Dr. Robert Lustig & Dr. Casey Means: guide to understanding your cholesterol

#metabolicfitness #metabolism #metabolichealthguide to understanding your cholesterol The ultimate guide to understanding your cholesterol panel (Dr. Robert Lustig & Dr. Casey Means) 80,413 viewsJan 6, 2022 2.7K DISLIKE SHARE DOWNLOAD CLIP SAVE Levels 21.8K subscribers Levels Chief Medical Officer, Dr. Casey Means, talks with Levels advisor and author of Metabolical to discuss how to interpret your cholesterol panel in order to better understand your metabolic health.Dr. Lustig walks through what HDL, LDL, triglycerides, and total cholesterol mean, how fasting insulin tests relate to your cholesterol panel, and how to improve your cholesterol numbers. This episode dives into how to interpret ratios of your cholesterol numbers like triglyceride-to-HDL ratio to learn more about your metabolic health. Grab a pen, your recent cholesterol panel, and this episode to work through your numbers! This is a companion episode to this article: https://www.levelshealth.com/blog/the... This episode DOES NOT CONSTITUTE MEDICAL ADVICE. Please talk to your doctor about all diagnostic testing. 00:00 - Intro 02:17 - Understanding cholesterol 02:44 - The correlation between LDL and heart disease 05:12 - The connection between LDL and triglycerides 07:14 - Good cholesterol 16:48- Measuring LDL 30:04 - Portal systems in the body 44:51 - The importance of liver function tests 54:05 - How to reduce liver fat Available on "A Whole New Level" in Apple Podcasts https://podcasts.apple.com/us/podcast... Available on "A Whole New Level" in Spotify https://open.spotify.com/episode/3adI... https://www.levelshealth.com https://www.instagram.com/levels http://www.twitter.com/levels #metabolicfitness #metabolism #metabolichealth #metabolic #continuousglucosemonitoring #glucosemonitoring #cgm #cgmlife #biowearables #biohacking #startup #startupcompany #startuplifestyle #startuplife #startupstories #startupideas #startuptips #startupadvice #onboarding #onboardingtips #onboardingvideo Chapters Intro 0:00 Understanding cholesterol 2:17 The correlation between LDL and heart disease 2:44 The connection between LDL and triglycerides 5:12 Good cholesterol 7:14 Measuring LDL 16:48 283 Comments rongmaw lin Add a comment... FDB Associates, LLC FDB Associates, LLC 13 days ago This is one of the most important 57 minutes of content in all of the internet! High substance questions and answers that were all understandable to non-medical professionals. Congratulations for knocking it out of the park!! Thank you both!! 4 Levels E.A. Miller E.A. Miller 5 months ago Holy cow. What a brilliant educator. I’ve been in medicine 30 years and I’ve never had cholesterol explained like this. Thanks, this was the highlight of my day. 85 Malcolm Achtman Malcolm Achtman 5 months ago I was curious to hear what Dr. Lustig feels a good HDL level is. I'm happy he mentioned (near the end of this video) that we should be moving above the typical recommendations of 40 mg/dL for men and 50 mg/dL for women. Cardiologist Dr. William Davis sets his baseline at 60 mg/dL. Dr. Robert Cywes recently suggested 75 mg/dL or higher for HDL. Dr. Lustig said the problem for some people is they are genetically predisposed to having low HDL. That might be true, but I'm thinking it might apply to a very small number of people. The reason low HDL seems to run in a family and seems to be genetic probably has more to do with the fact that the children typically eat what the parents ate, and if they're all eating a high sugar & carb diet it will naturally lead to everyone having low HDL. Before changing to a low-carb diet, my HDL values were in the 30-range. Now (on low-carb) I'm closer to 60 and I've even reached 70 mg/dL. Meanwhile, my identical twin brother, who continues to eat a higher carb diet, still has HDL hovering close to 30 mg/dL. Dr. William Davis tells a story about his HDL going from the 30's up into the 90's after getting off carbs. Note: This won't happen overnight. The increase is gradual over a period of time. And many people can achieve success raising their HDL with a proper diet low in sugar and carbs. 15 ph0ib0s1 ph0ib0s1 5 months ago Literally my life saver. His lectures about sugar saved my life. Several family members, some of them MD's died from diabetes 2 after experiencing the worst possible outcomes. After learning the truth from his amazing lectures, I found the way to fasting and low carb diets. 27 Andrew Scott Andrew Scott 2 months ago The best explanation on this topic that I have ever heard. Such wonderful, succinct clarity from Dr. Lustig, and excellent interview from Dr. Means. 8 Cletus Amlung Cletus Amlung 5 months ago Wonderful.. I did all three suggestions.. Got rid of processed sugar, Added intermittent fasting and exercise daily. Lost over 20 pounds in 6 weeks. Looking forward to getting my cholesterol tested. 28 stitchknit72 stitchknit72 4 months ago Exceptionally good info. Thank you Dr Lustig. And Kudos also to Dr Means for her interview style. I really appreciated that she asked questions and allowed Dr Lustig to answer without interruptions. 24 Matt Olsson Matt Olsson 5 months ago Great interview that explains cholesterol in an easy way for anyone to understand. 34 Levels Lucina Whitney Lucina Whitney 13 days ago Thank you, thank you, thank you for ever Dr Lustig ❤️ for sharing your knowledge in detail, and of course to the presenter for asking and commenting in a way that educates the audience on such life saving topic 🌻 2 Levels Lisa Long Lisa Long 4 months ago What an informative, understandable explanation of cholesterol!! Doctors have been scaring me with my 290 cholesterol panel for years. Last one sent me to a heart clinic where they tried to talk me into a statin. I've always been fit and healthy and rarely ill. I'm 64 and all my other biomarkers are excellent. My triglyceride (65) to HDL (72) ratio is .90! In your words, if my ratio is less than 150 I'm "gonna live forever." I'm passing this episode to some of my cholesterol-worried family and friends. THANK YOU! 10 Mary Koger Mary Koger 5 months ago This is the BEST interview! Easy to understand. This will help so many people. I’m going to share with my doctor whose always trying to get me to take statins. I know I’m healthy. Thank you. 24 Diana L. Diana L. 5 months ago (edited) What a fantastic interview! He's such a good teacher! I've learned a lot. Thank you for the content. And your questions were also nice, and you let him speak. Very good content! My only problem: you didn't give the units. We can figure it out, but it would be nice if the units were given (for insulin, etc), because we watch from all over the world, units may differ. 11 George Young George Young 2 months ago Chapter 9 of Metabolical taught me what I needed to know about my lipid panel. Total cholesterol 288, HDL 62, triglycerides 52. So I knew how to interpret the results. Dr told me I was a candidate for a statin and I told her I was a candidate for a new doctor 4 Abdo Yazbeck Abdo Yazbeck 6 months ago Exceptional interview! I have Metabolical (the book) but the summary (end explanation) of reading lipid panels in this interview is priceless. 40 Levels M T M T 5 months ago (edited) Fascinating interview! At my last yearly wellness physical check, I asked my doctor if there was a way to measure my level of insulin resistance and he told me that he was not aware of any testing to do so! I need to show him this YouTube video and give him some post graduate education! 16 Chaz Chaz 3 days ago (edited) The situation with liver function tests is even worse than you describe. Prior to educating myself my ALT was above the upper limit of normal on multiple occasions (46 to 60, as I recall). I had two different doctors tell me exactly the same thing: "It's nothing to worry about. It's probably just a little bit of fat in your liver". Asking them to recognize that a value over 25 is unhealthy seems like a stretch when a value explicitly noted as "HIGH" doesn't phase them. PS: Thanks for the awesome video! 1 Levels Sophia Ged Sophia Ged 4 months ago Dr Lustig is the best and Dr Means has a way to lead the interview making it highly beneficial and instructive for anyone who wants to understand his/her lipid profile. 4 F100 FE390 F100 FE390 5 months ago (edited) This is so valuable. At 55, I’m definitely going downhill due to what I’ve learned from videos is undoubtedly insulin resistance. I have all the symptoms. I refuse to go to a crap doctor. I watched traditional medicine kill my healthy father in 2.5 years. They are not stupid, they are intensely evil, milking insurance 100% intentionally. They want you as sick as possible. I’m intermittent fasting 16 to 20 hours a day. My first fast was 36 hours and it completely cured my trips to the rest room. Cured. 2 days. Completely. The rest of my symptoms are improving, but I want to go faster. 11 zewdu wondifraw zewdu wondifraw 4 months ago Very important interview to understand cholesterol without a doubt. Thank you for your effort, Casey, in creating such an overall understanding of cholesterol at large. 2 Al Al 5 months ago (edited) Wow ...the approach by you both to educate at a level even paramedics like me can understand 🤣, the best metabolic health vlog I have ever watched, and I watching all the big hitters. Thank you 😊 so so much .. a seminal moment in my journey towards becoming a metabolic health practitoner. Cheers Al 6 Jeff Darrell Jeff Darrell 3 weeks ago An outstanding presentation! If my Dr who has resisted NMR Advanced Lipid panels and Fasting Insulin tests doesn’t see this and agree to adjust, I may change Dr’s !! Thank you so very much! 1 Levels Angel Heart Angel Heart 4 weeks ago Thank you Dr Lustig for explaining the cholesterol panel. I now understand it! You are such a clear and concise teacher. I really appreciate you ❤️ Dan Mauney Dan Mauney 5 months ago Great interview with lots of powerful information. Thank you both for the lab ranges! 6 Michaela Treacher Michaela Treacher 2 months ago Excellent!!!!!! I've been in practice for more than 20years and finally I have a complete understanding for it. Thank you!!❤ 2 Ann Marie Ann Marie 5 months ago (edited) What a treat to listen to this valuable conversation. I’ve been a fan of Dr. Lustig ever since hearing his lecture on “Sugar The Bitter Truth.” This information is really going to assist my conversations with my elderly Dad and even BF. Both relatively healthy, active, and eat decently, but there’s room for improvement based on a few factors. Happy to say that my ratio is extremely low. Part of this is genetics, but a lot is my lifestyle. I’ll keep doing what I’m doing. 2 Sunil Koduri Sunil Koduri 5 months ago Very good podcast. Sent this to my family members who are doctors. Keep up the good work!! 6 Bruce Hutchinson Bruce Hutchinson 1 month ago (edited) What a team Dr. Lustig and Dr. Means. So clear and emphasizes the importance so well. 2 Levels Iane Howe Iane Howe 5 months ago (edited) To me the biggest issue is going to a doctor have them stuck on this old school thought. Have to either fight them or just sound like I don’t care. According to your explanation my numbers are actually great. One endocrinologist put in a statins because I was doing Keto to fix insulin resistance and he said my total cholesterol was high. I was in so much pain that I had to stop. I started IF and now all my numbers are great even having some carbs. That’s why I’m doing now low carb+IF. 3 Wendy Klug Wendy Klug 3 months ago I was amazed! What I most appreciated is that the doctor spoke very clearly, slowly, and succinctly. I was able to understand what he was saying and the importance of the information he communicated. 2 Karl Karl 3 months ago This was such a great dialog. A lot of good insight and advice. However, there are still mysteries in the human body. Some of my numbers are off-the-chart good (insulin 1.2, measured again, 1.9) but my ALT is 30-40. And, when I've had my blood taken at two different hospitals (for two different conditions) even one day apart, both fasting for 14 hours+, some numbers are wildly different, falling in the "caution" range and the next day being quite good. Dr. Lustig briefly mentioned that if a person has an acute illness, the measurements are not subject to the usual interpretation, and therefore are not useful for evaluating a person's metabolic health. I suppose certain chronic illnesses can cause various numbers to be high or low for reasons other than the typical ones as discussed here. I realize that it is impossible to cover all of the possibilities, and that's why a knowledgeable, engaged doctor is probably the best person to evaluate a patient's blood panels, but that is not an option for a lot of people -- either because doctors are not knowledgeable or engaged, or because it takes a lot of time and money to work with a doctor on these. So much opportunity for educating patients and giving them data about their own health! You were both fantastic in this. Looking forward to more content. Denise Spencer Denise Spencer 4 months ago Excellent discussion. You made it sooo clear… thank you! 2 Malcolm Achtman Malcolm Achtman 5 months ago Dr. Lustig mentioned that we should check our WBC (white blood cell) count and thyroid health before evaluating cholesterol, as those variables could affect our cholesterol results. Another important factor that Dr. William Davis reminds his tribe about is that you should never get your lipids evaluated while undergoing weight loss. He says the mobilization of fats during weight loss (even just a pound) could affect all the values and mislead the patient and/or their doctor. He says a person should wait at least a month after achieving a stable weight before getting tested. 5 Kathleen Shunstrom Kathleen Shunstrom 1 month ago What a great episode! I absolutely love the comment "the art of medicine" that is spot on! 👌 💯👏 Florabel Lucerio Florabel Lucerio 1 month ago #Dr.RobertLustig thank you for all you do! I got all your books and watched most of your lectures! Again thank you. There’s no word to describe how we appreciate you! Your brilliance is beyond! Shannon Blok Shannon Blok 4 months ago Fantastic and informative. Now I have the tools to speak with my doctor about my “High” cholesterol. Loved this. 2 Margot Denger Margot Denger 5 months ago Thank you SO much for this interview. Please have him back! 8 Michael Fernandez Michael Fernandez 1 month ago Outstanding! Thank you so much for sharing. I'm getting my copy of Metabolical today. I want to understand the details of every one of my metabolical tests and optimize each. This is how I plan to measure my fitness going forward. My metabolical fitness. Rosa Lagamba Rosa Lagamba 4 months ago Thanks to this brilliant Dr Robert Lustig I gave up all sugar and alcohol out my diet. I am 70 years old never been on medication, but softer from inflammation, and I was 35 pound over weight. Six month without sugar or any carb I lost 28 pounds and all the pain disappear. Let’s hope Dr Robert Lustig receive the Nobel Prize for his hard work. Seen him receiving the Nobel Prize would be the better than finding a new habitable planet 🌎 2 Annette Cinquemani Falbo Annette Cinquemani Falbo 4 weeks ago Another great conversation! I'm thrilled! I'm going to buy Rob's book too! So glad I found your channel! Jenny long Jenny long 5 months ago This video blew my mind when they talked about high triglycerides & untreated hypothyroid disease. Great video ! 6 jeffrey sorensen jeffrey sorensen 5 months ago I have been on a low carb ketoishdiet for 2 1/2 years. I lost over 50 lbs ( 40 in the first 3 months)10during the pandemic. All my metabolic health markers are very good with the exception of HDL.It was in the low 40s before changing my diet and am still in the 40s. I am 62 and do HIIT 3-5 times a week,do intermittent fasting 4-5 times a week OMAD ONCE PER WEEK.My BMI IS 22 and fat percentage is16% visceral fat is 1 according to my metabolic scale. I am6’2” 170 lbs at present. Even in my 20s at 140lbs my HDL wad in the 40 2 Tram Nguyen Tram Nguyen 4 months ago I just did the 2 hour glucose tolerance test and fasting-lipid panel together. My triglyceride is 62 and HDL is 66. My fasting glucose was 55, but My glucose after 2 hour was 245 mg/dL (too high). I am on keto/ low carn diet for 2 years. I don’t know should I worry about my health. jerad200 jerad200 3 months ago I am so grateful I found this. I have been detoxing from sugar for a bout a week now due to high ldl and triglycerides readings on my blood tests. I have already droped 70 points on my triglycerides but my ldl spiked. Going to take some time to clean the old liver out and restore my levels. 1 Dr. Riyan Dr. Riyan 4 months ago I do believe that the more you understand a topic, the easier it is for you to explain it. 1 Pavel Chorda Pavel Chorda 4 months ago Question, what is right, TG/HDL ratio or the other way around? Thanks for the amazing work 2 Kimberly B Kimberly B 3 months ago My recent ALT test result says that the standard range is 7-52[IU]/L. WOW...I'm shocked because this is even higher than Dr. Lustig mentions that the test quotes. It is so frustrating and hurtful that our medical system is so deceptive. 1 RXP91 RXP91 3 months ago I loved hearing the mechanisms being the signalling pathways. As a counter to the density of HDL ratios mattering much see this video which cites full references when Dr. Eric Berg made the same argument: https://www.youtube.com/watch?v=JvKNzLRmzLg highrzr highrzr 1 month ago Such good information here. It has helped me to understand my blood tests better and what my body is trying to tell me. I'm dragging my doctor slowly towards metabolic and nutritional enlightenment. To her credit when I asked for an NMR LipoProfile+Lipids test, she said that she didn't know how to interpret the results. I got it done at an independent lab, and I'll try to further enlighten her. Michelle Musillami Michelle Musillami 4 months ago This was one of the best you tube interviews I have ever listened too!!! Fantastic! 4 Mary G Mary G 4 months ago Fantastic program thank you for your life long hard work looking for more of your episodes 2 Hollywood Hollywood 4 months ago Omgosh thannnnk you for this video!!! This doctor has saved my life! The doctors didn't even care I have a fatty liver and my triglycerides are 359!!!! I've been researching for years to find out what I have and I'm finally seeing I'm on sugar overload too just like the doctor is describing. Im skinny fat and unhealthy just like he said! I love this doctor!!!! Ive been trying to figure it out for 5 years now!! I hope its not too late to heal my liver. This doctor actually cares!!!! Hes not masking the problems and open up ppl minds to the food industry and I applaud you and THANK YOU, THANK YOU FOR SAVING ME! His new book is EVERYTHING! And its all FACTS and makes soo much sense now!!!!! ! All I can say is thank you SOOOO MUCH FOR PUTTING THIS OUT THERE!!👏🏾👏🏾👏🏾👏🏾Let hope ppl wake up and see what's clearly going on in the medical field!!! There killing us really!!! How can I get insulin test because my pcp doesn't believe me when I talk to him about stuff like this! Going to the doctor is truly a waste of time and money! We have to be our own doctors nowadays! And that's sad cause there getting paid big bucks to do nothing smdh!!! 2 Marx P Marx P 3 months ago Read metabolical like 3 times ! Awesome ! It is a puzzle - my Alt was 34 higher then it was a few years back / I weight train regularly. Muscle breakdown will also cause higher levels . Had GGT done excellent !!! Also my fasting insulin was 1. 1 - triglycerides/HDL ratio 0.3 ! Cindy Cindy 2 weeks ago Thank you for this discussion!!! Made my day for sure. Levels Buck Dezno Buck Dezno 12 days ago Yes! (In regard to looking at the entire body as one system.) My doctor seems to think each thing in my body is disconnected. She doesn't seem to understand that the lab work tells a lot of things, but they are not indicators of exclusive systems. Betsy Durham Betsy Durham 4 months ago Awesome interview. Very understandable 👏🏽👏🏽👏🏽 1 Kaynen Brown Kaynen Brown 4 months ago You guys have no idea how much posting videos is helping people in the world. Thank you. 1 Levels Spinder Ellas Spinder Ellas 4 months ago Reading Metabolical now! Thank you for this talk and the book!! 2 Tom Nes Tom Nes 3 months ago Dr Lustig, Love your work. I'm halfway through Metabolical, Outstanding. 1 Donald B Donald B 5 months ago Great conversation. You two should do a series... 1 Sarah G Sarah G 2 weeks ago I like to watch all sorts of videos out there about health and nutrition. I watch them all… and wow. I am shocked with what is still out there. Dr. Lustig is brilliant. I loved this convo with Dr. Means. So a shocking video I watched earlier today was an older lady who was a dietician at a hospital talking about cholesterol and encouraging people to eat margarine and to stay away from saturated fats. That info was bad enough but never once was SUGAR mentioned. It’s like the old way of thinking never takes sugar into account. So now my next thought… when does Honey Nut Cheerios (processed, high carb, sugar) lose the “heart healthy” seal of approval? Eddie C Eddie C 3 months ago Damn I love this doctor explains everything just the Right Way, God bless you🙏 1 Manny Radzky Manny Radzky 5 months ago FABULOUS VID. Thank you both. By far top 3 vids I have watched on health. I have watched over 700 vids. Dr Lustig, 2 things please, 1. Keep on fighting 2. Live to 180, we need you around. Thanks again. 11 Levels B Inquisitive B Inquisitive 1 month ago Great program on metabolic disease and what needs to be done, if you find yourself in that chronic state, which unfortunately as was pointed out well over 89% of our population is now in. My last take away point is the harm to sugar and refined carbs have cause in the last 50 years.to do if your chronic Malcolm Achtman Malcolm Achtman 5 months ago Most experts I follow would say that Dr . Lustig's cut-off for fasting insulin is far too lenient. First of all, I think he should tell us what units of measurement he is referring to. American values are typically reported in uIU/mL, and that's what Dr. Lustig is talking about. But international and Canadian values are often reported in units of pmol/L. There's a huge difference. As a Canadian, I used to get very frustrated with this because my values in no way matched with what I would be seeing or reading about in U.S. material. Anyway, if you get a fasting insulin result in pmol/L you need to multiply that value by 0.143988 to obtain units of uIU/mL. z Bass z Bass 5 months ago Dr Lustig your book is just amazing 🙌 5 extranjeroviajero extranjeroviajero 3 months ago (edited) I have already dropped my primary doctor long time ago since I heard as this gentleman as others educating us not only about this particular topic but also others as important.. I do not need one anymore!!!! Education is very powerful!!!!! 1 The Wellness Room The Wellness Room 5 months ago Simply AMAZING! Very educational! 2 Laura Cerva Laura Cerva 5 months ago This is amazing. I need to watch about 50 more times. Thank you! 6 russ brown russ brown 5 months ago These two Doctor's are absolutely brilliant. I'm reading a lot about the function of LDL's role on fighting infection. Is this really true? If so, how come we rarely here about this in the media. We seem to here all the time about how it cloggs arteries, and how we should take statins. 1 My-YT-Inputs My-YT-Inputs 5 months ago Dr Lustig discussed "fasting" before lipid panel. I'm curious of your thoughts on Fasting length before blood draw and how that might affect Labs? The standard is typically either 10 or 12 hours...depending on Lab/Docs office advice. Dave Feldman, Cholesterol Code, suggests 12 - 14 hours. I ask because my summer 2021 Labs were higher than I expected but I was in a Fasted state of over 40 hours before blood draw. The year prior, summer 2020, it was not as bad but still I had been fasting closer to 40 hours. A retest due to an error with a more normal 12 hour fast and my numbers were super. Trig/HDL ratio of less than 1. Keto 2020/Carnivore 2021. 2 Kalimat Kalimat 5 months ago I don’t have words to thank you 🙏 dr Robert🙏🙏❤️ 4 mackie mackie 2 weeks ago My sleep gone blown away by listening to this .....thanks dr 2 Levels PHWshopping PHWshopping 3 months ago Need to hear how ApoB factors in. I was told by my doctor that the higher your LDL the higher your ApoB will be. Malcolm Achtman Malcolm Achtman 5 months ago Dr. Lustig said lots of doctors won't run an advanced lipoprotein profile because the insurance is unwilling to cough up the $500.00 fee. Well, there are lots of places that will run a full lipoprotein panel for much less than $500.00, and almost anyone could order it themselves and not even involve a doctor. My preference is to use a lab called SpectraCell (in Houston, TX). I've done it at least 6 times on my own and never needed my doctor's consent. I believe the current cost is about $150.00 US. And there are many other labs that offer a basic NMR lipoprotein panel for less than that. 2 Awa Lebe Binu Awa Lebe Binu 5 months ago (edited) Really good interview. Super informative. Also, $500 for a test that insurance won’t cover is a single drop in a huge bucket compared to what it will cost you if you just keep popping pills and going on with life as is. Get accustomed to Investing in your own health because no one else will when you’re living in a system where your illness is profitable to someone. 1 Mk Shffr Mk Shffr 1 month ago A couple of quick questions... 1. Given that scar tissue on the liver is permanent what do we do in the case of stage 3 or 4 Cirrhosis? 2. Where does molasses fit into the picture? jaime zhina jaime zhina 2 months ago This dr is great doing his lecture, most doctors wants to put in statins without even explaining to us what’s de differences between those lipid panels which ones are the good or the bad ones, DileepB DileepB 4 months ago (edited) Doesn't a NMR Lipid Panel measure sdLDL? Medicare and my supplemental insurance did pay for it. Most doctors do not order fasting insulin test. I had to fight with my doctor to get him to approve it. 2 doernerrr doernerrr 1 month ago Man is it nice to hear docs talking like engineers. l. S. l. S. 1 month ago (edited) Doctor is brilliant. Pardon my "French" He is Fucking knowledgeable. it is incredible. He should be Surgeon General. Evey of his interviews I watched. I am bewildered, how he takes medical terminology appart. So none medical mind can comprehend. All doctors, who are interviewing him, learn from him, as if they are in medical school. Casey, is very bright doctor. I have seen her being interviewed. Even she is amazed, how Dr. Elaborates, how organs are functioning. 1 Content Starved Content Starved 3 months ago My understanding is that all apo b particles under 70 nm, which includes large and small LDL’s, can cross the threshold and build up plaque in your arteries. The idea that large LDL’s are benign is a misunderstanding of the data that shows people with heart disease have lots of small LDL, but subsequent research shows that two different people with the same quantity of large and small LDL’s are at equal risk. Angela Asadi Angela Asadi 5 months ago This was GREAT information. Thank you. 1 Debbie Herrick Debbie Herrick 4 months ago Liver failure is how I just lost a friend who was a diabetic. Hooked up to dialysis and drug induced coma. Sugar sure does kill...! 2 Equs Narnd Equs Narnd 4 months ago (edited) OK, I'm doing Keto. My HDL is 107 and triglycerides are 52 which gives me a ratio of 0.49. Does what you said about living forever still hold? 4 Marilyn'sPlanet Marilyn'sPlanet 5 months ago (edited) Important video on the pitfalls of how Primary Doctors overlook the opportunities to prevent diabetes, stroke or a heart attack. Can you have the doctor use a white board to provide a visual example for those who are visual learners? How can you reverse the high triglicerides specifically. Any holistic remedies? Thanks for posting this. 2 Walt Dennig Walt Dennig 7 days ago Apropos getting rid of sugar. I did. However the electrolyte mix that I put into my water has stevia. I wondered why I wanted to drink so much of this water throughout the day - much more than was needed for hydration. This seemed like a craving situation, because I thought about sweets throughout the day. My chiropractor advised me that the brain interprets stevia much the same as sugar and therefore instigates insulin production. So, I changed the electrolyte mix to Keto K1000, which has no stevia or other sweeteners. I no longer have the sweetness craving and am drinking sufficient water to maintain optimum hydration. Peggy Batt Peggy Batt 5 months ago Very helpful information. Thank you!! 1 jaykana jaykana 1 month ago Now l understand cholesterol, thank you 2 Levels youtuber42 youtuber42 5 months ago I will pay more attention to GPT/ALT now. Went up to 48 for me last tear6. Kathy Noel Kathy Noel 3 months ago Explains so much of my issues 1 Linda Bragg Linda Bragg 5 months ago A friend of mine showed me his bloodwork taken or right before during his heart attack triglycerides were 288 and LDL 188. I was blown away. I had my bloodwork taken in September. I do about a 90% carnivore style of eating daily. Mine HDL was 94, LDL 149 and Triglycerides were 30. My doctor came in and said your cholesterol is a little high and I told her I figured it would be but wasn’t to worried. I told her my main concern was my liver results as my brother died of NFLD in February. She said not to worry about that because my triglycerides were 30 so my my liver markers were in the 20’s. That made me do some thinking and I thought so the triglycerides in my opinion are the bad cholesterol more than the LDL. 1 Rick Goulian Rick Goulian 4 months ago Great interview, thanks! 1 Malcolm Achtman Malcolm Achtman 5 months ago Dr. Lustig explains that it's the small dense LDL particles, which comprise about 20% of the particles, that we need to worry about, because those are the ones that can penetrate the epitheleal layer and contribute to heart disease risk. I think it's important to realize that this idea is a "theory" at this point in time and I believe some debunking of that theory has already started. Natalia Sánchez Natalia Sánchez 5 months ago Really great, AMAZING interview!!! I am so thankful for all this information you have provided ! MUCHAS GRACIAS!! :) 1 Haluk Isik Haluk Isik 6 days ago Life changing information here... thank you 1 Sherry Kent Sherry Kent 1 month ago Great and informative! persimmonpuddin persimmonpuddin 5 months ago Thank you for this interview! 1 Haroon Mirza Haroon Mirza 5 months ago Soooooo good !!! Took two A4 size paper worth of notes 🤓 3 Malcolm Achtman Malcolm Achtman 5 months ago I noticed Dr. Lustig keeps blaming "sugar," but I think he should lump the word "carbohydrates" (i.e. high-glycemic carbs) in with that. Dr. David Unwin tells a story about a patient who told him she improved her Type II diabetes by eliminating sugar and carbs. Dr. Unwin explains that he was always counselling his diabetic patients to cut out sugar. And he wasn't having much success. He sort of forgot that carbohydrates for all intents and purposes are sugar too. Based on what he learned from that patient, he modified his entire approach and had much more success with patients and is now a leading diabetes educator in the UK. Bottom line: It's not just sugar, it's sugar and carbs. 6 1cleandude 1cleandude 4 months ago Awesome video thank you both for sharing your time and expertise!! When he talks about sugar he not just referring to refined sugar? So refined carbs and wine (in my case) comes into play with my high triglycerides!?? Glycemic index of any consumed substance is critical! Thereby limiting insulin (the elephant in the room) output. Right??🙏🏻🙏🏻🙏🏻 NewPhaseOfMe NewPhaseOfMe 5 months ago Thanks for the summary at the end Dr. Casey 4 Kapp Davies Kapp Davies 5 months ago (edited) I always thought the American Diabetes Association is a group of esteemed altruistic doctors until I went over to their website and saw their top 2 board members are a lawyer and guy in finance/business. Their 3rd guy is a physician but mostly focused on the aftermath of diabetes complications. How or why on earth would this group care about prevention 😢. Our lives are being saved by these bold counter-culture docs from Stanford and UCSF. Thank you. 10 Elisa C Lopez Elisa C Lopez 5 months ago Awesome interview❤️ 1 Jackie Boone Jackie Boone 5 hours ago (edited) Dr. Lustig Can Berberine help with someone on a Keto diet ? ( instead of Metformin ) What about Choline from time to time .. 3 years on Keto and extremely low carb. Denise Monteiro Borges Denise Monteiro Borges 5 months ago Thank you for this information!!! 🥰🙏🏻 1 Deb M Deb M 4 months ago How do we get the attention of the medical community to change the cholesterol test standards? 3 Mike Smith Mike Smith 4 months ago Wow!.. This really helped when reading my panel. Thanks! 1 Pipin 🦅 Pipin 🦅 1 month ago Turmeric Circumin has been a blessing sorting out my cholesterol levels Linda Bragg Linda Bragg 5 months ago I asked my doctor what my A1C was and she said she didn’t do one because my fasting glucose was 84. I was not happy about that. But it was to late to do anything about it. But when I get my bloodwork done next time I will ask for one. Avash Avash Avash Avash 2 months ago Thanks God I found you. Yes Dr you are brilliant. For me you should be at all American Tv channels to inform people and to educate them. They are focus to watch Hollywood stars and 1 warbuc warbuc 5 months ago Absolutely fabulous! 2 Carin Wiseman Carin Wiseman 4 months ago Just did blood work,and they designated the upper range limit for ALT as 29. Does every lab have their own standard? Iman113 Iman113 5 days ago Very interesting and informative but also somewhat incomplete and inaccurate, what about apoB and its role in risk profiles? Atzi Mier Atzi Mier 5 months ago I truly appreciate Dr Casey and Dr Lustig for this most fascinating and educational video ! 2 kissmyab kissmyab 5 months ago I fasted for 17 hrs before the blood works. The results showed that LDL is a little bit above the range but triglyceride is very low. Is this possible? Thanks Doc. Jbt B Jbt B 5 months ago Great conversation. 2 Malcolm Achtman Malcolm Achtman 5 months ago Dr. Lustig says total cholesterol is a meaningless number and I have heard of LDL-C referred to as "fictitious." Dr. Lustig suggests high LDL-C infers 1.3X higher risk and that may possibly be true in the general population, but what would happen if you tracked high LDL in metabolically healthy people? I'm thinking we would find no association in these people between high LDL and heart disease risk. Michael Short Michael Short 5 months ago Excellent video. How do you work out you triglycerides to HDL ratio. My are triglycerides 0.5 mmol/l and HDL 2.65 mmol/l 3 Chris Acosta Chris Acosta 5 months ago Great job guys. 2 Paul Paul 5 months ago I believe that you either "misspoke" or were in error during your discussion of Triglycerides (TG) as it is my understanding that there is an inverse correlation between blood levels of triglycerides and LDL particle size. Thus, the higher one's triglycerides, the greater the number of small LDL particles. Conversely, the lower number of triglycerides, the higher the number of large, fluffy LDL particles. (Thus the importance of having low TG.). If you want a source I prefer to provide it in private as my source is a prominent physician with an internet podcast show. 2 RoedhamHouseRanch RoedhamHouseRanch 6 days ago I'm in Canada and they measure HDL/LDL/TRIGLYCERIDE differently....by mmol/L. So how are those numbers supposed to read with regards to what is good and what is not? GOOD FRIEND GOOD FRIEND 1 month ago Splendid! Thank you! R Nunez C. R Nunez C. 5 months ago Excellent info Muchas gracias ! 1 Cande Carroll Cande Carroll 1 month ago I just started reading "House of God." Oh, my God, how irreverent!! But thanks to both of you for the recommendation. Things haven't changed in health care have they? Scary!!! Brian Lutey Brian Lutey 4 months ago How does a ketogenic diet & intermittent fasting affect the triglycerides & vldl levels? William Hudson William Hudson 5 months ago Please Please Please... More episodes! 2 Malcolm Achtman Malcolm Achtman 5 months ago Cardiologist Dr. William Davis would disagree with Dr. Lustig that an acceptable triglyceride level is anything under 100 mg/dL. That is far too lenient and leaves lots of room to produce small dense LDL particles. In order to obtain an optimal lipoprotein profile Dr. Davis advocates achieving a triglyceride value of 60 mg/dL or less. Most standard reference ranges consider a triglyceride value up to 150 mg/dL to be normal and acceptable, but that is terrible. 2 john banwell john banwell 2 months ago My TRG/HDL is 0.80. My LDL is pretty high. My doctor no doubt wants to put me on statins. Haha. 1 JAI HD JAI HD 4 months ago Can he please call DC and get them to fix the healthcare system? That would be great!!! Ginge Brien Ginge Brien 1 month ago I would add an ultrasound of the liver. If one has a fatty liver I would suggest that regardless of the trig/HDL ratio or Homs/IR is ok this patient has a toxic metabolism and needs to change diet yesterday. rawmilk mike rawmilk mike 5 months ago When you're talking ethnic risk factors it's more important than ever to keep in mind you're talking about a risk factor not a cause. A generalization is meaningless to an individual. Jay M Jay M 2 months ago How do any LDLs (small or big) get past the slippery glycocalyx layer that covers the inside of blood vessels? Michael Rosler Michael Rosler 5 months ago Extremely usefull 1 Nonduality Nonduality 3 months ago Are there any doctors that align with what's being said in this video and order a full blood panel and explain the results to patients? I mean real doctors, not YouTube star doctors. Are there any? Here in Canada, I don't think there is a single one. Dhruv Arora Dhruv Arora 6 months ago GREAT INTERVIEW MAM 7 crisgilda garcia crisgilda garcia 4 months ago Thx much sharing posting educating interested people:) BigTenFans5 BigTenFans5 2 months ago If fasting insulin is a marker of liver health, what is the marker of Beta cell and pancreatic health? Starving myself to LIFE! Starving myself to LIFE! 1 month ago Are there any foods that have a ZERO insulin response? 1 JaySee JaySee 4 months ago If "small dense LDL" is worse than Large diameter LDL as the bad LDL, the greatest property is not that it "fits" into smaller spaces in the vascular system. The more dynamic property is that the surface area is much greater for the same quantity by mass if small diameter LDL is predominate. The formula for the surface of a sphere is 4(pi)R*2 where the area of a sphere is 4/3(pi)R**3. All interactions happen surface to surface; small LDL, for the same quantity, by mass, has the *much greater surface area. V M19 V M19 4 months ago Wow 500 USD for testing small dense LDL 😥 I pay equivalent of 4 USD in China it is done without asking for it. 1 Kim Merriman Kim Merriman 3 months ago How long is recommended to fast before a blood panel? Kim Merriman Kim Merriman 3 months ago How long is recommended to fast before a blood panel? Tralala bonbon Tralala bonbon 6 months ago Couldn't click any faster when Dr Lustig pops up in my feed 9 Levels Jose Rodriguez Jose Rodriguez 4 months ago Does use of MCT oil throw off a full lipid panel test? Yes you can retire (global mindset) Yes you can retire (global mindset) 1 month ago My triglycerides are 2.9 times my Hdl, not 1.5 times. Yikes! 1 Deb Stay Blessed Deb Stay Blessed 5 months ago (edited) Excellent video thanks for the video! Front row seat taking notes ,priceless. 😊 1 Gentle Oldmoviefan Gentle Oldmoviefan 2 days ago I like what he says at 32:03 . Succinct and memorable. Linda Bragg Linda Bragg 5 months ago Are we also talking about sugar alcohol which is a lot of keto sugar used? David fryett David fryett 5 months ago A shame he wasn't specific as the term intermittent fasting means so many different things to different people Bobby Ocampo Bobby Ocampo 5 months ago Please interview Dr Nadir Mir Ali. His theory is LDLs are firemen not arsonist 2 Richard Mauro Richard Mauro 5 months ago (edited) I realize it's another area altogether but when they spoke about giving the book as a gift I cringed. I love the book but Dr. Lustig and this woman fail to realize that it's not that simple. It's akin to telling an alcoholic that if they continue drinking they will die. The alcoholic has to reach their own conclusion. Giving the book away is thus a waste of money. We need to find other ways to help. My family eats too much sugar and refined foods, bread, desserts, etc. When I talk about these topics I sense they are intrigued but they will jokingly say "don't tell me how to eat." It's tough. Leading by example is our best approach but also protesting the destruction of food via the processed foods industry and helping the public/world understand, that although they believe they live in a free society, they are manipulated with the very things that help us live - food. Ok, I'll stop now! 4 Lawrence Wallace - guitarist Lawrence Wallace - guitarist 5 months ago are alcohol and sugar really equally as bad for the liver? Jayaprakash Rao Jayaprakash Rao 5 months ago Superb...thanks a lot... 1 Beni Kramer Beni Kramer 1 month ago (edited) Mean(s)ingful!!!¨ Does this mean:? If my doctor doesn’t understand the difference between small dense LDL, and large buoyant LDL, the healthy relationship between Triglycerides and HDL, the distinguished measurement of insulin/pro insulin and the correct range of ALT (below 20-25), GGT (below 10-20, Seneff&Koenig) Insulin (below 7), Uric Acid (below 4.5-5)….. That I should call my veterinarian, or Dr. Means, or Dr. Lustig 😝?? By the way lustig means funny in German…perfectly de-fooled 1 bitmau5 bitmau5 5 months ago Rob on the show? Yes please!!! 1 Charlie Fry Charlie Fry 4 months ago (edited) Low Triglycerides = 49; Low VLDL = 9, but high LDL-C = 134 and high LDL-P = 1411. I understood Dr. Lustig to say low triglycerides should correlate to lower LDL’s? Can someone explain what I’m missing please? Bob 11 Bob 11 10 days ago Excellent info thanks. Small suggestion.. your voice in combination with that mic is harsh IMHO. perhaps adjusting settings or finding a softer sounding mic or a preamp or plugin to simulate a tube preamp can help a lot. Barkeater Barkeater 5 months ago (edited) A national hero 2 Joe Joe 5 months ago A great lesson in metabolic health. I only wish he would have talked a little about blood glucose levels and A1C. Hopefully in another video. Dhruv Arora Dhruv Arora 6 months ago I LOVE DR. LUSTIG 6 Ken Ball Ken Ball 4 months ago To state that Trigs = VLDL and LDL-C comprises Pattern A LDL of 80% and Pattern B LDL of 20% (large buoyant and small dense respectively) is total rubbish. I have his book but have lost some respect for RL, his detailed lipid knowledge leaves a lot to be desired - listen to Dr Paul Mason who has far more expertise in this area. 1 Patricia Barrientez Patricia Barrientez 4 months ago This is great, but insurance companies still use cholesterol numbers to decide if they will offer a life insurance policy. I am currently uninsurable. Miguel Ortiz Miguel Ortiz 5 months ago My ratio is 1.47 3 john butler john butler 5 months ago What is the hdl triglycerides ratio. Times minus etc ? Kalimat Kalimat 5 months ago Great 👍🏼 and great 👍🏼 dr wonderful susy may susy may 1 month ago How bad is LDL of 120 in a 22 year old and in a 65 year old when both are healthy? Keto Man Keto Man 4 months ago Dr Lustig needs to explain the mechanism to get labs. Neither my GP nor my endo doctor will authorize the following labs I asked for. Homa.Ir. C peptide. Insulin survey. So just how does one get those labs when scripts are required because I cannot just show up at a lab with my checkbook and buy them? Danijela I. McGilicuddy Danijela I. McGilicuddy 5 months ago Bravooo ✅👍😁🌹 2 Cathy Cathy 5 months ago Your channel popped up and as it involved Dr. Lustig, I of course listened. I just had extensive lab work done as I changed my diet to carnivore 18 months ago and quit alcohol (was not a big drinker but felt puffy) so wanted to see how my blood work looks. I am especially thrilled that he explained ALT as mine is 12. Best interview I have heard in a long time. You have a new subscriber. 2 Natalie Chanel Natalie Chanel 5 months ago Would breastfeeding cause higher than normal liver enzymes?? Yannis K. Yannis K. 2 months ago Incredible explanation of cholesterol. There are not enough doctors out there that understand cholesterol, let alone explain it to their patients.. K Kostas K Kostas 5 months ago i have been watching videos/presentations for a long time, this is HANDS DOWN the most in-depth but at the same the most detailed and clear presentation of medical information Dr. Lustig is a giant in the field and respect to Dr. Means for summing up the fine points been postponing getting the book, i better find some time to buy and listen to it billy blackmon billy blackmon 3 weeks ago Dr. Means has smiling eyes very nice Julie M Julie M 3 months ago My hubby just had labs and no ALT in there!? This used to be standard? with heart with heart 5 months ago Thoughts on berberine?? Four Wheels Four Wheels 4 months ago Robert is smart Ahmed Sabry Ahmed Sabry 6 months ago Gr8 interview 2 Levels Beer Beer 1 month ago Dr lustig and dr bikman are the best 1 DJ STOEK DJ STOEK 3 months ago Thank you