#23 - Tom Dayspring, M.D., FACP, FNLA – Part IV of V: Statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 18 October 2018

⏱️ 120 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. In Part IV, Peter and Tom review the history and current use of drugs to prevent cardiovascular disease. They also discuss why some drugs appear to be more effective than others, an in-depth conversation about niacin, cholesterol and brain health, and the futility of using CKs (creatinine kinase) and liver function tests to identify adverse effects in statins, to name a few topics in this episode.

We discuss:

Bile acid sequestrants and statins [2:00];
Ezetimibe (Zetia) [15:00];
PCSK9 inhibitors [27:30];
Fibrates [41:00];
Fish oil, DHA, and EPA [1:01:00];
Niacin [1:05:15];
PCSK9 inhibitors [1:23:45];
Cholesterol, statins, and the brain [1:30:00];
Elevated creatine kinase (CK) and liver function tests (LFTs) on statins [1:50:30]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to the Peter Atia Drive. I'm your host, Peter Atia.
0:10.0	The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,
0:15.7	along with a few other obsessions along the way. I've spent the last several years working
0:19.6	with some of the most successful top performing individuals in the world, and this podcast
0:23.8	is my attempt to synthesize what I've learned along the way to help you live a higher quality
0:28.3	and more fulfilling life. If you enjoy this podcast, you can find more information on today's
0:32.5	episode and other topics at peteratiamd.com.
0:41.7	Hi everyone, welcome to episode four of the week of day spring. In this episode, we cover a lot of
0:48.0	drugs. We talk about statins, we talk about cholesterol regulation, we talk about Iszetamib,
0:53.4	also known as Zedia, and we talk about the most recent class of drugs introduced to this field,
0:59.0	a drug, a class known as the PCSK9 inhibitors. There are two such drugs on the market today.
1:05.7	We talk about fibrates, and we also talk about the use of fish oil, niacin or niac span, which has
1:11.8	fallen out of favor. This came up a little bit on the discussion I had with Ron Kraus several
1:15.8	months ago, and we can revisit it here. Tom has a very different point of view on this from Ron, so
1:21.4	you will be able to determine which of those views that you favor, which camp you're going to be in
1:25.5	on the niacin side. We talk about the role of cholesterol, statins, and brain health, and another
1:31.0	thing that I learned was about the futility of using CKs and LFTs to address statin response
1:40.1	or ill response. So again, another great example of how I'm doing these shows, but I'm learning along
1:46.6	the way, and so I'm confident that any physician listening to this is going to learn something,
1:51.3	and that hopefully this becomes kind of a part of your ongoing medical education. So sit back and
1:56.7	get ready for episode four. So while we're on that topic, let's go back and talk about the drug. So
2:05.1	we just finished with kind of one very niche story, but when it became pretty clear that there was
	...

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