LDL-Cholesterol is USELESS! Measure this Instead: ApoB

[@GregariousAntithesis]

I went out of pocket when the VA wouldnt pay for the comprehensive CardioIQ test that breaks all this down. Bottom line is my ApoB is high 128 but my ApoA1 is also high 172 which creates a ratio of .7 and makes me in average risk because the ApoA1 is so high. I also have a Lipo(a) of 131.8 which is also high and supposedly makes me at higher risk for cardio disease. Yet my HDL and Triglycerides are 90 and 70 respectively giving me a ratio of less than one meaning my metabolism is stellar and healthy and my fasting and average blood glucose is in 70s-90s only goes up around 145 max typically. I was pre diabetic, high blood pressure 200 lbs and reversed all of it been around 160 lbs for a year and a half. My advice is get your standard lipid panel watch your HDL snd Triglycerides as well as your A1C and fasting glucose and fasting insulin if you can. Your HDL to Trig ratio and blood glucose means more than all the advanced lab work can tell you. The bottom line is once you find out your ApoB is high and you are eating right and getting exercise there isnt a damn thing you can do about it. We all will die at some point and all these labs wont change that or help you to fix anything. Additionally i think all the cholesterol hypothesis is largely bunk. Xholestetol is a repair mechanism for damage caused by habitually high blood glucose not from oxidized LDL and all this complex garbage. Its pretty obvious eating processed food which is predominantly grain snd seed, pure sugar and fat poured into a digestive system, liver, body designed for whole food leads to metabolic dysfunction. Insulin resistance is a fallacy type 2 diabetes is a fat storage dysfunction that leads to ectopic fat in the liver and other organs and muscle. Liver damage leads to complete metabolic dysfunction. If the body only has 600 grams of total glycogen/glucose storage snd you continue eating high glycemic food the liver has to convert the excess into fat/triglycerides. Its not that the cells are insulin resistant they are full. So then obviously its a fat storage dysfunction issue not a glucose storage issue. Lastly why would we feed the human body a machine designed to burn fat as its primary fuel a constantly habitual over load of carbs/ glucose. At rest and during day to day activity we burn mostly fat not glucose because glucose is reserved for fight or flight or intense activity. Eat in equilbrium to a slight deficit snd get plenty of moderate intensity exercise and let all the stress go about cholestetol. No other animals are dying of heart attacks and strokes or have diet related health issues. You really think the body when fed a whole food natural diet has a problem with cholesterol in the majority of the human species 😂 Its all one big G damn scam for profits. From the science and medical eatablishment to the big corporate agriculture profiting off of and promoting disease. If it grows in nature and we have evolved to eat it or is an animal its largely not going to cause dietary dysfunction and disease. There is nothing natural or remotely conducive to health in processed grain and seed. Animals only eat grain as part of a whole plant not as a ground up pure sugar flour or oil.

[@MasterCarguy44-pk2dq]

Ah but now theyre pushing for "lab grown" meat, aka "Plant Based". They strip the soy and pea of nutriants and vitamins then inject their man-made rubbish into it. B i ll g at es comes to mind as does certain folks from ch yna buying farms in CAN and the states and using their junk seeds to destroy our crops and labd.

[@MasterCarguy44-pk2dq]

So what based on the jumbled mess above do you eat to stay well? Because the last half of your perspective is unclear, do you eat whole natural foods/grains or processed stuff. Some idea of those particular things would be nice. And agreed, if the entire md establishment wanted people "healthy", they'd go out of business.

[@kaitlananderson4302]

Do you know any sources(videos/articles) that talk about the apo b/apo a1 ratio? My apo b is high but so is my apo a1. Also my hdl and triglycerides are good.

[@AdamS789]

My cardiologist keeps preaching statins and pushed back on more through tests. I pushed him towards the NMR test to deeply analyze the particle sizes. He also balked on a CAC score and said both are not called for in the guidelines. My LDL is about 300 now. I’m complete Carnivore. Undetectable C-Reactive Protein, CAC score is zero. All other tests are pristine. Waiting for that NMR but no matter what, there will be no statins for me.

[@lpg12338]

Also, take a look at a carotid intima-media thickness test (CIMT), used to detect soft plaque.

[@fitnesse1288]

CAC is basically a useless test unless your coronary disease has progressed a lot. LDL isn't a perfect measure, but it's a much closer estimator of ApoB than CAC.

[@btudrus]

As long as you are insulin sensitive, forget "cholesterol"...

[@lpg12338]

@@btudrus I agree 💯%. 👍

[@Fullhouse6]

Both hubby and I did CAC scan. Mine 0 hubby 800 and now has a stent! Please fight to get it. Both of us low carb and runners.

[@scottl8469]

I’m an avid cyclist, but last year decided to revisit my training since I’ll be 60 this year. I started a zone 2-based training regimen, including a little running and regular rowing, and resistance. Work out 6 days a week (which careful zone 2 will let you do). Went for a check up, bp- 115/80 (although went to a doc about 4 month and it was 96/58. Lost 30 pounds. Doc comes into my checkup and begins, “this ldl…” and goes on to tell me I’m pretty much on my last leg. ???? I just don’t know what to think about healthcare anymore.

[@fryertuck6496]

"I just don't know what to think about healthcare anymore." Know what the person who comes last in med school becomes? That would be a doctor. 🤔

[@contrarian604]

@@fryertuck6496 It has nothing to do with coming in first or last. They all think this way because the curriculum is wrong, and has never been right. The true problem is a) the food guide, b) excess carbohydrate c) excess added sugars d) processed seed oils, e) demonization of animal and saturated fats f) demonization of cholesterol g) big food and big pharma h) modern medical dogma that makes it hard to reverse or practice counter to the old ways. It's a big mess now, even doctors who know the truth have a hard time practicing contrary to the "established guidelines", as they may be sanctioned for contravening "practice standards".

[@fryertuck6496]

@@contrarian604 My point was that even the worst medical student in every class gets the qualification. You wasted time with that pointless answer.

[@dossegundos7145]

It’s not rare to see Bp under 110, with avid cyclists, some even have a pulse under 40 when 55 to 60 is ideal for athletes. I also think that cycling hard 5 to 6 days a week is too much, if you are not racing or competing, maybe do a very relaxed recovery ride every other day or simply ride 3 or no more than 4 days a week, extreme workouts just increase cortisol and creates other issues like stress and very low testosterone. There is a way to find out if your cholesterol is a concern or not. Total cholesterol minus LDL and HDL and if you get 17 or lower, you are fine, it is called remnant cholesterol

[@williambuckley6128]

I had a similar response from my doctor because my ldl was 242. I told him I was a lead hyper responder. He looked at me and said what the f is that. I also said I would take a Fasting Insulin a test. The result was 2.4. Zero CAC score at the age of 58. I'm waiting for his next move.

[@simonround2439]

Just to confirm your point about high cholesterol not necessarily indicating atherosclerosis. I was given a total cholesterol reading of 350, which was so high that I was sent for a CT scan for a coronary calcium score. This turned out to be zero. The doctor still wanted me on statins though.

[@honkytonk4465]

still wanted your money though

[@simonround2439]

@@honkytonk4465 to be fair, none of this cost me any money. We get free healthcare in the UK

[@terryolay4613]

Tell the doctor he can have your statin portion.

[@thewildwilsonshow]

sweet to see you have a new video as after my blood work my doctor tried to put me onto the crazy statin again - so I had done the ApoB to ApoA1 test and my result was 149 MG/DL. The Cholesterol 292, Triglycerides 147, HDL 67, and LDL 194 - I've been doing best off the seed oils, lower sugar, and getting exercise best I can with bad knee these days. Sleep isn't as happy as I want it if that might make a difference. I do the best I can to be healthy. Daughter who is so sweet and loving says do more for your diet maybe. I enjoy stuff as older at 62. Keep learning and yearning to understand this some how. God bless and have a happy Easter!

[@differentlyabledmuslimjewi4475]

if sleep is bad, honestly just get a CPAP machine. Unless you mean its from some chronic aches in the body.

[@thewildwilsonshow]

@@differentlyabledmuslimjewi4475 it's from dreams actually and not good ones :(

[@diversifiedcollectibles9242]

Try under 25 grams of total carbs a day, your trigs should plummet.. and if you are over weight your other numbers should go down too, people with extra pounds tend to respond well to keto diet (their numbers gown down, more so than thinner people) no more than 25 grams of carbohydrates a day NO ADDED SUGAR BREAD OR PASTAS ETC..

[@黃文鎮-y3q]

Yes, I'll check that next time. Thanks!

[@SD-it8nj]

Hi Mike, I got my blood work results! Can you please tell me if I need to go on a statin Drug? My doctor said you should take it immediately now! Total cholesterol 335 HDL 101. Triglycerides 61 LDL 217. Non-HDL 234 Apo B 148. I appreciate what you’re doing for us.

[@ang1783]

unfortunately my doctor simply reject me when I suggested to add apo a and b tests. So when I want to go more science but usually doctors only care about standard procedure!

[@bobcocampo]

Why not cure diabetes to lower APOB and not statins

[@lpg12338]

My buddy Boddy Ocampo from Dr. Ford Brewer channel, good to see you here! 😁👍

[@yogiyoda]

Doesn't science show that replacing saturated fat with polyunsaturated fat lowers risk of heart disease? With what science are vilifying polyunsaturated fats?

[@beatciunia]

Great video! I have phone consultation with my Lipidologist next week and look forward to discussing ApoB. I'm not sure if can hold my nerves if this person calls LDL a bad cholesterol😏

[@leemanwrong]

I would be finding a new doctor if mine said that to me.

[@HumbleIdeas]

Hi doc, after watching your video, I have the impression that the error in the Friedwalde equation is likely to give a false negative rather than false positive, with regard to whether LDL is too high. In other words, if the figures from lipid test shows LDL is acceptable the real situation will be possibly worse, never BETTER. Which means, there is no point to get additional ApoB check, in case I get a passable LDL number. Grateful if you could comment. Thanks doc.

[@lisaa8795]

It's time? I'll say it's long past time to getting away from reviewing blood work solely for total cholesterol, then LDL & triglycerides exclusively, if you've been getting your apoB levels measured since 2009. Good information, thank you for posting.

[@DaveYadaraf]

Friedewald is no longer used since Feb 2021. Labs now use the NIH formula from Martin\Hopkins, as it is more sophisticated and handles a broader range of TG.

[@Primetime_dads]

I do have one question, since I know my ldl and total cholesterol will jump up with a meat diet, does APOB follow LDL. Because honestly I’m don’t care about ldl, I do care about my APOB. There is honestly no need for me to even do a animal based diet, my blood work is amazing, but I’m just tired of eating plants. So figure I give it a try

[@teresabasson3809]

In my case my LDL followed my APO B.

[@teresabasson3809]

Correction: Sorry. In my case my APOB followed my LDL. Both before Keto and while on Keto.

[@carloslacayo9631]

This is the problem I have with Lipids these past 10 years. 1st if LDL is high lets do Cardio IQ. Nope thats not correct we need to do NMR. Nope that is not enough lets do LP(a). Nope that is not enough lets do a calcium score. Nope thats not right anymore we are checking ApoB now. I try and follow everything and it all keeps changing and frankly I'm quite sick of it. I feel we will never find the true Risk Factors regardless of what diet you follow or medication you take. Statin, no statin, statin, no statin and now its back to statin and PSK9 inhibitors.

[@btudrus]

"Statin, no statin, statin, no statin and now its back to statin and PSK9 inhibitors." Just propaganda. Cholesterol never mattered. It was always a nonsense and propaganda. Insulin is what matters.

[@AshtasticAcrobat]

Exactly!

[@stavross3321]

This obsession with ldl and apob is unhealthy. People with high apob and ldl live longer and healthier. Cholesterol is protective. ❤

[@missdaisydoodle]

My apoB runs about 109 but I have low trigs (58) and a CAC of zero… so not sure what to think.

[@rtay0311]

I notice all influencers say find s new doctor , get this lab get that lab. It’s not the easiest thing to do in America.

[@mikeanthony8699]

You can get LDL measured directly

[@juliebrocklehurst-woods5247]

I have no health problems , my insurance won’t likely pay for an ApoB test.

[@medawurm]

what medications would lower ApoB?

[@bobbruce4135]

What are your thoughts on cardiac calcium CT scans?

[@lpg12338]

It can be a helpful test, just like a carotid intima-media thickness test (CIMT), they may allow you to plan a future lifestyle change, if needed.

[@Fullhouse6]

Saved my husband’s life. Had a score of 800 and now has a stent. Has been a lifelong runner and low carb diet. We were shocked. You never know!

[@andrewholt8356]

Triglycerides over HDL is better and focus on cardiovascular inflammation. Insulin resistance / diabetes is your biggest problem.

[@helios4425]

What's your opinion on The Mendelian randomization trials clearly showing a linear effect of LDL on CVD risk based on lifetime exposure?

[@YouTuber-ep5xx]

Correlation. But not ... (starts with letter c)

[@leemanwrong]

Mendelian randomization is just epidemiology which is associative and cannot inform on cause and effect.

[@knittingknut]

The test for Gamaglutamineal transpeptidase doesn’t even exist in the Labcorp or Quest Walk-in lab menu

[@kundansaran8962]

30 hours of complete fasting I lost 1 kg and it's been consistent over week. Even if one doesn't need to lose weight one can do a full day fast for sure for benefits. Even 20 hours is good for just health if not wanting to lose weight

[@btudrus]

For me, about 4 days of fasting increased by TC from about 200mg/dl to about 350mg/dl. Which inevitably means, ApoB must have been through roof as well. No one should be telling that fasting is increasing CV "risk", that's a complete BS. Clearly, even ApoB is a nonsense. It is not the primary cause of atherosclerosis, maybe some minor factor. Endothelial damage and immune system dysregulation by high insulin and through the Warburg effect in fibroblasts and other immune-system components IS the REAL CAUSE of atherosclerosis. Don't waste your time with cholesterol, LDL-C, LDL-P, ApoB, Lp(a) and all that BS...

[@kundansaran8962]

@@btudrus try asking this science from the experts. They will not know. Sadly we relied on west to lead the way to more discoveries and real science and all we get is dumb correlation and silence on valid questions on healing. This is how a path degrades over time.

[@williambuckley6128]

Can a Fasting Insulin Test get in front of these issues sooner?

[@slantVI]

Yes, to a degree. The Kraft test measures insulin alongside glucose during a Oral Glucose Tolerance Test (OGTT) to see how much insulin is required to achieve the particular blood glucose value. Dr. Kraft identified five patterns, I, II, IIIa, IIIb, IV and V. Pattern I is disease free, and it gets progressively worse. Patterns IV and V have a fasting insulin level over 10 units. So if your fasting insulin is higher than 10, you have metabolic syndrome or type II diabetes. If it's below, you'll need to have a timed series of blood draws after a fasted glucose challenge, then compare to the profiles for patterns I, II, and IIIa / IIIb.

[@btudrus]

Insulin is the only thing that matters...

[@lennonzamora5387]

I remember hearing a while back that ldl-p is the best biomarker--is it splitting hairs between the two? Apob vs ldl-p that is.

[@brandonyoung4910]

If ldl is high you can bet your ApoB is elevated too. Test needed

[@Highintensityhealth]

LDL-C by standard tests doesn't even actually measure LDL particles, it's the stuff inside. Not ideal.

[@johnk6757]

I understand apo-b is better but doesn't ldl c correlate really well with apoB so is a reasonable alternative for regular checkups (i.e. insurance will pay for it, apoB is out of pocket)

[@gageevans606]

There is so much content but did I miss where he says what the numbers from the test should look like?

[@jordanesquetyson8223]

Why do all these keto-carnivore doctors ignore the fact ApoB is causally related to atherosclerosis?

[@winniecash1654]

Because they're told to sell statins.

[@jordanesquetyson8223]

@@winniecash1654 they are against selling statins, they say apo B carries zero risk regardless of how high it is. I dont think any doctors promote selling statins, they are sold as a generic drug, they are very cheap, at least in australia.

[@winniecash1654]

@Jordanesque Tyson everyone I know has been told to take statins. Which means their doctors are pushing it. My doctor told me to take it, and that was because my cholesterol is elevated, but all the other markers are within range, and HDL is high. I wasn't given apoB test, but instead was told to take statin. I won't do it.

[@jordanesquetyson8223]

@@Stefan_Doz it is 100% proven, number 1 cause, not debatable. kzbin.infoitFSkc2brec

[@condoguy710]

my ApoB and my HS CRP were both off the chart. I am at a loss as to what to do. I am 62, I just lost 20 pounds so I am 6'1 200lbs now. My ALT was 26 and my Hemo A1c was 5.0.

[@knockstarstv5711]

take a statin and inhibitor

[@davidny4638]

What supplement regimen do you recommend ? Your intense but all my friends want to know, ok Berberine

[@igorplot4923]

Dear Mike, would you please comment (make a video) on a new study from The Journal of Internal Medicine on Low Carb Diet: " Low-carbohydrate diets, low-fat diets, and mortality in middle-aged and older people: prospective cohort study" the results are a bit shocking... Appreciate your time and effort! Regards, Igor

[@GregariousAntithesis]

Heart attacks and strokes are largely diseases of civilization, diseases of excess and laziness. Before humans created agriculture and started manipulating plants and animals we were eating whole foods like the rest of the animals on the planet. Ask yourself, why would a food we have been eating since the dawn of time, animals, create dietary health issues. It makes no sense to blame cholesterol for causing the damage. Its like blaming the paramedic who is trying to save you for the accident. We were never meant to primarily eat glucose as a fuel our body burns largely fat at rest and day to day activity. Glucose is the primary driver of metabolic dysfunction. When you habitually consume high glycemic foods the liver and body have finite storage of glucose so one the tank is full the liver has to turn excess glucose into fat and obviously this leads to metabolic fat storage dysfunction. Metabolic dysfunction is the driver of almost all dietary disease and obesity. The cholesterol hypothesis needs to die as a archaic short bus theory for disease.

[@camarosspr]

Meat consumption was ultra low

[@GregariousAntithesis]

@@camarosspr not when we were hunter gathers.

[@edrock4605]

I guess I am to stupid can't understand ApoB.

[@jimlofts5433]

Hi from Perth Western Australia - Is ApoB the same as LDL pattern B that is linked to unexplained heart attacks sometimes in very healthy active people in their 40-50's

[@wellnesspathforme6236]

TG/HDL is a decent proxy for oxidized LDL. Oxidized LDL does correlate to bad health comes. It isn’t 100%, but it is easily calculable from a dirt cheap and/or standard blood test, so you can get a history going back in time. I believe if likely represents the toxic activity of iron overload in the tissues, with a possible contributor being elevated glucose and/or insulin. TG/HDL should be less than 1.0.

[@rationalmuscle]

Very true. And all kinds of stuff can skew trigs as you probably know. Wine was the killer for me. Even moderate amounts jacked trigs, which tossed off every other marker and raised OxLDL over 60. That's "high", but not excessive - still it's normally much lower than that. 30 days no wine and back to normal. Everyone's gotta find out what triggers the trigs.

[@wellnesspathforme6236]

@@rationalmuscle Alcohol is the fastest sugar there is, right? It just shows your liver struggles to handle fast sugar (it is a very big club! lol). Do you eat iron fortified foods? These filings are actually quite toxic. Look into Morley Robbins to learn more. Dr. Chris Palmer makes an excellent argument for using keto as a therapy for addressing mood/mental disorders.

[@Texas81999]

I have visited doctors all over the world and only in the USA did they check bp

[@mbustube1]

VA doesn't test for ApoB.

[@jhkdet]

Thanks Mike ! Is there a protocol you recommend to lower apo b , I’m currently sitting at 170 🙃

[@MelsTruth]

Thanks

[@Primetime_dads]

Ok, so been vegan for 8 years, just jumped on a animal based diet. Been animal based diet for 2.5 weeks Got my blood work today, I’m sure all this is from plant based, but some is not. Because my cholesterol did shoot up fast, so that 2.5 weeks of meat and fat did affect it a little. Here are my results, I’m gonna do a 3 month animal based to see how high my cholesterol goes up 😂 So my results were APOB was 68 Fasting insulin 2.2 C-peptide 2.0 HS CRP 0.18 Total cholesterol 160 Ldl 97 Hdl 57 Trigs 40 Vldl 9 My total and lDl are usually 120 total and 50-54 LDL. So I the 2.5 weeks of meat did already affect my cholesterol, which is cool, I already knew that was gonna happen 💪 Anyway, I was just so excited that I’ve been high carb for Almost 9 years and had a fasting insulin of 2.2 No im ready to go eat some meat hahah tired of just plants

[@Manskeeeee]

Are you focusing more on lean meat? I'm in the same camp as you and want to go back to eating meat. My libido as a vegan is nonexistent and I'm tired of it.

[@Primetime_dads]

@@Manskeeeee no I’m eating beef.

[@Manskeeeee]

@@Primetime_dads Fuck it. I'm eating meat again lol

[@SandrinaN]

What if one has high ApoeB or Apoe(a)and such despite being on strict low carb diet, strength train, walk. What then? What is the answer? What more can one do?

[@lpg12338]

Take a look at niacin and how it affects ApoeB.

[@SandrinaN]

@@lpg12338 Thank you for the suggestion.

[@lpg12338]

@@SandrinaN Dr. Ford Brewer has a live stream every Wednesday at 9 AM CST. He has a few videos on niacin and it's benefits. Good Luck! 👍

[@SandrinaN]

@@lpg12338 I will check it out. Thank you.

[@dillonscearcy]

What's your thoughts on Alan Aragon saying theres no direct cause of seed oils and cardiovascular problems.

[@leemanwrong]

He's correct in that we have no cause and effect studies on seed oils. We also don't have cause and effect studies on smoking and cancer but the strong associations we see are enough to show us that its a bad thing.

[@dillonscearcy]

@@leemanwrong ohh that makes sense! Thanks for the reply bro!

[@turtledunkknucklebaby8089]

Yeah don’t bother with ApoB either. It’s not going to tell you anything useful. It’s more or less no different than just having your LDL checked. You won’t get a pattern. Get your HDL and triglyceride and check that ratio if you want. But your A1C is your most useful number. And if your A1C is really low. It’s all but guaranteed your HDL to triglycerides ratio is going to be good. Because it more or less gives of metabolic health in terms of sugar damage.

[@subtropicalken1362]

What are the inaccuracies of ldl direct measurement?

[@nanchesca3950]

My drug- pushing doctor is retiring. Now who will relentlessly try to get me on statins?🙄

[@Buckaroobaby1]

Drugs never helped me. Eating celery did.

[@bobcocampo]

What is the association of HBA1C to APOB? HOMA IR and APOB?

[@rualablhor]

None imo

[@wilsont1010]

APO-B or oxidized APO-B? By measuring just APO-B are we missing the elephant in the room?

[@lu77xiaojun37]

What if your PCP actually has a brain and directly measures your LDL rather than using the quicker, less expensive Friedewald formula calculation? 🤔

[@paulbrowning1758]

Why do you say "It's fair to say LDL is useless?" Are you a scientific researcher, or are you just cherry picking the comments of "experts" who best fit into your narrative?

[@pbziegler]

Peter Attia says ApoB is causal for heart disease but where's the science? The evidence that proves the lower your ApoB the longer you will live is where? I like Peter Attia. He's a really smart guy and has a lot to teach us. But this claim is pure guesswork.

[@Jack-hy1zq]

0.75× 👍

[@itsm3th3b33]

What is your background? What qualifies you to talk about this stuff, in contradiction to doctors' advices?

[@nico2000ad]

Fantastic another gem of info ❤thank you 🇦🇺🦘💪

[@jeffrey4577]

❤

[@vas4739]

My PCP will not get the stratified blood draw for cholesterol so I told him don’t bother even discussing it with me- it’s off the table. I’m nearly finishing my 5th year of keto & fasting- brought ALL my metabolic markers down to really good levels but still working on my HDL/triglycerides ratio- almost there! He said in shock how did it do it… I told him repeatedly I was starting keto & fasting so now I will be starting my 6th year 8/12 … off ALL Rx 4 years this month! I get him to order blood draws so I can measure my progress or where I need to adjust my supplements for OPTIMAL results. He STILL doesn’t understand & fights me on that saying the tests should be once or twice a year. So now I’m carnivore keto… too bad what he wants. I care about my health even if he hasn’t a single clue!

[@TA0096]

Same here and now they want me on Statins! I’m not taking them because that’s a lifetime commitment. My values equal out to a good value. Went to a cardiologist and he told me the same thing. I’m almost at the point of saying it’s more big pharma then it is about my health. It’s scary and very exhausting!

[@junkgirltoo5005]

@@TA0096 fired 2 docs because of pushing statins.

[@TA0096]

@@junkgirltoo5005 I’ve got excellent insurance. And I have LabCorp here. Thanks for letting me know about this!

[@MindOverEverything]

​@Tabby Avoid pharma drugs and NEVER take a statin Marek health has affordable testing services

[@vas4739]

@@MindOverEverything I thoroughly agree with you! I had a 6 day hospital stay for surgery in my mouth and my cardiologist’ colleague stopped to see how I was doing since I am a heart patient and he casually said “I se you’re not on a statin ( I got off ALL 17 Rx ) so my reply was “do I look statin deficient?” Since my bloods show I’m doing fantastic….

[@realDaveFeldman]

Hi Mike -- it's been a minute! Actually, now that I think about it, it's been at least two... we have the 4 papers on LMHRs & the Lipid Energy Model, and the LMHR study is well underway at UCLA. Speaking of -- our participants will likely have ApoB in the very highest % compared to the general population. But will we see a likewise signal in baseline and progression of atherosclerosis at a population level? Per the LEM, I hypothesize this as unlikely given I think there's a clear distinction in functional vs dysfunctional lipid metabolism with regard to resulting ApoB levels, but only our coming data will provide key insights on this given it is the first to prospectively study those with extremely high LDL/ApoB without corresponding ASCVD risk factors (given the context).

[@btudrus]

Lipids don't matter. Insulin does. High insulin causes the usual atherogenic dyslipidaemia. High insulin also causes atherosclerosis by dysregulating the immune system. The doctors got it all wrong...

[@haimeliyahu1]

Thanks for commenting, Dave. Saved me a few minutes to type a similar comment )

[@alertsemail7057]

My APOb and APOa is closely related to his and my hba1c is 4.7 GGt is 8. My blood work actually is very similar to his all the way around. Animal based(pound of meat a day) with fruits and a couple vegetables. Not low carb per-say just “organically” low carb ha glad to hear I’m doing good (I do blood work on my own even though I’m healthy it’s super interesting)

[@claybutler]

This is all smoke and mirrors. High LDL always means high ApoB. It's a mathematical certainty. And since ApoB is the new hot thing, we now have this weird situation where in the keto and carnivore community, people who are completely dismissive of their LDL in the 300 to 500 range, are suddenly concerned about their elevated ApoB. You can't be fine with one and not fine without the other. It would be the equivalent of being fine with your weight in kilograms, but not fine with your weight in pounds. Attia and Dayspring have been aggressively pushing this ApoB narrative. But really, its just a kinder gentler way to tell you that your LDL is too damn high! I'm really surprised how many people are falling for it. So at the end of the day we're still talking about LDL. You're either fine with your LDL level, and level of ApoB that comes with it, or you're not. If you're not then you need to lower your LDL because that's how you lower your ApoB.

[@btudrus]

Correct. Both LDL and ApoB are irrelevant. It is insulin what matters. High insulin / insulin resistance elevates the LDL/ApoB in completely different maner from keto/fasting. The LDL subfractions are still relevant...

[@rualablhor]

Well said 👏

[@ApoBeef]

@@btudrus Stop spreading fake science. The data does not support your hypothesis.

[@lu77xiaojun37]

Smoking is not good for you. It causes lung cancer, which is a much slower and painful death than a nice quick ass kicking heart attack.

[@davidcottrell1308]

yup.....EXACTLY.

[@knittingknut]

At age 70 My ApoB was 134 mg/dl. (shock horror) But I know I’m metabolically healthy so I’m not worried. My waist to height ratio is 0.5 My fasting glucose 72 mg/dl Insulin 2.9 uIU/ml HbA1c 5.2% High sensitivity C reactive protein was 0.52 mg/dl Trigs were 54 Liver panel totally normal CAC was 0 three years ago.

[@HAL-1984]

Yeah nobody seems to explain this contradiction..

[@Sandra-ki2kq]

Those are great numbers ! Mine are not as good as yours. Most recent are trig 78 a1c 5.4 and H crp

[@magicf7076]

ApoB is the newest lipid hype. Forget it. Only if *the ratios* between VLDL (triglycerides), HDL and LDL are out of balance, that could be a *marker* (a symptom!) of an atherosclerotic static.

[@paulbrowning1758]

So you're saying ApoB is B.S., too. That's probably more true than LDL is B.S. The host of this channel is no expert on such matters.

[@JayJay-un3rp]

My ApoB was 133 (LDL 160. I am 51 years of age and have a similar blood profile to yours. Although I have not done a CAC I will do a CIMT this week. From the liver diagram at 12.46 on the video it seems that ApoB is a normal biological process and is not a problem unless or until it becomes oxidated (am I understanding this correctly?). So could it be that healthy individuals like you and I have high LDL/APO-B, but this APO-B is not oxidized, but yet still shows up on the blood count as a high number?

[@grochef]

Thank you for this, Mike. I will take a look at this paper. Dr. Malcolm Kendrick wrote the book, "The Clot Thickens". In that book, he identified the one common issue that led to atherosclerosis: Damage to the glycocalyx and the epithelium. He outlines how only arteries are affected and NOT veins because it is the high pressure and turbulence that causes the damage that calls macrophages to the site of the damage. He also details how myriad things cause the damage: Hypertension, smoking, air pollution, elevated blood sugar, etc. Therefore, it is not that the LDL is bound to the wall of the artery, it is bound to the damaged wall. I need to take that issue and put it together with the ApoB research to see how clots form preferentially with ApoB laced lipoproteins at the site of blood vessel damage.

[@lpg12338]

Yes, I agree 💯 %. Take a look at endocalyx pro and arterosil hp, they are two very interesting supplements for microvascular health. 👍

[@gp74990]

Good point Gregg Rocheford. I think the new focus on ApoB is much like the longstanding focus on LDL. While ApoB is not unimportant, their is no hard evidence to prove ApoB is "causing" atherosclerososis, and I believe the study's use of the term "causally related" is misleading. Rather, ApoB is most likely involved because of other factors. For me, the most important part of the video is at 5:50, where we hear about the danger of oxydation. I'm less worried about the ApoB number than I am about the state of the particles. At my next blood test, I'm getting checked for Oxidized Low-density Lipoprotein (OxLDL), LabCorp TEST: 123023.

[@btudrus]

Not just that. High inuslin prevents the healing of the arterial wall. Why do you think a fatty streak consists of a huge number of not-functional monocytes? Why in every and each step of atherosclerosis you see a dysfunctional component of the immune system? There are two leading causes: high insulin which disturbs the immune system signalling and the Warburg effect (e.g. in fibroblasts) which prevents the resolution of e.g. the firbous tissue. Both of which are caused by eating sugar. Even if you damage your glycocalix and your endothelium, as soon as you are metabolically healthy, your arteries will heal and there will be no "plaque".

[@tommy2c]

Review Dr. Allan Schiederman's work, as well as Dr. Tom Dayspring, there is significant evidence that ApoB is casual for athrogenic disease. It is the most important direct connection to heart disease.

[@grochef]

@@gp74990 Thank you, GP!

[@bobcocampo]

Kraft test on insulin resistance is more indicative of heart attack and stroke.

[@btudrus]

It is because high insulin combined with endothelial damage is the ACTUAL cause of heat attack. Forget cholesterol...

[@randeepwalia1507]

What research are you basing that on? This absolutely does not align with the research done on CVD.

[@kevinlindsay5255]

some fantastic information but i had to watch this video many times as the presenter spoke so fast and didn't leave time for us mere mortals to take in the information. Shame really as the information is really crucial

[@LatimusChadimus]

It's videos like these that caused me to share with a bunch of people. You do some really good research and your presentation is also really good

[@gerard6629]

I don’t know if we will be ever be able to figure out what makes a level proper. Back in 2004 as a vegetarian my total LDL and HDL was 100. Now many years later I eat carnivore my total LDL/HDL is 622. My apoB was 249 with 59 listed as oxidized(I had that tested as well). I have a zero calcium score and had no carotid artery plaque as well. I feel 100% fine no aches no pains and no meds. At 53 my goal is to keep myself feeling the way I do now until the end of my days on this planet.

[@russg1475]

I am a hyper-responder. My total cholesterol went from 200 to 639 after 4 months on carnivore diet (meat, fish, eggs, salt, water, coffee ). I am wandering if I should continue this diet.

[@gerard6629]

Me too, my total rose to 622. I have better body composition than when I was 16 and about the same weight I was back then. I feel incredible and have seen too many positives to look back. I have been carnivore for almost 4 years now. At the end of the day you have to do what you think is best though.

[@camarosspr]

Do a CIMT Carotid study You'll find the inflammation soft plaque In you're artery walls.

[@billdublewhopper3064]

​@@russg1475 you are taking a huge risk

[@bobtosi9346]

@@russg1475 why would you stop

[@Kiskassklan]

My total cholesterol 246...hdl 63...ldl 172 Triglycerides 95. Calcium Score Test..264 I'm 69 years old. Doc put me on Pravastatin 10mg. I was in denial that I hD high blood pressure so I put off meds. I think the high BP caused the Calcium Score. I'm now eating better avoiding sweets and eating small amounts of wheat. My A1c was 5.1

[@chichibonita]

It’s like you knew I needed this video! Was checking this out yesterday! Trigs are 73, HDL 70, LDL was 162 n total Chol was 244 and an A1C of 4.8 my glucose about an hr or two after eating was 96.0 mg/dl on a modified, carnivore lifestyle, mostly removed processed foods, sugar, alcohol, exercise 4-5 times a week. Definitely getting those tests asa so I can know the full picture!

[@mohamedtawfeeq8524]

your apoB will likely be around 180 very very high unfortunately

[@chichibonita]

@@mohamedtawfeeq8524 thanks for your opinion, I’ll definitely get it checked and go from there 🤷‍♀️

[@DiogenesNephew]

​@@mohamedtawfeeq8524 Mine was quite high at 165. I'm going back to my old keto ways from hypercarnivore.

[@Imtoooldtoargue]

Was just told this by my Dr. I laughed so hard that I accidentally dropped the phone and hung up on him.

[@rfbead321]

GPs are essentially useless and ignorant in the lipid concepts. It's all about selling you statins.

[@brandonyoung4910]

If your ldl is high, your ApoB is high

[@arturo8475]

this guy is not a doctor stop lisentining to youtube

[@randeepwalia1507]

LDL is highly correlative with ApoB so, have some humility, call your doctor back and get your ApoB levels checked

[@powerliftercarnivorecoachedgr]

I'll never take statins again. I naively took them 22 years ago when my Dr said i needed them, but after aching all over and not being able to train, I stopped taking it. The more research I've done, the more I see that statins cause a lot of harm and do very little to help with heart disease. I'll stay pure carnivore and drug free, except for my warfarin, because I have Factor 5 Leiden, thank you.

[@KT17555]

I think ApoB links to Carb intake. I had been doing Keto for 5 years and after I started to take Carbs, my ApoB and LDL increased significantly. I think I i will go back to Keto again!

[@phwshopping1426]

I haven’t seen anyone address this I wonder if you’re right?

[@lindamardula733]

Remember the old VAP test? We used that a lot, they no longer have that test. They do have specialized cholesterol testing looking at ApoB, it’s not used frequently, only a very few cardiologist in my area. It’s was not covered by insurance companies years ago when I practiced medicine. I paid out of pocket for my testing.

[@Highintensityhealth]

The VAP was incredibly inaccurate though, too! Glad it's retired.

[@lindamardula733]

@@Highintensityhealth agree, it was the only one available years ago.

[@mlong1958]

I've come to my own theory, after much study, about LDL and HDL. The liver is not stupid. Feed it a proper human diet and it knows what to do. I don't take any drugs that interfere with that intellegence.

[@sarahellen5846]

Until I look at my ApoB to apo A-1 ratio, my labs look like I have bomb in my chest ready to go off any minute. My ApoB/A-1 ratio (130/220) is .59 which is excellent but my doctor wants me on statins and is begging me to limit animal foods and saturated fat because my ApoB is so high. She wont account for this ratio that measures the balance between atherosclerosis indicating B and protective A-1. For context, I'm a 44 yr old female with strong family hx of cvd and have been keto for almost 9 yrs and have had literally zero cheat days. I don't eat seed oils, nuts or processed keto junk food. I eat whole, animal based foods. My family is worried and I'm wondering if I should be.

[@btudrus]

"My family is worried and I'm wondering if I should be." No. Insulin is what matters.

[@carolr.556]

I agree! Why is the ratio of APO-B/APO-A not discussed? I would also check your fibrinogen, homocysteine and Oxydized LDL to be sure you are o.k. KETO is a life saver.. it lowered my triglycerides from 101 to 44! I need to get back on it!

[@luk5827]

@@btudrusWhat you mean exactly ? Need to have low insulin level ? And low insulin resistance ? Why doesn’t matter the Apo B / Apo A1 ratio ?

[@btudrus]

@@luk5827 "Need to have low insulin level ? And low insulin resistance ? " Correct. "Why doesn’t matter the Apo B / Apo A1 ratio ?" Because it is just a marker of insulin resistance / sensitivity...

[@luk5827]

@@btudrus But why doesn’t need to worry about LDL ? Normally LDL can’t be lowered . Insulin and Insulin resistance can be lowered with : fasting , low carbs , exercises . I have LDL = 123 mg/dL , but i don’t know what Apo B and Apo A1 i have . What Insulin and Insulin Resistance should i have ?

[@JayJay-un3rp]

So correct me if I am wrong, but from the diagram at 12.46 it shows that ApoB is a normal biological attachment to the VLDL/IDL/LDL particle from the liver, and is not a problem unless or until it becomes modified through oxidative stress? If this is the case, then could it be that people with a high APOB that are otherwise healthy in all other biomarkers, May have the majority of this APOB un-oxidized, and therefore not atheroslerotic? If so, do tests need to be tuned to distinguish between oxidized APOB and non-oxidized APOB?

[@Malcolm-Achtman]

Some "experts" I follow say ApoB is a rather useless marker as it is a value that includes large LDL particles (that are not problematic, not oxidized, etc.) plus small dense LDL particles. In other words, it's as misleading as LDL-C for all intents and purposes. They would suggest we focus specifically on the "small LDL particle number" and not get too concerned about what your ApoB value is.

[@xiradio]

That's what I've read. Lipo (a) is far more dangerous. If someone is pattern A like me, but by Lipo B is 191 ((a) is 19) I think the real risk is still low since my TG and HDL are in good range.

[@btudrus]

@@xiradio Insulin is what matters.

[@danteburritar2822]

Yep, size of LDL particles matters - and obviously this is what ApoB measures indirectly (generally speaking you want less particles / lower ApoB) but you can’t come out with a certain ApoB value being optimum as it does not take account of particle size which is th emost important thing. So yes ApoB is better than the usual formulae/estimate but not as good as LDL-p test.

[@tktkwei]

I thought LDL-C is linear correlated with ApoB. If this holds true, then there is no way someone with 200 LDLC can have less than 100 ApoB, which still has the same conclusion that it’s bad. So does that mean LDL-C and ApoB measurement give the same conclusion even though it measures different things?

[@xiradio]

Exactly. My LDL is 312, but I'm pattern A with ApoB 191. The fact that I have more than double the "standard" LDL would probably also indicate a matching increase in ApoB. My Lipoprotein (a) is 19. TG 85, HDL 60.

[@fitnesse1288]

You're completely correct.

[@tktkwei]

@@xiradio Yeah, I am really confused about all the talk with ApoB. To me this is just looking at the same conclusion from different angle. My Tg 48, HDL 58, LDL 200, VLDL 7. I am pretty sure my ApoB is more than 100. I did NMR lipid before and it was pattern A. Insulin less than 5, hs-crp 0.7. My LDL is the same as three years ago prior to KETO. I guess I am born to get CVD? 😆

[@btudrus]

ApoB is yet another BS. Just ignore. Concentrate on insulin and metabolic / mitochondrial health, that's what matters.

[@rualablhor]

Ldl (C) is a proxy...meaning proportional to apoB.

[@samuelspade889]

Medical field is captured most doctors are told to sell the pharmaceuticals. Amazingly most patients never figure it out. It’s like they get a reason not to heal themselves and wear their maladies as a Medal of Honor. Listening to type 2 diabetics proudly discuss their symptoms is one weird ass conversation.

[@eliseville]

You fail to see the mental depression that Low D-obese/diabetics get trapped in! Humanity needs to be freed from these traps, not shamed into deeper self-hate. My slow path worked painlessly: 1) Raise D LEVEL > 50ng or 125nmol 2) Go Keto/IF 3) Add exercise

[@dirkmoolman]

You are still ignoring the whole root cause of atherosclerosis, which is sugar. Not cholesterol. Sugar oxidizes and binds to cholesterol. Sugar damages cholesterol. A standard Lipid Panel will not pick this up. You have to look at your Triglycerides, and also measure your LDL particle sizes. Dr. Paul Mason has great videos on this. Sugar causes heart disease.

[@dancetilldawn484]

My PCP she doesn't know how to do the ratios she prescribed a statin for me even though I have low risk based on just my LDL. These doctors will actually wreck your good health my blood pressure is like 117 / 76, my triglycerides are 105 / my HDL which is 84 and total cholesterol these numbers come up is 1.26 + 3.5 beautiful numbers low risk for heart disease. My glucose is 88. It was 20 mg of she left the prescription which I ignored it's actually causes heart disease ultimately especially if you don't need a statin. It's a $30 billion dollar industry.

[@Bernardclement1955]

I have a calcium score of 2450. Statins were prescribed even though my cholesterol levels are fine. I have refused statins. My cardiologist is not happy. I'm 68 5ft 9in and 68 klg or 150lbs. So I'm eating meat , zero sugar , and zero seed oils. I take vitamin K7, berberine, and magnesium with tumeric. I will keep doing what I believe will help me.

[@richardfield5176]

Consider having a CT angiogram with IV contrast....with such a high calcium score, you probably have coronary vessel disease ! A cardiac angiogram may be in your future as well.

[@ddessert314]

I think you’ve gone a little overboard by saying LDL-C is useless. Sure, apoB is better, but that doesn’t make everything else worthless.

[@arnoldfrackenmeyer8157]

So, how long will ApoB be the Heart Disease Villain before they change their minds and it's something else? 10 years? 15 years? maybe 20?

[@dawngonzalez508]

After watching Peter Attia talk about ApoB - I asked my doctor to include it in my last labs. She was like Ap-what? Had no idea what it was! She ordered it for me anyway - and it's kinda high. I'm very reluctant to go on meds to lower it - will you do a video on natural ways to bring it down?

[@anthonyshaw8698]

What😮 She didn't know🤔 These doctor's😕

[@lpg12338]

Check out niacin and how it affects ApoB.

[@dawngonzalez508]

@@anthonyshaw8698 I know, right!

[@dawngonzalez508]

@@lpg12338 I started niacin and Psyllium - hopefully I'll see a difference next time it's checked.

[@carolr.556]

Check your APO-A to B ratio! APO-A is HDL protective Check you CRP, homocysteine, fibrinogen and you VLDL and your OXY-LDL. My APO-is 109 but my APO-A is 177! Ratio is 0.61 low risk! My homocysteine is the problem and I am on methyl B Complex to bring that down! Avoid STATINS!!

[@fastechsystems404]

My LDL is 169 so the cardiologist wants a CT calcium score. Seems like a lot of dangerous radiation. Is that the only way to know if your arteries are filling up with plaque?

[@magicf7076]

Wrong. ApoB is the newest lipid hype. Forget it. Only if *the ratios* between VLDL (triglycerides), HDL and LDL are out of balance, that could be a *marker* (a symptom!) of an atherosclerotic static.

[@uaeio]

What a garbage, without saying what to do about this biomarker

[@DiogenesNephew]

So I'm a very active 32 year-old man and have been at an ideal weight since I was probably 12. I started doing keto several years ago just to be optimal, and Ive been hypercarnivore for something like a year now. My LDL is elevated as one would expect, by my triglycerides are stubbornly high at about 140 mg/dL and my HDL is between 55 and 65. I eat *very* little carbohydrate and essentially zero of that would be from sugar, and I lift weights, jog, and hike regularly. Can you help me understand why this could be happening? Oh, also my CRP is practically zero at

[@TheCoachmy]

I wish you would do a talk like this for us NON-doctors and not native English speaker. Like 'LDL for dummies' - u lost me 3 min in the talk. ❤ From Denmark 🇩🇰

[@BilboSandbaggins]

Same. I wish I was smarter lol

[@y.g.1313]

Look, measuring triglyceride to HDL ratio is definitive and more reliable for cardiovascular risks. No need to go into deep forest like you do about other particles. LDL is not only irrelevant as you say, high LDL is actually good for your longevity.

[@ApoBeef]

There is no scientific backing to your statement.

[@danteburritar2822]

I suspect he means a high level of large LDL particles is healthy - it is small LDL particles that are potentially dangerous : oxidised LDL and LP(a). The best test is LDL-p to test the particle sizes.

[@y.g.1313]

@@danteburritar2822 if your trig/HDL ratio is good (below one ), then particle size numbers are irrelevant, since the first determines the other. Particle size test is about 10x more expensive, while trig/HDL is cheap, part of standard lipid panel. My ratio is 0.53, which is beyond good. So I do not care that my LDL is above 250 mg/dl.

[@bobcocampo]

APOB looks like an indicator only.

[@JMK-vo8pv]

I totally agree, Bobby. Dr. Malcolm Kendrick opines that all this lipoprotein ideology is nothing more than a distraction from the real cause of CAD-inflamed and damaged glycocalyx/endothelium followed by clot and ultimately coronary plaque.

[@jeffreyscottfishman]

I find it almost impossible to have high ldl eat lots of saturated fat on a carnivore diet and still find ways of having a low apo b. If anybody on here is on a keto or carnivore diet with low ldl and apo b please hit me up and tell me how to do it. Without statins!

[@karenlucci2154]

OMG! I just got finished reviewing my blood work results and then your video appears! Perfect timing!.Thank you!!

[@kundansaran8962]

Peter Attia could not even follow a diet with discipline because of cravings. I will take everything from social media doctors with a grain of salt now

[@kundansaran8962]

Watch his video why he couldn't follow keto diet. It was not because he thought of health. That gives enough info on someone's psychi

[@kundansaran8962]

You will do fine. Keep doing good work. Don't stop being active and fasting. I have seen people do very well till long who lived disciplined life. Everything in moderation except temptations for rich foods or junk food

[@thetackroomtx]

Mike , thank you so much for keeping us informed. I have high lipo (a) I moved to a plant based diet 6 yrs ago. It help some, really helped my inflammation. ( I'm 63, 104lb) My Dr, runs all my labs through the Cleavland Heart Lab - I just looked and the requisition form( I make a copy before I take to lab) and there is no test for the Lipo B. they have the AopA1 but not the B - find that interesting. I might just call them and ask. How can I get a list of the labs you recommend so I can go back to my Dr. and have him order the ones that were missed. Thanks again for the content 🙏

[@JesusGarcia-Digem]

All doctors at the Veterans affairs hospitals need to watch this video! They are obsessed with LDL!

[@HigherSelph]

Would you believe Aetna denied coverage of my Apoe test? They don’t cover homocysteine either, unless you need it for certain reasons (mine was high due to MTHFR, but there’s no code for that). What’s more, Quest billed them $4k for my panel-it ended up costing me $135, only needing to pay 20% coinsurance, since my deductible was met. The state of healthcare is horrendous.