A patient lost 40 lbs three years ago.
Gained back 45.
She wasn't lazy. Her hypothalamus was doing its job. Leptin drops, brain reads starvation, hunger rises, metabolism slows.
It's not a willpower problem. It's a thermostat problem. The thermostat can shift.
New article on the science below.
@Catalyst2Thrive Brad, you're giving me some confidence to expect my running fitness/speed to return. My long winter in AK and patient with mobility/strength are showing upward trends. Thank you.
@Catalyst2Thrive I remember the days I couldn't get my HR above 90 if I wanted to in my early 20s. I was both super fit and on the edge of over-training.
@JohnGoldman Love the real data. Zoom in and it doesn't feel like you're always losing weight. Zoom out and the trend line is sharply downward. Stabilization soon.
1 in 5 people carry Lp(a) levels associated with significantly elevated cardiovascular risk. Most have never been tested.
It's not on your standard lipid panel. It doesn't respond to statins. And it's largely inherited.
If heart disease runs in your family, ask about Lp(a) by name.
Jim had been on a statin for 8 years. LDL-C well controlled. Previous cardiologist said he was well managed.
Father died of a heart attack at 54. Brother had a stent at 49.
We checked his Lp(a). It was 187 nmol/L.
His statin was doing almost nothing to lower it. Nobody had ever tested for it.
@StephenSeiler I'm seeing discussions on this paper and this concept all over my X feed. I was not aware of this phenomena but the description and multiple variables in differential times clearly matter @Alan_Couzens
@JohnGoldman Nice clinical pearls for the readers. "natural" always better. Some assistance not unreasonable with medical supervision and while working on foundational health (sleep, nutrition, strength training & aerobic exercise/physical activity).
New therapies specifically targeting Lp(a) are in late-stage trials.
The era of treating this directly is coming.
But you can't treat a number you've never measured.
If heart disease runs in your family and your standard labs look fine, ask about Lp(a) by name.
One in five people carry a cardiovascular risk factor that statins don't lower, diet doesn't change and almost no one has tested for.
In a study of 5 million+ adults over 8 years, fewer than 1 in 300 had ever been checked.
It's called Lp(a). One blood test. Done once. The answer doesn't change.
Lp(a) is ~90% inherited. Set at birth. Stable across your lifetime.
It predicts heart attack, stroke, aortic stenosis and peripheral artery disease independently of everything else on your panel.
At extreme levels, heart attack risk is 3-4x higher than in people with low Lp(a).
@DavidDack Never made it to under 35. Still a trickle of a dream. I think I’m 42 capable but will be <40 by end of August. Simple smaller goals as we reach middle age.