logww45

@PeptideData @ManOnThePen I don't think so. Weight loss is harder for many, particularly for those who are T2D. There are a sizeable population who do not get appetite suppression, hence weight does not come off easily. On the other hands, almost all get benefit in glycemic profile.

@ManOnThePen You only lost 31 pounds in 3 years on 15 mg of Mounjaro/Tirzepatide? That's a shockingly low amount. On your new diet, especially if you used to be T2D, why are you eating so many carbs?

4 weeks ago, I went off GLP-1 therapy after being on the highest doses for 3 years. (Type 2 diabetic) In the last 28 days I have tracked meticulously. Starting weight: 281.4 pounds I’m averaging 2,597 calories a day. Protein: 206g Carbs: 189g Fats: 123g I’m working out 4x a week (HIIT) for around 1.5 hours with an average burn of around 750 calories. I also started TRT at this time. 140mg/wk. Today, the scale says 295.2 +11lbs

@ManOnThePen Did they report A1c

$LLY $NVO New data Patients lost weight on Wegovy or Zepbound, then switched to oral GLP-1 orforglipron. A full year later Weight was basically maintained, not regained. Injectables to a pill Same results That changes the long game.

@pjones_al @ElieJarrougeMD Would love some reputable citations on this? One thing to be careful about is false equivalence. Hunter/gatherers are also exposed to toxins, just vastly different than us living in industrialized urban centers.

@ElieJarrougeMD Are you familiar with the studies that show hunter gatherer societies without western diets/industrialized food systems have LDLs below 70mg/DL and dont develop ASCVD?

This is not something to be proud of to be honest. To pharmacologically drive your LDL to the ground assumes that natures messed up by having our liver makes 90% of it and we the smart humans are fixing its mistake. You want to reduce your cardiovascular risk? Keep glucose and A1C normal, insulin low, triglycerides low, visceral fat low, inflammation low, stress low. Don’t eat junk food. Oh and don’t smoke. LDL? Doesn’t really matter independent of the rest.

@NashTNoptions @sweatystartup @OxytocinGABA how low of a fasting insulin is cardio protective

@sweatystartup @OxytocinGABA ApoB is not as important as some might think. IF (big IF) your fasted insulin is low and your crp is below 1

My heart lipid panel is now top 1% of the top 1%: ApoB: 33 Chol Total: 87 HDL: 47 Col / HDL Ratio : 2 LDL: 29 CRP, HS: .5 All in mg/dl. Lets go!

@AlphaBetaAnil @docwas What about renal and cardiac issues from water retention?

@docwas Pioglitazone which is the only insulin sensitizer should be first line in all patients with prediabetes and diabetes if not contra indicated.

ADA standards of care 2026. Metformin no longer first line in most people with type 2 DM

@Paddy_Barrett What would you say is the upper threshold of HOMA-IR for predicting VAT induced insulin resistance?

But I don't want to do a DEXA scan... No problem. Just assess for the downstream consequences of excess VAT i.e. Insulin Resistance eg Fasting Insulin & Glucose -> HOMA-IR score. /10

"What is a normal weight?" As a cardiologist, I get this question all the time. My answer is not what most people expect. 📕Make Sure To Bookmark✅ 🧵👇 /1

@Wisdom_HQ Why stop at 40, why not 100? In fact why not 1000% (move the decimal point one place right).

@sunnydirect8 @CaryKelly11 @BenBikmanPhD Sadly if you die young, there will be no recourse. You can either cherry pick data to follow a path, or look at large volume data with mounting evidence. The choice is yours really. Your cherry picked path is not a guarantee for failure, but comes with high risk.

@CaryKelly11 @BenBikmanPhD My old US health insurance company in 2015 wanted to increase my health insurance cost because of high LDL or force me to seek "counseling" and take their poison drugs.Someone said "do the opposite of what the Doctors say". This has been correct most of the time in my experience.

"If all cardiometabolic markers are good, like insulin, c-reactive protein and the LDL is high, it is actually one of the greatest predictors of longevity." ~ @BenBikmanPhD LDL plays a protective/reparative role. Pass it on.

@Grapeap85429203 @CaryKelly11 @BenBikmanPhD Carnivore is not a long term solution.

@CaryKelly11 @BenBikmanPhD Why do they not mention more about elevated APOB and OXldl? These markers are both elevated for me as a 2 year carnivore and from what I gather are even more important.

@CaryKelly11 @BenBikmanPhD Absolute rubbish. He cannot process any data beyond keto/carnivore.

@markinho_gc @IndiraFuentes86 @IGOARANBAR @carogomezmartin @cristinatejerap @fjavesc @chemachir @drfherediaz @mendez_bailon @Vic_Tos19 @clyoch It would great to understand pathophysiology of this particular phenotype, as weight loss driven treatment will certainly not work well for this group.

🔰Lean type 2 diabetes: the overlooked epidemic reshaping global health. 🤓How fascinating is everything surrounding T2DM Lean T2DM represents an underrecognized epidemic requiring fundamental transformation from weight-centric models toward precision medicine frameworks that acknowledge diabetes pathophysiology’s heterogeneous nature. doi.org/10.1186/s13098… @SEDiabetes @diabeteSEEN @Diabetes_SEMI @redGDPS @CMEINDIA1 @anymzcs @endocatracha @drshafikuchay @RZubiranS @magraziagirone #MedX #internalmedicine #MedTwitter #proudtobeGIM #MedEd

@BryanTegomoh @foundmyfitness I have been a diabetic for 20+ years, it was never ordered. Thankfully, uacr has been part of the ADA guidelines, so that one does get ordered. I wish ADA would add cystatin C, because by the time serum creatinine truly rises, your kidney has entered the zone of no return.

@foundmyfitness The problem is cystatin C is not regularly ordered in metabolic panels for kidney function

Creatine is probably not harming our kidneys. Studies using doses up to 11 grams per day for a year have found no harmful effects on kidney, liver, or cardiovascular markers in healthy people. Yet the “creatine ruins your kidneys” myth refuses to die. Even some healthcare professionals still repeat it. Creatine breaks down into creatinine, which shows up on blood tests. If you supplement with creatine, your creatinine levels can go up, but that doesn’t automatically mean your kidneys are failing. It often just means… you’re taking creatine. If you take creatine and your lab work shows elevated creatinine, it’s often a false alarm, not a sign your kidneys are shot. A more reliable marker of kidney function to use when taking creatine is cystatin C. Creatine has plenty of debates around it. But at this point, in healthy people using reasonable doses, “it wrecks your kidneys” shouldn’t be one of them.

@alexleaf Just echoing your sentiments in a different timescale.

@logww45 I'm not following your point. Can you be more clear? My post was satirical to point out the absurd logic used by Sama.

“Safe” fasting blood glucose: – 1980s: under 140 – 1990s: under 126 – Today: under 100 The science hasn’t changed. The sales targets have.

@SamaHoole Too many people feel no warning before their first MI, and majority of those events are their last event lifetime. "Feel" is not a good argument based on evidence.

Lab work on carnivore: Your LDL will probably go up. Don't panic. What matters: - Triglycerides (should drop) - HDL (should rise) - Insulin/glucose (should improve) - CRP (inflammation marker, should drop) - Liver enzymes (should normalise) LDL going up while inflammation drops is protective, not harmful. Judge by how you feel + metabolic markers, not cholesterol.

@EricTopol @NEJM That is a poor summary of the article. Would you like to be that one man out of 452 who died because you were not screened? I certainly would not.

The prostate cancer PSA screening story over 23 years of follow-up for >166,000 participants: more detection, small reduction of mortality @NEJM nejm.org/doi/full/10.10…

@CynFarmGirl @robertlufkinmd I have had somewhat similar experience with someone who is supposedly a diabetes educator! Sadly, she failed recognize how type 2 and type 1 differs, and went on to give a laundry list of suggestions that all wrong: frequent snacking, up your carbs, bedtime snack with carb!

@robertlufkinmd The sad part. Dieticians haven't updated at all. I saw one in the spring. She recommended all the things you mention. Tried to tell me olive oil was bad. Didn't know what tallow was and advised low fat high carbs and going vegan.....for diabetes no less.

My mom was a dietitian. Our health was number one priority. I was raised on skim milk, margarine, vegetable oils, low fat foods. I avoided saturated fats and cholesterol. I developed hypertension, dyslipidemia, gout, and prediabetes. Where did I go wrong?

@LighthouseDPC @HeathVeuleman Where would one go to find a stress echo at that price?

- If you can't AFFORD Medical Care you are DENIED Medical Care. EKG costs $18 at our Cardiologists office and $390 on the Sentara Hospital cash website. We have a Healthcare FAMINE. If Grocery Stores Price Gouged like this in a Food Famine people would riot in the streets. Congress allows this to happen to keep the "Donations" flowing. Congressional "Donations" should be posted with every vote. You can buy Medical Care on the Free Market. You buy everything on the Free Market, Food, Clothes, Furniture, Car Repairs, Housing Repairs, everything. Why aren’t you shopping for your Medical Care? Here are some examples of the Hospital Owned/Free Market Medical Care prices our patients get: Abdominal Pelvic CT - $3,814/$400; Head CT - $2,526.00/$164.34; Mammogram - $339/$135; Abdominal MRI - $2,667/$700; Brain MRI - $3,425/$700; Pelvic US - $604.50/$110.61; Dexa Scan - $513.5/$39.70; CMP(1 lab) - $206.50/$2.80; EKG - $390/$18; Echocardiogram - $1,536/$200; Stress Echo - $1,139/$250; Sleep Study - $507/$150. #Healthcare #Hospital #Greed #Corruption

To understand why hospitals and health systems prices are so high, and why physician-owned hospital prices are so low you need to appreciate the mechanism of payment. 73% of HCA hospitals are on percent-of-billed-charges contracts (>85% of non-profit hospitals are still on the same type of contract). These are archaic payment methodologies that physician-owned hospital’s don’t even qualify for today. These hospital and health systems artificially inflates its chargemaster each year to squeeze more reimbursement from the payer. That’s why an EKG can cost $50 at your physician’s office; and $325 at a physician’s office who is employed by the hospital. Same equipment. Same interpretation. Different location - and that’s the only difference. You are being scammed. Wake up. While it’s true, I’m not a big fan of payers, everyone has to wake up and see that hospitals and health systems are the root cause of healthcare costs in America. Physicians. Are. Not. The. Problem.

@w9life @MariosGeorgakis Funny! I bet you will say the same for statins 😂

@MariosGeorgakis causes diebetes . no wonder high LDL is a longevity factor

Summary of recent wins for PCSK9 inhibition👇 Important to remember that PCSK9 inhibition was discovered and validated as a therapeutic strategy through human genetic studies

@Mangan150 By 12%, you mean absolute 12%? For example, the scale says 12, yet the real measure is 24m

Please note that smart scales that claim to measure body fat % are almost always underestimating the figure. I’ve seen cases that were off by up to 12%. These are helpful to measure progress, but be careful about relying on them. For men especially, if you can “grab” excess fat around your stomach, back, and/ or love handles, odds are you are carrying too much body fat. You don’t need to have visible abs. But it is quite easy to tell if there is excess body fat on your body.

What are the clues of poor metabolic health? Each is red flag: -Elevated blood pressure without meds -A1C higher than 5.6% without meds -High triglyceride-glucose index -Triglycerides / HDL ratio over 2 -Overweight or obese BMI -High body fat % -Large waistline