Nick Norwitz

The LDL Illusion... We might be measuring the wrong marker...
Link: staycuriousmetabolism.substack.com/p/the-ldl-illus…

When I was a kid, I figured out that drinking really hot chocolate right before my mom took my temperature could fake a fever.

The thermometer said "sick." But I was perfectly healthy.

In medicine, we call this a surrogate marker. And a new massive meta-analysis suggests we might be falling for the "hot chocolate" trick when it comes to LDL Cholesterol and Statins.

The New Science:

A review published in the European Heart Journal analyzed 20 Randomized Controlled Trials (RCTs) including 194,686 participants.

🤔 The researchers asked a simple question: Does the magnitude of LDL reduction predict the reduction in cardiovascular risk?

🫨 The answer: Not really.

Here is the data breakdown:

The Statistic: They looked at r2 (which tells you how well one number predicts another).

The Result: The r2 for LDL-C on major adverse cardiovascular events ranged from 0 to 0.1.

The Translation: Reducing LDL-C more didn't necessarily mean reducing heart attacks more.

But wait—This is where the nuance lives (and why headlines often fail us).
In these trials, statins did reduce cardiovascular events. But if the LDL drop wasn't the predictor, what was?

The likely answer is a complex set of effects on the background of metabolically unwell patients.

Statins don't just lower cholesterol. They are also anti-inflammatory and improve vasodilation (blood flow). In a metabolically unhealthy population (which is most of us), these effects might be the real heroes, while LDL gets all the credit.

We have built a massive industry on a surrogate that, in isolation, might just be hot chocolate.

Read more by clicking the link above. And remember... sharing is caring :).

#metabolichealth #LDL #cholesterol #medicalresearch #newstudy #statins #cardiology

6 days ago | [YT] | 443



@rahvastepaabel

We gonna sell billions more statins before this is over

5 days ago | 5

@shredderSupreme91

I’m not surprised. My LDL can peak in the 500-600 range when going full blown no carb, yet zero negative metabolic markers & most of all, clean arteries. My Doctors dnt know what to make of my case lol. But thanks to pages like yours, I do. No statins for me

5 days ago | 6

@mbrochh82

"Nutrition Made Simple" and PlantChompers gonna be in disbelief...

5 days ago | 4

@lukaszklopotek

Thank you!

3 days ago | 0

@PatientAdvocateHelp

Great post! Statins are also antibiotic against staphylococcus aureus which has evolved to become a persistent intracellular pathogen infecting our immune cells like macrophages. We were warned by the discoverer of penicillin not to overuse antibiotics because it would develop antibiotic resistance and cause pathogens to become superbugs. Today the number one cause of systematic inflammation is intracellular staphylococcus stimulating IL-6, TNF-a, IL-1b while polarizing macrophages to M2. Whereas the aforementioned is the main cause of insulin resistance, inactivation of Brown Fat, diabetes, low testosterone in men, elevated blood glucose, elevated Branched Chain Amino Acids (#1 predictor of diabetes), Linoleic acid accumulation and elevated AGEs.

3 days ago | 1

@InvestIQ_Keith

But, is there a reason to lower LDL?

4 days ago | 1

@AlexV-jh7ul

But what about the PCSK-9 inhibitor trial? Do we have any reason to believe that there it was also some other effects of the medication that caused reduction in CVD events, rather than just LDL lowering?

5 days ago | 3

@alessandrobaroni6229

Awesome post!

5 days ago | 0

@michaelwhitaker5882

good stuff Nick!

5 days ago | 0

@LowCarbLowDrama

Are we directly measuring LDL? No. In the standard lipid profile test, LDL is merely a calculation derived from the Friedewald equation, an assumption-based calculation that loses accuracy when triglyceride levels are elevated.

5 days ago | 1

@redblueyellowlight_brigh91956

👌

5 days ago | 0

@Padraigp

Ceyenne pepper also does all of that for vascular health without the horrible side effects of statins that some face eating more saturated fat decreases your LPa levels significantly too but we don't compare taking a statin to anything other than placebo we never compare it to eating more fat or taking vitamin c or Cyrene pepper we always looking through a tiny oin hole with so little perspective or comparison

4 days ago | 0

@askyourselfwhatdoyoureally3542

Sell Steak 🥩 not statin

5 days ago | 1

@K_F_fox

The headline looks like it's trying to be talk about remnant cholesterol? Am I reading that right?

1 day ago | 0

@si_vis_amari_ama

Its a no-brainer. We are fortunate to already know about inflammatory markers, HOMA-IR, damaged LDL and subfractions, and the value of trig/HDL ratio, etc, as a true painting of the metabolic picture. Some people just need a massive RCT to convince them to perhaps consider other evidence. Wake up.

4 days ago | 0

@DCGreenZone

Cholesterol-lowering medications called statins appear to reduce arterial inflammation, but whether that’s from cholesterol reduction or something else is being debated. Abstract Lipopolysaccharide (LPS) has potent pro-inflammatory properties and acts on many cell types including vascular endothelial cells. The secretion of the cytokines MCP-1 (CCL2), interleukins, and the elevation of oxidative stress by LPS-activated vascular endothelial cells contribute substantially to the pathogenesis of vascular inflammation. Mechanistic studies demonstrated that SRP significantly inhibited the LPS-induced production of proinflammatory cytokines such as IL-2, IL-1, IL-6, and TNF-α in aortic tissue. Furthermore, it also inhibited LPS-induced oxidative stress in the aortas of mice, whereas the expression and activity of monocyte chemoattractant protein-1 (MCP-1) decreased after SRP treatment. In conclusion, SRP has the ability to reduce LPS-induced vascular inflammation and damage by modulating MCP-1.

5 days ago | 1

@The-Golf-Grinch-2.0

Well, when I did not control my lipids with statins and got caught up listening to cookie crap like this and following a carnivore diet, my atherosclerosis more than double in 18 months. So now I don’t listen to quacks on YouTube and take my statins again and control my lipids. Just remember, all these YouTubers are killing people with disinformation, it’s great if you’re a generic mutant that has 400 LDL and doesn’t have any plaque. But normal people be very careful when listening to things on YouTube, 2 years ago I wish I never did.

4 days ago | 1

@here_for_the

Still shillin for big pharma, like a good doctor should.

5 days ago | 0

@ansound6500

Do you know any doctors in Ireland who is not indoctrinated and understand research?

5 days ago | 0