Is ApoB a Better Test Than LDL? | Thomas Dayspring | The Proof Clips EP
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- Опубліковано 7 чер 2024
- Renowned lipidologist Dr Thomas Dayspring joins me to discuss the significant role ApoB plays in assessing cardiovascular risk.
Dr Dayspring shares valuable insights on how maintaining optimal ApoB levels from a young age can have a profound impact on cardiovascular health later in life.
Our discussion touches upon:
• The importance of understanding ApoB's function in cholesterol transport
• The limitations of traditional lipid panels and why ApoB measurement is crucial
• Strategies for managing ApoB levels through lifestyle changes and early intervention
• The potential consequences of neglecting ApoB in cardiovascular risk assessment
As Dr Thomas Dayspring and I explore the latest research on ApoB and its critical role in maintaining heart health, discover why this often-overlooked biomarker is gaining attention in the world of cardiovascular medicine.
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Always great to hear a replay of Dr. Dayspring's discussion. He brings clarity and passion to the topic.
And is paid by pharmaceutical companies...
@@polibm6510 EVEN IF that is true, I am glad. He has things to say that people value. Not everyone does.
@@woofinu Like "take statins"...?
The keto, carnivore, "triglyceride ratio" people just checked out.
😀 yes, after a couple of comments ...
‘White coat’ syndrome. Just cause this guy comes across with authority snd gravitas, you assume he has it all sussed correctly. The nature of science tells us this might all be very differently understood in the future
@@georgecav "sussed?" Is that new urban slang? What does that mean in English?
@@Joseph1NJ worked out
@@georgecav "English MFker, do you speak it," Sam Jackson in Pulp Fiction.
While I get that that low ApoB is advantageous in preventing heart disease, why is it that a number below a certain threshold means you won't have the disease develop? While a high number certainly means more particles and potential to wreak havoc, a low number still means they are in your blood stream. I would think no matter the number, some are still going to embed themselves in the arteries. Why does a number below a certain threshold mean there NO development of the disease? I believe that's what Dayspring said in this video.
They have studies on people who have genetic mutations that result in LDL levels that are very low and they have essentially no atherosclerosis. I was eating a high fat low carb diet, as was the craze recently, and developed a xanthelasma under my eye. My LDL turned out to be 240! I now eat a Mediterranean diet and take low dose Pravastatin and Zetia and it is now under 70. Zero side effects for me and feel great.
ApoB/LDL don't need to be zeo, because one of your liver's functions is to clear out excess apob/ldl particles! 😉
How well/efficient your liver does this, determines how high your apob can get before it gets critical. So, the precise thresshold number is individual. And the number will probably change as you age and your liver gets less and less efficient.
So, when using general thresshold numbers for apob, we tend to pick the lower thresshold numbers, just to be more certain of reaching the desired effect for majority of people ! 😉
Apo b includes vldl which is bad if it’s high but you could have gotten these detailed tests for years on your own if you paid out of pocket. Tech has been around for detailed blood tests for years now and for some reason people still arguing about these basic tests like ldl c and Apo b which aren’t that accurate
Focus on one number alone (in this case ApoB) will not describe overall cardiovascular health. From my lab results last week, for which I paid out of pocket: ApoB 256; "VLDL levels not sufficient for VLDL size
determination"; total cholesterol 553; LDL 474; HDL 86; triglycerides 56; Lp(a) 18.2; HS-CRP 0.95; insulin serum 6.7; insulin resistance score
I am starting to worry. Post memo & 62, cholesterol metabolism SNPs are junk, most recent lipids deteriorated with TC of 7.9mmol ( 305 mgdl) and TG 2.2 (195 mgdl). Pattern B confirmed, familial MI paternal & vascular dysfunction maternal. I'm ticking all the lifestyle boxes but can't make a sustainable dent in my panel numbers to offset the genetic milieu and various autoimmune inflammatory processes. Do I take Ezetimibe and cross myself bc I have problematic LDL Receptor SNPs and lifestyle alone isn't cutting through? Probably yes.
At what point does the ApoB decide to crash into our endothelium. What is the difference at low levels and at high levels. Is it that I high concentration is just too much for our blood to handle.
Can the deposits be reversed?
Most would say not, but it can stabilized. Then there are people like Drs Ornish and Esselstyn who say it can.
I am at that highest 80 percentile despite improved diet, also obese,sedentary, family history of CVD. So at 33 years of age I decided to start minimal dose rosuvastatin and ezetimibe. Soon I will check how much my 116 apoB dropped. Over 2 months in no side effects thankfully.
That didn’t make sense. So why not lose weight and exercise before taking drugs? Or you can’t be bothered?
You should get a CAC before taking those meds.
@@DK-pr9nyI agree, but then what? My CAC is 36. I thought that wasn’t too bad, but my cardiologist put me on a low-dose statin anyway. Dr Cywes, also a cardiologist, who also posts videos here on UA-cam, says he doesn’t even consider statins unless you have an 80 or higher. Getting the test is great, but knowing how to interpret the results is something else.
@@porridge57 If it comes back at zero, then no need for a statin.
@@DK-pr9ny Okay, but mine is 36. Statin or no, in your opinion?
Like Dr. Anthony Jay (he's not an MD, has Ph.D. in Biochemistry from Boston University School of Medicine) said in a recent video, saying you have high ApoB is like saying you have high cholesterol without saying you have high cholesterol. It used to be "your cholesterol is too high." Thirty years ago that became "your LDL is too high." Now it's "your ApoB is too high," or "your Lp(a) is too high." The "solution" for all of those things? Same old, same old: a statin. And the disclaimer from the companies that make them? "Statins may not reduce your risk of heart attack."
...and you got high cholesterol because you ARE insulin resistant to begin with (u don´t have to b diabetic !!). So even if you bring down cholesterol, you´re main problem is still there.
@@usernwn7qe insulin resistant with a serum insulin level of 6? I don’t think so.
@@ssa8479 well, then you're probably not a typical case. Just as there are individuals with heart disease and low-normal cholesterol.
@@usernwn7qe I don’t know what is “typical,” and don’t intend to speculate without knowing the science behind it. Just pointing out that your assumption that my “high” cholesterol level was because I was insulin resistant was off the mark.
It’s high for the opposite reason: I’m insulin sensitive, have very low triglycerides, low Lp(a) and low HS-CRP.
@@ssa8479how do you know that this is the reason? All the things you mentioned can co-exist with very low LDL.
The cognitive dissonance is quite striking. Paraphrasing, ‘kids don’t get atherosclerosis, well, they do now but only because they eat junk and have insulin resistance at a young age’ . Yet, it is still primarily apo-b? Insulin resistance is associated with high apo-b so is it insulin resistance that primarily drives CVD and apo-b is along for the ride?
William Cromwell didn’t seem to say apo-b ‘crashes’ anywhere - rather he spoke about transcytosis which is a different proposition altogether. Equally, he said the particle somehow gets oxidized which stops it getting back out of the artery wall. This was on a ‘the proof’ podcast. Again, this seems to point to the fact that some other process is at play. Stop the oxidation and stop the problem? Just saying that the more apo-b you have the more chances of some of it getting oxidized doesn’t sound like ‘proof’ to me …
I would put forward that one doesn't have to be tested for unhealthy levels of LDL or APOB - one only has to look in the mirror...
I have LDL 474, ApoB 256. 18% body fat and a BMI of 21, still in good shape and active in my mid 60s. "Mirror, mirror on the wall" doesn't always work. This old keto dude isn't worried about the numbers.
@@ssa8479 I'm very happy that you are feeling great - that's what we are all striving for. One interesting fact you wrote is that your LDL is 474. From my understanding, LDL is what repairs damaged (or inflamed) body parts. If your LDL is high, I would think that it is high because it's fighting some kind of inflammation in your body. Once the damage is repaired, your LDL should lower. I'm not sure , of course, if this is what's happening with you, but generally, I thought that this was the typical way LDL worked.
@@docbegone1716 I agree with your assessment, to a certain degree. But I’m a layperson too, and when the primary care doctor raises the statin issue, it creates some uncertainty.
I have an appointment next month with an endocrinologist for my hypothyroidism, suspect my PCP has me on too high a dose.
Also planning a consultation with a cardiologist who’s familiar with a keto diet.