Because Good Medicine Deserves Better Explanations
In 2012, telling a heart patient to cut carbohydrates could still get you labeled a heretic. Fat was the villain. Carbohydrates were the gospel. Medicine spoke in percentages and pyramids, not physiology. Calories were our currency, and balance was our creed. But the numbers on my desk told a different story.Triglycerides were falling, waistlines shrinking, … Read more
At first, they were diabetes drugs.
GLP-1 receptor agonists—liraglutide, semaglutide, and later tirzepatide—were developed to help patients with type 2 diabetes regulate blood sugar. They mimicked a gut hormone, GLP-1, that modulates insulin, glucagon, and gastric emptying. They also acted on the brain.
Appetite went down.
Weight came off.
And people noticed.
Not long ago, I saw a 58-year-old man who had done “everything right.” His LDL cholesterol (LDL-C) was well controlled on a statin, his blood pressure stable, and he exercised regularly. But he carried extra weight around his waist, his triglycerides were persistently high, and a CT scan revealed clear signs of atherosclerosis in his … Read more
Sometimes, the most dangerous number isn’t the one your doctor talks about. While LDL-cholesterol (LDL-C) steals the spotlight in most lab reports, it’s not always the best predictor of cardiovascular risk. Hidden in plain sight is a more powerful marker: non-HDL cholesterol (non-HDL-C)—a measure that captures all the cholesterol carried by atherogenic, plaque-building particles, not … Read more
The TG/HDL-C Ratio in Clinical Context For decades, cholesterol has been the headline act in our understanding of heart disease. High LDL-cholesterol (LDL-C) — the so-called “bad” cholesterol — was cast as the main villain, while HDL-cholesterol (HDL-C) earned praise as the “good” kind. Statins became the blockbuster therapy, and LDL-C targets the cornerstone of … Read more