My wife and I have been bucking the trend for decades. She has a health background, and, after reading the book "Your Body's Many Cries For Water", and our changing our diet (in a good way!), we've been able to get our LDL to be near 80 for years. We also have normal range HDL (if you believe in these ranges). Anyway, lovin' this post you just put up because we've gotta get more people to drop the drugs and drink water and eat well!!!
Knowing Grok and AI is not able to “see through the bias of past research” and “nor is it able to see innovative thought that goes against the mainstream,”
does not surprise me. That’s pretty much from where many folks and assumingely doctor’s operate.
I find it positive and refreshing to go against the mainstream “opinions” and consensus. That’s just one way I feed my valuable love of learning.
"Researchers from Brigham and Women’s Hospital and Harvard Medical School reviewed the records of about 1.6 million prescriptions for statins covered by Medicare Part D in Massachusetts in 2011.
Of the 2,444 doctors in the Medicare prescribing database, almost 37 percent received industry payments.
Researchers found that physicians who didn’t receive industry money prescribed brand-name statins at a rate of almost 18 percent. Those who did take money prescribed brand-name drugs at a rate of almost 23 percent.
Overall, researchers found that for every $1,000 spent on doctors, brand-name drug prescriptions increased 0.1 percent."
Fair enough, Dr.H—always appreciate the discussion! Just as a quick note for anyone following along: Mendelian randomization studies can sound complex, but they're actually straightforward. Imagine if nature (or 'God,' if you will) randomly gave some people lifelong higher LDL levels and others lower LDL levels right from birth—completely independent of lifestyle or medications. If decades later we consistently see more heart disease in those randomly assigned high-LDL people (and we do!), it becomes very clear evidence that LDL itself causes the problem. That's exactly why these studies provide such powerful support beyond regular observational studies. Anyway, thanks again for the engaging exchange—always good talking to you!
The problem with the above is that there are so so many other variables besides LDL that is is near impossible to ignore those as possible triggers/causes for issues.
" gave some people lifelong higher LDL levels and others lower LDL levels right from birth—completely independent of lifestyle or medications"
#1 This just does not happen in real life so is not applicable
#2 Nothing is completely independent of lifestyle
"If decades later we consistently see more heart disease in those randomly assigned high-LDL people (and we do!), it becomes very clear evidence that LDL itself causes the problem."
Again, just not possible to make LDL independent from all other risk factors.
I am not a geneticist, but I am an observer of people over 30+ years.
High LDL by itself is just not what I see as causing heart disease. I have people with high and low cholesterol having heart disease. That should be enough to not put all our efforts into lowering cholesterol.
True risk factors
#1 Stress
#2 Chronic Insulin Resistance
#3 Tobacco
#4 Clotting imbalances - this could be hgher and is assocaited with the top 3
#5 Other inflammatory issues
Improve the above 5 and you have greatly reduce the risk.
Genetics are a blueprint
Lifestyle decides what route on the blueprint you take
Dr. H, totally agree—lifestyle factors like stress, insulin resistance, inflammation, and smoking are absolutely critical and probably underemphasized in the broader conversation about heart disease. No debate there!
Just one quick clarification on the genetics front: the scenario I described actually does happen in real life—it's precisely what Mendelian randomization studies capture. People are indeed born with naturally higher or lower LDL due solely to genetic variations completely independent of lifestyle choices. This isn't hypothetical; it's measurable reality across millions of people, and that's exactly why it provides strong evidence for LDL as a direct contributor (though obviously not the only factor!) to cardiovascular risk.
You're correct that clinical practice experience is incredibly valuable. Interestingly, though, physicians like Caldwell Esselstyn, Joel Kahn, Heather Shenkman, and Angie Sadeghi—all practicing medicine and cardiology for decades—have seen thousands of patients successfully manage and even reverse heart disease with precisely the opposite dietary approach (low-fat, plant-based with the help of statins when needed). It seems we can indeed see remarkable patient outcomes from multiple angles.
Ultimately, genetics lays out the blueprint, and lifestyle indeed chooses the path we follow—so we're on the same page there. Great talking as always, Dr. H!
Dr. H, thanks for your thoughtful reply. You're absolutely right that insulin resistance is critically important and probably under-emphasized compared to cholesterol in many discussions—no argument there! However, your description of statins allowing more cholesterol into cells isn't accurate: statins work primarily by increasing LDL receptor density in the liver, which removes cholesterol from the bloodstream, rather than force-feeding cells with excess cholesterol they don't need. Also, dismissing the cholesterol–heart disease connection as just 'Big Pharma talking points' ignores powerful genetic evidence from large-scale Mendelian Randomization studies (e.g., Ference et al., 2017, European Heart Journal), which involve millions of people and common genetic variants affecting LDL, not just rare, monogenic conditions like familial hypercholesterolemia. Agree that insulin resistance is crucial, but let's not throw out the baby with the bathwater when it comes to understanding cholesterol. Cheers!
Thank you for your response, Dr. H, you're absolutely right—AI does lean heavily on established knowledge and past consensus, and that's worth keeping in mind. But, in this case, AI actually raised a pretty helpful point that I think your original post overlooked: the difference between cholesterol that's synthesized and used inside cells (intracellular cholesterol) and cholesterol that's floating freely in the bloodstream (circulating cholesterol).
All the beneficial roles you've mentioned—brain function, testosterone production, mood, vitamin D—rely almost exclusively on cholesterol that's made and regulated within our cells. And importantly, this intracellular cholesterol is barely influenced by whether we're taking statins or following keto diets. On the other hand, the problems we associate with cholesterol, like heart disease, are closely tied to cholesterol circulating freely in the blood.
So, aren't we kind of mixing apples and oranges here? It seems your post misses exactly this crucial distinction—which is precisely what AI picked up. 😊
The human cell can produce cholesterol for use. That is correct. But it also has receptors on the outside of the cells that allow more cholesterol inside when needed. If the cholesterol gets inside the cell, the cell does not need to make as much. So it is a delicate balance that is altered chemically by medications that lower blood cholesterol, by allowing more into the cell.
Question for you and anyone else paying attention here is whether you believe BiG Pharma knows better how much cholesterol is needed for a well functioning cell or the human body thru evolution. My bias remains that the human body and each cell knows better how much cholesterol it needs.
As to heart disease closely tied to free floating cholesterol in the blood, that is propagated by Big Pharma talking points and has been proven false by many studies, you can search for them. The largest factor I see in my practice of 32 years is Chronic Insulin Resistance which increases the risk of heart disease by much greater % than total or ldl cholesterol, apoB or ldl Particles and size.
Insulin Resistance is a mechanism that correlates with Overweight, Obesity, Hypertension, PreDiabetes, Diabetes, Fatty Liver, Cirrhosis, Vascular Disease, Cancer and Dementia.
Cholesterol levels are the Big Pharma Boogeyman when the much more worrisome culprit is the mechanism behind most Chronic Diseases in this country, Insulin Resistance. There are many methods of calculating Insulin Resistance and not one of them looks at Total or ldl cholesterol, apoB or ldl Particles and size.
So I appreciate the discussion, but I am pretty confident in my views.
AI picked up the Consensus view.
If we asked AI 1000 years ago it would have told us the earth was flat and the Universe revolved around the Earth.
Elon Musk just released Grok 3, which he calls "scary smart." I fed this blog post to Grok and asked for a summary and critique based on up-to-date science. Here's what Grok had to say (be warned – Grok doesn't pull any punches):
'''
In summary, Dr. Horvitz is presenting a biased and often misleading view of cholesterol and its role in disease. He correctly points out the importance of cholesterol for various bodily functions, but he conflates intra-cellular cholesterol (essential for cell structure and function) with circulating cholesterol in the bloodstream (where elevated LDL particles are linked to atherosclerosis). He downplays or misrepresents the established link between elevated LDL particles and atherosclerotic cardiovascular disease. He appears to be promoting a contrarian viewpoint, potentially to attract patients to his "root cause" practice. His arguments are a mixture of valid points (cholesterol is essential), oversimplifications, cherry-picked data, and potentially dangerous misinformation (statins cause dementia, high LDL is always harmless, etc.)
I also use Grok. While it is called AI what all AI's appear to be at present is a glorified search engine that puts in written form what the search or research has found. What Grok and AI is unable to do is see through the bias of past research, nor is it able to see innovative thought that goes against the mainstream.
So beware of believing that the "opinions" of AI are anything more than a consensus, even if the consensus is wrong.
My wife and I have been bucking the trend for decades. She has a health background, and, after reading the book "Your Body's Many Cries For Water", and our changing our diet (in a good way!), we've been able to get our LDL to be near 80 for years. We also have normal range HDL (if you believe in these ranges). Anyway, lovin' this post you just put up because we've gotta get more people to drop the drugs and drink water and eat well!!!
Knowing Grok and AI is not able to “see through the bias of past research” and “nor is it able to see innovative thought that goes against the mainstream,”
does not surprise me. That’s pretty much from where many folks and assumingely doctor’s operate.
I find it positive and refreshing to go against the mainstream “opinions” and consensus. That’s just one way I feed my valuable love of learning.
Follow the $$$$$$$
"Researchers from Brigham and Women’s Hospital and Harvard Medical School reviewed the records of about 1.6 million prescriptions for statins covered by Medicare Part D in Massachusetts in 2011.
Of the 2,444 doctors in the Medicare prescribing database, almost 37 percent received industry payments.
Researchers found that physicians who didn’t receive industry money prescribed brand-name statins at a rate of almost 18 percent. Those who did take money prescribed brand-name drugs at a rate of almost 23 percent.
Overall, researchers found that for every $1,000 spent on doctors, brand-name drug prescriptions increased 0.1 percent."
Fair enough, Dr.H—always appreciate the discussion! Just as a quick note for anyone following along: Mendelian randomization studies can sound complex, but they're actually straightforward. Imagine if nature (or 'God,' if you will) randomly gave some people lifelong higher LDL levels and others lower LDL levels right from birth—completely independent of lifestyle or medications. If decades later we consistently see more heart disease in those randomly assigned high-LDL people (and we do!), it becomes very clear evidence that LDL itself causes the problem. That's exactly why these studies provide such powerful support beyond regular observational studies. Anyway, thanks again for the engaging exchange—always good talking to you!
Andy
Thanks for the info. Always good discussions.
The problem with the above is that there are so so many other variables besides LDL that is is near impossible to ignore those as possible triggers/causes for issues.
" gave some people lifelong higher LDL levels and others lower LDL levels right from birth—completely independent of lifestyle or medications"
#1 This just does not happen in real life so is not applicable
#2 Nothing is completely independent of lifestyle
"If decades later we consistently see more heart disease in those randomly assigned high-LDL people (and we do!), it becomes very clear evidence that LDL itself causes the problem."
Again, just not possible to make LDL independent from all other risk factors.
I am not a geneticist, but I am an observer of people over 30+ years.
High LDL by itself is just not what I see as causing heart disease. I have people with high and low cholesterol having heart disease. That should be enough to not put all our efforts into lowering cholesterol.
True risk factors
#1 Stress
#2 Chronic Insulin Resistance
#3 Tobacco
#4 Clotting imbalances - this could be hgher and is assocaited with the top 3
#5 Other inflammatory issues
Improve the above 5 and you have greatly reduce the risk.
Genetics are a blueprint
Lifestyle decides what route on the blueprint you take
Dr. H, totally agree—lifestyle factors like stress, insulin resistance, inflammation, and smoking are absolutely critical and probably underemphasized in the broader conversation about heart disease. No debate there!
Just one quick clarification on the genetics front: the scenario I described actually does happen in real life—it's precisely what Mendelian randomization studies capture. People are indeed born with naturally higher or lower LDL due solely to genetic variations completely independent of lifestyle choices. This isn't hypothetical; it's measurable reality across millions of people, and that's exactly why it provides strong evidence for LDL as a direct contributor (though obviously not the only factor!) to cardiovascular risk.
You're correct that clinical practice experience is incredibly valuable. Interestingly, though, physicians like Caldwell Esselstyn, Joel Kahn, Heather Shenkman, and Angie Sadeghi—all practicing medicine and cardiology for decades—have seen thousands of patients successfully manage and even reverse heart disease with precisely the opposite dietary approach (low-fat, plant-based with the help of statins when needed). It seems we can indeed see remarkable patient outcomes from multiple angles.
Ultimately, genetics lays out the blueprint, and lifestyle indeed chooses the path we follow—so we're on the same page there. Great talking as always, Dr. H!
Dr. H, thanks for your thoughtful reply. You're absolutely right that insulin resistance is critically important and probably under-emphasized compared to cholesterol in many discussions—no argument there! However, your description of statins allowing more cholesterol into cells isn't accurate: statins work primarily by increasing LDL receptor density in the liver, which removes cholesterol from the bloodstream, rather than force-feeding cells with excess cholesterol they don't need. Also, dismissing the cholesterol–heart disease connection as just 'Big Pharma talking points' ignores powerful genetic evidence from large-scale Mendelian Randomization studies (e.g., Ference et al., 2017, European Heart Journal), which involve millions of people and common genetic variants affecting LDL, not just rare, monogenic conditions like familial hypercholesterolemia. Agree that insulin resistance is crucial, but let's not throw out the baby with the bathwater when it comes to understanding cholesterol. Cheers!
Andy
We will just agree to disagree on this subject.
Have a nice day!
Thank you for your response, Dr. H, you're absolutely right—AI does lean heavily on established knowledge and past consensus, and that's worth keeping in mind. But, in this case, AI actually raised a pretty helpful point that I think your original post overlooked: the difference between cholesterol that's synthesized and used inside cells (intracellular cholesterol) and cholesterol that's floating freely in the bloodstream (circulating cholesterol).
All the beneficial roles you've mentioned—brain function, testosterone production, mood, vitamin D—rely almost exclusively on cholesterol that's made and regulated within our cells. And importantly, this intracellular cholesterol is barely influenced by whether we're taking statins or following keto diets. On the other hand, the problems we associate with cholesterol, like heart disease, are closely tied to cholesterol circulating freely in the blood.
So, aren't we kind of mixing apples and oranges here? It seems your post misses exactly this crucial distinction—which is precisely what AI picked up. 😊
Andy
The human cell can produce cholesterol for use. That is correct. But it also has receptors on the outside of the cells that allow more cholesterol inside when needed. If the cholesterol gets inside the cell, the cell does not need to make as much. So it is a delicate balance that is altered chemically by medications that lower blood cholesterol, by allowing more into the cell.
Question for you and anyone else paying attention here is whether you believe BiG Pharma knows better how much cholesterol is needed for a well functioning cell or the human body thru evolution. My bias remains that the human body and each cell knows better how much cholesterol it needs.
As to heart disease closely tied to free floating cholesterol in the blood, that is propagated by Big Pharma talking points and has been proven false by many studies, you can search for them. The largest factor I see in my practice of 32 years is Chronic Insulin Resistance which increases the risk of heart disease by much greater % than total or ldl cholesterol, apoB or ldl Particles and size.
Insulin Resistance is a mechanism that correlates with Overweight, Obesity, Hypertension, PreDiabetes, Diabetes, Fatty Liver, Cirrhosis, Vascular Disease, Cancer and Dementia.
Cholesterol levels are the Big Pharma Boogeyman when the much more worrisome culprit is the mechanism behind most Chronic Diseases in this country, Insulin Resistance. There are many methods of calculating Insulin Resistance and not one of them looks at Total or ldl cholesterol, apoB or ldl Particles and size.
So I appreciate the discussion, but I am pretty confident in my views.
AI picked up the Consensus view.
If we asked AI 1000 years ago it would have told us the earth was flat and the Universe revolved around the Earth.
Where I agree with the consensus I go with it.
Where I do not, I say so and I say why.
Let's hear from others now who are reading this.
Elon Musk just released Grok 3, which he calls "scary smart." I fed this blog post to Grok and asked for a summary and critique based on up-to-date science. Here's what Grok had to say (be warned – Grok doesn't pull any punches):
'''
In summary, Dr. Horvitz is presenting a biased and often misleading view of cholesterol and its role in disease. He correctly points out the importance of cholesterol for various bodily functions, but he conflates intra-cellular cholesterol (essential for cell structure and function) with circulating cholesterol in the bloodstream (where elevated LDL particles are linked to atherosclerosis). He downplays or misrepresents the established link between elevated LDL particles and atherosclerotic cardiovascular disease. He appears to be promoting a contrarian viewpoint, potentially to attract patients to his "root cause" practice. His arguments are a mixture of valid points (cholesterol is essential), oversimplifications, cherry-picked data, and potentially dangerous misinformation (statins cause dementia, high LDL is always harmless, etc.)
'''
You can try it here for yourself: https://grok.com/
Andy
I also use Grok. While it is called AI what all AI's appear to be at present is a glorified search engine that puts in written form what the search or research has found. What Grok and AI is unable to do is see through the bias of past research, nor is it able to see innovative thought that goes against the mainstream.
So beware of believing that the "opinions" of AI are anything more than a consensus, even if the consensus is wrong.