#136 | Live Long Strong; Dodge the #1 Killer (CVD) | Michael Twyman MD

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The USA declared war on heart disease in 1955. 70 years later it is still the leading cause of death. What about statins and all that medical progress we’ve had. Exactly, what about it?

Dr Michael Twyman is a board certified cardiologist who runs Apollo Cardiology, a clinic serving patients from all over the world. His approach is to understand cardiovascular health from a whole body perspective. Rather than focus on LDL and HDL and apoB, he says we need to look at the bigger picture of cardiovascular health….namely cardiovascular health as a marker of whole body health. He says plaques can start building early in life….stop the progression now to eliminate the need for dramatic interventions with significant side effect later in life.

We discuss specific behaviors and supplements and even medications to signal the body to stop building plaques. A statin is only one of many potential solutions. Since recording this episode, I have stopped taking my low-dose statin that was significantly reducing my muscle power, and replaced it with better tools.

  • Stop damaging the Glycocalyx (the protective barrier to the lining of arteries)
  • Stop making so many ApoB particles
  • Make more receptors to remove more ApoB particles
  • Lower reabsorption and absorption of cholesterol from food in gut

Bullet points

  • Damage to glycocalx
    • Causes: high oxidative stress (mitochondrial disfunction), inflammation from any source: gut related, infection (COVID), smoking, high insulin, high glucose
    • Signs: high BP, erectile dysfunction
  • Supplements to consider
    • Vit k2 – keep calcium in bone not arteries
    • Garlic – support glyocalix health
    • Berberine — increase LDL receptors (like a weak pcsk9)
    • Bergomot – lower LDL production (like a weak statin)
    • Ezetimibe (not supplement) — reabsorption of cholesterol
    • Aspirin (81 mg) – complicated. Had an event?  Aspirin for life. No event yet?  Higher CAC?  Aspirin. Unless high risk of bleeding.
  • Blood markers review
    • Homocysteine <10
    • GGT high means low glutathione (high oxidative stress)
    • Uric acid. High means poor metabolism. A marker of gout but also damaging to glycocalyx.
    • Oxidized LDL — 5 alarm code
    • hsCRP — good to know but if high doesn’t point to the problem
    • Myeloperoxidase (increase with infection) — HDL dysfunction
    • Boston heart panel

Related info and episodes:

More Dr Twyman info:

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The ever curious athlete who demands answers.
About the Author
Curious athlete who demands answers. Husband to Susan ( Father of 3 daughters. Athletic pursuits over time, in reverse order: cycling, skiing, mountaineering, rock climbing, triathlon, golf, tennis, football.

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