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Cholesterol Update: An Essential Component Of Our Health (NOT A Villain)


Cholesterol has been touted as a villain, yet it is a requirement for every single cell in our body. How did this crucial component become demonized and what exactly should our “numbers” be? Join Dr. Jack Wolfson and Dr. Lauren Lattanza as they go in-depth on what you should eat, what you should avoid, and what are some natural alternatives to statins. Learn all about the Eat Well, Live Well, Think Well mindset that will contribute to living a healthier life. Discover that cholesterol IS an essential component of your health and NOT a villain.

False Promise of Statin Report

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Cholesterol Update: An Essential Component Of Our Health (NOT A Villain)

Welcome to a special Q and A edition of the Healthy Heart Show with our board certified cardiologist, Dr. Jack Wolfson. We are always looking to get you to your 100-year heart with health and longevity at its focus, trying to get you staying and feeling your best. We wanted to talk about one of the major conditions that bring people into our office and into our care, and that is high cholesterol. We see a lot of it here. We have a different approach than you might define from a conventional standpoint. We wanted to dig into some of the frequently asked questions that we get from none other than our own board-certified cardiologist, Dr. Jack Wolfson. Welcome.

Thank you so much. It’s great to be talking about this. Many people come in and they’re told they have high cholesterol. How do we know if it’s high? How do we know it’s low? What’s high? What’s low? What we’re trying to find is the perfect cholesterol for each individual person. If people have abnormal cholesterol and abnormal lipids, I like to refer to that as dyslipidemia as opposed to high cholesterol.

Dyslipidemia means there are abnormal lipids. Our audience knows over here at Natural Heart Doctor that we are doctors. If somebody has abnormal lipids, we want to find out why and fix the why. Let’s try and avoid pharmaceuticals going forward as it pertains to cholesterol. Essentially, they’re useless and there are much better ways.

Cholesterol is a foundational component of our bodies. Maybe you can give a little background about what is cholesterol and why is it so essential for us?

Cholesterol is so important. It’s in humans and it is in human breast milk. That’s why it’s inside of eggs because that’s how a chicken comes to life by eating and consuming the yolk to form its body, including high amounts of cholesterol. Cholesterol is inside all animal and seafood product foods. It helps to build our brains. Our brains are loaded with cholesterol. The cell of the brain called the cell membrane is loaded with cholesterol. All of our hormones, specifically the sex hormones, aldosterone and cortisol are predicated on the cholesterol molecule.

Cholesterol is critical for our digestion. As the liver makes cholesterol, it puts it into the gallbladder to be used to make bile to emulsify fat and help us digest our food. Last but not least for this conversation is that cholesterol is coursing through the skin. As sunshine hits the skin, it turns that cholesterol into Vitamin D. Oftentimes, high cholesterol can be determined to be from sunshine deficiency syndrome. As Vitamin D levels go up from sun exposure, cholesterol levels go down. In many cases, that’s a good thing.

It is essentially a component of every cell in our body. It’s in our GI. It’s in our skin. It’s truly head to toe. Why does it get a bad rap?

Cholesterol gets a bad rap because the pharmaceutical companies armed the doctors with the language to say that cholesterol is bad. It’s marketing for pharmaceutical companies. To sell their pharmaceutical goals, they essentially make us think that cholesterol is bad. When I say the word “cholesterol,” what jumps to your mind? What’s the first thing you think of in that word association? When I’ve asked this question from the stage, people will raise their hands and say, “I think about heart attack, stroke, blockages in the arteries, cheese, meat or eggs. I think that it’s a harmful substance.”

When it comes to cholesterol, it’s best to avoid pharmaceuticals as they are useless.

What we need to do is go back and educate people, “This is what cholesterol is. This is why it’s so important to do what we do. Humans and animals cannot live without cholesterol.” Ultimately, it gets a bad rap because it is the quickest and most convenient way to sell drugs. The doctor tells us our cholesterol is high and then they prescribe drugs to “treat” those numbers. That’s what I call the false promise of statin drugs.

It’s a word that has been villainized by the pharmaceutical industry. They’ve got an effective solution for bringing those numbers down. Unless you know, “Do you need to bring those numbers down? Do you want to bring those numbers down?” It’s an educated decision that should be made.

Let me ask you. You’re much closer to your medical training than I am. When you were going through naturopathic medical school, what was your training on that? I would assume you guys weren’t pushing statin drugs on everybody. What was the company line or the school line about cholesterol for you?

As in any other class, we would learn the physiology about it. We would jump into how and why we would treat somebody with X, Y and Z conditions. It was jumping from the physiology of understanding that the cellular membrane of essentially every cell is made up of cholesterol molecules. We jump into our cardiology class of, “Why would we want to decrease that? Why do we need to?” We’re learning about the HMG-CoA reductase and everything downstream. The statin drugs are HMG-CoA reductase inhibitors. We’ll get a little bit more into the statins and so on.

If you’re bringing those down, then you’re in inhibiting an entire downstream effect of things that are beneficial and necessary for everything in your body. We were not taught to utilize these drugs. We were aware of these things that were impacting the cellular levels, the blood levels of the different molecules, and with a newer science approach to what is harmful and what’s beneficial, and the certain kinds of these molecules that we want to keep on the lower end. Going back to the old school methodology of good versus bad cholesterol when we’re only looking at total LDL and HDL, we know better science now about the foundations of LDL and HDL.

LDL and HDL are important. Those are molecules that carry cholesterol around the body. We knew this from the MRFIT Trial from the 1970s that was reported into the 1980s. This was a huge trial by the Public Health Department at Harvard University. What they found is that total cholesterol is a poor predictor when it comes to overall life or death. They found that total cholesterol between 160 and 260 tended to be the sweet spot. What does that mean? Above 260, your risk of dying is higher but below 160, your risk of dying is also higher. It’s like this U-shaped curve. The sweet spot for total cholesterol is 160 to 260.

That’s a huge range that most people do fall into. We’re trying to find a perfect cholesterol level for each individual person. When we talk about our therapies and our ideas of eat well, live well and think well. By doing that, you tend to get close to the perfect cholesterol level for you. If you were walking around the planet Earth several thousands of years ago, what would your total cholesterol levels be in order for you to get the job done in the body?

If you need a certain amount of cholesterol for your brain, for your hormones, for your digestion, for your Vitamin D, as an antioxidant, all these other things, part of the immune system that cholesterol does, it’s about finding the perfect cholesterol for each individual. LDL and HDL have a purpose. LDL is often called the bad cholesterol, but that’s just pharmaceutical companies speaking. LDL has a purpose. It’s made in the liver to transport its passengers around the body. If we think about the LDL like a bus, the LDL bus carries passengers like cholesterol, triglycerides, fat-soluble vitamins, and CoQ10. The LDL particle is an important bus.

HHS 40 | Cholesterol
Cholesterol: Cholesterol is coursing through the skin. When sunshine hits the skin, that cholesterol turns into Vitamin D. So high cholesterol can often be determined to be from sunshine deficiency syndrome.

The HDL particle is important as well, which is why all mammals have HDLs. HDL serves many different roles, not only in removing excess cholesterol from areas where it’s no longer needed, but HDL is also part of the immune system. HDL influences insulin secretion and blood sugar control. There’s no such thing as far as the bad and the good LDL or HDL. As we talk further, we’ll find out more about what are the bad LDLs and the bad HDLs? What can we do about it?

That’s where we need to get into some more specialized testing and look beyond the 60-year-old science and understand what is problematic. We’re not just chasing lab values to satisfy something on paper. We need to find your perfect cholesterol. We can figure out how to do that by doing these specialized testing. You and I always are running these certain markers. Let’s start with oxidized LDL, for example. That is one of the more problematic molecules that we’re looking for.

You’re a big fan of the oxidized LDL. This is starting the initial discussion of the tests that traditional medical doctors are not doing. The oxidized LDL shows us damaged LDL particles. The oxidation process is like the rusting of a car or the rusting of metal. The iron starts to oxidize. It turns it into that reddish, rust type of color. That’s the oxidation process. Our body has oxidative stress. Our body gets damaged from a variety of things. As cholesterol and LDL particles continue to circulate around the body, they become small, dense and oxidized particles. We should measure those.

The oxidative process of LDL shows that LDL is an antioxidant. It’s used around the body to zap up or mop up that excess oxidative stress that’s occurring. The LDL particle gets oxidized and it needs to be removed. Otherwise, it’s going to be avidly taken up by the endothelial cells that line the blood vessels, and then we develop coronary artery disease, heart attack, and possibly death.

It’s an important thing to measure oxidized LDL There’s future testing that will tell us about oxidized HDLs. That’s being studied as well. Among all these particles, there certainly are ways to differentiate and to dive a lot more in-depth than total LDL and total HDL, which are not effective markers to look at someone’s risk.

I often explain to patients when we’re going over their labs, that if it’s small and dense, we want to protect that inside lining of the blood vessel or the endothelium. Think of the endothelium as this meshwork. If you got a rusty golf ball that rolls in that, it’s going to be much more likely to fall underneath that meshwork and create plaque. Some oxidation processes that your body does try to heal that.

Ultimately, it will contribute to plaque and a fatty deposit inside that endothelial layer. It’s trying to stay away from oxidation and inflammation in the body to prevent these harmful molecules. Another marker that we often run that is hit and miss, whether our patients have had this run before or not, is lipoprotein(a) or LP(a). What is it? How do we measure it?

LP(a) is something that most people are not aware of even after they’ve had a heart attack. It tends to be a causative factor in a large amount of heart attack victims. It is a genetic abnormality that leads to the increased production of this particular protein called LP(a). I like to think of it as an LDL particle with razor blades. It does so much damage to the blood vessels. It interferes with the normal clotting system of the body.

Cholesterol gets a bad rap because pharmaceutical companies armed the doctors with the language to say that it’s bad.

Most people do not get that measured. The pharmaceutical companies know it’s bad. They’re coming up with pharmaceuticals to lower that particular number down. There are some natural treatment solutions we’ll talk about as well. Most people are not getting the LP(a) checked. The test that you and I run over here and that our team runs at Natural Heart Doctor that people are available to purchase online is the apoB/apoA-1 ratio.

People need to have their apolipoproteins measured. Since the early 2000s, we’ve known that the best way to assess risk from the lipids standpoint is the apoB/apoA-1 ratio. Duke University’s Dr. Salim Yusuf was the first to promote this in the early 2000s. The lower the ratio, the lower the risk. Ideally, that apoB/apoA ratio is certainly below 0.7, preferably 0.6 and lower. Essentially, what that means is that we’ve got a lot of these apoB particles that are the LDLs and HDLs. We don’t want a lot of those, but we do want a lot of the A particles, which essentially gives us a good estimate of the HDLs and also HDL functions. We want to check those different things, what the apoB/apoA-1 ratio is, and also cross-check LP(a).

The pneumonic I always used to remember that in med school was B for bad, A-1 is good. You can remember it like that. These are not specialty testing. Your doctor can run them. They just often choose not to. With your background and training, how is it that conventional doctors were trained to test and treat cholesterol?

Unfortunately, we’re not trained about the cause of why people have abnormal cholesterol levels. It comes down to eat well, live well and think well. That leads to a lot of those abnormalities. We’re told cholesterol is bad. We want to prescribe a pharmaceutical to lower the cholesterol numbers down. Back in the 1960s and 1970s, there were certain things that were used for that endeavor.

Starting with the discovery in 1976 a molecule that could inhibit the HMG-CoA reductase enzyme from yeast, and therefore stop the production of cholesterol that morphed into Lovastatin, which was the first approved statin drug. The brand name at the time was called Mevacor. This was released by Merck Pharmaceuticals. It led to billions and billions of dollars of sales of Mevacor.

Unfortunately, patients aren’t getting the results they need. We’ll talk about what do statins do? What do they not do? There are some other pharmaceuticals like Zetia or ezetimibe that are used. The data on the benefits of Zetia ezetimibe are limited. PCSK9 Inhibitors are the injectable form for cholesterol reduction. Data from their release back in 2018 New England Journal of Medicine showed that although there was a dramatic reduction in cholesterol levels and lipid levels, it turned out that more people died in the PCSK9 group than in the placebo group. We need to be careful when we use artificial means to lower numbers down. It’s a problem.

There’s the baseline of the pharmaceutical options. Statins are these PCSK9 Inhibitors. Unless I’m mistaken, that’s the only option. There are a lot of associated risks and side effects with those drugs that the study found increased risks of mortality. You hear a lot about statins as I do about these patients that have been prescribed statin drugs and have numerous side effects. What are some of the side effects that you hear that patients come to you with?

They get that name statin drugs because the generic name always ends in statins like atorvastatin, simvastatin, lovastatin and rosuvastatin. There was one called cerivastatin TERU. The brand name was Baycol by the Bayer Corporation. That was released by the FDA onto the market in the late 1990s, then subsequently pulled later in 2001 when there were many reports of life-threatening rhabdomyolysis or muscle damage and even deaths related to Baycol. That particular statin was pulled from the market.

HHS 40 | Cholesterol
Cholesterol: The HMG-CoA enzyme does other things besides make cholesterol. When you inhibit it, it lowers your amounts of CoQ10, prenylated proteins, squalene, and more, which are all important to you.

We keep coming up with stronger and stronger ones. It is a phenomenally lucrative industry. Lipitor is the single highest-selling, revenue-generating drug of all time. It is sold hundreds of billions of dollars of that particular product alone over time. It’s been an absolute amazing cash cow for Pfizer. Ultimately, there are a lot of risks. There are a lot of reports out there of muscle damage, liver damage, kidney damage, brain issues, and hormonal issues that people have. This is all in the medical literature.

The HMG-CoA reductase enzyme does other things besides make cholesterol. When you inhibit it, you’ve got lower amounts of CoQ10. You’ve got lower amounts of something called dolichol. You’ve got lower amounts of something called prenylated proteins. You have lower amounts of squalene. These are all important to the human body. When you don’t have them, you’re going to suffer the consequences.

Do statin drugs have any benefits?

Our policy is against the use of statin drugs and this is why we have that policy. Ultimately, the literature tells us that statin drugs are not beneficial. Despite what your doctor says, the most recent publication looked at a combination of what’s called primary and secondary prevention people. Primary means you’ve never had a heart attack or stroke. You’ve never had angioplasty, stents or bypass.

The secondary is where you’ve already had a heart attack or stroke. You’ve already had stents or bypass surgery. When you look at all those people in sum total, which are tens of thousands of people, what they found was that those who took statins versus those who took a placebo, there was a lower risk of heart attack by 0.2% on an annual basis. There was a lower risk of stroke by 0.1% on an annual basis. There was a lower risk of dying at 0.1% on an annual basis.

If you’re reading this, would you want to take a statin drug knowing the possible side effects and the limited benefits that are reported in the medical literature? We could also get cynical about this and say, “Those who fund the studies, write the studies and therefore, get to determine the results.” Let me ask you, Dr. Lauren, would you think that if you were getting paid to even make up fake data, you would make up better data than what this shows? It’s not impressive.

It’s incredibly skewed. It certainly has some bias there. If we did the same study on these individuals that came to us and we put them through our program of a true paleo diet, avoiding toxins, eat well, live well, think well, and then we found their improved risk factors at the end of that, that would be significant findings. These articles and findings were likely not.

It’s not about how we reduce the risk from 5% down to 4.9%. It’s about how we reduce your risk of heart attack, stroke or dying over a certain timeframe to 0%. We know that they don’t do that. We do that with our people at Natural Heart Doctor. The more they follow our treatment plans, the better off they’re going to be. As far as statin drugs, I don’t like to prescribe them for all the different side effects and lack of benefits.

Lipitor is the single highest-selling, revenue-generating drug of all time.

One of the main risks of statin drugs is that they lead to a false sense of security. People think that they can just pop a Lipitor, eat whatever they want and live however they want. It’s this false sense of security that leads to so much death and destruction. People are protected. When I was a hospital-based cardiologist, we used to tell people, “Take a Lipitor and do whatever you want.” We should put Lipitor in the drinking water. That rhetoric is horrific.

You can understand how the medical doctors come to that because our medical education is so controlled by pharmaceutical companies. The pharmaceutical companies sponsor all of our training events, the schools and continuing education. The pharmaceutical representatives come in and they “detail” the doctors on the latest pharmaceuticals. They provide lunches, dinners, trips and freebies.

It’s a pretty incestuous industry that has unfortunately led to the public getting conned and ultimately, dying. That’s something we’re trying to avoid here at Natural Heart Doctor. I often tell the story and I told the story in my book about my father who would die at the age of 63 of a brain-based disease. My father, unfortunately, took a statin drug. That and other factors led to his demise. I feel pretty strong about avoiding the use of statins.

It’s a false sense of security against, “I don’t want to have a heart attack, so I’m going to take my Lipitor and then I can eat and do as I want.” In 2013, the American Heart Association released new guidelines regarding statin use. Within that, 1 in every 3 Americans aged 45 to 60 would have fallen into the guidelines to be prescribed a statin drug. If that doesn’t show you their initiative to dole out the pharmaceuticals, I’m not sure what will. At the top of it, it says, “Diet and lifestyle modifications should take precedence before prescribing.” You then get into their dietary and lifestyle suggestions and they’re skewed as well. “Don’t eat eggs. Don’t eat butter. Don’t eat red meat,” all fall into line. Is that what is contributing to cholesterol? I don’t think so.

The dietary intake of cholesterol-rich foods has very little to do with cholesterol levels in the body. There was also a study that was released in 2017 where they looked at people 65 and older. It was called the ALL HAT-LLT trial. This was published in the Journal of the American Medical Association. What they found for people taking statin drugs for primary prevention versus placebo, the primary prevention group with statin drugs had an 18% higher risk of dying if they were over the age of 65.

In fact, if you looked at the group specifically that was over 75, there was a 34% higher risk of dying over a 4-year time period if they use statin drugs. Question the use of statin drugs. Dr. Lauren and I are not telling you to stop your pharmaceuticals. Talk with your doctor first. We can help you. Schedule with us at Natural Heart Doctor. Everybody in our practice looks to remove statin drugs. Stopping statin drugs is easy. You just stop them cold turkey. There’s no weaning process. You just get off of them and life gets better.

We have to implement our own treatment philosophy. Maybe we can talk about the gist of our treatment philosophy on dyslipidemia here at Natural Heart Doctor.

We have to make the people a different version of themselves in order to get different results. It’s not like you can take a person who has a heart attack and they were prescribed Lipitor, and then stop the Lipitor and help for the best. We need to make sure that we’re making a different version of the person, a healthier version of the person who had the heart attack. That’s the ultimate strategy at Natural Heart Doctor.

HHS 40 | Cholesterol
Cholesterol: Every diet should be organic. Avoid pesticides as much as you can, and always go gluten-free. Because eating well helps you find the perfect cholesterol levels for you in your body.

That’s how we came up with that whole treatment philosophy of eat well, live well, and think well. When we do those three pillars and add in the “test, don’t guess,” so we do the most advanced cardiovascular and metabolic testing in the world. We use evidence-based supplements to supplement that health, the test result, eat well, live well, think well. Understand that even with a perfect diet and a perfect lifestyle, we got a lot of ground to make up.

The first 35 years or first 55 years of someone’s life may not have been the best. We got to do our best to make it up. Ultimately, sometimes we need to supplement because the food, the air, the water and the soil are unfortunately polluted. We’re not getting all the nutrient density that maybe our ancestors achieved. We need to do that whole package in order to make that person a different version of themselves. That’s what makes them heart attack proof.

Decreasing overall risk, not just to make a 0.1% change on a graph, but improving their lifespan overall getting to their 100-year heart. Like we say, eat well, live well, think well, it’s dietary strategies and it’s not usually the saturated fats that often are condoned as the contributing factor for dyslipidemia. We often find that it’s these processed sugars and a high carbohydrate diet that increase the triglycerides and fuel this insulin resistance that spurs this problematic dyslipidemia.

We have to get to the bottom of that. We have to live and think well because increased stress, a poor stress response, and a constant sympathetic activation contribute to dyslipidemia and increased cardiovascular risk as well. We have to break it down piece by piece. That’s why holistic medicine is so incredible for this in so many symptoms that we see here at Natural Heart Doctor. Let’s break it down into eat well, live well, and think well. Let’s elaborate a bit on the eat well component of this.

When it comes to eat well, there are a lot of different opinions that are out there. Should we go vegan, vegetarian, paleo, keto, carnivore or anything in between? I wrote the book, The Paleo Cardiologist, eating hunter-gatherer foods, free ranch, grass-fed animal products with the organs preferably in there. Eating wild seafood is probably the healthiest food on the planet, things like coconuts, avocados, eggs, olives, green leafy vegetables, fruit in season, and a little bit of nuts and seeds as well. That’s the ultimate strategy when it comes to nutrition.

I do want to highlight a couple of things that every diet should include, which do include organic foods. When we go organic, we’re avoiding all the pesticides as much as we can. We’re reducing the level of pesticides. Pesticides are proven to increase cardiovascular risk. Pesticides damage the gut microbiome. No matter what diet you follow, please make it organic. We are always also gluten-free. I and my family never eat gluten. We’ll talk about this in the testing section.

We test people for leaky gut. A leaky gut equals a leaky heart. A lot of leaky gut stems from gluten consumption. We want to avoid that as well. We’ve got a lot of other documents that talk about our dietary philosophy and the way that we follow things. When you eat well, that helps you find the perfect cholesterol levels for you and your body. Please don’t be afraid to eat cholesterol-rich foods like eggs, liver, and even raw dairy. There’s a time and a place for raw dairy, which is loaded with cholesterol. That’s how cows feed the brains of their babies and how humans, monkeys, gorillas and giraffes nurse their young as well with cholesterol-rich foods.

These cholesterol-rich foods are not the problem. What are some of the problematic foods to avoid in the case of high cholesterol or dyslipidemia as a whole?

You have to make the person a different version of themselves in order to get different results.

It’s avoiding the pesticide produce, conventional factory-farmed meat stuff, and farm-raised seafood. Certainly, high sugar is a problem. High sugar increases triglyceride. The higher the triglycerides, the higher the risk of heart attack, stroke and death. Artificial foods, artificial colors, artificial flavors, and artificial sweeteners are always to be avoided as well. Ultimately, these foods are not fit for human consumption.

Humans never consumed a large amount of grain, such as wheat, barley and rye. They never consumed a large amount of corn or soy. These are not hunter-gatherer foods. They should be extremely limited. In the case of gluten-containing foods, they should be avoided. We’ve got the testing to prove it to people. As we do our test don’t guess philosophy.

Let’s break down live well.

We came up with the idea of live well to be this bigger umbrella term. By the way, either the eat well, live well, think well, none of them is more important than the others. We talk about in the live well category the critical nature of sunshine. Therefore, is sunshine more important than food? It may be and some medical authorities believe that to be the case.

Sunshine hits the skin and turns cholesterol coursing through the vessels of the skin into Vitamin D. We know that people with the highest levels of Vitamin D have the lowest risk of everything. We want to do strategies that increase Vitamin D. We do that ultimately from sunshine exposure. You and I have talked about this before. Our skin is more than just for aesthetics. It’s more than just for keeping the bag of bones together. The skin is a solar panel. The more we get our solar panels in the sunshine, the better our health is going to be. That’s one tenet of live well.

Sleep is critically important. We go to sleep with the sundown. We wake up before the sunrise. People who get between 8 and 9 hours of sleep live longer, have less heart attack risk, less stroke risk, and better cholesterol levels. Embrace that as well. In the live well category, avoid environmental toxins and pollutants, pesticides, parabens, PVCs, VOCs, plastics, and mold micro-toxins. Those things play a role. Inside live well is physical activity.

Everybody knows that exercise has an impact on lipid levels as well. It raises HDL, for example. I don’t like to use the term exercise too much because that makes me think about somebody at the gym or on a treadmill. I like physical activity, going outside, walking, hiking, biking, standing up, paddleboarding, kayaking, and being outside in nature. That has a dual role in the sense that you’re physically active and you’re outside in nature and you’re in the light, which is all good.

Also part of that live well philosophy is going to be making sure you’re under the care of a doctor of chiropractic for maybe something known as spinal hygiene. Chiropractic care is important. Don’t forget the autonomic nervous system innovates the liver and the liver is responsible for making cholesterol and clearing cholesterol. I do believe that the chiropractic adjustment, which is proven to lower blood pressure, inflammation and oxidative stress, and increase heart rate variability. In doing all that stuff, it supports healthy cholesterol levels as well.

HHS 40 | Cholesterol
Cholesterol: Anger, anxiety, depression, and social isolation all increase your risk of cardiovascular events. If your body is always under stress, it’s not going to do the cleansing process that it should be doing.

As much as there is spinal hygiene, there’s also dental hygiene. It’s making sure you’re under the care of a good holistic dentist because periodontal disease is linked to cardiovascular disease. Undoubtedly, as you have periodontal disease, this inflammation and infection stokes abnormal lipid formation and oxidized LDLs. That’s a big umbrella about live well. You can see how people have a lot of opportunities to make a lot of changes that will positively impact their cholesterol and lipid profile without statin drugs.

Especially those higher risk like the small, dense and oxidized because if you’re not living well, you’re exposing yourself to all these pesticides and other environmental toxins that can otherwise contribute to a vast amount of oxidation in the body. The majority of our audience already knows to not smoke, but I’m throwing that in there. Live well is important for bringing down oxidation in the system. There are three pillars of this bar stool that are all equally important. The final pillar of this bar stool is to think well. Let’s break down think well, and why managing stress and mental well-being is so critical for this.

Think well was in Chapter 5 of my book. Chapter 5 was titled One Nation under Prozac. It’s to highlight that the answer is not Prozac but understanding that anger, anxiety, stress, depression, social isolation, and all these things markedly increase your risk of cardiovascular events. If your body is always under stress, it’s not going to do the cleansing process and the reparations that it should be doing. If your prehistoric body thinks it’s getting chased by a tiger all the time, it’s only concerned with surviving at that moment.

Our catecholamines, epinephrine, norepinephrine, cortisol, and everything is up and high. When your body’s doing that, it’s not paying attention to the appropriate policing or modification of cholesterol and LDLs and HDLs and the like. We want to make sure that we find our happiness however that is. However you can reduce your stress levels, anger and depression, the answer is not Prozac. The answer of course is to find your happiness naturally. We’ve got the team here at Natural Heart Doctor to help support people in that as well.

What works for some might not work for everybody. If you heard the time breathing exercises, you would roll your eyes and you know that’s not for you. There might be something else as easily accessible that is for you. If you don’t have something that has worked for you already, reach out to us. That’s why we’re here to get you on these pillars of eat well, live well and think well. That brings us to an important part which is testing and not guessing. Let’s talk about some of the tests that we do here at Natural Heart Doctor. We’ve alluded to some of these points but overall.

A lot of cardiologists and the guidelines written over the years downplay the use of testing. Most of these doctors think everybody who’s had a heart attack should be on statin drugs, no matter what their cholesterol levels are. The reality is that we can learn so much from the most in-depth testing in the world. The 1970s testing is what I call the cholesterol total LDLs, HDLs, and triglycerides. Not a lot of information can be gained from that particular test. It was popular. They came out in the 1970s when my father was starting off as a cardiologist. In the 21st century, we have so much more advanced stuff that you and I order every single day for our patients and clients.

We talked about the apoB/apoA ratio. You have to have that measured. You want to know about LP(a) and check that number. You want to know about all the markers of inflammation and oxidative stress. You want to know about vitamin D. You want to know about homocysteine, intracellular vitamins and minerals, glutathione and CoQ10s. We talked about leaky gut equals leaky heart. Do you have a leaky gut? Do you have gluten and wheat sensitivity? We also talked about the triple toxin test, looking at urine for metals, mold micro-toxins and over 40 different environmental toxins.

That’s the start of what we do at Natural Heart Doctor. The six tests that I threw all in there quickly, that’s what we call level two testing. We go beyond that as well, with level three and level four testing as it pertains to total cardiovascular health. Every lab testing company, whether it’s Labcorp, Quest, Cleveland HeartLab, Boston Heart Lab, or whatever you’re using can check and should check for the apoB lipoprotein, apoA lipoprotein, and LP(a). These are markers that any doctor can check and should check and you better know your numbers.

The dietary intake of cholesterol-rich foods has very little to do with cholesterol levels in the body.

Unfortunately, we get the standard 50-year-old lipid panel. That’s all that patients have to go on. They get their prescription and they go on. We need to do more in-depth testing. We need to figure out if there’s oxidation inflammation and where that’s coming from in your life so that we can undo that damage and not allow it to continue accumulating.

We can identify the source of these things. We can work to avoid it in our lives. We can eat well, live well, think well. Sometimes we do still need to bring on some supplements. There is some evidence of some naturally occurring supplements out there. What are some of your favorites? We share our top list, so let’s go through these.

You and I are both big fans of berberine. Berberine has been studied by Asians for many years. There are thousands of studies at, which is the government database that houses all these studies. Berberine is effective for the modification of the lipid panel to lower LDL particles, raise HDL particles, lower triglycerides down, and even has some impact on LP(a) as well. If we’re looking to get rid of the apoBs and increase apoAs, berberine is great.

One of the many ways that berberine influences enzymes in the body is that it increases the amount of LDL receptors in the liver. They catch those enzymes in the liver that pulls used up old LDL particles out of circulation. That’s one of the things berberine does that’s similar to the mechanism of PCSK9 inhibitors. You don’t have to spend all the money on PCSK9, where you can take a natural substance like berberine.

Berberine does not work as strongly as PCSK9. There’s some fantastic information about berberine. That’s why we threw it inside of our OptiLipid. It’s the key ingredient inside of our nutritional supplement called OptiLipid, which is six different plant-based substances into one product without any fillers. It’s manufactured by one of the best companies in the nutritional space. Some of the things in there are curcumin, resveratrol, silymarin, green tea extract, and ginger. These are all things that have evidence-based outcomes. We’ve been successful with our patients using those products.

These six ingredients are all heavy hitters. If we’re looking at the literature and the downstream benefits of inflammation, antiaging, cholesterol and blood pressure, the findings are truly limitless. OptiLipid is probably one of my favorite supplements that we carry here because pretty much everybody can benefit from it.

If you’re on the market for an all-encompassing type of supplement, that’s usually my go-to. There are some other supplements. We won’t skip those but the components of daily defense. We like to bring some things that have multiple benefits like Daily Defense. It has that little bit of psyllium husk and some other anti-inflammatory components. Maybe you can talk about the Daily Defense Power.

Daily Defense was created to be a delicious way to start your day. It does contain New Zealand grass-fed whey protein, which helps to heal the leaky gut and boost glutathione. That is always a good thing to reduce that oxidative stress and clear out those oxidized LDL particles. In addition, it’s got phase one and phase two liver detoxifiers, so things that are known to support good liver function. If we have a good liver function, that’s how we make those LDL receptors. We clear the old particles out of the circulation.

HHS 40 | Cholesterol
The Paleo Cardiologist: The Natural Way To Heart Health

We also have the phase three products in there, those binders, the organic psyllium husk, the inulin, and the flaxseeds that are there to bind up cholesterol that’s secreted into the guts. Instead of it being re-absorbed, these binders will bind that excess cholesterol, poop it out the other side, and get great results. Daily Defense is a fantastic product. It pairs so well with OptiLipid, as far as the things that it does for oxidative stress, inflammation, lipids, and so on and so forth. It’s a great combination there.

Studies are emerging about how important it is to properly detox on a daily basis. Daily Defense and your liver are what’s manufacturing the cholesterol. We have to make sure that your liver is in good standing with all of those phases of the detox pathway. That brings us to maybe the gut supplement like some probiotics. Let’s talk about the Heart Helpers. That circles back into why it’s beneficial for cholesterol levels.

Probiotics have been known to be good for lipids and for inflammation for many years. Probiotics are the bacteria that will colonize your gut, restore the health of the gut, improves the immune system, and improves the leaky gut. These good bacteria help to promote short-chain fatty acids like ureteric acid, which helps to nourish the colonic cells to help the healing and the inflammation that exists in so many people’s colons.

People are deficient in these good bacteria because of years of antibiotic use of fluoride, chlorine and drinking water. It’s so many things and then mentioning the pesticides as well. Many things are stacked up against us to destroy our gut microbiome. That’s why we formulated Heart Helpers with ten different strains of beneficial bacteria that are proven to support the cardiovascular system and more. The 25 billion CFU capsule doesn’t need to be refrigerated. It’s in a nitrogen-purged blister pack to maintain the integrity of Heart Helpers.

It’s one of our best sellers and something so foundational to people. Everybody could benefit from Heart Helpers. Everybody can benefit from Daily Defense. Everyone can benefit from OptiLipid and the ingredients that are in there. Not only does it optimize lipids but it also helps to optimize blood sugar, inflammation, brain health, antiaging properties, anti-infective properties as well against viruses, bacteria and parasites. There are lots of good stuff there.

The first three that we have mentioned are things that I use daily and things that I have for both of my parents. My mom is like, “What should I take?” These top three, the OptiLipid, the Daily Defense, and the Heart Helpers are easy go-tos to maintain adequate intestinal nutrition, and cardiovascular and liver health. These are some heavy hitters. What about some niacin? It’s a form of vitamin B3, Time Release Niacin more specifically. What are some of the findings that we have on niacin? Why would we implement this?

Time Release Niacin is a fantastic supplement. We’ve known this since the 1980s as well through the Coronary Drug Project. The people who were randomized to take niacin live longer, which is very exciting news. Niacin helps to boost up HDL and apoA particles. Niacin helps to reduce LP(a). It’s got the most evidence of any supplement to reduce LPA. Niacin also has data on erectile function.

From the men out there, they get that bonus from taking niacin for erectile function. It does have some side effects in the sense of a flushing type of feeling, almost like your skin is itching and burning. That’s why we recommend taking the capsule with dinner. Oftentimes, people just need a 500-milligram capsule to get the results. That’s where Time Release Niacin fits in well. It helps to modify that ratio.

Don’t be afraid to eat cholesterol-rich foods. You should be afraid of pesticides, high sugar, and artificial foods.

A few years ago, there was a study published that mainstream media took a hold of saying niacin was bad. The problem was that it was a study that was done on people where everybody was on a statin drug. The niacin users also received another drug that helped to prevent the flushing. Because the results were negative, they condemn the niacin when maybe the problem was the statin and the pharmaceutical that was added to prevent the flushing. The Coronary Drug Project is a fantastic study that highlights the benefits of Time Release Niacin. It’s part of our toolbox as we try to help supplement a healthy lifestyle.

There have also been some patients that tried taking Time Release Niacin and still have that uncomfortable flushing. Pectin from apples is known to suppress that flushing feeling. Have some apples with your dinner and throw that in the mix as well. An apple a day is an okay thing to add to any routine. The research is there to an extent. A lot of people touted a little bit more benefit than you or I have found. What do we think about Bergamot in the mix of dyslipidemia?

We get people who come in asking about Bergamot. Some supplement manufacturers come in and talk to us about Bergamot and are enthusiastic about its use. There are a few studies that show the benefit of Bergamot. I’ve never been impressed clinically with our patients. It’s not something that I’m against. It’s just not something I use often for any indication. We have a lot more tools in our toolbox to use for lipid than Bergamot. I’m not a big fan.

On that note, Red Yeast Rice is a statin. Although it’s the more natural form, it still is a statin. It’s still going to have those same downstream effects of inhibiting all of those other beneficial components that are made by the liver. If you’re inhibiting that same HMG-CoA reductase enzyme, you’re going to be inhibiting all of the downstream beneficial components as well. It’s low on my list.

People with familial hyperlipidemia are people with total cholesterol levels of 350, 400, and 450, people who are sky-high. There are not as many people who are like that. There may be a role for that in those people. We’ve got our fair share of people like that. It’s interesting that familial hyperlipidemia has those high numbers. Numbers are one thing but does it translate into a heart attack, angioplasty, stents, and bypass surgery? It appears to be more relegated to men. Men with familial hyperlipidemia seem to suffer cardiovascular events much more so than women. I don’t think there’s a role for statin drugs, but we can use Red Yeast Rice in some of those people and see how it works. If it works, we stick with it. If it doesn’t, then we get rid of it.

We keep that in our back pocket as a more natural approach. How would we want to reduce and eliminate the use of pharmaceuticals by patients?

We alluded to this before. There’s not a weaning process. With blood pressure drugs, sometimes we need to slowly remove the pharmaceuticals in order to prevent rebound hypertension. In the case of cholesterol drugs, that’s not the case. We can stop them cold turkey and then get a good assessment as to where things are at. Don’t stop on your own. Work with a natural doctor to get off your pharmaceuticals. Health and wellness and the path to the 100-year heart are without statin drugs.

How can people start to work with Natural Heart Doctor so that we can help them on their path to a 100-year heart?

If you want to work with Dr. Lauren Lattanza, all you got to do is pick up the phone and call the office and get on Dr. Lauren’s schedule and mine. This is what we love to do. We’re so passionate about giving people not only the 100-year heart but the 100-year brain, the 100-year body. We want to let you do all the things you want to do, travel the world, dance at your granddaughter’s wedding, be physically active, be happy and be in positive relationships.

Ultimately, that’s what we do at Natural Heart Doctor. We use that whole philosophy of eat well, live well, think well, and test don’t guess, and evidence-based supplements, while we’re reducing and eliminating pharmaceuticals, dangerous procedures and surgeries. That’s what we do. All you got to do is pick up the phone or send an email and talk to us. We’ll be seeing you all real soon.

We separate ourselves from the lifespan and just chase numbers on labs and turn it into health span and making you feel good all of those 100 years and potentially even beyond. Let’s get you set up, identify your risk factors, and see what needs to be done, but prevention is always the best cure. Finding and understanding where you’re at and not just relying on what your genetics, what your mom, dad, grandfather or grand grandparents went through, but let’s optimize that for you and your life.

We don’t want to blame things on genetics. People love to use genetics as that cop-out thing. The reality is that our genetics are pretty much perfect until man-made lifestyles, toxins and poisons trigger our genetics to do bad things. Don’t blame it on the gene. Blame it on the food. Blame it on the lifestyle. Fix those things up. That’s the path to your 100-year heart.

We can do better and we will get you to your 100-year heart. Thank you so much. Thank you for your questions. Thank you, Dr. Jack Wolfson for your well-thought out answers. We appreciate you.

Thank you so much, Dr. Lauren. I appreciate you. You and I together and the team at Natural Heart Doctor are getting everyone on their path to where they need to go and making a positive influence in the world. I appreciate you and all your help in getting this message out there to the world. Thank you.



About Dr. Jack Wolfson

HHS 40 | Cholesterol

Jack Wolfson D.O., F.A.C.C., is a board-certified cardiologist who uses nutrition, lifestyle and supplements to prevent and treat heart disease. He completed a 4 year medical degree, 3 year internal medicine residency and 3 year cardiology fellowship. He served as the Chief Fellow of his cardiology program, managing all of the other cardiology trainees.

Dr. Wolfson then joined the largest cardiology group in the state of Arizona and spent 10 years as a hospital-based cardiologist performing angiograms, pacemakers, and other cardiac procedures. He was the Chairman of Medicine, Director of Cardiology and Director of Cardiac Rehabilitation.

He was selected by his peers as one of the Arizona “Top Docs” in 2011. In 2012, Dr. Wolfson founded Natural Heart Doctor to offer patients the ultimate in holistic heart care. People from all over the world consult with Dr. Wolfson, traveling to Arizona or virtually for natural heart care.

Dr. Wolfson has appeared on every major news station and major newspaper along with hundreds of appearances at live events, podcasts, and online interviews. He has taught medical doctors and practitioners from all over the world.

Dr. Wolfson was recognized as one of the Top 50 Holistic Medical Practitioners. The Paleo Cardiologist, The Natural Way to Heart Health is the first book by Dr. Wolfson and is an Amazon best-seller. He is also a contributing author to The Textbook of Integrative Cardiology.


About Dr. Lauren Lattanza

HHS 40 | Cholesterol

As a Naturopathic Physician, Dr. Lattanza is trained to treat the whole person and get to the root cause of disease. Knowing that the world we live in is full of toxic elements, sedentary lifestyles, nutrient depleted food sourcing, and environmental chemicals, it is Dr. Lattanza’s goal and passion to identify the often overlooked causes of disease. She offers specialized testing and treatments to optimize patients’ health which can prevent, decrease, or eliminate the need for pharmaceuticals.

Dr. Lattanza is based in Scottsdale, Arizona and helps patients across the US reclaim vitality and work towards their 100 year heart.

About Dr. Keith Smigiel NP, DC

Dr. Keith Smigiel

Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.


Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

Call (480) 535-6844 for details and scheduling.


Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

Call (480) 535-6844 for details and scheduling.

Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

Call (480) 535-6844 for details and scheduling.

Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

Call (480) 535-6844 for details and scheduling.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.