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最近，我深入研究了一种名为Cavadex的灌肠疗法，它宣称能够逆转心血管疾病，特别是溶解动脉斑块。制造商的宣传令人印象深刻：短期内显著改善症状，甚至挽救生命。然而，作为一名医生和科学家，我必须以批判性的眼光看待这些说法。
科学证据不足，而非个案奇迹
Cavadex声称通过溶解动脉壁中的胆固醇来发挥作用。然而，目前缺乏充分的科学证据支持这一说法。虽然我个人也存在动脉斑块问题，但我并没有选择Cavadex，原因很简单：现有研究不足以证明其疗效和安全性。个案的成功并不能代表普遍有效性，我们需要的是严谨的临床试验数据。
生活方式才是基石，而非速效药丸
我始终强调，健康的生活方式是预防和逆转心血管疾病的关键。均衡饮食、规律运动，这些才是真正有效的策略。我们不应过分依赖未经充分验证的药物或疗法，将希望寄托于所谓的“奇迹疗法”。
FDA监管与法律风险
更令人担忧的是，美国食品药品监督管理局（FDA）已发出警告，Cavadex作为心血管疾病治疗药物在美国的销售是非法的。这进一步加剧了我对其安全性和有效性的担忧。
环糊精的局限性与给药方式的挑战
Cavadex的主要成分是环糊精，一种理论上具有溶解胆固醇潜力的物质。然而，现有研究结果并不明确支持其在人体内逆转动脉斑块的有效性。更重要的是，Cavadex的给药方式——灌肠——也存在问题。通过灌肠吸收的药物很难有效地到达动脉壁，其生物利用度可能远低于预期。
我查阅了多项研究，其中一些显示环糊精在动物实验中可能有效，但在人体实验中，特别是使用灌肠给药的情况下，效果并不显著。
超越胆固醇：关注代谢紊乱和炎症
心血管疾病的根本原因并非仅仅是胆固醇。代谢紊乱和炎症才是更重要的因素。即使Cavadex能够降低胆固醇，也可能无法从根本上解决问题。
对Cavadex临床研究的质疑
我仔细分析了支持Cavadex疗效的现有研究。许多研究样本量过小（例如，仅针对一名患者），或者使用静脉注射而非灌肠给药，这使得研究结果难以推广到更广泛的人群。此外，一些研究中对斑块减少的评估也缺乏客观标准，难以令人信服。
胆固醇的误解与代谢疾病的忽视
长期以来，人们普遍认为高胆固醇是心血管疾病的主要原因。然而，越来越多的证据表明，这种观点过于简化。LDL并非单纯的胆固醇，而是脂蛋白，其与心血管疾病的关系远不如甘油三酯复杂。甘油三酯水平升高往往与代谢紊乱，特别是糖尿病前期密切相关，而这才是心血管疾病的更强驱动因素。
令人遗憾的是，许多医生仍然未能充分认识到代谢疾病的重要性，导致许多患有糖尿病前期的人甚至没有意识到自己患病。
结论：谨慎为上
总而言之，我对Cavadex灌肠疗法持谨慎态度。目前缺乏充分的证据证明其疗效和安全性，其给药方式也存在挑战。与其依赖未经验证的疗法，不如关注生活方式的改变，积极控制体重、健康饮食、规律运动，从根本上改善代谢健康，降低心血管疾病风险。 如果您想尝试Cavadex，请务必充分了解其风险，并咨询您的医生。 切记，健康的生活方式才是预防和治疗心血管疾病的基石。
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00:16 播客介绍
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00:35 播客内容
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01:03 本期视频讨论Cavadex，但故事需要科学支持。
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01:30 Cavadex声称能溶解动脉壁上的胆固醇，但我用的是更便宜的盐水灌肠。
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01:59 盐水灌肠和Cavadex的共同点是使用方式和缺乏清除动脉的证据。
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02:25 我有斑块，但我不使用Cavadex，因为其效果和安全性存疑。
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02:53 环糊精并非新事物，但尚未成熟。
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03:23 Cavadex可能促进身体溶解胆固醇，但我不希望只依赖药物。
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03:39 生活方式是良药，应该优先关注，而非依赖药物。
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04:00 研究表明环糊精可能使胆固醇更易溶解，从而逆转动脉斑块。
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04:20 Cavadex存在三个问题：证据不足、基于胆固醇问题的假设以及药物传递问题。
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04:43 环糊精的药物传递问题在于其易被消化，无法口服。
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05:04 大部分研究通过静脉注射进行，不适合家庭使用。
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05:29 Colram的解决方案是灌肠，但证据不足。
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05:55 尽管灌肠可能令人尴尬，但若能逆转心血管疾病，许多人愿意尝试，但关键是缺乏证据。
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06:19 Cavadex官网宣称其能改善健康，但FDA已发出警告。
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06:45 Cavadex在美国作为心血管预防药物销售是非法的，但可合法用于治疗罕见病。
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07:14 Colram的CEO对FDA的监管表示不满，认为Cavadex可能威胁到医药行业的利润。
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07:40 这场FDA与Colram的争端，关键在于谁是对的，以及谁将胜出。
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07:56 FDA可能犯错，但这次我支持他们。
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08:19 我不认为Kyle Hodgett是骗子，但可能有些误导。
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08:47 我曾批评FDA对CGM的延迟批准，但这次我同意他们对Cavadex的立场。
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09:14 我同意FDA对Cavadex的看法，但并非盲目支持。
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09:35 大型制药公司未介入Cavadex，可能认为风险过高。
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09:45 在尝试Cavadex灌肠前，需要更深入地了解。
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10:10 首先要考虑Cavadex对人类是否安全。
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10:33 相对于尼曼匹克症，Cavadex可能相对安全，但新药临床试验风险高。
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10:58 许多药物在上市后才发现严重副作用。
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11:27 关于Cavadex的安全性问题不再深入探讨，接下来讨论其有效性。
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11:54 Cavadex在小鼠实验中显示能去除动脉斑块，但存在给药方式和物种差异的问题。
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12:20 冠状动脉造影是常用的斑块检测方法。
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12:43 一项关于Cavadex逆转动脉斑块的研究只涉及一名患者，存在局限性。
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13:06 单个案例研究适用于提出假设，但不适用于评估大规模治疗效果。
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13:35 该研究采用静脉注射Cavadex，而非灌肠，且未排除副作用。
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13:49 动脉疏通效果不明显。
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14:15 影像显示右冠状动脉斑块可能减少，但缺乏明确的放射学报告。
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14:27 至少这项研究是关于人类的。
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14:55 另一项研究也存在样本量小和给药方式的问题。
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14:59 静脉注射，而非灌肠。
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15:25 CIMT报告显示斑块大小或类型没有太大变化。
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15:52 CIMT是一种检测动脉斑块的有效方法。
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16:10 基于现有证据，无法证明Cavadex能逆转颈动脉斑块。
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16:27 即使Cavadex通过灌肠吸收25%，大部分也会被肝脏代谢掉。
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16:48 最终只有约12.5%的药物可能到达动脉。
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17:03 关键问题是如何安全有效地将胆固醇输送到血液中。
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17:25 纳米组装技术可能是一种新机制，但尚未成熟。
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17:56 Cavadex制造商网站上的案例需要更多证据支持。
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18:15 认为Cavadex可以解决心脏病，而忽略生活方式是错误的。
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18:38 不能通过支架、补充剂、搭桥手术或药物来解决生活方式问题。
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18:54 胆固醇在动脉斑块和心脏病中起作用，但不是主要风险因素。
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19:20 Cavadex的理论基础是胆固醇是斑块和心脏病的主要原因，这个假设源于Ancel Keys。
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19:36 Ancel Keys的研究存在争议。
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19:53 稳定斑块并不一定需要去除胆固醇。
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20:22 炎症是心血管风险的关键。
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20:32 炎症是心脏病和中风的主要原因。
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20:54 斑块稳定性比去除胆固醇更重要。
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21:08 Honda研究表明斑块稳定后，心血管风险降低。
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21:37 稳定斑块的人群心血管风险与无斑块人群相似。
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22:05 斑块逆转可能与胆固醇无关，减重和使用他汀类药物可能导致斑块逆转。
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22:35 胆固醇与动脉、血液和饮食有关的假设正在消亡。
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22:45 关于心血管斑块和血液胆固醇水平的假设正在消亡。
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23:08 LDL不是胆固醇，而是脂蛋白颗粒。
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23:25 脂蛋白用于隔离血液中的脂肪。
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23:48 脂肪栓塞可能致命。
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24:10 HDL和LDL主要携带胆固醇，其他脂蛋白主要携带甘油三酯。
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24:37 携带甘油三酯的脂蛋白与心血管疾病更密切相关。
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24:57 糖尿病前期是比胆固醇更强的心血管疾病驱动因素。
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25:24 认为胆固醇是问题会导致过度依赖药物。
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25:50 代谢问题而非胆固醇是根本原因。
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26:11 基因可能增加风险，但生活方式是关键。
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26:38 这不是缺乏他汀类药物或Cavadex的问题，而是代谢疾病的问题。
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26:56 大多数人不知道自己患有糖尿病前期。
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27:17 大部分医生无法正确诊断糖尿病前期。
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27:45 尝试Cavadex前请三思。
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28:05 Cavadex是一种未经证实的药物，可能无法解决心血管疾病或代谢疾病。
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28:14 我希望我是错的，但我通过生活方式的改变逆转了自己的动脉斑块。
00:00
- Welcome to the PrevMed Health Podcast with Dr. Brewer, your go-to source for heart attack and stroke prevention. And I am your host, Ford Brewer. Each week, we dive deep into the latest trends, expert insights, and practical tips to help you decrease your risk of heart attack and stroke. 语法解析
00:16
We discuss plaque reversal, insulin resistance, prediabetes, diabetes, cholesterol, supplements, medications, and so much more. So sit back, relax, and have this journey to a long and healthy life together. Can an illegal enema reverse cardiovascular disease? Plaque. 语法解析
00:35
Heart attack and stroke. Take all that risk off the table. This is a video about Cavadex. C-A-V-A-D-E-X. We've had a lot of requests. It's made by a company named Colrem. Probably a mashup of cholesterol remedies. Their website tells stories like reduction of angina in two weeks. Stories are great. You know, I'm a scientist and I realize that statistics bore people to death. 语法解析
01:03
But stories really need to be backed up by good science. How is Cabidex supposed to reverse plaque? It's supposed to dissolve the cholesterol in the plaque, in the artery walls. Now, if you look a little bit harder at this enema, you'll see that it's not a Cabidex enema. I'm just too cheap to pay hundreds of dollars, maybe even thousands, depending on how much you get. 语法解析
01:30
for a video prop. This is a saltwater enema. Costs me about two bucks. But this enema pack may have a couple of things in common with cabodex. Number one, it's inserted in your rectum. And number two, it may have about as much evidence that it can clear arteries. Oh, I guess you can tell I'm not using it. And some personal information, I have plaque, cardiovascular plaque, 语法解析
01:59
I have my own story about it. But why am I not taking it? They say it reverses plaque, it dissolves it, and even if it doesn't, it's safe and harmless, so why not try it? What's the risk? So, again, I reviewed it, and here are my thoughts. Cabotex is a form of cyclodextrin. It's a cyclic sugar or starch made from starches by bacteria. 语法解析
02:25
and some other manipulations. Cyclodextrins are not new. They've been around for a while. I've done videos on these before. Though I think the last one was about four years ago. And again, unfortunately, I have to say about the same thing that I did four years ago. They're promising, but still not ready for prime time. It's a chemical that's supposed to dissolve cholesterol crystals. 语法解析
02:53
in fact, for some reason, it's supposed to help the body genetically gear up to dissolve cholesterol crystals and not only just in plaque but in the bloodstream as well. So everything sounds great. We've got a miracle drug on the way, right? Maybe not true. So again, here we go down the path of looking for yet another drug. You know, I hope it works but it gets back to the point of 语法解析
03:23
Lifestyle is medicine. Lifestyle is difficult but it's safe and let's focus on our lifestyle first and make sure that we've done everything we can before we try to bail ourselves out of a bad lifestyle. 语法解析
03:39
with yet another medication. Cavidex is a beta-cyclodextrin. Some research has suggested that cyclodextrins in general have the potential to make cholesterol particles more soluble, making it easier for them to exit the plaque in the artery wall and therefore reversing arterial plaque. There are three problems. 语法解析
04:00
The evidence, at best, is inconclusive for both efficacy, how well it works, and for safety. The second problem, it's based on an assumption that this is a cholesterol problem, and that's an assumption coming under a lot of fire as new evidence comes out. 语法解析
04:20
Number three, the third problem is the drug delivery issue. It's a major problem for all the cyclodextrins. It's because they're starches. Starches get degraded by the stomach when they go through the stomach and small intestines. They get digested. They're metabolized very quickly, so we can't just swallow these things. 语法解析
04:43
So most of the research has been done using IV, sticking a needle, getting it directly into the bloodstream with a needle. IV is a non-starter for home use. Research models have used up to 18 episodes of IV over 36 days. That starts to sound like a hospital stay or skilled nursing. 语法解析
05:04
or prolonged home nursing care. That's again a non-starter. No insurance is going to pay for that. So, enter Colram. Colram's solution was, or is, an enema. What makes sense, expose the cyclodextrin, the Cavadex, to the intestinal walls, but bypass the stomach and small intestine. Maybe it's a little bit awkward, but… 语法解析
05:29
But to reverse cardiovascular disease, who wouldn't do that? The problem is there's just so little evidence that it works. So let's go to the website. On the website, the makers of Cavitex say that the drug saves lives. And it's been improving health in those who've taken it for over three years. And some videos promise plaque regression in a month, one month. 语法解析
05:55
No angina, no plaque. It's evidently unclogging arteries. An occasional enema in exchange for clean arteries, again, sounds like something I'd do, and I'm betting I'm not the only one. But just to spoil everything, along comes the FDA. The FDA wrote a letter to Colram saying that this is an unapproved drug, 语法解析
06:19
and is therefore illegal to be prescribed or sold in the U.S. as a medication for cardiovascular prevention. Got to give you a fine detail here. This is legal, and it's being used for Niemann-Pick type C disease. This is a devastating cholesterol transport disease. People rarely live to age 30 if they have Niemann-Pick's. They make it into their 20s. 语法解析
06:45
So there's a little bit of a difference on the risk-benefit equation here for those patients. Back to the letter. Kyle Hodgett's founder and CEO of Colram wrote his own letter, and it's there on the Internet. He talks about he's just fed up. He's had enough with the medical industry, the FDA, supporting profiteering by Big Medicine and Big Pharma. His product, Cavidex, could decrease profits dramatically. 语法解析
07:14
from so many medications, stress tests, cardiac echoes, cath lab costs, etc., etc., etc. Sounds like a really good thing, right? Well, so this is the big dust-up, and for those of you who are not familiar with the term, a fight or a brawl. Who's right? Who's wrong? It's interesting, and maybe what's even more interesting is who's going to win this? 语法解析
07:40
Is the FDA just a bunch of bureaucrats in the pocket of big pharma and big medicine? Or did they misunderstand something critical? If they did, I can witness for you, it certainly would not be the first time the FDA screwed up. 语法解析
07:56
Or is Kyle Hodgett a profiteer, a modern-day snake oil salesman, or just a little bit misguided and overzealous to try to help people? I've had my own disagreements with the FDA, and pardon me, but we're going to go down a bunny hole there. It's important to understand, I don't just support the FDA on a lot of their decisions. I am on this one. 语法解析
08:19
The delay behind CGMs, continuous glucose monitors, that took years. The FDA said these were not safe. And meanwhile, Canada and European citizens were using them and getting incredible benefit for years. And I was screaming the whole time on my videos, and I'm not sure anybody wanted to listen, or at least they didn't listen. Thank you for your patience with me going down that bunny hole. The point is… 语法解析
08:47
I'm agreeing with the FDA on this one, on Cavadex, but I'm not a shell for the FDA. Cavadex is just a completely different situation. First, is Big Pharma trying to squelch this? I don't think so. I mean, this could be a great opportunity for Big Pharma. They've got plenty of dollars. They could buy the patent from Colram or even better, recreate their own version of a cyclodextrin and squelching it 语法解析
09:14
It's just not going to work. There would be too many other big pharma with big money who could do this, who are going to go after the opportunity, assuming it's actually there, because that opportunity could result in mega bucks. But nobody's touching it. Why? Maybe they see a bridge too far. 语法解析
09:35
Just like I do. But are you still tempted to go to the Colerim website, enter your credit card number, and pull down your pants for that enema? 语法解析
09:45
Before you do, let's go a little bit deeper. The first claim to consider is that cyclodextrin is safe, or Cavadex is safe for humans. Here's a paper published in 2013. Remember I mentioned Niemann-Pick type C disease a few minutes ago? The devastating disease most people don't live to their 20s, let alone their 30s. This paper involves a few patients with that disease. 语法解析
10:10
and showed relative safety, at least compared to Neiman-Pick. Like many, I suspect Cavidex and the other cyclodextrins will turn out to be safe overall. If you're ready to take your chances on safety with this, let's go back to clinical trials. Clinical trials are trials of new medications, new procedures, new treatments, 语法解析
10:33
They're notorious for massive bad surprises. Let me give you a few examples. Adderill XR, if it's for ADHD, heart and brain damage. Lotrinex, irritable bowel syndrome. It worked great until it started rotting out colons. Oriflex, a non-steroidal anti-inflammatory. Again, it worked great until you started seeing severe liver damage. 语法解析
10:58
You know, I'm not going to belabor the point. If you're interested, just Google drugs withdrawn after market. So that's it for safety. I'm not going to go any further on that. Let's just ask the question, does it work? Let's go to what we call efficacy. Does it work? Here's the next claim. Cabot X removes arterial plaque in mice. And that appears to be true, but there's still a couple of problems. The first one, Cabot X was injected. It 语法解析
11:27
It wasn't given by enema. The second problem is that mice are not humans. So is it too much to ask to see evidence for use of enema in a human? Here's an article published in October 4th of 2024, very recently. It seems to suggest that Cavitex reverses arterial plaque in one human subject using coronary CT angiogram. It looks like there's plaque reduction. 语法解析
11:54
Coronary angiograms or angiography is one of the most popular methods for demonstrating plaque. It involves injecting dye, x-ray dye, contrast dye into your leg or arm and then a CT scan to find plaque in the artery and to map it out. Again, as you see on the screen here, the images look great. It's expensive and invasive, but if your goal is to see a clear image, 语法解析
12:20
That's the way to go. Unfortunately, this study also appears to have some challenges. The first one was, how many patients were involved? One. That's right. Now let's discuss N of 1 experiments. They're popular. I use them. I did an egg-speriment a couple of weeks ago. 语法解析
12:43
We did a video and a lot of people were very interested in it. But drawing conclusions from other people in an end-of-one study can be a stretch. They're great for raising questions and hypotheses, but to assess what's going to happen to thousands or millions of people when they take a treatment or an intervention… 语法解析
13:06
N of 1 is not the way to go. Let's get back to the CT angiogram study done on one person showing plaque reversal. They applied about 18 IV injections of Kevadex in a 36-day period. Again, IV straight into mainline, right into the bloodstream, not an enema. So even if the IV treatment might work, that doesn't mean that the enemas will. And worse, 语法解析
13:35
We don't know if it can cause unknown side effects, but I promised I'm not going to go back to the safety issue. Here's the third flaw, unclogging arteries. That doesn't look quite as convincing… 语法解析
13:49
to me as it might to you, at least first blush. They look great and they show the images. You can see some decreasing plaque or what looks like to be decreasing plaque in the right coronary artery. But let's look at the measurements. So they report 60 to 70 percent blockage on the first image but a no clear assessment on the second image. No description of the radiology report. 语法解析
14:15
And obviously, as a scientist who's gearing and looking for evidence, I'm still left wondering why. But at least there's finally a study on a human. 语法解析
14:27
Oh, and I guess that's part of the problem, as we mentioned, one human singular. Another paper published one month earlier, September 26, it concludes that the research on cyclodextrin shows that it reduces carotid plaque, that is, plaque in the arteries of the neck. But again, we have those same flaws showing up yet again and again and again. One subject, 语法解析
14:55
Injected treatment, IV, not enemas. 语法解析
14:59
and CIMT report doesn't really show that much change on plaque size or type. CIMT, if you haven't heard of it, it's a test that we use to find soft or dangerous arterial plaque, inflamed arterial plaque. Plaque is stable unless it's soft and inflamed. CIMT stands for carotid intima media thickness test. The intima and media are two layers of the artery wall where 语法解析
15:25
where plaque tends to reside. So if you look at the thickness, you're beginning to understand how much plaque you have. Now, in an ultrasound, there's no radiation. It's not invasive. It is a great way to find arterial plaque and to measure it. It can be hard to find an expert to do it, though. More information about this test and my own plaque reversal story in a video will provide a link at the end. 语法解析
15:52
So, based on that evidence, I don't see how they can claim it reversed carotid plaque. Claims that the enemas will work, in general. You'll see that on the website. They claim that 25% absorption rate comes from an enema of cabot eggs. 语法解析
16:10
Well, that's actually a big challenge too. And here's why. If it's 25% absorbed, it means it gets to what we call the splanchnic bloodstream. That's not the bloodstream where the artery plaques are going to be. That's the bloodstream going from the GI tract, the intestine, 语法解析
16:27
up to the liver. So it's going to have to pass through the liver first, where the liver will knock out another 50%. So instead of 25% actually having a chance to reach the arteries, the true amount will still be closer to 12.5%. 12.5%. 语法解析
16:48
And that's being optimistic. It's back to that key issue with all the cyclodextrins. How do you get the cholesterol into the bloodstream safely and effectively? Can there be a better way? 语法解析
17:03
Well, in June of this year, there was a paper that showed a new mechanism. It's not as new as you think. Theoretically, it's been around for a while. It showed promise, and it's called nano-assemblies. You know where that's going. Nano-assemblies, again, to quote myself from four years ago, they're just not ready for primetime. 语法解析
17:25
The last piece of evidence about the effectiveness of Cavitex is on the manufacturer's website. They show a case of Dr. James Roberts, one of the main promoters of Cavitex. He reversed his own plaque using Cavitex, and he tells the story. Now, as I said earlier, I agree with having stories. Even though I'm a scientist, I can recognize most people are bored by statistics. But stories need to be backed by good evidence. 语法解析
17:56
or they can misdirect a lot of people. The assumption that Cavadex will fix heart disease regardless of lifestyle is a big mistake. Similar to stents, this can lead to relying on a drug or an intervention, like a stent, instead of making the necessary lifestyle changes. 语法解析
18:15
And if you've seen one of my videos, just one other, you've probably heard me say somewhere in there, you cannot out stent, out supplement, out bypass, out prescribe a lifestyle problem. And in this case, you can't out Cavadex or out enema a lifestyle problem. 语法解析
18:38
Here's one last thing on why I'm skeptical about Cavadex. When you study arterial plaque and heart attacks, you'll realize that even though cholesterol does play a role, an important role, it does not appear to be the major risk factor. 语法解析
18:54
This whole Cavadex house of cards is built on the assumption that cholesterol is the primary cause of plaque and heart disease. That assumption stretches back to Ancel Keys and even beyond. Ancel Keys, in case you don't remember, is the guy that we have to thank for making cereals and other grain products the base of the U.S. food pyramid. 语法解析
19:20
And if you haven't heard about that yet, you probably haven't heard about his research that the seven countries study. That was flat wrong. Some say he cherry picked his data unethically. Others say, well, he was just wrong. 语法解析
19:36
That's a debate for another time, another video. Let's go to the core question here. Do you actually need to remove cholesterol to stabilize your plaque and therefore reverse your cardiovascular risk? And the simple answer is no. 语法解析
19:53
Now, the first guys to discover this were Paul Rydker and Gavin Blake. They looked at studies like Wascoff's, Jupiter trials, and other things and noticed that it didn't seem to matter how high your cholesterol was in terms of your cardiovascular risk. What did seem to matter was cardiovascular inflammation. And again, inflammation, I'm not telling any new stories. There was a Time Magazine cover article 语法解析
20:22
What, 20-something years ago? Saying inflammation is the major cause of heart attacks and strokes and a bunch of other things. And the medical community seems to still… 语法解析
20:32
not have caught up to that fact. Plaque stability is more important for risk than removal of cholesterol. And in fact, removal of cholesterol has very, very little evidence supporting it at this point. That all sounds theoretical. Let me give you a study. It's called the Honda study. I talk about it quite a bit when 语法解析
20:54
I'm seeing patients. It gets back to that CIMT, the carotid intima media thickness test, and it shows a few things. First of all, it shows that this is not subjective. This is objective. They use optical character recognition techniques. 语法解析
21:08
to demonstrate level of calcification. They used Kaplan-Meier's, there's like a life table analysis, to show how often people had cardiovascular events. After the patients stabilized, it was really clear. They were stable. There was no risk for cardiovascular disease. They had about the same risk as people with no plaque. But the people that were not stabilized, who had plaque that was not calcified, continued 语法解析
21:37
to have risk for cardiovascular disease. Even plaque reversal maybe doesn't have much to do with cholesterol. The director of cardiology at Harvard made the point that we've had plaque reversal happen before. That's nothing new. Many cardiologists say it doesn't happen. Most doctors say it never happens. It's just because they haven't seen it. Now, here's what he mentioned. Weight loss, like 30-pound weight loss, 语法解析
22:05
is the most common place to find it, but you can also see it with, again, statin use. As we said before, Ancel Keys was not alone. Most people still think cholesterol is the major cause of cardiovascular disease. Why is that? Cholesterol in the artery means cholesterol in the blood and cholesterol in the diet. Again, at least according to Ancel Keys and most people. Ancel Keys' failed assumption about diet is finally dead. 语法解析
22:35
after many decades. But the assumptions about cardiovascular plaque and blood levels of cholesterol are taking longer to die. 语法解析
22:45
They still appear to be on their way out, though. Here's one of the problems with those assumptions. The first misperception involves cholesterol. LDL is actually not cholesterol. It's a particle called lipoprotein. Lipo meaning fat, protein meaning protein. Again, a little bit of geeky stuff, but we can get over that. Lipoprotein is a particle made of 语法解析
23:08
Fat and protein. That's what it is. You see, when we eat a salad with olive oil dressing or when we eat a steak, when you eat anything with fat, that fat doesn't mix with the water in your bloodstream. So your body creates a protein. 语法解析
23:25
Because you need a way to isolate that fat from the water. If you don't, it'll form a big blob and that can be lethal. These big blobs of fat are called fat emboli. People are known to die from that. And it happens with major trauma, like a car wreck where the pelvis or the large, the femur, the large bone of the leg were broken. 语法解析
23:48
So, let's go back and talk about lipoproteins just a minute. So, those proteins that carry these fats, there are some that carry mostly cholesterol. That's HDL and LDL. There are others that carry mostly triglycerides. That's, again, some geeky terms, IDL, VLDL, chylomicron remnants. 语法解析
24:10
Here's the thing. There's really no debate that the triglyceride particles are far more closely linked to cardiovascular disease, cardiovascular plaque, and disease risk. In other words, the proteins carrying triglycerides are far more associated with risk than the proteins carrying cholesterol. Why is that important? Triglycerides are a marker for prediabetes. 语法解析
24:37
Prediabetes is a much stronger driver of cardiovascular disease than cholesterol alone. Now, do I sound like I'm ranting from a mountaintop? Who cares? Why is this so important? Why do we continue this debate? This is far worse than just a cholesterol traffic jam. Here's why. 语法解析
24:57
Thinking that cholesterol or LDL is the problem leads to a reliance on medication. I'm not saying anything outlandish here. Lifestyle is the solution, not pills or stents. Or enemas. One of the biggest tragedies of our current medical system is an over-reliance on drugs and stents for a lifestyle problem. When you think about that, it should become clear that it's metabolism. 语法解析
25:24
not cholesterol, that caused the problem in the first place. Cabot X goes back to assuming this is a plumbing problem. Cholesterol stuck in there alone is not the problem. It's the inflammation caused by the metabolic disease, the prediabetes. Now, what causes that? Aging, obesity, and, wait for it, lifestyle. 语法解析
25:50
And yes, genetics play a role. Genetics may load the gun, but lifestyle pulls the trigger. At the end of the day, this is a lifestyle issue. So let me repeat, this is not a plumbing problem. It's a metabolic problem caused by differing levels of aging, genetics, obesity, and 语法解析
26:11
and lifestyle. It's not caused by a deficiency of statins or PCSK9s or a cyclodextrin enema. Even though, yes, cholesterol can trigger some inflammation, it's just not LDL that causes that. It's another major problem that we're refusing to see. It's called metabolic disease or prediabetes. Why are we refusing to see it? Why are 90% of the people that have it totally unaware? 语法解析
26:38
because their doctors are unaware. Again, I'm not making these numbers up. They're there in the statistics. By the time we're age 18, over half of us have prediabetes. By the time we're 60, more like 80% of us do. And 90% of us that have it 语法解析
26:56
Don't know it. Oh, I've had a test by my doctor. He says I'm fine. That's the problem. Three quarters of doctors don't know how to diagnose this. And again, I'm not making that number up. That's in the surveys as well. So if your doctor doesn't know how to diagnose it, how would you expect to know about it? 语法解析
27:17
let alone treat it. The bottom line is that I just want to give you more perspective before trying this new drug. If you want to try Cavadex, go for it. If you already did, then let me know in the comments. And don't blame me for encouraging you because, again, I think my interpretation is it may be not legal for you to do that. Anyway, if you did try it, let us know. I'm very, very curious. 语法解析
27:45
I'm interested in knowing about your experience with it. So, at this time, I'm concluding that Cavadex is an unproven drug, and like other drugs, it'll probably never be the answer for cardiovascular disease or metabolic disease like undiagnosed prediabetes. 语法解析
28:05
You know, I actually hope I'm wrong. I'd love to see a pill that fixes this whole problem. I'd even take an enema. I did reverse my own arterial plaque, and I 语法解析
28:14
I didn't rely on medications to get that done. We hope you found today's episode informative and useful. Be sure to subscribe to our podcast to stay updated on all our latest episodes. For more information about becoming a patient or participating in our exclusive events, visit PrevMedHealth.com or call 859-721-1414. 语法解析
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