Відео

The trouble is that most people confuse change with innovation. They then go about "innovating" when what they are really doing is creating "change".

@@vlmdrounds yeah, it’s often hard to tell at the time if a change will really end up being an improvement.

No! However, I did spend time researching the topic as a rabbit hole I went down when reading on something else...

@@vlmdrounds ah, darn it! 😛

You'd need to shift your clock. I'd say to eat a light meal no later than 1 am (say a protein shake) and then make sure you use an eye mask and drapes to keep your surroundings light-proof. Sleep your 8 hours then upon waking, expose yourself to light. Your breakfast will be later in the day as will all your meals but just follow the 'clock' you have established for yourself and keep it consistent.

@@vlmdrounds interesting that you recommend protein two hours before bed… is that enough time to fully digest it? I know protein is quite thermogenic… although I guess whey is quicker digesting…thanks!

I've had that happen to me and it's pretty scary!

@@vlmdrounds often I’ll also get it when I dream that there is a scary person in my bedroom by my bedside! I wake up in panic but I clearly recall the “waiting period” before I can actually check the room to make sure its clear

Basically you have to sleep 7-8 hours. Your REM sleep is at the end of the night and if you cut shrt your sleep you will not get to most of your REM phases. Check our my full episode on sleep for details: ua-cam.com/video/qdDyR8CAs40/v-deo.htmlsi=02OlOOYJUPLHK6tA Also alcohol and sleeping pills interfere with REM sleep so best to avoid them.

Thank you for watching. I wish we had better quality control on our food supply!

Glad you like it! 😁

I know, it's sad, isn't it? Everything is contaminated these days!

I don't have any on thermochemistry, I'm afraid. What is it about thermochemistry that you want clarified?

@@vlmdrounds I have my exams and I feel frustrated some how I didn't get a good mark on the partial and this us the final ,we are taking thermochemistry hess law and the others law to calculate enthalpy change kichrofs law bond formation or dissociation and born haber cycle it is called maybe and chemical kinetics entropy gibs free energy chemical equilibrium kc and kp

@@samimeat8239 I won't have time at such short notice to make videos on those topics, but you might find this person's videos helpful: ua-cam.com/video/XhtE_XYbBUI/v-deo.htmlsi=EOlJlJixZdZ8-Pi8 Good luck!

@@vlmdrounds thank you amigo

Thank you. And don't eat your chocolate on an empty stomach!

😁😆

An aneurysm is a defect in the blood vessel wall resulting in a bulging or ballooning out of the wall. It can be due to tissue defects and, when they reach a certain size, are at risk of rupture and an internal bleed. The pathogenesis is different from atherosclerosis.

@@vlmdrounds Thank you for your response! And thank you for the definition, as well. It is clear that the observed effect is quite different (clotting vs. bleeding out). The physiology (or anatomy?) is also different. It would seem to me that the pressure gradient is a significant factor in an aneurysm rupture. It appears that the pathogenesis of an aneurysm is less well understood than that of atherosclerosis - except in the case of physical defect or injury. The pathogenesis of atherosclerosis is not as well understood as some people assume. Inflammation does appear to be a risk factor in both. My apologies for pushing back, I do realize that you are not a <vascular surgeon>, and my original question was in case you had taken special interest as you bring unique insight from your 'deep dives', which we all appreciate. So my brief Googling of a couple of generally reputable websites and browsing a couple of research papers brings these results: *The University of Michigan Samuel & Jean Frankel Cardiovascular Center* _Atherosclerosis is a major cause of abdominal aortic aneurysm and is the most common kind of arteriosclerosis, or hardening of the arteries._ *Mayo Clinic* Aneurysms. _Atherosclerosis can also cause aneurysms, a serious complication that can occur anywhere in the body. Most people with aneurysms have no symptoms. Pain and throbbing in the area of an aneurysm may occur and is a medical emergency. If an aneurysm bursts, it can cause life-threatening bleeding inside the body._ *Are Aortic Aneurysms Caused by Atherosclerosis?* Conclsions. _From the perspective of prevention, it appears that the risk factors for aortic atherosclerosis and probably atherosclerosis itself are necessary elements in the causal pathway for the great majority of aortic aneurysms in this cohort._ *Atherosclerosis and abdominal aortic aneurysm: Cause, response or common risk factors?* _The authors suggest that their findings fit better with atherosclerosis and AAA developing in parallel rather than atherosclerosis directly leading to AAA. _*_[...]_*_ the findings from the current study are not able to convincingly refute a role for atherosclerosis in AAA._ So, the science isn't settled. As for me, I have confidence that using my keto ==> carnivore leaning diet to minmimize blood sugar spikes and protect my glycocalyx; limiting ultra-processed 'foods' & ferreting out industrial processed seed oils from consumption (including 'health' supplements in soft-gels); and finally increasing exercise activity will help arrest the progression of both of these conditions. thanks again!

I'm afraid I haven't been following the studies you mentioned. Maybe when I have a bigger team one day. Right now it's a bit of a juggling act trying to do everything on my own!

@@vlmdrounds Understood. I don't have the background that you do, so I have the luxury of glossing over some of the details. With the US healthcare establishment failing me, I am just attempting to navigate the better signals amongst the noise. It is refreshing to learn that the science isn't settled - but that we are fearfully and wonderfully made! Each of the scientists I mentioned have YT channels - a suggestion for critiques in future videos?

@@jamesalles139 Thank you. I am sorry that you have had to be under the current sick care system. My dream is that there be a real, science-based alternative for everyone one day!

@@vlmdrounds Oh my and LoL I felt bad saying that you weren't a <surgeon> in another post, and figured I really ought to do some research to see if I knew what I was talking about. Dr. Loh, you don't go overboard 'tooting your own horn' on this YT platform. And guess who I stumbled on. A patient. On Metabolic Multiplier. _Love a conversation that heals: Dr. Vyvyane Loh_ BY NICHOLAS NORWITZ · PUBLISHED OCTOBER 8, 2020 · UPDATED DECEMBER 27, 2022 I am beside myself, having pretty much stepped in it. speechless, I am going to get my dinner. It is nice when the world gets smaller.

@jamesalles139 It's wonderful that you are prioritizing your health through diet and are now working on exercise. If you are worried about brain effects of statins, have a discussion with your care provider on lipophilic vs. hydrophilic statins (pitavastatin is lipophilic)

Yes, I don't think many people are aware of that and that iblood iron studies may not reflect what is going on in the body at all. Also, how iron impacts cholesterol metabolism in endothelial cells--very intriguing!

@henryjones3176 You're welcome. Physicians rarely get a chance to tell their side of the story and I just wanted to put my experience out there to let people know what we have to put up with.

Thank you for watching/listening. Cholesterol metabolism is exquisitely regulated. When absorption is high, synthesis goes down and vice versa. That is a very, very simplistic view--the accessible pool of cholesterol is impacted by immune signaling, rbcs, hepcidin levels (see spisode 54) and different tissues may have different responses. Attention is shifting now to the immune aspects of atherosclerosis and factors impacting apoB levels. This is part of what I emphasize to physicians in my training program on metabolic health. I agree that it is frustrating that current medical practice is so far behind the latest science. As an MD I have to careful not to give medical advice to non-patients and I have to restrict myself to medical education on social media. My hope is that more awareness of how current medical paradigms leave much to be desired in terms of getting patients healthy. We need a better curriculum! 🙏

Glad you like it. The slides take a while to prepare but I hope they are helpful.

@justsaying7065 Thank you! I will put them on the ever-growing request list (!!) but it will take quite a while since I do all of this alone. I'll keep plodding!

@@vlmdrounds Thank you for responding to me! No worries; take your time. I know it takes a lot of research/work to put together the episodes. Appreciate everything you do!

@bevswright I am so sorry to hear that. Unfortunately most of the medical world sees it but doesn't address it and once past the pre-cachexia stage, it is really hard to treat. I have had so many requests to talk about this and I will do my best to get to it.

Thank you! Working on the next episode--wish I had more time! Thanks for listening.

@brandyriedel4399 Thank you! That's one binge I am grateful for!!!

@HowardDoss-ij2me Thank you for taking the time to listen and to give your opinion. I thought I would share the following articles for your consideration: 1) This first one is a news report on some latest research: www.news-medical.net/news/20230227/Study-supports-the-concept-of-atherosclerosis-as-a-T-cell-autoimmune-disease-targeting-the-arterial-wall.aspx 2) www.ncbi.nlm.nih.gov/pmc/articles/PMC3984678/#:~:text=Giving%20the%20similarities%20with%20autoimmune,early%20stages%20of%20the%20disease. 3) www.nature.com/articles/s44161-023-00230-0 I'd be sincerely interested in hearing your feedback and critique of those studies. This is how real science is done so I appreciate your opening up the discussion. This is the thoughtful, well-considered conversation that I've been trying to stimulate and I am grateful for your succinct remark. I've pinned your comment so others can follow and participate. Thank you again! Warmly, Dr. Loh

@RK-ww5sj Thank you. Is there any particular topic you'd like me to work on for an episode? Since I have no team it may take me some time to get to it, but I like to keep a list of topics for future episodes.

@nvraoo Hi--I will try to make a synopsis video as many have requested it. I just haven't had the time. My apologies as this podcast is primarily geared towards medical professionals and I realize this episode is too long for the general public. I will work on a shorter video in the next few months. Thanks for listening.

@harryturnbull4781 Sorry I wasn't clearer, Harry. I was saying that clotting is part of the immune response and therefore a part of the atherosclerotic process which is, in essence, an immune process with auto-inflammatory and autoimmune components. Kendrick's hypothesis is on the right track--the details may be a bit lacking and off but he is far closer than many others.

@@vlmdrounds Ok thanks. Does this also tie in with some thinking that insulin resistence pre-empts inflammation and other issues such as clotting?

@@harryturnbull4781 Insulin resistance is one factor in inducing a pro-inflammatory state. ROS formation through different mechanisms results in inflammation, as does circadian disruption.

@kardste8114 I will work on getting a video up on this. I don't have a team so everything has to be done by me and I am working full time, so please excuse time delays. I will definitely do an episode on this. With cachexia I do not generally recommend a plant-based diet to my patients. Since it is accelerated muscle loss under inflammatory conditions, people need the most bioavailable and nutritionally complete proteins sources and I prefer to use animal proteins (dairy and eggs for vegetarians) whenever possible.

While modified apoB has greatly increased risk of ending up in the vessel wall, simply having a lot of apoB alone does increase risk since we cannot ignore probability. However, I believe the increased risk with apoB count is not linear. Personally I do not subscribe to the annihilation game with apoB. We always talk about homeostasis being an important regulator of health and the extreme goal of apoB extinction appears directly contradictory to homeostatic regulation. 😁

I am totally baffled. She put forward a thesis statement in the intorduction; a dissemination of Malcolm Kendrick's blood clot-artheriosclerosis theory.........and then never referred to him, his theory or his work again.

Because microcalcifications are very hard to see, they may be in soft plaques, yes. Macrocalcifications form from microcalcifications, so at least in the initial stages statins form microcalcifications 1st before stabilizing the plaque. Your complaint with statins is a fairly common one. Some people are now doing scans that can pick up soft plaques which would be useful in assessing risk.

Yes. But it does take careful attention to nutrition, exercise and also decreasing inflammation. Would you be interested in a video on this?

Appreciate your thoughts. I refer to this in Episode 45.

I will work on this. It may take me a while but I'll get to it!

That's a good question. I wish more people realized that they can influence so much of their own health through their lifestyles. However, evidence-based practices in nutrition, sleep and exercise are hard to come by and should not be couched in simplistic terms ("eat healthy, exercise more!") If you are interested in structured, science-based approach to protecting your arteries, you can find out more by scheduling some time to talk here: calendly.com/tulaversity/free-program-information-session

@@vlmdrounds Thank you.

Calcification is part of the immune response to damage and fibrosis. Calcification is an attempt to stabilize the structure of the plaque/lesion. It may be argued that necrotic plaques without calcification may be in greater danger of rupture.

@@vlmdrounds Thanks. What statin if any is preferable to Pravastatin?

@dry509 I am assuming you mean how we maintain a balance between inflammatory and anti-inflammatory states. Our bodies tolerate a wide range of swings in acute situations. I think the danger is in a chronic of prolonged state of inflammation or tolerance. Attention to the basics of nutrition, exercise, sleep and alleviation of stress are always fundamental to keeping a state of 'balance' in the body.

@susanwebstersyoutube2385 thank you. I hope it was helpful!!!

@cya177 My pleasure. I hope you found it helpful

Happy to. These episodes take a long time for me to get out since I work full time and I don't want to just cover the topics superficially. But I assure you I will do an episode on this!

@Straycurrent Thank you! It's heartwarming to see so many people who really care about science. Gives me hope!