Paul Saladino MD podcast 190. What a cardiologist thinks of my cholesterol, with Michael Twyman, MD
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Nov 21, 2022 Board certified cardiologist, Michael Twyman, comments on Paul's blood lipids and discusses apoB, cardiovascular risks, oxidized LDL, and seed oils. They explore true indicators of cardiovascular risk, insulin resistance, the importance of nitric oxide, glyphosate problems, the Lp-PLA2 test, and mitochondrial health.
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Insulin Resistance Drives Most Clinically Relevant Heart Disease
- Clinically meaningful atherosclerosis is usually linked to insulin resistance, often undiagnosed.
- Insulin resistance impairs wound repair and promotes chronic arterial inflammation leading to plaque progression.
Test Endothelial Function Before Drug Decisions
- Test endothelial function before treating numbers; use MaxPulse and EndoPAT to assess arterial elasticity and flow-mediated dilation.
- If EndoPAT ratio <2 or stiff pulse wave, prioritize lifestyle fixes to restore nitric oxide and reduce inflammation.
Boost Nitric Oxide With Nitrates And Natural Pathways
- Boost nitric oxide with diet and behavior: eat nitrate-rich leafy greens, get nitrate-reducing oral bacteria, preserve stomach acid, and get UVA/UVB light on skin.
- Avoid antiseptic mouthwashes, proton pump inhibitors, and behaviors that kill saliva/stomach bacteria needed for the nitrate→nitrite→NO pathway.