Low LDL Cholesterol Level of 29 Made This Man Very Happy – Here’s Why

Low LDL Cholesterol Level of 29 Made This Man Very Happy – Here’s Why


So he’s got an LDL of 29 and he’s happy
about it. He’s actually got good reason and we’ll go into that on this video. So the patient’s name is Joe Reilly and
he posted all of this information. I’m not sharing anything that Joe hasn’t
already posted. Joe actually did a video with us a couple of months ago and he
shared with us he’s had LDL values over 225 and he’s had a world-class LP(a)
value not over.. actually over 1,100. According to Joe, he’s also had the
aortic valves calcification surgery. That’s been associated with these
very high levels of LP(a) but you can find all the information that Joe
posted including his own lab values and imaging values. Go to the PrevMed website,
click on Blog/Forum. Then once you get to the forum, if you go over the next
couple of days, you might see the Brewer effect there. If you don’t see that, you
can enter the Brewer effect here in the search area. Search for it and that
that’ll come up. Here’s what you’ll find in terms of what Joe has posted and
again started out here’s what happened. Joe came to the Orlando event and he’s
recommending that others come to it too. He said you know and it’s true you get
not only a two-day boot camp but you also get the complete labs,
the evaluation with me one on one. So you get all of the stuff done. Oh and I
forgot the CIMT (the artery scan). You get all these things done at one fell swoop
and you can start taking care of your health. And that was a big challenge for
Joe. Again, it’s not common to see somebody with FH (familial
hypercholesterolemia). The estimates on on prevalence are between 1 in 250
and 1 in 500 people. In addition, it’s even more rare to see an
LP(a) as high as Joe’s has been. So he’s got two major factors. In addition
he was starting to get some insulin resistance. So again, Joe had some
challenges and he knew it and he needed some work. He
and I talked about this LDL value and whether or not to go on a statin. He was
already on Repatha, one of the PCSK9. If you don’t know what a PCSK9 inhibitor is,
you can google my name in YouTube and Ford Brewer PCSK9 inhibitor. We’ve got
several videos on it. Here’s the thing. I know there’s huge debate about LDL
levels and a lot of folks coming out these days say, “No, you really want it
higher.” I myself and somebody who routinely says it’s not LDL, except in
some cases, and in Joe’s case, it does appear to be an issue in people with
familial hypercholesterolemia. And if you’re not familiar with that, I’ve got
several videos on that as well. Actually, after these studies on PCSK9 inhibitors,
you got a whole new mantra, a whole new push with cardiologists out there saying
LDL does matter. Here’s the point. I don’t think any of us know for sure and I as a
physician, well, will certainly support a patient that wants to take either of the
the routes that may be documented and show real evidence and this route
certainly shows real evidence I think. And I was telling Joe, I think if I were
in his situation, with his combination of issues, I would probably go for the lower
LDL as well. And here’s why. Not one, not two, but three studies all coming out,
indicating the same thing – decreased heart attack and stroke events for these
for this class of patients using PCSK9 and going all the way down to levels of
20 to 25 for LDL. So anyway, let’s take a little bit deeper look at what Joe
posted. As you see here, his LP(a) went from what was that 450 down to
373. And again, when we added the statin back to his Repatha, his LDL level went
from 78 to 29. And here’s what Joe was actually excited about.
He had you know a PLAC2 level of 126, got that down to 81. We did several
other things with Joe, a major part being a focus on insulin resistance,
Obviously, that is clearly the most important thing to me out of all of the activities that Joe could be doing. Added niacin and again for the LP(a) and you did see a significant drop in LP(a). Of my patients that
have LP(a), most of them say, “You know, I want to get it down to zero.” Well,
that’s not practical and it’s not going to happen. But what you do tend to see, similar to what happened with Joe, is you can… if you can get that LP(a) to decrease another 20 to 30 percent, you’ll usually start to get some
decrease in the inflammation as well. So the goal for LP(a) is not to just
totally eradicate it. The goal is to get it down maybe a third or so. As you see
here, Joe’s got some significant CIMT challenges again which he posted on the
forum. As I said, Joe’s done a video to explain all this with us before. Now
let’s take a quick look at the studies that are saying you really do
need to get to those lower levels especially if you have these problems.
New England Journal, the FOURIER study May 4th, 2017. Evolocumab, it’s again
one of the PCSK9 inhibitors and what they showed what was it was a large
study 27,000 people and they did get significant
decreases with the PCSK9 inhibitor. On the LDL levels, they got lower LDL,
heart attack rates as well in their study. They go in to talk more about the
PROVE IT-TIMI studies & the TNT trials which said that you wanted to get
LDL levels down to about 70. And again, to my point, there’s still way too much
focus on LDL and nearly enough focus on the major driver
which is insulin resistance, pre-diabetes, metabolic syndrome on this. They went
ahead and mentioned the GLAGOV trial. With the GLAGOV trial, they got decreased
heart attack and stroke rates down to levels of 20 to 25 LDL within they got
decreased heart attack and stroke rates down to the high 20s. With these kind of
numbers, you’d expect to see brain fog and other neurological problems. Right
well, not so fast, actually they didn’t… they didn’t see the brain fog and the other neurocognitive problems. How about the ODYSSEY study.
New England Journal, November 29, 2018. The same thing. They got these low rates of
low levels of LDL and continued to see decreased rates of heart attack
associated with that. What about ODYSSEY and the
neurocognitive side effects? There were actually fewer neurocognitive side
effects in the placebo group and ODYSSEY guys that had the higher LDL
levels. So again, major debate about these issues out there. And again, I’m totally
comfortable in supporting my patients, assuming they have some well-documented
reasons for going where they want to go. And as I said with Joe’s case, at
the end of the day, I’m not sure, but I think I may want to go there with him if
I had the same issues. Thank you again for your interest. I’ve had so many
patients come to me because they quote their diet here why don’t you take this
statin and let’s see what happens what let’s see if a heart attack or stroke
happens. No, prevention is a science. We know what’s going to happen, we know what
to look for, we know how to prevent it. Come see us in Louisville on November
8th and 9th. Get your CIMT artery scan, all your labs. See me and spend two days
learning usually what your doctor doesn’t know yet about the science of
prevention. Look forward to seeing you there. Thanks.

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