Do You Really Need a Statin? Cholesterol, Heart Risk, and Who Actually Benefits

And we're live. Awesome. Exciting. This is great. All right. So, we're going to wait for people to roll in here. While we're doing that, all right, we got 10 people join. Let's go. Welcome everyone. So grateful to have you. I know it's super nice day out, so appreciate making time. Educating yourself about your health. We're going to wait for people to roll in for the next minute. While we do that, if you're live, comment down below where you're joining from. We'd love to hear so much more fun when we get to interact with you guys in the audience. It makes it feel like we're not alone on the internet. So, yeah, let us know where you're be here with you, Cole. [laughter] Just kidding. But yeah, so yeah, let us know where you're coming from. We're going to get into it.

We're going to be talking about statin medications today, heart health, preventive health, functional medicine, how the conventional medical system looks at statins. So, it's going to be really exciting once statins are one of the um most prescribed medications, right, Colin? In the world, yeah. Yeah. fun facts about statins while we're waiting for people to roll in? I think the last time I checked, statin medications alone, like excluding all other medications, it's like a two or three hundred billion dollar industry. Just statins. Something like that. I looked up the statistics a couple months ago. But it's it's crazy. Yeah. So, it's not just a drug, it's also a huge money maker for It's a huge, huge market in the pharmaceutical industry, yeah. I'm not saying that's good or bad, it's just a just a number, so. Yeah, we'll we'll dive into that today.

I think a lot of people are interested in kind of how big pharma and medicine is all connected, and we're going to talk about that cuz it's certainly interesting. So, um Awesome. All right, we got Michelle from Thank you, Michelle. Um Can you comment on statins and start Michelle already knows what we're doing. Yeah, we're going to do some FAQs. [laughter] So, you If you have questions as the episode goes on, make sure to drop them in the comments. Uh we can't guarantee that we're going to get to all the questions cuz sometimes we get a lot, but the earlier comment, the more likely we are to answer them. So, um yeah, comment as we go on. So, let's get right into it. So, um what if the medication you were told you need for the rest of your life is only part of the story? So, statins are one of the most commonly prescribed medications in the world.

Like Colin said, they're it's a $300 billion medication, but most people still do not fully understand who they actually benefit, what they are doing in the body, or whether the real drivers of cardiovascular risk, which is what statins are meant to prevent, are being addressed underneath, all right? Talking about root cause and functional medicine. So, in this episode of the Med Matrix Method podcast, we're breaking down the truth about statins, who may benefit from them, where the conversation gets kind of oversimplified, and why cholesterol, right, which statins are meant to lower, should never be looked at as one isolated number.

So, we're also going to talk about cardiovascular cardiovascular risk, inflammation, insulin resistance, and thyroid function, um deeper heart labs that we can look at, lifestyle, and how functional medicine approach helps patients understand the full picture before making long-term decisions about their health, right? So, um yeah, we're going to talk everything about functional medicine. Today's episode is called The Truth About Statins: Who's Actually Benefiting From Them, and we've been looking forward to talking about this because it's something that we see all the time. A lot of patients come into the practice already on statin medications or being told they need to take one.

So, patients who are prescribed a statin without fully understanding why, or patients who are worried about cholesterol, but have never had the deeper conversation about what is actually driving their cardiovascular risk. So, I'm excited to be joined today by one of our main functional medicine providers at the practice, Colin Arnott, who's going to break down what patients should actually understand about statins, cholesterol, cardiovascular risk, and how functional medicine looks deeper and at the bigger picture beyond one number. Um so, here's how today's episode's is to go. If you're just joining us and you're live. We're going to start with our discussion. We're going to talk about what statins are, what they're good for, kind of what numbers we're looking at when we're assessing cardiovascular risk, all that.

If you have any questions like I said earlier, make sure to drop them below in the comment. After the discussion, we'll walk through a case study of actual patients and then we'll do a live Q&A with you guys here today. Just a reminder before we get started, this episode is for educational purposes only. This is not meant to be personal medical advice and should not replace care from your own medical provider. If you are interested in receiving personalized functional medicine guidance from us, one of our providers at MedMatrix, we'd be happy to help. You can go to our website medmatrixusa.com, book a discovery call, and start the process of becoming a patient. All right, let's get started. So Colin, why don't you introduce yourself? Sure, Cole. Thanks. I'm Colin Renard. As you said, I'm one of the lead practitioners providers at MedMatrix.

I have a pretty unique background in chiropractic medicine and natural medicine. I practice medicine as a PA at MedMatrix and I am multiple board certified in various disciplines including in anti-aging, natural medicine. I'm fellowship trained in functional medicine and I've been at this for a little over 10 years now. So I treat a lot of things from cholesterol and heart disease to um to things like hormone replacement, nutrition, all kinds of things I do. So we do a wide range of things at MedMatrix and cholesterol and heart health is just one of the many. So I'm excited about this topic. It's a great great things we need to talk about. Yeah, same here. So let's start at kind of like a high level. What exactly are statins and like what like what is the purpose of a statin? Yeah, so a statin and we we use the term statin because the medication names end in the word statin.

Rosuvastatin or you know, whatever all these different types of statins. So um the um the statin is basically a medication used to lower LDL cholesterol, which is uh a type of cholesterol that has been shown to cause uh heart disease. Uh but the word on that now is a little bit mixed. The studies are kind of disproving that essentially. It's not that simple. So, the cholesterol pre- uh cholesterol is produced by the liver. So, the statin medication is commonly prescribed to lower the the LDL cholesterol, which ultimately can lower cardiovascular risk, especially in patients who have already had some sort of heart issue, um heart disease, a stroke, they've had a heart attack, they have diabetes, or they have other risk factors like family history, they're a smoker, they're overweight.

Um so, basically the medication is to make your cholesterol be within certain numerical parameters on a blood test. So, when we do cholesterol checks for patients, which we do at Mid Matrix as part of their initial follow uh as at their initial visit, we um we're checking cholesterol and a statin is designed to lower the cholesterol beyond the uh into the reference range. So, the goal is really to make it as {quote} normal as possible. But, the question is is is that really what is most appropriate for patients? And that's really where um some of the research is going now is how does this all work? Why is this appropriate? You know, is this actually what we're trying to do? So, Yeah. Um but like you said, one of the most common pre- prescribed medications, commonly prescribed medications, and I looked it up, statins uh generate uh $20 billion a year in revenue worldwide.

So, It's only what? just those. Yeah. Okay, I think I misspoke earlier. I think I heard an extra zero, but that's still a lot. No, yeah. Well, I think I think over the lifetime of this statin it's produced hundreds of millions, but they they they they make about 20 billion dollars a year and they've been out for X number of years. So, the profit total is in the hundreds for sure. That's a lot. Well, okay. So, you said something that like challenged a lot of conventional medical thinking that you probably most doctor most patients have heard from their doctors that they've talked about a statin which is like LDL cholesterol equals bad. Right? You have too much LDL, that's bad. Why don't we dive into a little bit about like the difference between LDL and HDL right now is just for context for the viewers. Sure.

So, LDL cholesterol is basically been thought to and previously shown to um cause heart disease. So, basically LDL is a type of cholesterol that takes take um takes uh fat and moves it to the heart. HDL cholesterol does the opposite. It pulls away um the bad stuff from the heart. So, the LDL cholesterol has been {quote} {unquote} labeled as the bad cholesterol and HDL or high-density lipoprotein has been deemed the good cholesterol and heart-protective. So, um when we look at really what the difference is from a risk perspective, uh LDL cholesterol has been shown as I said to be strongly connected to atherosclerosis or plaque or hardening of the arteries and cardiovascular risk. So, statins for decades uh have shown that the primary prevention of heart disease is trying to reduce that LDL and that's what the statin is essentially doing.

But, new research in the last 1 to 2 years is basically saying, well, is that really what is best? And is really is that really how we lower heart disease risk by lowering this parameter? And the evidence is showing that maybe what we've been doing for the last 20 years in lowering people's cholesterol is not as good as we thought in preventing heart disease. So, that's really where the questions are starting to come up of appropriateness of statins for people. Should we be lowering cholesterol as low as as as low as we are trying to Mhm. Yeah, the data is is proving that maybe it's not as easy as we thought. Cool. Yeah, a little cliffhanger for you there. We're going to definitely get more into that as far as like what cholesterol does in body and when is what's good, what's not. So, yeah, we'll definitely talk about that later. So, um okay.

Why are statins so commonly prescribed in conventional medicine? [gasps] They're so commonly prescribed because almost everybody is going to have a cholesterol that might be above that reference range of what is considered {quote} normal. Uh for example, cholesterol is uh total cholesterol on a lab is anything below 200. So, if you hit a certain age, 35, 40, if you're maybe even a little bit overweight, if you don't eat that great, your cholesterol is probably going to be over 200. And um the target number for LDL that we've been talking about is 100 on a lab to be normal. It might be a little bit different depending on the lab, but that's kind of the average.

So, again, if your diet is not super perfect, you may be a little bit overweight, uh maybe you don't work out very much, and that is probably what a lot of people nowadays in at least America, that's kind of American culture, standard American diet. We're not as active as we used to be. We sit all the time. Uh most people's cholesterol are probably going to be on that be beyond that number. And in the sort of healthcare industry, as we talk about on this podcast all the time, there's an industry behind medicine and there's algorithms and there's protocols. So, if you don't want to potentially run into an issue later on for a patient with them developing heart disease potentially and their cholesterol is above those markers, you might be put on a statin.

And it's kind of it's kind of become commonplace and for a lot of providers that work in big box healthcare, so what I mean by that is like big medical systems, hospital systems, university hospital systems, they have protocols. You know, if you have a patient with a cholesterol above a certain number, they must be on a statin or you could be fired or you might have your pay, you know, docked um cuz they track all those. It's all algorithmic in those big centers. So, it's extremely common for people to be on statins. And um it it heart disease is one of the most common issues we deal with now just because as a culture we've become so much more unhealthy. Everybody A lot of people are overweight. So, it's a really really commonly used medication. Very common. Yeah, got you. So, you said some really interesting things there. One was the reference range.

So, there's like this reference range and it's like pretty black and white. If you're over it, okay, here's a statin and that's kind of like the conventional protocol that they have. Can you can you dive deeper into that because the initial question was like why do so many patients get Like why are so many people put on a statin? And it seems like part of the reason is cuz they just kind of have this like black and white number. Can you can you talk more about that? So, it it is a black and white number and like I said, if the reference range is probably lower than it should be and it used to be. So, for example, um total cholesterol years ago before statins were were introduced was thought to be normal up to 300. Then when statins were introduced, they changed it to 200 to sell more statins. And this is very widely understood. I mean, I'm not making this up.

This is This has been documented in in studies. So the thought was, well, if we need to sell this drug, we need to make sure that enough people will fit into the parameter of the the the labs cuz otherwise no one's going to be on this drug. So the the question is is well, is the reference range too low? Like if you have a cholesterol of 250, do you need to be on a medication for that? Well, maybe you don't, right? What are the risk factors? What's your family history? What's your diet? What's your lifestyle? But again, in a conventional medical setting where there is this very distinct line in the sand, if you're over a certain number, it's kind of like an automatic. You kind of you kind of just get it, you know? Not every prescriber is like that.

Not every medical conventional medical provider is going to be like that, but I'd probably say a decent 3/4 of the health care system is going to look at these labs as very black and white. So as soon as you go over that number, here you go. Here's your medication, and that's kind of the end of the story. And then once you're on the medication, if your labs are normal, that's it. You stay on it. And then it's kind of there's really no question about it, and it kind of ends there. And people are starting to get frustrated with that cuz it's like, well, do I do this forever? Like if I'm only 40, I'm on this medication for the rest of my life. Is that reasonable? I don't know. So then patients come to us and start asking us questions about it. Yeah, what do you think is the most frustrating part about all that for patients?

I think the most frustrating part is and this kind of goes into other facets of health care is a lot of this is just unexplained to patients. Patients get frustrated because the reason why something is done for them is not necessarily explained very well. So, you go to your doctor, maybe it's an annual physical, or you're having some other complaint, and it's like, "Oh, your cholesterol is high, so here's a statin. See you in a year." You know, 5-minute appointment. Is that good? Is it bad? I'm not necessarily saying it's either, but patients kind of walk out of the appointment, and it's like, "Ah, I don't really know why I'm doing this. It wasn't explained to me. It wasn't really There was no a lot of that context necessarily. Um and I'm speaking very broadly. I'm not saying every health care provider does this, or this is every patient's experience, but it happens a lot.

Happens a lot to my patients and patients uh my colleagues' patients. Um so, it's definitely something that we see significantly. Um so, it becomes more of an issue when patients just don't feel like they know what they're doing when they leave their doctors' appointments, or why something was given to them. Yeah, and why like in your opinion, why is that a problem? It's a problem because we're we're taking away autonomy from patients. We're taking away patients' kind of ability to understand their health, and it becomes more of a system like on a patient rather than the patient understanding why they're doing something. Um it the their health care just becomes, like I said, algorithmic and pre-prescribed by certain standards. There's not really a lot of understanding. People are losing that autonomy. They don't know how their body works.

They don't know what to expect from certain things. They don't know what to expect from side effects or potential issues. And it just becomes a collection of prescriptions as they get older, right? Every couple 5 10 years, they've accumulated a few more, a more, a more. And if you ask patients, I do it all the time. It's like they don't even know why they're on some of the stuff. Yeah, my doctor gives it to me. I don't even know I'm taking it. Yeah. You know. Mhm. It's tough. Yeah. And I'm not saying that's a good or bad thing, but I really value in the way I practice health care and teaching patients. You know, I'm an educator, really as as a health care provider. I'm supposed to educate patients so they understand what they're doing and can make health a very active thing for themselves. Yeah, totally.

Uh well, I think I I think there's a problem when patients don't understand why they're doing certain things, right? Totally. Big problem. Okay, let's let's transition into I think insurance and like the whole conventional medical system is going to like keep popping into this conversation cuz this is just like one of the I think best examples of kind of how conventional and functional medicine are different is like heart health and statin medication. So, we'll kind of keep coming back to that, but I'm going to try to keep us on the agenda here. So, um let's talk about like why is it So, we talked about LDL at the beginning. Like here's this number. It's kind of like black and white, right? Um patients they're over 200, they're kind of most of the time in the conventional medical system, they're handed a statin medication. Why is LDL not enough?

Like just looking at that one isolated number, black and white, why is that not enough? Yeah, so LDL is not really enough because in there's some recent studies that have come out that basically say if LDL is high, is that a good predictor of heart disease? And some of the recent studies that have been published with hundreds of thousands of people are basically saying, well, we don't know if LDL being elevated is a good predictor of heart disease. There's a lot more to it than that. So, we can look at LDL and being high in the presence of say someone who um has diabetes or is pre-diabetic, is obese, um has a very strong family history, um has high blood pressure, has um, other types of class other types of cardiac markers that are elevated. Their diet's really poor. They're a smoker or were a smoker. So, if we take LDL by itself, that's not really a great predictor.

And this is how I try to educate my patients to say, "Well, you might need a medication. You might need a statin if some of these other things are uh, going on, right? Have you smoked? Are you overweight? Do you have diabetes? Uh, do you have high blood pressure? Uh, what's your diet like? Do you drink a lot of alcohol? Those are the things that really start to influence LDL being bad. And really what happens is is um, the LDL becomes really malfunctioning. Like it doesn't function well. You get a lot of inflammation from being overweight, from smoking, from poor diet. And that's really when it starts to become a problem. So, you have to take into consideration all of those things. But the conventional health care setting might not. They're just looking at the number and say, "Okay, well, your LDL's high.

You're going on a statin." It's like, well, I've had patients that are triathletes with high cholesterol. Do they need a statin? You know, you have to consider all these other things. So, that's really where the personalized approach from a functional medicine perspective, I think, is most important. Cuz I want to make it very clear, I'm not pooh-poohing statins. We're not having this podcast episode to pooh-pooh statins or the health care system. We're just trying to understand all the different parameters of how this all works together for patients and come up with um, you know, the best possible outcome for a patient and not just one-size-fits-all health care. Yeah, and and let's talk about it.

Let's talk about like how you actually do take a deeper, more personalized approach to evaluating like the patient as end of one, not, you know, every averages or pro- like different, you know, black and white ranges. So, like when when you see a patient like when who is like what's the type of patient that you're like, okay, this is a statin is actually going to benefit them. This is like a good idea. Right. So, um we we assess patients from a cardiovascular risk all the time. So, some people could be could benefit from it. Um statins may be highly beneficial for some patients and less clearly beneficial for others. And if a patient has had previous heart disease, um you know, they've had a stroke, they've had a heart attack, they're pre-diabetic or diabetic, that a statin is probably highly appropriate for them.

Um because the goal is to not have them have another heart attack or another stroke. Um but in the conventional medical setting, that's kind of where it stops, right? And I'm not saying that's bad. It it it it's a good thing cuz we don't want the patient to have another heart attack, but really from our perspective in functional medicine, it's like, well, we're trying to reverse the the course here. You know, if the patient is overweight, if the patient is diabetic, if the patient does have high blood pressure, if their diet is poor, I'd love to get my hands on this person and say, okay, do you want to reverse your course of your health, you know, issues so you don't have another heart attack? If you do, great.

If you don't, well, I hope the statin protects you from a heart attack, you know, great if it does, but the goal for us is to really take that patient and change their health altogether. And not just keep the statin for as an insurance policy, but change the health care outcome altogether. So, it is they are beneficial, but I'd love to maybe make it so that the patient didn't need it essentially maybe in the future or they needed it at less of a dose or something. You know, there's always room raised to improve things. That's kind of what we're trying to do. Gotcha. And then what's the Explain to me the type of patient who like some of the patients you see like the example you gave was the triathlete. Right? When when do prescribing statins become more nuanced and you're starting to look at other cardiovascular risk markers? Yeah.

Yeah, so so like we said, if you're drawing this hard line in the sand, who's really benefiting from the statins and and who might um not benefit? So, if you're if you have a patient that has very low risk, you know, maybe they're not obese, they don't have diabetes, they're not pre-diabetic or have insulin resistance, they don't have high blood pressure, they don't have a strong family history, they take really good care of themselves, they eat really well, they exercise, their cholesterol might be a little bit high for maybe another reason. Maybe their hormones are low, which can cause high cholesterol to be higher. So, should they be on a statin to prevent heart disease that is probably likely not even there given their parameters of health?

I'd probably argue no, but if you try to convince a family doctor or an internist or a cardiologist of that, it's going to be a hard it's going to be a hard bargain because they are taught, well, if the cholesterol's over a certain number, they have to be on a statin. And we've talked about on this podcast all the time, there are medical legal implications to this, too. If you don't prescribe certain medication the way it's supposed to be prescribed based on certain outcomes, you could be liable if something happens to that patient. So, rather than open yourself up for liability, you prescribe the drug and you just, you know, leave it alone. So, we're not trying to over under prescribe in a functional medicine perspective, we're trying to do what's most appropriate.

And sometimes from a cardiovascular risk, we can do other tests, imaging studies, other types of screening tools to assess patients' cardiac risk um rather than just rely on cholesterol. And that's really what I try to do and educate patients on is what else can we do to better to understand if you do really need this. Cuz if you do, great. If you don't, then let's try to figure that out. Yeah, it's really interesting because what I mean again, something I want to like key in on what you said is like your hormones, like your high cholesterol can be result of lifestyle. So that includes your diet, stress, sleep, your hormones, right? So you go in and then the surface level thing that's presenting is a high LDL so you get put on a statin, but none of these other things get addressed.

And this is again, this isn't to say that like, you know, this is every single other conventional medical office, but it's it's it's the general case out there. Yeah. Yeah, what like what happens when cuz I imagine you see patients in every stage of the journey before they get put on the statin and decades after they get put on the statin. What happens to patients when, you know, they get put on a statin that's addressing the um high LDL, but the lifestyle isn't addressed, their hormones aren't addressed, and all the other root cause factors that are leading to this go unaddressed? Yeah, so what happens to patients when they're put on the medication and and things are not addressed is uh they just kind of go about as status quo, right? Until they until they get kind of sick and tired of not having these other things addressed.

So in a in an ideal world, I have an and this is not necessarily appropriate for everybody, but I have had cases where um the patients will have high cholesterol, maybe it's not too high, they're on a statin, and we start to do a lot of work, their diet, their lifestyle, hormones, all kinds of things, and it comes to a point where their cholesterol becomes too low. And that's not good. And that's something we're going to talk about so soon um is sort of what what role cholesterol plays cuz cholesterol is not bad. We're supposed to have it. We're not just supposed to take medication and get rid of it as much as we can and not have any. That's not how this works. So, I have had patients completely change their life and their when I repeat their cholesterol levels, it's like, "Ooh, your cholesterol's now getting too low.

So, let's have a conversation with your doctor about maybe coming off of the statin and seeing what happens." And that happens a handful of times, um you know, in a month, in every few weeks, where it's like, we really need to take a look at what you're doing with your medications because the statin is now causing things to be too low based on the work we've done and we it's really not appropriate for you to be on it anymore. Um and that's where we work with patients' doctors, their primary care providers, and really come to a consensus amongst all of us of if this is appropriate. So, that's really the goal. It doesn't happen with everybody and it's not appropriate for everybody, but it is cool to see when we can reverse some of this stuff. Yeah.

Yeah, let's talk about some of the root causes that as like a functional medicine provider and the other clinicians at Matrix are are looking at. So, let's go into each one. So, first one's um hormones. How How do your sex hormones contribute and if you could also just kind of go through what your sex hormones are real quick. Sure. Contribute to your cholesterol and cardiovascular health. So, um with sex hormones, so sex hormones are estrogen, progesterone, and testosterone. So, sex hormones significantly impact cholesterol because sex hormones such as testosterone are made by cholesterol. So, a lot of times I see patients where they will have elevated cholesterol in the presence of low hormones. Basically, what the body is trying to do is produce more hormones by spitting out more cholesterol.

Um so, when hormones can get regulated, like a testosterone in a male, optimizing that testosterone will almost always, not always, but a lot of times, um reduce the cholesterol without any other intervention. And it's pretty remarkable to see, and it's it's quite a lot. It can be 100 points, it could be 50 points. I mean, that's a huge amount. So, if a patient is on a statin, and then we optimize their testosterone, and their cholesterol comes down 50 points, it's like it might be too low now. So, that's where we have to do all this work to to understand what's best. So, sex hormones are a huge huge influence on on cholesterol. I see it all the time. And patients get upset when they're not at me, but they get upset when they say, "Why didn't my doctor tell me this?" And it's like, well, it's not that they don't know it.

They learned it in school, but it's not relevant to what they're trying to do. They're trying to sell you the medication. That is their answer. Um it's not good or bad, or wrong, or right. It's just what they are told to do. That's how the education is in that conventional medical setting. Right. So, but patients get annoyed. They're very upset. They they don't understand why some of these other parameters are not discussed. Totally. Yeah. Um I have a question that kind of veers into the hormone replacement world. Sure. Which I know you're an expert in. So, okay, patient comes in, let's say it's a male, right? He's [snorts] low testosterone. Let's say he's in his 50s, and he's on a statin medication. Um let's or or or a woman, right? Dealing with like estrogen, right? Yeah. Um after menopause. You put this patient on a hormone medication, right?

We can talk about bioidentical hormones, which we use at the clinic. And then they're able to get off the statin. But why like the end goal is like to get like patients off medications? Like why is being on testosterone a better option as a medication uh than being on a statin, right? Cuz it's like, okay, we replace one medication with another one. Why is like Why is this a more like preferable medication? Does that make sense? Yeah, it makes sense, but I want to make sure I'm I'm I'm clarifying for our audience that I I don't want people to think that our goal is to at Mid-Matrix or from a functional medicine perspective, we are not here to remove people's medications. You don't come to us and we take all your medications away. That's not what we do. That's not appropriate health care.

We augment medications with the patient's doctor that prescribed that medication um cuz that's a a professional courtesy. It's not my job to take medications away that I didn't prescribe. But, what we're trying to do and and to answer your question is we're trying to make the treatment plan the best for the patient with whatever that looks like. So, some patients do need a statin even if they've had even if they're on hormone replacement because they had a heart attack or there's some genetic issue or they're a smoker or there's pre-diabetes or whatever. So, it's not like hormones are going to replace a statin, but what you're asking is wouldn't it be better to optimize a patient's hormones and try to optimize cholesterol and cardiac parameters than just feed cholesterol medication? Yes, that would be preferable. Does it happen all the time? Not necessarily.

But, if I can take a male from your example, optimize his testosterone, get him feeling a lot better, and his cholesterol gets down low enough where he doesn't have to be on a statin, that would be very ideal. Be great. Be totally totally great. Is that always the case? No. Um but, it does happen. It does happen all the time, for sure. Yeah, so what are so what are because again we're going back to kind of like root cause idea because the hormones are going to affect the kind of lead to the higher cholesterol which then leads to statin, right? So, what are some of the you you mentioned how um hormones need cholesterol to essentially be built in the body, right? For our body to make hormones. Uh what so what are the like long-term side effects of being on a statin medication? Cuz there's probably there's a lot of good things and there's a lot of bad things that go with it, right?

Reduce cardiovascular risk, but then there's also people say statins cause all cause Alzheimer's. They uh we well we know they can lead to hormone imbalance. So, can you talk about like the long-term side effects of statin medications? So, the the statins one of the I'll start with what some of the good things are cuz I don't want to poopoo too much. But some of the good things about statins from what the literature shows is that if a patient has plaque or some sort of atherosclerosis in their arteries where there's a hardening basically people know that you know hardening of the arteries. A statin has been shown very very successfully to stabilize a plaque. So, if a patient has known plaque in their arteries basically it can stabilize it so it doesn't break off and cause an embolism or a floating body in the bloodstream that could cause a stroke or a heart attack.

So, statins do a very good job at stabilizing already existing heart disease, okay? Which is great. But on the flip side statins have do do have a lot of side effects. Fatigue is a huge one. Like like uh fatigue to the point where people are unfunctional. Um pain, muscle pain, significant muscle pain. One of the biggest side effects of statins is it reduces some of your energy molecules like CoQ10 or coenzyme Q10 which is a molecule that basically is needed by your cells to produce energy and give you energy. Um also vitamin B12 can be affected another energy molecule. So a very common inch issue with sends is this really really bad fatigue, low energy, muscle pain to the point of like really extreme debilitation. And that's where we have to understand, okay, what's going on here? Why is this happening and is this still appropriate for a patient?

Um and I have patients that have barely any risk factors, their cholesterol was 20 points above the limit and they're put on like the max dose of a statin and they have tons of side effects. It's like, oh boy, okay. Not saying that this is wrong, not saying you shouldn't be on a statin, but why is it so high? You're having tons of set side effects. So there's a lot of there's a lot of risks and benefits that really have to be discussed with patients and that's another thing what we're talking about earlier. A lot of this is not discussed with patients either. So it's just like, here you go, you have to be on this. No discussion of risks, alternatives, benefits. And patients get frustrated when they don't tolerate the medication and then it just becomes a well, you have to be on it, too bad. Um Yeah. So there is good and bad, but side effects are common. I will say that.

Do see side effects a lot. Got you. Why do you Can you hold on? Can you hear my AC unit just went on? I don't want to be an annoying sound. Uh I don't hear anything. Okay, great. Um okay, so [laughter] I want to make sure audio is good for you guys. I don't I don't know. Yeah, I hope I hope I we got like 40 people here live. I don't know how many are on Instagram. I don't know how many are on the website, but if you guys are um enjoying this, drop a comment, let us know if you're uh learning something. And if you have questions, odds are that someone else has the exact same question. So by commenting, you're going to help everyone learn more. It's going to be more fun. So, if you have a comment or question, just definitely drop it below. We're We're going to get into Q&A in like probably 15, 20 minutes here. Um Okay.

So, let's transition into the functional medicine approach and how we kind of actually do this day to day. So, um how does functional medicine We've kind of touched on this, but we're going to go deeper. How does functional medicine look at cholesterol and statins differently? It's a great question cuz that's what we do. So, functional medicine The functional medicine approach really looks at cholesterol um from a broad spectrum of view. It's not in isolation. So, our our philosophy on health care from a functional medicine perspective is to ask why the cholesterol pattern exists and what's really happening in the body. Is there inflammation? Is there insulin resistance? Is the patient overweight? Is there a thyroid problem? Is there a hormone imbalance or hormone deficiency? Um is there a liver issue? Right, cholesterol is made in the liver. So, is that a problem?

Um You're You mentioned this, Cole, your sleep, your stress, um your nutrition, what's your body composition, how much body fat do you have, um and also genetics plays a huge role. So, we talk about patients' family history. You know, I've had patients where, "Yeah, my dad, my uncle, my brother all died of a heart attack at like age 45." Oh, okay, that's really significant, you know, so certainly metabolic disease, obesity, diabetes, and heart disease are knife and fork disorders really at their core. You know, but there are also genetic components, so we cannot ignore that, too. Um so, there's a lot of things to discuss from a functional perspective, and understanding all these parameters is really how we make the best uh best treatment plan for a patient around their heart health or just health in general. That's exciting.

I mean if I if yeah, I mean why wouldn't you want that type of approach when it comes to your health? Right. I mean I I I would. It almost seems common sense, right? Like it it it's it when you say it's like yeah, why wouldn't you do that, right? But it's it's not the case. It's common sense to us cuz right it's what we do. We live this everyday, right? You and me. We this is our this is our this is our very existence and when I see patients everyday and they're and when they tell me the stories of what they deal with with their doctors it's it's sometimes hard for me but to believe because I don't live in that world as a healthcare provider, but it is the norm and I forget that cuz we're like in this little bubble in our beautiful clinic treating patients and they're doing great. And it's like doesn't everybody do this? No. Oh, I forgot. Yeah. So, yeah.

Yeah, so we're excited for all of you joining us live whether you're new to functional medicine, you're actually an active patient. I know we have a lot of patients that tune in. And if you know someone who's you know struggling or wants more for their health, definitely share this uh episode with them. So, Okay, next question I think a lot of people are going to love which is when evaluating a patient, um what are like some expanded testing that like you typically wouldn't see in conventional medicine that allow you to like evaluate heart health and just do a better job? Yeah, it's a great question. Expanded testing cardiovascular testing is really where you get a lot of data about patient's health beyond a standard lipid panel. And a lot of these markers we're doing from the very beginning with a patient as their part of their new patient uh blood panel.

Um there are things like apolipoprotein B, lipoprotein A, um LDL particle number and particle size, non-HDL cholesterol. I know these are big medical terms and I I'm not necessarily going to define all of them, but they are there are other types of cholesterol markers beyond a standard lipid panel that people really should be getting as part of a standard approach to their heart health, because it gives a lot more data. And there's there's a lot of literature and and medical studies to prove that. Basically saying the standard lipid panel, the total cholesterol, the HDL, the LDL is not quite enough to understand a patient's heart risk. Uh but you also need other things that might not necessarily be related um directly to cholesterol, but have an effect.

Things like your insulin, which is what controls your blood sugar, um a hemoglobin A1C, which is a marker of diabetes, something called a C-reactive protein or CRP, which is an inflammatory marker, um an amino acid called homocysteine, which has been linked to heart disease. And then also things like your thyroid hormones, your liver markers, um we can measure omega-3 fatty acids, which are types of fats in the body that are very um beneficial. Things like vitamin D can also have a significant impact. And then from day one as part of patients' uh initial on boarding with Men Matrix, we do a full body composition analysis. So like how much visceral fat do you have? How much muscle do you have? What is visceral real quick? What is visceral fat? Visceral fat is fat around your midsection and in and around your organs. So visceral fat is the worst kind of fat.

It is fat that is basically kind of enveloping around your organs internally. Your kidneys, your liver, um it's the worst kind. It's the most uh been shown highest mortality rates when people have high visceral fat. Right. And when you go to your normal doctor they're really just looking at the weight and BMI, right? Right. You mostly weight. Yeah, weight. How much do you weigh compared to your height and give you a BMI. Um and BMI is basically a really poor marker of any type of risk, cuz like I have a high BMI, but I'm a bodybuilder. So based on my height and weight ratio, I have a very high BMI. I'm technically obese, but I'm not. I'm like single digit body fat. So it's a very very poor indicator of things. So, understanding some of these body composition metrics is much more useful. Mhm. 100%. Yeah. Yeah. That's the essence of the functional medicine approach.

So, okay, what's I know one of the tests that I know a lot of patients come to us to get specifically, and that's very important, is the ApoB test. Can you talk and inflammatory markers? Can you talk more about those? Yeah, so ApoB Yeah, apolipoprotein B is part of our new patient standard panel for all new patients. And ApoB can help show the number of atherogenic particles that may contribute to plaque. So, basically, it's a protein that tells us how much potential plaque is in um in the body. And then, lipoprotein A is a genetically influenced risk marker that may not show up on a standard lipid panel. Um and these markers really help explain why a person with {quote} {unquote} like normal cholesterol may still have a risk. So, um and then why someone else may have a different level of risk.

So, we do these cardiac markers all on on like I said, on all new patients because it gives us a baseline of their risk, and we can sort of understand what what we need to do, if anything, to understand um for potential more testing. And then, we talked about the CRP, the uh it's C-reactive protein, it's a mark of inflammation. Again, if you take high cholesterol and start introducing inflammation, that's when it becomes a problem. So, high cholesterol by itself is not necessarily a problem. It's when you introduce inflammation, that's when it starts to plaque and stick together. So, when you look at all these parameters together, you get a much better sense of a person's heart disease risk versus just a lipid panel by itself. Great. Um That's exciting. Um okay, let's I'm just looking at timing here.

I think we should Seems like we have a awesome engaged audience with us today, so we're probably going to have more Q&A. So, let's let's go uh let's go into a case study, and then Q&A, and then that'll probably put us out about an hour. Yeah. So, um I kind of alluded to this before. Um it's a case of a male who had um low testosterone. And the goal was not necessarily to do anything about heart disease. He came to me with um symptoms, very common symptoms of low testosterone, you know, low motivation, fatigue, feeling run down, low libido. Um his testosterone levels were low. He was concerned about body composition. He wanted to see more results in the gym, more muscle mass, less fat. So, um he had also pretty high cholesterol to the point where it was still pretty high even with statins. He was on a statin, but his cholesterol was still beyond the limit of the normal reference range.

So, um I treated him for about 6 months with optimizing his testosterone hormone replacement therapy, and we got to a point where his his cholesterol started to dip too low. So, to give people perspective, I'm talking about the total cholesterol, which um like I said, the reference range goes up to 200, and then beyond 200 is technically abnormal, {quote} {unquote}. Yeah. After about 6 months, his cholesterol went from it was like 250 something on the statin. And then it was down to like 140 something if I remember, and I was like, "It's getting a little bit low, kind of." Like anything below 150.

So, we had to have a discuss I I um I put a message through to his primary care doctor, and I was like, "Listen, you know, he's been improving, his health is changing, we're on hormone replacement, and um I'm I'm concerned about the cholesterol getting too low, especially for a male on testosterone. It's like you need that cholesterol, you need that cholesterol to feed the brain, you need that cholesterol to feed um the soft tissues of the body. So, um his doctor was totally He's like, "Yeah, let's come off of it, see what happens, keep monitoring the cholesterol. If it goes back up again, we can we can see." He didn't have a very strong um like family history of heart disease. It wasn't like he didn't have a prior heart attack or anything. So, he Yeah, with his doctor's okay, we got him off the cholesterol med, and um I'll check it again.

I think he I'm I'm due to see him in a couple months, but it was kind of a really exciting thing cuz this sort of stubborn, as they called it, cholesterol, where it's like, "Yeah, you're on a statin, but it's still really high, so we're going to keep you on the statin." Well, his hormones were influencing the the cholesterol, um and that's really where we started to see the win of the cholesterol being um being uh the culprit or part of the part of the culprit. So, it's it's fun. It was fun. When I can get people off of meds that they uh don't necessarily want or need to be on, it's fun. It's cool. Um it's not appropriate for everybody. I want to make that very clear. But, to per your question earlier, Cole, it's like, "Well, what's better, you know, getting a guy optimized on his hormones or being relying on a statin forever?" Well, obviously, the the hormones would be better.

So, when we see cases like that, it's really exciting. And especially exciting when their doctors are like uh uh awesome. This is great. Like, "Thanks for doing this work. Like, you've you've extended this guy's life by probably 10 years." Like, "I know." [laughter] I I Thanks. I know. But, it's really nice to have people's conventional doctors be supportive of what we do cuz um it's not it's not like that all the time, unfortunately. Yeah. Yeah. I I know. It's interesting. [laughter] You'd think most doctors would want, you you all their patients to like be going above and beyond for their health, but not always the case. And what about like other benefits for this patient or other patients? Cuz now that his testosterone's optimized, he's off a medication that's maybe lowered his cholesterol that his body needs.

What like what are the, you know, improvements that other patients or this patients have seen when things like that happen? Well, a lot of times we are experiencing, especially with something like a statin, um we're we're dealing with patients that are having side effects. And that's really the biggest issue. And more often than not, patients come to me and it's like, "Yeah, I started that statin and I just like I'm tired all the time or I get these muscle cramps. My doctor won't take me off of it cuz they don't want to and they're worried about me having a heart attack." And it's like, "Okay, not saying that the statin is bad, not what I'm trying to say, but could we do some work to potentially lower the dose, right? Do you have to be on the 40 mg? Could you be on 10 and or five in a perfect world and have a much better potential outcome and a side effects?

So, it's it's trying to do the best you can for the best outcome. And it's not always getting off medication. Like I said, it might be lowering the dose if we can do that. Um and the the side effects get better. These are These are the goals we're trying to get. Yeah. So, it's exciting when we can do it. That is very exciting. Um okay, I got Sorry, I got one more question left here in my notes that I I skipped over and then we're going to go right into Q&A. So, question is uh for like can you just explain the process from A to Z when someone comes to MedMatrix and their goals are around high cholesterol, statin medication, um you know, heart heart risk, all that. Yeah. Yeah, when someone comes to us at MedMatrix with high cholesterol or questions about statins, the process really begins with a full health history. We do that for every patient, no matter what the chief concern is.

Um we do a full medication review. We talk about family history. We talk about their symptoms and their chief concerns. We do a full lifestyle assessment, which you don't get at most other health care offices. We talk about your nutrition, your stress levels, your sleep, you know, how you how much water do you drink? Like, you know, do you drink wine? Do you drink alcohol? Do you smoke? We do a full assessment of body composition. Like I said, every patient that walks in the door as a new patient gets a full body composition analysis. And then we do a really deep dive in labs. We check over 80 biomarkers for every new patient.

So when we take all when we put all this information together, the goal really is to understand the patient's complete cardiovascular metabolic health and how we can utilize that as part of the healthy aging process of their treatment plan and how we can maximize that for the patient. A lot of it is health assessment risk. You know, it's it's trying to prevent a heart attack in 5 years. It's trying to get patients on a new journey. So that's really what we're doing is preventive care, a lot of preventive care. Yeah, and then what does the initial visit look like with a provider like yourself? It's exactly what I just said. The initial visit is doing all those things, asking all those questions, full health history, family history, lab review, body composition review, coming up with a treatment plan, discussing further treatment or sorry, further testing that might be needed.

You know, do you need further imaging to assess your cardiac health? Do we need a specialist? What types of medications are you on? What are your goals? So this is all done in the first visit. It's a lot of it's a lot of information in the first visit. So I I always tell patients, you know, when you come to the first visit, bring like a notepad, bring your questions. There's a lot to talk about cuz there's a lot of stuff to absorb. And it's really the beginning of a health journey for our patients. Yeah, exciting. Love it. All right, let's get ready into Q&A. Thank you guys for sticking around. Let's start with this one. What about a woman's case study for statin cholesterol cardiovascular that puts me on the spot. Um I'd have to think. Um Guys, when I prepare for these podcasts, I have to kind of go through my Rolodex of patients to think about something to do.

A woman's case study that in relation to cholesterol, um women still women still uh heart disease is still a very common cause of death in women. And I feel like women and heart disease are still underappreciated. Like women don't have heart attacks and women don't have They do, 100%. Um so, one case Okay, one case that sticks out is I had a patient, a female patient, who um on her initial labs, her cholesterol was very high. And she was like the picture of health. Uh I think she was in her early 40s, worked out all the time, ate perfectly, but her her cholesterol was really high. So, it's like, "Okay, well, how do we understand this better, right? Do you need a statin? Do you need a cardiologist? Do you need What do you need?" So, I ended up doing a um what's called and we should do a whole other podcast on this. It's called a calcium score.

It is a CT scan of the heart with a calcium score. And basically, it assesses plaque in the heart in the arteries of the heart. And this otherwise perfectly healthy 40-something-year-old woman, thin, no heart disease that we knew of, no diabetes, no blood pressure, no strong family history, um or actually, yes, she did have a strong family history. Um she had a moderate amount of plaque in her heart arteries from this calcium score that we did based on the the extensive cardiac panel that we did. So, I did send her to a cardiologist and the cardiologist did a full workup on her, stress testing and all kinds of stuff and between the two of us we came up with a really reasonable treatment plan to keep her safe and to prevent further heart disease, but it was not somebody that was a very typical picture. Um but there was a really strong family history, so that might have been the culprit.

But again, it was you know, if we hadn't done the work we did and and the further testing, she might have had a heart attack at like 45-50 being a a thin athletic woman, which who would think, right? So, it's really like I said, the goal here is not to necessarily poopoo on medicine. The goal is to come up with really really good um preventive treatment plans, preventive outcomes. That's the goal. So, that was yeah. Yeah, that's a great story. And that's also like a really good example of like how functional medicine and conventional medicine can like work together. I think sometimes people pin functional and conventional medicine as like enemies and like these are things that work against each other. Um I think what we're against is just like, you know, half-assed healthcare, all right? But like they they can actually work together like really well. So, that that was a great story.

So, um Let's get I think this one's really interesting. Julie, I feel like I've seen you on these lives before, so We have to do some of the earlier questions too, Cole, cuz you tell people the earlier if you Well, we'll only answer this one, but we tell people to answer that do it earlier. You get in early You get my word. We'll get back. Sorry, it's my bad. Cholesterol nourishes your soft tissues, i.e. your brain, heart, even low too low equals brain issues, dementia leading to Alzheimer's {question mark}. So, I don't I'm I'm not going to say that um too low cholesterol leads to Alzheimer's or dementia. That's a very very bold statement that I'm not going to make. But do we know that cholesterol is really important for your brain health and nourishing the brain. Yes, we do.

Um, neurocognitive decline like dementia or Alzheimer's is a very very complex multifactorial These are multifactorial issues. So, it's not appropriate to say, well, if your cholesterol's too low, you're going to get Alzheimer's or dementia. Or if you're on a statin, you're going to get Alzheimer's or dementia. That is not appropriate to say. I'm not going to say that. Um, what I will say, like I said, is we do know that the the importance of cholesterol in the brain is high. It's an important molecule for your brain. And I think that's the best way I can answer that. Okay, great. Yeah. Um, let's see. Go to the top. Um Michelle, we kind of answered that. We'll get to your other question. There's There's a Can you comment on statins and stroke risk?

So, um, as I commented earlier that if you've had a stroke or if you have known heart disease, um, the good thing about statins is they can stabilize plaque. So, if there's known heart disease, if there's known, um, atherosclerosis, or if you've had a previous heart issue, we the statin can stabilize the plaque inside the artery so that it won't break off and cause another stroke. So, for people that have had prior strokes or really significant heart attacks, statin therapy is like a no negotiable from cardiology or like a family doctor. And from a functional medicine medicine perspective, I'm not going to argue with that either. Because the data does show that if you are on If you have had a prior heart, um, issue, a heart event, a stroke, or whatever, there is some data to support that.

So, it's not my job to kind of override that and say, "No, no, conventional medicine is wrong." That's not, like you said earlier, Cole, we're trying to work together. So, if we can help prevent future stroke with a statin, great. We'll leave that alone. Our goal and our job at Mid-Matrix as functional clinicians is to say how else can we improve this patient's health and longevity. What else can we work on? Can we work on diet? Can we work on hormones? Can we work on um you know, longevity and all these other things. So, that's that's really what we're trying to do. Awesome. Yeah. Should we eat a big breakfast? we eat a heavy breakfast? Oh gosh, this is like a this is a whole 'nother podcast. Um I I don't know how to answer that. Should we eat a heavy breakfast? I I don't know. I don't know what this person is referring it to. I guess in general, just in general nutrition.

Usually some people say do fast, don't eat breakfast. Some people say eat a lot of protein at breakfast. What's your like favorite breakfast protocol? Depends on the patient. Some people do really well fasting till like lunchtime. Um some of the best clinical evidence for longevity says you should have at least 30 to 40 g of protein when you wake up in the morning to get your energy and your blood sugar. Yep, to get your energy and your blood sugar balanced for the whole day. Um that's probably my best advice, but it's very different depending on the person. Okay. Yeah. Um your apoB and inflammation markers are much better for heart disease risk for risk of heart Yeah, we talked about that. Um they are really valuable tools to understand heart disease risk. So, thank you for the comment, Julie. Can you talk about oxidized LDL?

Um so, oxidized LDL is um so, we talked about LDL or low-density lipoprotein. So, oxidized LDL is um it's it's LDL that's been damaged by free radicals, which are chemicals in the body that have specific effects on soft tissues. Um oxidized LDL is the primary driver of atherosclerosis or hardening of the arteries because um not to get too biochemical, but basically the um the immune system cells in the body consume oxidized LDL. And they turn it into what's called a foam cell. This is like bringing me back way back to college days. Um and then what happens is is the foam cells stick to your artery walls and build plaque. So, um unlike standard LDL, which safely transports cholesterol like I mentioned at the beginning of the podcast, oxidized LDL triggers vascular inflammation. And vascular inflammation is what causes the plaque to build up.

So, um yeah, this is where we run into problems. So, yeah, not to be too biochemical on people, but um yeah, gosh, that's That's what it How do we How do we What drives oxidized LDL and what reduces oxidized LDL? So, um the like I said, when you um when you have like these free radicals in the body, um which are particles that can disrupt certain membranes and soft tissues, oxidative stress basically. It's a balance between unstable molecules and antioxidants or um uh important molecules or or um yeah, um things that that reduce stress. So, when free radicals when these free radicals or these unstable things floating around um outnumber the good ones, the antioxidants, they uh attack the lipids and um they they chemically modify them to make them more harmful essentially. It's a whole biochemical pathway that I had to learn 20 million times that is fried in my brain.

Um so, you know, things like cigarette smoking, diet, all that stuff is big. Yeah. Got you. All right. Does lowering the dosage of statins mitigate the side effects? It can. Yeah. And I'm not saying that to advise you, whoever this person is, on things that you should do. If you have concerns about side effects of a statin, you need to talk to your doctor. But, um yes, dosing I have seen can change the side effects. So, from say like a 5 mg of a something to a 20 mg of a something can definitely change the side effect profile. So, I I said this before, if I have a patient that needs to be on a medication and we're doing a lot of work, diet, exercise, hormones, and I can get them from a 20 mg of a something to a 5 mg of a something very safely with their doctor's help, um that's great. You know, if they had side effects and they're they're feeling better now, that's a win. Yeah. Sweet.

I love this question right here. Can beetroot help reduce cholesterol? Um I love beetroot. Why do you love this question, Cole? know. It's just fun. I think it's like it's like little health hacks are always fun. [laughter] Um so, beetroot is uh beetroot helps with what we call vasodilation. It dilates the veins. Um so, in the arteries, so it's a very very commonly used um supplement. I use it all time I use every day, but beetroot can naturally support healthy cholesterol because it's a very very high soluble fiber and it has very high antioxidants. So, because it's highly pigmented, it's that really strong red color. Um it's has a lot of antioxidants and a lot of phytonutrients.

So, these ox- these antioxidants and phytonutrients basically bind um certain what we call bile acids, which are made of cholesterol, and they remove them from the body, which can promote lowering um bad cholesterol and preserving good cholesterol. So, not necessarily a primary treatment, but could be used as a as a an adjunct of a like a cholesterol lowering treatment plan, for sure. Yeah. Great. Great discussion. What about other problems like liver disease, chronic kidney disease? Have we done a podcast on kidneys? I don't think we have. I don't think so. On chronic kidney disease, we should. Yeah, this is a whole This is like a whole episode. This is like an hour-long discussion. Yeah, cuz I [laughter] don't really know what the question is. So, like cholesterol and chronic liver disease or chronic kidney disease?

Um I mean, the cholesterol, you know, high levels of cholesterol and triglycerides damage small blood vessels in the kidneys, which can reduce blood flow. Um and also, conversely, chronic kidney disease impairs the body's ability to process fat. So, this can cause an abnormal cholesterol profile. So, it kind of works both ways. But, this is like a whole podcast episode. Yeah, we should make a note of that. That's a good one. All right, and then last one. Are you saying with a history of stroke, heart attacks, one should be on a statin to prevent a second event? I am not going to answer that. That is a personal health question for a patient's doctor. But, according to the medical literature, if a patient has had a heart event, like a heart attack or a stroke, the medical literature has shown that statins do prevent subsequent events.

But, every patient needs to be evaluated on a different level for their risk. Um it's not a blanket thing for everybody, and this is really where personalized health care comes in, and this is where cardiology does excel. And when patients do have an issue, what's the best way to prevent another issue? Um so, I don't want to guide anybody in one way or another, but the literature does support that. Yeah, so the answer is depends. It depends. And um there's a lot of risk factors there. There's a lot of different variables to look at, but generally it is acceptable, it is accepted and well and well understood in the medical literature that the one of the best ways to prevent a second or subsequent um heart event is with statins. So, it's as part of an entirely multifaceted other treatment plan as well. Great. All right. Yeah. Cool. That's it. We're a little over time here.

Um Colin, what should patients do if they want, you know, more personalized health care and they live in Maine and New Hampshire? Yeah, so if you're, you know, interested in a more personalized approach to your health, whether it's um you know, statins, cholesterol, hormones, um you know, they we'd love to have you. We evaluate um whether you need any of these things, right? Um but we're trying to understand from a patient's perspective all the parameters that we talked about, right? Um we're trying to understand all the labs. We're trying to understand your cardiac markers. We're trying to understand your risk factors. We really want to understand your nutrition, you know, what your blood sugar is doing. Um how much visceral fat do you have? What's your strength training like? What inflammation do you have? Do you smoke? What's your family history?

So, there's a lot of parameters that go into this and really that's what we're excelling at at Mid Matrix is understanding all of these different parameters together, um whether it's to evaluate for heart disease or for hormone dysfunction or any other common problem that we treat every day. Um so, yeah, that's that's really uh what we do best. Well said. Yeah, and if you learned anything from today, like we talked about earlier, it's like this is not common knowledge for a lot of people and you know, a lot of patients are out there guessing with their health and there's you know, we can definitely provide a lot of answers. There's more answers out there. You should be in the know when it comes to your health.

So yeah, share this with a loved one or friend who you think would benefit and then if you are interested in working with us as a patient at MedMatrix, you can go to medmatrixusa.com and you can apply to be a patient there. With that said, thank you everyone for joining. Thanks for the comments. It was so fun dealing with you guys and we'll see you in the next one. Hey Colin, what's the next what's the next podcast? What is it? We got some ones coming up. We got I got the calendar here. We got muscle, menopause. We got We got how to stay strong. Sharpen energy as you age. That's with you and Dr. Rose. Yeah, that's next Thursday. Yeah. Yeah, so next Thursday, how to stay strong, sharpen and energized as you age. It's a really longevity focused. That's going to be with Colin and Dr. Rose. If you guys want to tune in there, you can find that on our social media.

You can follow us on Instagram at MedMatrixMain or Facebook MedMatrixUSA. All right, that's it. Got everything. All right guys, thank you for joining. Thank you Colin for the time. All right, bye. Thanks. Bye.