
every day. So most Americans' cholesterol profile is more likely
to cause plaque. But the pharmaceutical company they have taken
(32:24):
care of that. Right. We now have more cholesterol medications
than I've ever had access to to help patients get
their cholesterol down to an LDL of fifty five. Right,
you've had a heart attack, you've had a stroke. They
want the LDL down to fifty five, and that's the
(32:46):
lowest it's ever been recommended to get. Seventy was a
few years ago, and most providers like, how are we
going to get there to seventy? We know how this works, right,
It's hard to get patients to seventy. It really is
just by diet alone. It's kind of hard. So you
(33:07):
normally need a pharmaceutical product to get it down to seventy.
Now they want it down to fifty five. Again, this
is for those patients who've had the strokes or heart attacks.
They have a lot of vascular disease already established. This
is for that patient. So now we have several more
(33:27):
cholesterol medicines other than the one you're familiar with, the
statin category, right, The lipiatur zo core semastat been out
for many years and really a great category, one of
those super duper category of medicines that doctors use every day,
very popular. That has helped Americans and doctors control plaque
(33:52):
development and stabilize cardiovascular risk. But again, side effect issues
come into play. Costs come into play. Sometimes just the
potency of the drug, even though you're taking the highest dose.
Again because of your genetics, because of how your body
interacts interacts with these drugs, we can't get your cholesterol
(34:19):
to what they call target. Right, there's a target that
we're looking for. And again the previous target was seventy.
We want the LDL to be seven. Again, I'm talking
about high risk. You've already had strokes and heart attacks.
These are considered high risk patients for secondary events. We're
trying to prevent another event from happening. They want that
(34:42):
cholesterol to be fifty five fifty five, so that means, primarily,
in my opinion, you might need to be on more
than one cholesterol medication. And normally that's what that means.
You're gonna need to be on at least probably two
or Again, we now have all these options, you might
be on three cholesterol medications. Again, not for everybody, not
(35:06):
general population is probably going to be for a small
segment of our patients, probably thirty five percent of our
patients would probably need to be on two or even
three cholesterol medicines to get to goal of fifty five.
And again, you've had this struck heart attack. We don't
want nothing else to happen. That's always a patient's concern
when they've had the big event in the hospital. What
(35:27):
can we do so that this won't happen again? There
you go, get that LDL down. The fifty five phone
lines are open eight nine six kV ot won one
hundred three three zero ko Yeah, I'll be back in
our last segment. All right, welcome back to the doctor.
(35:53):
We meta. Our phone lines are open eight nine to
six kalvy ot won one hundred three three zero Kova.
I Remember, if there's a topic you'd like me to discussed,
just call my office four nine three four seven three
six two one, or you can call the radio station
and leave that topic and we'll be more than happy
to talk about it. Remember, this is the genesis of
(36:13):
the show, just to try to make this thing as
easy and simple and straightforward for you as possible. It's
complicated out there to figure out what is good what
is bad a lot of times, and we're just trying
to make it simple again. We discussed the category of peptides,
these nutraceutical dietary supplement that you can get for yourself
(36:34):
to see if it can help you feel better, work
out better, have more endurance, it's the sort of the
latest category that they've discovered. The human body is a
very complex chemistry machine, and there's just all these different
areas that can be tweaked or augmented or influenced, and
the peptide category is sort of the latest on the
(36:55):
market to see if it will help you. Homer and
placement therapy has been very popular for many years. It's
the same idea, right, it just don't feel good. I
want to feel better, I want to have more strength,
I want to look a certain way, I want to
skin look better. I don't want to be tired. The
list is pretty long, so how can I do that?
So hormone replacement therapy is another way to do that,
(37:18):
And you can look at peptides kind of as a
hormone sort of replacement or augmenter that you can take
that can sort of increase or decrease certain levels of
certain hormones that then tell your body to do X
or Y. So it's sort of the idea, right, We're
always sort of playing around with our bodies and trying
to figure out what works. It's nothing wrong with it
(37:40):
most of the time. It's relatively safe. Again, no matter
what product that you consume, you get from your provider,
you get it over the counter yourself. Just be aware
and be ready for the risks of taking any sort
of product for a polling period of time. Most of
the stuff is pretty benign. Again, most these companies that
are producing these products, they don't want to any pr nightmares,
(38:02):
any politic relations nightmares, not in the environment that we
in where if anything goes wrong, I mean very rapidly,
the public knows about it. So again that's not good
for business. So a lot of times they don't want
to put a product out there that they know is
sort of toxic. They know it's not a good product.
So most of the time, but the most part it's
(38:23):
a good product. It's not going to change any I'm sorry,
it's not going to hurt most people. The risk is low,
and so they introduce to the market. But at the
end of the day, you kind of have to do
your own investigation and try it out see if it
works for you. And again, I just spend a lot
of time talking about cholesterol management just so you know,
moving forward, you might be prescribed to cholesterol medicine even faster.
(38:49):
And again, there's two different categories, right what they call
primary prevention and secondary prevention. Primary is when nothing has
happened to you and your healthcare provider is trying to
prevent any event from happening to you. Secondary is when
something's happened. You've been to the Hospel, you have this stroke,
and we don't want a second crisis to happen. So
the dosing of the medicines, the type of medicines are
(39:11):
different for both of those categories, but based on the
current cholesterol guidelines. Again, another risk factor for cardiovascal disease
that we look at all the time. We want the
numbers lower and lower and lower, and we want the
medicines on board sooner and sooner and sooner. Again, we
have better risk calculators, yes, risk calculators that your provider
(39:33):
can plug in some basic information and kind of figure
out your risk. And if the risk is high enough,
then a lot of times you warrant a cholesterol management
from a pharmaceutical product such as a statin or the
list of other medicines that are out there that are
now on the market to help lower your cholesterol other
(39:53):
than eat right and be physically active and don't drink
sugar because those activities tend to make your cholesterol profile
more what we call athrogenic, meaning it's going to form
plaque given time if you continue down this road. So
that's why diet is number one. But a lot of
(40:14):
times we would need a little help from a pharmaceutical friend,
and that can be a statin category on top of
the other three categories that are now on the market
that helps which were not available. So it is possible
that for cholesterol alone, you might be on two or
three medicines on top of your blood pressure medicines, on
(40:36):
top of your diabetes medicines. Ugh, I don't like it
any more than you do, to be honest with you.
Just I guess been in the game over twenty years,
and really it's upsetting when a person walks in having
to take all of those medications like that. Just I
feel for that patient because that's expensive and that's time consuming. Right,
(40:59):
your whole day is just about taking these meds, But
a lot of times it's just about cleaning up that
diet and eating food items and drinking food items that
do not generate inflammation in your system. Inflammation is a
big plaque producer as well, and the diet has a
(41:19):
lot to do with it anyway and draw your weekend.
Stay dry, don't drink and drive. We'll see you guys
next week. Take
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