I tried a statin and PCSK9. Did not like the statin and could not afford the PCSK9. Insurance wouldn’t cover it. I did recently buy enough Bempedoic acid to go about a year and my doc obviously wants me to do something, especially that. I have not taken a pill yet. I don’t think it will improve my ACM.

Honestly I have no bad symptoms. My times are still pretty good on the 2 mile run, this morning the temp here was 10F, so obviously a little slower than summer, but still ok. I trust Michael Eades, knowing he is not talking directly to me and just about statistical things and his medical opinion. I read his first book and have followed him for probably 35 years. He says if you have not had a heart attack by 65 a statin won’t help. I turn 64 in 4 hours. My only symptom is a series of bad CAC’s slowly inching up. According to the study he found, you calculate the density and if it’s in the safe area, then you are probably safe. I’m probably safe.

Since my last CAC I’ve gone through 4 boxes of Beta cyclodextrin and done extensive chelation with some EDTA, quite a lot of DMSA and finally I’ve done a couple months of Pectasol plus glyphodetox which is an alginate. Supposed to also clear out glyphosate and molds. My next CAC will be any time soon, I usually do it around my birthday. I’ll call them and see what works on Monday. If it’s a disappointment then I might give BA a try. Even though I know the calcium doesn’t actually hurt anything, still it shows I’m doing something wrong.

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Arterisol by Calroy and Endocalyx Pro are both aimed at vascular health - maybe worth looking into

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Thanks! I had looked at this when talked about on here before and had started taking some of the ingredients separately and kind of forgot about it. Now I see this:

Fucoidan sulfate is validated as a hybrid of heparan
sulfate and chondroitin sulfate

and this:

A high dose of glucosamine sulfate

Now armed with the sulfate talk from the above, I see how this could possibly be worth the very high price. I’ve always taken glucosamine chondroiten and MSM, but still this seems like it could be good.

I’ll take another look, thanks,

I bet you’ll have higher returns by purchasing Dr Alo’s cholesterol book: ($140) than anything else really. At least you’ll know whether what you’re doing is nonsense or not, and that’s worth it’s weight in gold.

Good luck either way.

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In fact you are not. I mean you are really potentially in a very bad place.
Forget about statistics here, as we are all individuals, so here is my case which is somewhat similar to yours:
Last year I was training to do a marathon in a Boston Qualifying time, so insanely fast for my age group (60-64). A few weeks before the event I decided to check everything was OK with my heart because my CAC was 161 (Not very high but not 0 obviously). As my PCP was not interested, I went to the Cardiovascular Performance Program at MGH in Boston where they do know that you can be fit but might have asymptomatic heart issues and they sent me to get a CTA.
The next day, just after I finished a very hard hill sprints workout, the cardiologist called me and sounded very worried, asking several times if I was really OK, and to stop right away any strenuous activity.
Turned out that I had 2 blockages at 90+% on 2 coronaries plus a few less spectacular other ones. Those blockages were made of almost all soft and unstable plaque with very few calcium in them which is the most dangerous situation and shows that the CAC is not that useful at the individual level.
I ended up going to the Cath Lab in high priority to get 1 stent (*) on the LAD. They could not stent the other blockage because of where it was. After that they let me run only in zone 2 for 6 months before I could resume a normal training. As I had absolutely no symptoms, I was running again (in zone 2) the week after the stent and now I’m back training for the BQ time marathon.

Conclusion: You can have a low or even 0 CAC, be super fit with a VO2 max of 50 at 61, have absolutely no symptoms, even when training for a hard marathon, and still have 90+% coronary blockages made of soft and unstable plaque.

Conclusion 2: I had other tests like echo cardiography, stress PET scans, etc. that showed that even with those blockages the heart perfusion was 100% normal with 0% ischemia. They think that the endurance training created lots of capillaries and other small blood vessel than allows the heart to get all the blood it needs. Which BTW is exactly the point of that thread!

(*) Interestingly, that stent was coated in rapamycin.

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You do know that the number one symptom that people with atherosclerosis first experience is heart attack and death, don’t you?

See the peter attia podcast on atherosclerosis - see this video, queued up to the exact point of the relevant discussion:

Screen Shot 2024-12-23 at 3.24.38 PM

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Be sure to measure soft plaque. CCTA. Then you’ll know if you must be aggressive or if you are succeeding in removing the plaque buildup. This is potentially life threatening, and there is no need to guess or use statistics or other people’s results. Look and see. Good luck.

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Let’s be real here. You can’t remove plaque build up (except maybe a little by crushing LDL/apoB). But you can reduce event rate by using FDA approved drugs designed for that purpose.

Optimizing event rate is what matters at the end of the day. Whether someone gets a heart attack or stroke, and so on…

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There is information that many over breath and push out too much CO2. The body needs a good balance of O and CO2 for the most effective delivery of O through out the body.

In real life a person often must choose between being right and being effective.

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Can you share the most compelling information / data in this area? I’ve never heard anything about this before.

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Here’s a paper from Dr Dallam on nasal breathing during exercise. The nasal breathing benefit is the other side of the coin to overbreathing causes too much CO2 loss (with consequences including sympathetic activation and poor oxygen delivery to tissues)

https://www.researchgate.net/publication/338558548_The_Effect_of_Nasal_Breathing_Versus_Oral_and_Oronasal_Breathing_During_Exercise_A_Review

I’ve done two interviews with Dr Dallam. Super smart academic and elite endurance athlete.

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I have to say I was pretty skeptical when I read to Nestor’s Breath and Oxygen Method but the arguments and science were pretty compelling.

Evolutionary creating and maintaining a nose is very energy intensive and unless it provided a definite survival advantage we wouldn’t have it.

I tried mouth taping at night and focus on nasal breathing through the day, even during exercise - except for heavy weight lifting, I still have to Valsalva grunt thru my mouth.
I tried nasal breathing for intervals and can maintain nasal breathing for up to 90% maximal heart rate. I was pretty stoked.

Seem like my nose is clearer now and I am bit more calm.

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@Dr.Bart Congratulations. You are ahead of me despite me working on nasal breathing for 3 years. I have learned to sleep nasal breathing without tape (I used tape for a long time). And I am aware of breathing through my nose almost all the time. I nasal breathe during weight lifting; which reveals a strange delay in my increased “air hunger” from effort …never during a set but always afterwards. But I just cannot nasal breathe at high heart rates during exercise. My nasal passages just betray me … I’ll keep at it.

I agree that noses are an evolutionary advantage. Expense to build but oh so useful: filtering dust and microorganisms, adding NO, adding moisture to protect the lungs, creasing a back-pressure to force using the diaphragm to pull air past turbinates. When using the diaphragm we breathe deeply and more slowly which results in less CO2 loss resulting in better oxygen exchange (delivery of O2 to tissues) and less sympathetic activation (stress, anxiety, etc). I believe higher co2 means we also have higher bicarbonate to combat acidification from anaerobic exercise (can tolerate higher lactate).

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Guys, I do nose breathing too, and believe in some benefits, but I don’t believe that’s what the nose evolved for. Note, that nasal pasages appear in a huge variety of animals, mammals, birds, reptiles amphibians, fish and so on. The anatomy/morphology of these passages is quite different across the animal kingdom, which tells you that most of these “reasons” listed are unlikely to be the key drivers of evolution, as they don’t appear consistently in all these animals, while nasal passages do. The connection between lungs and nose is not at all the key here - after all, there are no “lungs” as such in fish, yet fish have nasal passages and the nose therefore functions quite differently in that connection. What appears consistently is something extremely obvious yet not mentioned: the sense of smell. I think that’s probably like 90% of the reason for the persistence of a nose through evolutionary history. A fish, like a shark, can detect the presence of blood in the water in extreme dilution at great distances. It’s the sense of smell, detecting airborne or waterborne molecules that are the fundamental reason for the existance of the nose and nasal passages. Things like moisture, filtration and temperture control are certainly factors, especially in mammals, but the sense of smell is going to be the real driver. A dog in the wild, a cat, an antelope and so on, all need their sense of smell for their very survival - all the other things mentioned, like the use of diaphragm, are far, far, far down the hierarchy of function, if they are even factors at all.

That said, to me the biggest factor in nose breathing is the restriction of airflow - in exercise, it likely has a very good training function for the cardio-pulmonary system and the use of oxygen, especially in hypoxia. Athletes sometimes even use devices to restrict their breathing, which intentionally put a strain on their lungs, diaphragm muscles etc. At night, you need to breathe through the nose so that you cut down on the danger of dry mouth, because dry mouth leads to a host of dental problems (methmouth is equal parts teeth grinding and dry mouth), when teeth and the gingiva are not bathed in saliva, nasty bacteria proliferate. So I’m there for all the advantages of nose breathing, but let’s not lose sight of the key reason for the nose: the sense of smell and moisture retention in the mouth (much more than moisture in the lungs). I have not read any books about nose breathing, but listened to a podcast (I think it may have been on Attia’s podcast?), and there does seem to be science behind it, so I was happy to adopt it. Regardless, it seems that many people experience benefits, and that’s all that matters!

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These are good points that are certainly important. I have no idea how you come up with what’s more important than another thing that has also survived millions of years of natural selection. You are not deficient in confidence, so you have that going for you.

Watermelon is a good source of citrulline (and lycopene). That’s why I eat a cup of it every morning with breakfast. Citrulline is also frequently included in pre workout supplements.

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LOL, good snark, JL, keeps me on my toes! But in this particular case, the explanation is remarkably simple. That which is more important is the thing that appeared first in evolution, and has been preserved in each and every single case of a nasal passage occurance. Pretty obvious really. In each and every instance of nasal passages, we have a sense of smell. From the earliest examples. That is not true for many of the other functions, such as connected to lungs, since nasal passages exist even when there are no lungs present - such as in fish. Which I already highlighted, thus showing my work. That said, you are absolutely right, in different animals, the different functions of nasal passages are emphasized, possibly even surpassing the sense of smell(?). Thus in human beings, maybe other functions are more important than the sense of smell - I don’t know, though the sense of smell seems key even here, as the paper below states. But that wasn’t my point. My point was strictly focused on evolution - the claim that the nose evolution preserved those other functions preferetially - that obviously is not the case, as the most important function evolutionarily has been the sense of smell, as I showed above (being first, and present always).

Here is an interesting paper looking at the interplay of these very issues, and the olfactory aspect even in the human nose looks pretty robust, so my confidence in this is boosted (not that I have a deficit of self-confidence, as you note, lol):

https://journals.biologists.com/jeb/article/222/Suppl_1/jeb186924/2802/The-navigational-nose-a-new-hypothesis-for-the

Quote:

" If nose shape is under positive selection, then, barring the hypothesis of Dr Pangloss that the human nose evolved to hold up spectacles (Gould and Lewontin, 1979), we must consider the hypothesis that it could function in olfaction. Subtle changes in nasal anatomy can be associated with significant differences in olfactory function (Zhao, 2004). For example, the shape of the tissue immediately past the nostrils (i.e. nasal vestibule) can have a significant effect on the flow of air to the olfactory epithelium (Zhao and Jiang, 2014). There are large individual differences in this area, with some individuals showing a distinctive notch (Ramprasad and Frank-Ito, 2016). Because the perception of intensity for soluble odorants increases when airflow is lower (Sobel et al., 1999), Li et al. (2018) hypothesized that the notch would produce a vortex that would increase sensitivity to more soluble odors, which their results confirmed. Moreover, narrower noses had larger notches, more intense vortices and higher sensitivity to soluble odorants (Li et al., 2018). Thus, there may be local turbulence in specific regions in the nasal chamber that can influence olfactory as well as respiratory function (Zhao and Jiang, 2014).

An olfactory hypothesis

If structure influences sensory function, then this structure may be adapted to a specific use. In humans, the shape of the external ear can be predicted from the statistics of the auditory landscape (Parise et al., 2014). The relative size of the eye in birds and mammals scales with the speed of movement (Heard-Booth and Kirk, 2012). If human nose shape has an olfactory function, it may have been similarly shaped by its olfactory landscape.

One reason why there should be a relationship between olfaction, nose morphology and climate is that the conditions supporting olfaction are also climactic. Odorants may become easier to detect with increased absolute humidity because water molecules compete with odorant molecules for substrate positions (Igue et al., 1972; Vander Wall, 2003), although the exact relationship between humidity and the behavior of molecules can vary in complex ways (Emanuelsson et al., 2013). Laboratory studies of olfactory threshold in humans confirm that odors are easier to detect in conditions of higher humidity and temperature and lower barometric pressure (Kuehn et al., 2008). Thus, one might predict that using olfaction would be favored in hot, humid climates but not in climates that are cold, dry or found at high altitude. In fact, there is a positive association between nasal breadth and absolute humidity (Zaidi et al., 2017; Maddux et al., 2016).

The observation that nasal breadth associates with a climate conducive to olfaction may be a clue to an olfactory function for the human external nose: the use of odors in spatial orientation. The reason is that the use of olfaction in orientation makes specific demands on the external morphology of the olfactory sensors. This is because olfactory navigation is enhanced by using stereo olfaction, where paired olfactory sensors (antennae, nares) that can compare independent samples increase the accuracy of orientation to an odor source, as I will review below. Perhaps the evolution of the external pyramid in Homo is an adaptation for spatial olfaction and hence is another contribution to the integrated suite of adaptations for efficient long-distance travel that has been characteristic of the genus since Homo erectus."

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There is no doubt sense of smell is important. The decline in brain function with age accelerates with a loss of smell sense, and can be recovered somewhat with the use of scents to exercise the brain. Scent is tied into memory like music. I find music is the easiest way to time travel…but scent is like that also. Grandma’s perfume, a pine scented Christmas tree (from a can for the artificial tree people), the smell of lit birthday candles, baby breath, a new car smell, the alcohol wipe before the needle, the expensive whiskey.

Time to play my favorite hits of the 70’s on Spotify….to be a teenager again.

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Yeah, loss of sense of smell is scary, often presaging dementia AD and all sorts of morbidities. I didn’t know you could exercise the sense of smell though, that’s wild! It’s interesting how the loss or impairments of the senses are tied to neurological pathologies. Loss of hearing and impairments of vision are also correlated with dementia. Understandable, as the brain areas that correspond to the various senses deteriorate and are a canary in the coal mine. In general, the senses dull with age, like famously, people tend to oversalt their food as they grow old, because they need stronger taste signals, the sense of taste deteriorates. Balance, coordination, you could go down the list. The brain just keeps trying to adjust, compensating, shifting areas, but at some point, there is just no more spare capacity left. This is one reason why maintaining brain health is so important, preserving spare capacity. Blood flow to the brain is super important, and exercise greatly enhances that. Nutrients need to reach, waste needs to be removed. There are so many metabolites in the brain tissue that are poorly characterized, avoiding neurotoxins - with age it gets harder as the blood brain barrier weakens. And the brain is all you have, totally irreplaceable, you can swap organs, and if your body is in poor shape, you can still keep on going, but once your brain deteriorates, it’s game over. Take care of your senses - I have many posts here about vision protection, nutrition, lutein etc. - as when these go downhill, so does your brain. That’s my holiday message😁.

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