The Root Cause Of Heart Disease & How To Tell If You're At Risk | Dr. Ronald Krauss

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Published 2023-08-23
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Heart disease is still the number one killer in the world, yet most people don’t actually understand what markers put them most at risk.

The general consensus is there are two types of cholesterol—the good and the bad—the good is thought to be high-density lipoproteins or HDL, and the bad is low-density lipoproteins or LDL. But we now know from research that it's much more complicated than that—there are actually various sizes and densities of these lipoproteins.

Today on The Doctor’s Farmacy, I’m excited to talk to one of the leading lipidologists, Dr. Ronald Krauss, all about lipoproteins, what they do in the body, what they mean for heart disease risk, and why a typical lipid panel alone is insufficient.

Dr. Krauss is a Senior Scientist at Children’s Hospital Oakland Research Institute, a Professor of Medicine at UCSF, and an Adjunct Professor of Nutritional Sciences at UC Berkeley. Dr. Krauss’s research aims to understand how to best prevent cardiovascular disease through early detection and management of its major risk factors: most notably, elevated levels of blood cholesterol and lipoproteins. He has published over 450 research articles and reviews on metabolic, genetic, dietary, and drug effects on plasma lipoproteins and the risk of coronary artery disease, with over 100,000 citations of this work.

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Research mentioned in this episode: pubmed.ncbi.nlm.nih.gov/37425714/

00:00 Intro
01:17 The History of Heart Disease
03:39 Cholesterol vs Lipoproteins
08:15 Normal Cholesterol Levels
12:53 LDL Particles
15:00 Saturated Fat
19:43 Meats
20:43 Is Meat a Concern
22:08 Observational Studies
30:00 ApoB Test
33:30 Statistics
37:15 LDL
46:15 Lean Mass Hyperresponsive vs Poor Metabolic Health
51:35 Lipid Testing
54:35 Low Carb Die

All Comments (21)
  • @km-bo3zx
    Wow! Great stuff spread throughout the entire interview, including his dietary recommendations, at the 55:00 minute mark!
  • đź’Ż Fantastic episode! I've been ordering an advanced cardio IQ fractionated lipid panel for myself ever since I found out about the severe limitations to the standard lipid panel. Despite always having healthy results in the standard panel, the advanced panel revealed why people in my family die of heart disease more than any other condition. Please have more guests like Dr. Krauss!🙏
  • @johntatman9168
    When you only have a hammer everthing looks like a nail!!! Fits perfectly with LDL and statins.
  • @HeyHeyAlabama
    I understand from other dr.s that what you eat doesn't add to your cholesterol, it's how the liver makes what it needs. Many carnivores don't have a cholesterol problem, and there are indigenous tribes in Africa that eat only meat and a few fermented foods who have no cholesterol, stomach or bowel problems. There are also those on ketogenic diets for over 20 years with no problems.
  • @marygrogan6101
    Thanks for this. Luckily I have an ayurveda doctor who helps me as my pcp kept saying I needed statins and then some other new drug, which if I had taken would have made things worse, especially the new drug which the fine print said not to take if you have low thyroid. My ayurveda doctor suggested 2 tests to see if the cholesterol was a problem, or not. Fortunately the tests showed that my veins were squeaky clean.
  • @dminarsch
    I asked the Lab Core lady how often the NMR test order comes in. She said she just did four that cardiologists ordered the previous day. So more docs are ordering these more informative tests.
  • @burnhamv
    how do you get a pdf file of this video - thanks
  • @suzanneb5572
    Very hard to catch (due to bad audio akd mumbling!) the recommended tests if someone has high cholesterol in the standard tests. Could you please write them out?
  • Also, I found it instructional that he doesn't order Apo B tests because the advanced lipid panel gives him that picture. I knew of both tests, including the nuclear one, and I enjoyed learning about the origins of each!
  • @kanugupta1515
    Any recommendation for vegetarians diet for ALL Tcell leukemia patients ..for teenager !!
  • @adamjohnson402
    This is great, but still don't know what the best approach for me is. I am 43 years old and had a heart attack while I was working out in January. My total cholesterol has always been in the 200's so nothing crazy. I did recently get cardioIQ test completed. I am on a low statin dose of 5mg of Crestor Mon, Wed, Fri. My LDL particle number was 2070 and my LDL small was 490 and my LDL medium was 520. I have LDL pattern B. At this point, not sure if I should try Niacin or not. I eat very healthy and workout 5-6 times a week. Any advice?
  • @georgefurman2234
    I've used niacin for decades, at levels between 1000 to 3000 mg daily for mood adjustment and the extra benefit is that my cholesterol went down to around 220 and I feel great! Start taking it at low levels, it's a vasodilator so it increases the diameter of blood vessels and can cause a redness and a warmth under the skin. New studies show a relationship between niacin and NAD+. Very interesting, it appears to be a precursor of NAD+ and that is good for the mitochondria.
  • Dr. Hyman. Great information. Great interview. Obviously this guest is an advocate for drug therapy on lipids. Can you cover the mitochondrial effect of lipid lowering drugs? We would like to know things like CoQ10, and other effects that these drugs have on the mitochondria. Is mitochondrial dysfunction the root cause in the first place?
  • @Droidzi
    1:00:52 - the "Is it really that bad to just take a statin" showdown âš” nicely restated, your position Mark on the subject
  • @breakalegfpv9532
    what do you think about the new investment in vaccine "s and PPE Frome capitol hill?
  • @cgArtsy5
    If all the ldl particles measure the same as apo b test, then why is my LDL small particles and my LDL medium particles both high but my Apo b is low? My total cholesterol is normal.(@. 54:00)
  • @kenswanston820
    @markhyman - Dr. Hyman - You briefly touched on genetic predisposition for heart issues...which I've got, along with my 3 brothers and sister, and potentially my 4 kids and 3 (so far) grandkids. What treatments (if any) are available to deal with genetic issues? The LIPID clinic at St. Paul's Hospital in Vancouver, BC has started me on EZETIMIBE (10mg) and ATORVASTATIN (10mg) and baby ASA....I'm a 71 (soon 72) year old male, 6'4", 210-215lbs. A CAC (Coronary Artery Calcium) scan a few months ago came back with over 1000. The blood tests ordered so far have not broken down the particle size and I detect a distinct hesitance to deviate from their processes. What, if anything could/should I be suggesting/demanding for a better testing analysis and/or treatment?
  • Have you seen people that were not LMHR and were seeing good lipid levels, but became a LMHR after using Keto over time?