Hello, this is Dr. Pati and we’re going to get started with our webinar this evening. I welcome you to this webinar series. I know we didn’t do one last month but we’re back on track for fall. Give you a break over the summer. I wanted to share with you the mechanisms by which we’ve been correcting cholesterol and diabetes, and reducing it really in our practice. It very much follows the Five-Point model that I’ve been talking about but I wanted to get into some specifics here on specific things, and specific mechanisms that we use for this.
I’m stuck on my slides. So, of course, we know that cholesterol basically goes up as we age. This slide shows that if you look in the 20’s. People in the 20’s, there’s basically nobody with high cholesterol but nobody really gets measured there. I would tell you that that is actually not accurate anymore. I have a lot of patients in the teens and the 20’s. You’ll be surprised at what kind of cholesterol levels you’ll get if you start measuring it at that age.
So, I really definitely suggest cholesterol screening much earlier; actually, all screening much earlier. The general trend is that cholesterol goes up as we age. So once you realize that, we also realize that our starting cholesterol which generally if you look at LDL cholesterols. The starting LDL in most people somewhere in the teens and 20’s would be somewhere in the 60, 70 range.
Even the cardiac literature now is showing that if that 60, 70 range for LDL that’s actually the most protective for our vascular system and any kind of cardiac effect. We also know that fasting blood sugar goes up as we age. If we look at the American population, they’re actually showing on that left side a 50% incidence of abnormal glucose tolerance test and that’s just among a general population. So, it’s a pretty high number.
We also know that compared to individuals with an HbAlC of 5.5-6, that people who are above 6.5 have a 39% increased mortality rate. So, we know that HbAlC, sugars, cholesterols are all connected with mortality. The goals that had been set by the NIH Panel Committee and this is actually directly out of their things but for a high-risk individual, the LDL goal is supposed to be less than 100. They say optional should be less than 70.
I can tell you that the literature is really pointing to it being in the 70 range. So our LDL goal that we’re aiming for is really the 70 range. If you look at triglyceride levels and we know that triglycerides are independently connected to cardiac mortality. There’s a 54% increase in the relative risk of a cardiovascular event if the triglyceride is above 150 and so we try to drop that under a hundred.
So obviously, any time we have somebody who comes in with a slightly alleviated cholesterol or a gravely alleviated cholesterol, or even somebody who comes in with any kind of abnormality and their sugars, we get to the point where we think that we need to prescribe a prescription. The first thing that I always like to ask myself is, what is out of balance in the body that’s allowing this cholesterol to go up?
Obviously, it’s not a Lipitor deficiency. Obviously, it’s not a Metformin deficiency. There are other factors that are contributing to both cholesterol and sugars that are changing over time. It turns out that our cut-offs are greatly above the point at which we actually increase our risk and I’ll show you some data towards that but obviously, it’s not these deficiencies.
What we’ve found is that generally as we correct hormones and nutrients and correct the way the bowel and the liver are processing cholesterol and sugars, we end up being able to correct most cases of high cholesterol and most cases of alleviated sugars or a pre-diabetes or diabetes, if you will.
So it’s a very methodical approach to just restoring each of these things because obviously the main reasons why the cholesterol goes up is because certain hormones go down. Things like testosterone and thyroid, particular nutrients that are involved in cholesterol metabolism and toxicities in the gallbladder and the liver and the bowel which change the way in which cholesterol is processed.
In this restorative type of approach, you’re always looking for optimal levels. I’ve shown this slide before showing that an optimal blood sugar is really under the 80-85 range but we basically call it normal all the way up to a hundred. When we call it pre-diabetic and then 126 is diabetes. The data to support this, you look at this study and this study actually…
I’m sorry I have to look at the year that this was published. Let me see here, 1999 in Diabetes Care. This study basically shows that it’s a 22-year prospective study in helping non-diabetic men and what this one showed is that even in people who have a fasting blood sugar over 85, there’s a 44% increase in cardiovascular deaths. Not in non-cardiovascular deaths but in cardiovascular deaths.
It’s a statistically significant number even after they adjusted for age and smoking and lipids and blood pressure and lung function, and everything. So, when we say that an optimal blood sugar really should be under 85, really should be under 80 – it’s absolutely correct. As soon as we start to see that creeping up, it’s time to do something about it instead of waiting for the pre-diabetic. By the time we call pre-diabetic, that situation’s been easily going on for about 15 years.
So, in keeping with the restorative approach, basically it takes somewhere between 15-18 years to develop vascular compromise and that’s also what they’re seeing in the cardiac literature. As I was mentioning, when you have any of these abnormalities you know that it would be something in this pathway.
There’s particular hormones associated with cholesterol and sugar metabolism. The ones that are most notable: progesterone, connected directly with insulin resistance; testosterone, contributing to insulin resistance and LDL increase; thyroid, connected with increased LDL and total cholesterol.
I can’t tell you how many people just by correcting testosterone and thyroid… I’m going to show you an example, will actually start to reverse their cholesterols and their sugars just by correcting the hormones alone. There’s also nutrients associated with cholesterol and sugar metabolism and the slides seem to be wrong but we know that for example, in order to activate progesterone, you need a certain amount of iodine and boron.
In order to activate testosterone, you need a certain amount of zinc and iodine. In order to activate the thyroid, you need a certain amount of vitamin D and Ferritin and iodine and zinc and selenium, and vitamin A. Those all have been published in AMA and many of the journals prior to. So obviously, these particular nutrients associated with cholesterol and sugar metabolism and as we correct these nutrients to normal levels, we start to see better metabolism.
Toxicities that are associated with cholesterol and sugar metabolism include most of the ones listed here and more importantly, compromise in the methodology by which we actually can get rid of them and that would be an acidic pH. An acidic pH does not facilitate proper functioning of the gallbladder and the liver.
We know that plants increase plant-based diet and more oxygen will lower those cholesterol levels. We know that Phase 1 and Phase 2 detoxification of the liver and also the way that cholesterol’s processed. All of this is hampered when we have a lot of toxicities going through the liver. Additionally, the liver activates thyroid and testosterone, and thyroid and testosterone are directly involved in the metabolism.
Moving the bowels. When you dump cholesterol metabolized into the bowel, if you move it – it’s something which gets expelled. So getting the body to work in its elimination to be more efficient is part of the mechanism also. We’ve had a system that we’ve used in over a thousand patients. The reduction of disease risk factors that we’ve seen is an approximately 20-40% reduction in total cholesterol which I’m going to be showing you sort of what the range of things that we do.
Triglycerides dropping 50-100 points. We’ve had some and these are average numbers. We’ve had patients who have dropped their total cholesterol by a whole hundred percent. We’ve had people with triglycerides drop it over 200 points. So, these are averages. HgbA1C drop up to two points. Obviously, sustainable improvement in body composition.
To give you an idea of this. You know I’m going to show you a case and what you’re going to see is that as you start to restore multiple things, the patient of course feels better but in addition, not only are they feeling better but the cholesterol corrects and their sugar corrects. So, this is a 57-year old male coming in with:
Low sex drive, two over ten. Low motivation of two over ten. Depression and anxiety of seven over ten. He’s on Zoloft. You may recognize that all three of the top are testosterone-related symptoms. Testosterone deficiency in a 57-year old, you’ll expect testosterone at about 50%. Since I have been measuring testosterone in much younger males, I find that testosterone levels are definitely much lower in even younger males these days.
This gentleman had a weight gain of almost 22 lbs. Very low energy. A cholesterol level of 276. Basically, we order and we do the Serum Labs generally as our baseline at 7-8AM with 12 hours of fasting. We ordered an Estradiol, testosterone, thyroid, pancreatic markers, insulin, HgbA1C, adrenal markers, cortisol and DHEA, nutrient markers and lipid profile.
I order a regular lipid profile. There can be some argument made for ordering the Berkeley profile but with the mechanisms we’re using, we’re lowering all parameters so we’re just ordering a regular lipid profile to begin with. Other tests that we routinely do are an exam, a bone density and I use the Functional Intracellular Analysis Spectracell.
In this gentleman’s case, his testosterone level came back at 237 with a bioavailable being 90. So obviously, he was very low and that obviously correlates with the top three symptoms. Actually it correlates with all six symptoms that he’s mentioning because weight gain especially fat gain is going to be testosterone related and so is high cholesterol.
His free thyroid is 300. TSH is 3. You may recognize these numbers as being completely within the range of what you would expect. However, we wouldn’t call it until it reached the 5th percentile by lab. So, I can tell you that with the symptoms he’s having that that free T3 of 300 really needs to be greater than 400 and that’s kind of what we aim for.
If a person comes in and say, “I’m feeling great. I’m motivated. Energy is great. Not depressed. Weight is great,” and they have a free T3 of 300. I’m going to leave it at 300, but in this person of course, we’re going to treat him. We explained to this gentleman how his cholesterol, his weight, the way he’s feeling, the sex drive is all related to multiple imbalances in all areas and that we would be picking methodically priority, interventions in each area to help him correct his situation.
We always provide literature and a written individualized 5-point plan where we write out specifically what we’re doing in each area. For most people that moment is very much a “Aha!” moment but we started treating him of course. In this case, testosterone-wise I could have put him on PLO 75 mg a day which I think in this case this is what we actually did. Other options would have been to do 100 mg a week or 50 mg twice a week sub q.
In his case we started him on slow-release thyroid at 19 mcg and asked him in 10-14 days to double it to 38 mcg. I used the slow-release in his case because he has anxiety of seven over ten. If he did not have the anxiety component, I would have probably used either Armour Thyroid or Synthroid/Cytomel, which Synthroid/Cytomel it turns out is T4/T3 bioidentical but Armour has T4 and T3 together.
Of course, we know that Armour’s potency is not quite what it used to be but I still use quite a bit of it. It’s covered by insurance and it’s an immediate release. It’s going to have a more profound effect in general instead of slow-release ones. Nutrient-wise, we started him on B12 injections which we use routinely at 10,000 mcg, methylated cobalamin. Essentials 5-1 is the multi that I use with Omega 3 and I’ll show you the Omega.
I talked to you of Essentials 5 in 1 many times but it has many of the key ingredients for thyroid, testosterone, insulin, and adrenal glands. So, it’s specifically formulated for that and so those are the two that I standardly use. Vitamin D, I haven’t mentioned his vitamin D but his vitamin D was low.
I think what we’re looking for in any kind of thing is no preservatives, vegetable capsule, all of these things. I don’t know if any you have seen recently the data that came out showing that most supplements in the United States are contaminated and especially the ones that people are getting sort of in sports, arenas and so on. Contaminations included heavy metals and things like that.
So, all kinds of stuff you wouldn’t expect for petroleum products, PCBs and things like that. So, I think the Spectophotometric testing of raw materials is even more important now than maybe it was before. As far as the Omega, we know that there’s you know 15,000 total papers that are published on Omega. So, it’s nothing that unusual and we obviously know that using omega3, you can lower the stroke mortality by about 36% just with that alone.
You can lower the baseline triglycerides using about 2 g of DHA/EPA by about a good 20-30% right there. When we’re using the RxOmega which I use, which is enteric-coated even two capsules are going to give you the equivalent of almost four. With four, of course, you can see in the green that you have almost a 30-35% reduction in triglycerides.
I can tell you that we’ve had lots of experience watching triglyceride levels absolutely drop with no other intervention than some hormones in omega. This just came out recently, the American Heart Association News of May 2011 showing that prevention of treatment of cardiovascular events should include using 2-4 g of marine-based omega3. Increasing your intake of fibers and reducing fructose, trans fats, and saturated fats.
They reported that with that approach, patients can expect a 20-50% lower triglyceride level and you can see that from what we saw previously in the slide that it obviously is the case. I always get this question about krill oil versus fish oil. These slides are going to be available on the website of MD Prescriptives.
You can see that krill oil is 7-24% omega3 content versus fish oil is going to be greater than 30% and RxOmega greater than 75%. Of course, the stability and sustainability and absorption of krill oil is not the normal claims that they’ve been showing. They’ve had very minimal studies and actually the FDA is requiring them to remove them from their claims.
Many of you may know that when giving omega3, you can measure from Spectracell. This is a measurement of HS-Omega which basically tells you the percentage of omega and you’re looking for about 8% in your RBCs to protect you from some cardiac death that reduces it by about 90%.
This is the formula that I use for IM B12, 10,000 mcg of methylcobalamin with 400 mcg of folate. In this gentleman by week six, on the testosterone, the thyroid, the Essentials, and the Omega and B12, his sex drive and motivation had come up to a 6. His depression and anxiety had dropped from the 5-6 to a 3. His fatigue had come up from a 3. Energy to a 6-7 and his testosterone had come up.
Interestingly, even with this minor change, his total cholesterol had come down from 280-250 and the LDL had come from 130 to 122. So, we really haven’t done much. He’s already starting to see a change. At that point, we increased thyroid, added a little bit of iodine 12.5 mg, two times a day in this case. That’s not something I’m necessarily doing in everyone.
By week 10, sex drive, motivation, energy – all at 8-9. Depression at a 1. He discontinued the Zoloft. You’re talking two and a half months into his program. He gets labs at three months. His total cholesterol has come down to 212 with the LDL at 115. You can see that with some simple intervention, testosterone, thyroid, B12, Essentials, Omega, and the B12 of course, was discontinued by eight weeks – has come down.
We still would like to lower that cholesterol even lower. So, at this point one would do what we call a Metabolic Balance Program. I’m going to show you a case where I used that but there’s other things that we also do. One of them is adding. There’s two products that I sometimes add for this. I can tell you that either one of them would lower the cholesterol by 20% at least, somewhere between 20-40%.
So, the combination; one is Cholest-X and one of them is FiberPro. I usually use them separate but if I have a very difficult case or to challenge the case I’ll use them together. Cholest-X is basically a blend of different things which we’ve been using for about two years. The low dose is four capsules a day, twice a day and a higher dose which is really what I start people on is three capsules two times a day.
If you look up the date on any of these ingredients, you’ll obviously see that most of these ingredients have been well-studied. Red Yeast Rice as you may know has some Lovastatin in it. A year ago the FDA came in and regulated any cholesterol product that has concentrated extracts of Lovastatin. So most products that have concentrated extracts are now off the market.
This is not a concentrated extract but the combination here as I said has been lowering the cholesterol levels anywhere from 20-40%. Sometimes even more than that. We’ve had excellent luck with this. We use it in about 10% of our patients. It’s designed for Statin Intolerant Patients or those who don’t want to take statin.
We’ve had LDL drop 50-75 points. We actually have a study going that we’re hoping to report in American Heart Association by next year. I’m going to show you the second product in this case that I use. A 62-year old woman with diabetes and she was on Metformin 750 mg. You know people never come in with just diabetes.
They’re going to come in with all kinds of other complaints because not only is their sugar off but so are some of the hormones and so are some of the nutrient. So, the energy level here was 5. This patient was waking up a couple of times at night which she had gotten used to but you know when you wake up at night, you’re not able to stabilize or restore your adrenal glands or your immune system.
You really need that REM 4 sleep in the fifth hour of solid sleep and you need to maintain it for two and a half. That’s why we tell people eight hours of solid non-waking sleep. If they’re waking up to urinate, it’s because they’re aware their bladder is full. Most people wake up to urinate if they’re sleeping light enough for that.
A depression of 5 out of 10 and a sex drive of 3, so obviously, this person is feeling pretty lousy. The lab values are showing a progesterone level of 0.5; an Estradiol level that’s less than 20; a free thyroid at 248. So, all of these what we’re aiming for is in the brackets. The TSH is 2.8. Again, none of these really fall out of the normal ranges but we’re looking for optimals.
We’re looking for that TSH to be under 1.8. A HgbA1C on 750 of Metformin is 7.2. Her doctor had offered her going to maximum dose but she was feeling nauseated on the Metformin and didn’t want to try other options. So, she’s trying what we’re offering. We’re really aiming for that HgbA1C to be less than 5.3 because we know that that’s the level which correlates with a fasting blood sugar less than 90, less than 85.
We also know that that’s the level that’s associated with the least glycosylation of your vascular system and your neurological system. So, fasting blood sugars 111. We’re aiming for less than 85. Triglycerides were 288. Extremely common to have the triglycerides up when you have a sugar issue. So obviously, her cardiovascular risk to drop it, we have to correct all three of those last values.
We use the similar model that we’re talking about and in her case, we used Armour Thyroid. We usually start… If somebody had a big anxiety component and they have adrenal insufficiency, I would have started with 15 of Armour but she didn’t have those two things. So, I started with 30 of Armour and approximately every 3-4 weeks, we’re bumping to 60-90.
If the Armour gets to 90, after that I generally add just T3 either in the form of compounded slow-release or Cytomel 5 mcg which is an immediate release bioidentical T3. She’s on a Vivelle Dot Estradiol at .05 because the estrogen level was undetectable. Progesterone at 100 mg. We started her on Essentials 5 in 1 and Omega.
So, it’s a good start to address some of the insulin issues and to start activating the hormones that are associated with cholesterol and diabetes that we’ve actually started her on. By week four, the energy level has come from a 5 to a 6. Not a real huge difference but the sleep, there’s absolutely no waking. So, we’ve already corrected that and in that, you’re going to correct the adrenal glands and correct the immune system.
The depression has gone from a 5 to a 3 and the sex drive has stayed where it was, which is low. Obviously, she feels better. She’s still on the Metformin. I was mentioning to you, these numbers, the one I hadn’t mentioned is her insulin was 18. Again within range for regular lab systems but we know that that number really has to be under 5 for you to have good insulin control and proper protection from cardiovascular events.
So she was started since she was feeling better on a mechanism which would take her from the red line where she’s swinging up high and swinging down low into the blue line. Of course, swinging up high, swinging down low, anybody who comes in and tells you they have hypoglycemia – generally, you can be rest assured that they also have hyperglycemia.
You always can prove it by getting a HgbA1C but swinging up they generally not only store fat but you’re increasing glycosylation everywhere and swinging down they sometime have hypoglycemic symptoms like fatigue or dizziness, or a sugar craving. One of the best ways actually to bring yourself from the larger curve to the more moderate curve is to have your complex carbs and proteins match in terms of volume.
As far as the mechanism we use and this is something I have gone over before but again will be in the slides. We start with a bowel cleanse. In week two, we put on linking with the protein and complex carbohydrates. In week four, we do a liver cleanse. And of course, there’s an exercise component and a supplement component to some of this.
The 7-Day Vegetable Cleanse which we use basically is specifically for cholesterol, insulin resistance and weight, if weight is an issue. At seven days of minimizing canned, boxed, processed, refined, overcooked, microwaved and avoiding all meat, fish, dairy, eggs because they form acid. Sugar, alcohol, soda, tea, coffee and using a lot of vegetables.
The ones in yellow are the ones that enhance liver detoxification. We usually instruct them to make a vegetable soup and roasted vegetables, all on like on a Saturday or a Sunday and start carrying them around so that they always have something to eat. There’s no calorie restriction here.
It’s a 7-day plan which we ask them to congratulate themselves for every success because this is the kind of thing which sounds very simple. When you get hungry and you haven’t planned and you’re not carrying around a large purse or a large something if you’re a man, with some water and Tupperware or some kind of glass thing, if you can possibly avoid plastic with food and a cold pack.
Talking about plastic because I forgot to mention it before in the detoxification thing but one of the things that we become keenly aware of, I’m going to take a diverge here for a second, is that in the United States our plastics are capable of, they have folates in them. Of course, folates are capable of binding to the pituitary gland, the thyroid, the pancreas, the adrenals, and our ovaries and testicles.
They’re extremely strong endocrine destructor. In most countries the plastics have to have things that are proven safe before you can wrap food or put any kind of food in it. In the United States, we have an “innocent until proven guilty” thing. So of course, all of our plastics do have folates in it.
If you want to watch an interesting movie about this. There’s a movie called the Bag It Movie which you can find on Bagitmovie.com which is this guy who is basically teaching and doing a documentary on the effect of plastics on the environment. His wife got pregnant and he decided to shift the documentary to what the effect of plastic water, plastic bottles, how much folates the baby’s coming out with. It’s really quite amazing.
So avoiding any kind of plastics around your food is definitely challenging. Food and water is something which we have to start thinking about. We suggest a 7-day meal plan. This is just a 7-day thing and we try to get them to drink a lot of water and you know have the family participate.
We use a bowel cleanse where we use PureCleanse Bowel 1 and 2 and the PureBiotic. This is for one month. We run this first and then in the second month, we use the liver cleanse which I’ll show you. When they come in at week two, we tell them to celebrate any success they’ve made. We introduce them to the new plate.
The new plate at breakfast, lunch, and dinner is always to maintain; 50% vegetables, 25% protein, 25% complex carbohydrates. We know this plate ratio for breakfast and again for lunch and again for dinner. Your breakfast would be 50% sautéed or roasted vegetables and eggs, and a cup of steel-cut oats. You’re good because you balanced the insulin swing from being on the red line to being on the blue line because you’re linking your complex carbs and proteins.
You maintain that kind of attitude towards your lunch and dinner also. We also ask them to be aware of having a total fiber of 30-40 g per day, both insoluble and soluble fiber. We know insoluble fiber is going to promote the movement of the digestive system. Many of those are actually in the PureCleanse Bowel regimen and that’s how it works.
Soluble fiber is critical for binding sugars and cholesterol. So, it’s found in oats and peas and beans and apples, citrus foods, carrots. There’s a whole list. We recommend 25 g of soluble fiber. Recommended coming from the food source but sometimes we end up giving them supplements and there’s a lot of them on the market.
This is one that I use that I very much like. It’s a 60% soluble, 40% insoluble made by Karuna Corporation in California. It has a combination of things in it. Two teaspoons is going to equal about 6-7 g of fiber with that ratio that I told you. So, it’s not a solution. I tell people to take you know two teaspoons a couple of times a day. It’s a tolerance thing.
People have to start slow with this product because you can get very gassy with it but what we suggest is that just introduce yourself to like half a teaspoon at first and then keep working up to the highest one you can take. The higher it is the better because obviously, you would need you know ten… Well, I guess you would need about eight teaspoons a day to match your entire requirement from this alone.
We also give them a weekly questionnaire where it has a total of 25 points and we’re trying to encourage certain things like water intake. We’re encouraging them to have above 60 ounces and if they have 60 ounces, they get three points. At least five snacks per day, they get three points. At least 10 veggies per week, they get three points. Ten different vegetables of different colors.
A conscious breathing per day. A number of bowel movements per day. We know these are connected with their ability to lower their cholesterol. We know we’re changing the curve by the plate ratio and some of the supplements we’re using. In week four, we add the liver cleanse and again, this is a one-time thing we do for the month before putting them on anything.
PureCleanse Liver is the one that we’re using with Milk Thistle and NAC and so on. In this patient, we also put her on Gluco-X. Gluco-X is a combination of cinnamon, gymenema, bitter melon, fenugreek. Many of the things that we know to lower sugars and any kind of diabetic medications people are on.
My experience with this and the mechanism we’re talking about is that we’ve had patients who are on insulin that have had their insulin. We’ve had patients who’ve been on Metformin that have come right off of Metformin. Actually, if you look at the other products that are glucose formulas on the market from many different companies, you’ll note that the Gluco-X from MD Prescriptives has all of the ingredients at a dose that is therapeutic.
So utilizing… just a recap. A hormonal regimen which got her to feel better followed by a bowel cleanse and a liver cleanse and using Gluco-X, we were able to get the fasting sugar from 18 to 11. The fasting blood sugar from 111 to 94. The HgbA1C from I think it was 7.2 to 6.2. Most importantly, the triglycerides from the upper 200 range to 154. This is in three months.
So, this is not ideal. This is not what we want. We want the fasting insulin at five, the fasting blood sugar under 85, HgbA1C of 5.2, triglycerides lower than that. So, what are we going to do now? So this is when you keep the Gluco-X going and let me see… This is also when in her case, we actually hadn’t put FiberPro on. So, this is where we actually, in her case, added FiberPro.
That’s the end of the case. In her case just as a follow-up, she’s actually lowered her Metformin down to 250 and I think she’s going to be coming off of it altogether. All of her parameters have moved in towards the lower direction which happened over about a six-month period of time from here. So, the initial change was very quick and then the rest of it is kind of slow but still gets you down to where you want to get using this kind of model.
So, I do want to start taking some questions. I wanted to mention to you guys that I’m doing a Hormone Restorative Therapy Workshop for Men and Women: Science and Case Applications and Bio-identical Hormones, Nutrients, Detoxification, the whole thing October 1st and 2nd in Orlando. It’s two workshops actually back-to-back.
One is Basic Protocols and Case which covers all of the hormones and comprehensive review. The second one is Advanced Protocols and Cases. It’ll be heavily case-related. There’ll be a full set of slides and articles that you’ll get on DVD and hardcopy. There’ll be four didactic sessions within these workshop followed by illustrated cases and facilitated interactive question and answer things.
So with that, I stop and thank you for sticking to our webinar and ask you what you would like to ask me as questions. We can open up for questions and I think I had to do something for that which, here we go. Okay. So we’ve got… Okay. Do you check B12 Serum levels before treating with high dose IM B12 injections or given empirically?
What I’ve found is that Serum B12 levels are generally not correlating with the intracellular levels and the way that you can tell is if you look at the MCV and you see a MCV that’s pushing above 88 into the 90. You’ll often see it at 95, 97, 98 very large self. You know that intracellular B12 and folate are low.
You also can confirm that will Spectracell testing which I normally do to confirm this. I don’t confirm it because I give it empirically knowing that it’s water-soluble and that I can correct most of it. I usually give it for about eight weeks and it makes a huge difference. What if a patient comes in on a statin. Do you work around this or take them off of it?
Most of the patients that are coming to us are actually interested in coming off of their statin or they’ve come off of it and come in. If they’re interested in coming off of it, I suggest that they come of it immediately and usually we’re getting the levels. I mean if you wanted to do it very purely, you would take them off of the statin drug, let their cholesterol go up, re-measure their cholesterol, and then do your program for the academic benefit.
We don’t do that. What we do is is we tell them to come off the statin and we go ahead with the program the way it is. For example the gentleman that you saw, he wasn’t on a statin. So, and the other thing I should mention about a statin drug is that, it turns out that we always fault that the rate of side effects on statin drugs was close to 5%.
I have been in conversations with several cardiologists and now with the data vary showing you that if you really take a good history, the rate with statin drugs is closer to 25%. So, if you have somebody with a really crazy cholesterol level and you don’t want to risk having the cholesterol shoot up and you know just having that kind of risk in there. You can immediately start with adding the Cholest-X and then if you want to come off of it, you can come off of it.
Let me see. Next question. By the way, we have almost a hundred percent rate of people coming off of statin drugs if they’re interested in coming off of it and maintaining very low cholesterol levels when you’re… As I said, when you correct the testosterone, the thyroid – you correct the nutrients in the bowel and liver.
When will you be offering the two workshops other than October 1 and October 2? That hasn’t been determined. I don’t know. Probably sometime next year. It’s probably the right thing.
How do you get the webinar protocols? The way you get webinar protocols is on MD Prescriptives’ website and also from them you’ll get a newsletter that should come out within a week that will explain. Basically, it’s a patient newsletter. It’s aimed at your patient and it is un-authored. So, that means it’s an editable format for you to put your own name on and basically send it to your patients. That’s where the protocols are plus the slides are usually there.
Can you please explain in a little more detail the folic acid you use. Is it mixed with B12? Yes. The folic acid is 400 mcg mixed with the B12 per cc. The next one. Do you have any experience with Byetta weight loss? No, I do not have that experience. Next one but I do have experience by the way with Metformin in weight loss.
What I’ve found is that in order to have Metformin work for you for weight loss, you really need a dose of close to 1500 mg but you know I’d be liberal in using it if somebody had insulin resistance. Next. Please explain why you’d rather use PO progesterone than transdermal? The PO progesterone is slightly, it’s not slightly – it’s significantly more clinically effective in those patients who have significant symptoms of anxiety and sleep disorders because they generally also have some adrenal insufficiency.
So, if you have adrenal insufficiency or compromised or you have somebody who has panic attacks, you’re not going to be able to control it on transdermal progesterone because you’re not going to make enough of the 5 Alpha-Pregnane and the 4 Alpha-Pregnane to bind to your GABA receptors in the brain because those are made in the liver.
As you know, most people suggest and we of course, know that anything that goes through the liver gets processed in a certain way and for testosterone and estrogen, that processing actually creates toxic product and toxic metabolites. For progesterone, the metabolites are actually rather helpful especially if you have somebody who has sleep and anxiety issues. On the other hand, if those aren’t big issues and you don’t have a big adrenal component, the transdermal progesterone is perfectly reasonable and we use quite a bit of it just depended upon the patient.
So, that takes us to… Oh, one more question. How frequently do you need to see a patient on this program? For their detox, we see them at week one and then we see them a week later. Otherwise, we’re really treating them based upon seeing them every 3-4 weeks and we have a 15- minute visit every 3-4 weeks.
Will you treat a patient with this condition who also is a Factor V (Five) Hetrozygous Status? Yes, I would with no problem. Do you use progesterone troches? Not much, but troches are absolutely a reasonable way to go. I mean the nice thing with these hormones and nutrients and everything we do is, I think ideally what we try to do is keep a very large toolbox.
So when we’re doing hormones, we know how to use it as trophies and sublingual and as a cream, and as an oil. Know how to use all the patented Estradiol products and all the thyroid products because what you’re going to find is that for each patient, what matches them might work differently.
I mean I’ve had patients who do terrible on oral progesterone, terrible on transdermal progesterone, and then I put it into a sublingual which is only an immediate release. Theoretically, I don’t expect it to work at all but for that particular patient it works beautifully. So, I think that having an expanded toolbox and having an open mind.
As you can see, there’s many interventions. You don’t necessarily choose all of them. You don’t have to have everybody on Gluco-X, and everybody on Cholest-X, and everybody on FiberPro. You kind of choose what suits people and go from there. So with that, that’s the last question that I’m going to be taking.
I am very happy that you guys attended and I hope you got what you needed out of it. If there’s any questions, you can direct it to MD Prescriptives and access the webinar online there. I’ll be looking forward to being able to meet you guys at some point and do the next webinar. Thank you very much.