Cholesterol, Heart Disease, and Statins

Measuring cholesterol is our best indicator for preventing heart disease.  Statins are very safe medications used for decades to prevent and treat heart disease.  Cardiac screening includes traditional LDL, and also Lipoprotein A and Apolipoprotein B for more detailed understanding, along with CT Calcium score to directly evaluate artery damage.

Family History:  Genetics plays the largest role in high cholesterol.  Diet and exercise help.  If family has heart disease and high cholesterol, chances are high the children will too.  In short, it is ok to have avocados and eggs in your diet.

Statins:  Statins are excellent drugs (like Lipitor & Crestor).  Lower LDL directly correlates with lower heart attacks and strokes.  Statins are also anti-inflammatory on arteries and help reduce aneurysm risks.  Even low dose of statins are helpful.  Beware those criticizing statins in order to sell their own supplements.  Dr Peter Attia MD provides an excellent summary of statins and controversies.  

Alternatives: Diet and exercise alone rarely sufficient to lower high LDL.  Zetia (Ezetimibe) is a good additional medication to use for those who have side effects from other medications.

Red Yeast Rice: Supplement advertisers push this as alternative to statins and it actually helps.  The reasons it works is RYR actually has a statin in it.  So, it is the SAME thing but lower dose and not as effective. 

Bronchitis and Colds

Antibiotics are not needed for colds:  We take no pleasure irritating patients or parents.  Antibiotics treat bacterial 
but not viral infections.  95% of upper respiratory colds, including bronchitis, are viral.  Some are allergies or caused by chemicals (smoke or vaping).  Treat symptoms.  Mayo Clinic Guidelines  

Weight Loss

The new weight loss drugs are working very well for most people, but do have some side effects (we source semaglutide for ~$250/month.) There are few simple solutions to anything in medicine. Semaglutide (Ozempic & Wegovy) and Mounjaro primarily cause nausea for 10-20% when first started and for some people it is too much to continue, particularly if start at higher dose. This article is a good summary: Obesity Drug Side Effects. In short, long-term weight loss is successful with exercise plan and better nutrition, to avoid repeating the weight gain. https://www.nature.com/articles/d41586-023-03183-3

COVID-19

Treatment: Early treatment is best, and approach depends on timing and symptoms.  Paxlovid is working very well when started early.  We may use Budesonide and Dexamethasone, and home oxygen in severe cases.  COVID has evolved a lot and our treatment does too. We use best medical evidence. 

Vaccinations and Prior Immunity are the best defense against COVID19.  COVID Vaccines turn potentially serious illness into a cold, and we only recommend vaccines for those at high risk – We do not recommend for healthy children or young adults.  Vaccines help the body respond faster to infection, but do not always prevent it.  Vaccines are your personal choice. This is a great discussion on controversies and censorship by Dr Prasad, We Need to Talk About the Vaccines, Public Debate on Side-Effects is Being Censored.  

Vaccine Controversies:  There is a lot of misinformation. ZDoggMD.com has several excellent videos and Vaccine Details from CHOP.  

Supplements

Supplements – We do not sell or take commissions (kick-backs) on any supplements or medications.  Suppplements have there place but are not a substitute for either healthy nutrition, regular exercise, or medications when needed.  We recommend several supplements for specific conditions.   Any good supplement will clearly state what is the active ingredient and dose.  If it has “proprietary ingredients” it is likely a scam and false promises.  Supplements should be third party tested, and you can verify on many sites: e.g., Operation Supplement Safety.