399: High Cholesterol Isn’t Always What You Think | Nick Norwitz

I don't think anything can make you more motivated or more excited than self-experimentation and being curious and continue to be- continuing to be a student, right? And to learn, like, and ask questions.

I mean, obviously, you know, we were talking before the sh- show started, like, I'm predisposed to high cholesterol, and there are so many times I walk into a doctor's office and they look at my results and say, like, "Your cholesterol is too high and you need a statin." But my C-reactive protein or my marker of inflammation is low, and, you know, my triglycerides are low, and my ratio is great, and I generally eat pretty healthy, and doesn't cholesterol, like, protect your brain? Like, I'm so confused.

Like, and you're asking all these questions that people don't ask because it's not in the business of creating a statin that then would create billions of dollars.

[laughs]

Y- yeah.

I mean, there are, there are definitely minutia and, and nuances there.

I guess at a high level, I'd sum it up as saying, like, medicine does work best at the individual level.

Medical systems work best at the population level because they are a business.

Now, that puts healthcare providers in a very tricky situation just because of, like, time limits in terms of, like, what you can give to each patient, but also what you can read and learn.

Like if you think about how much information is spewing out into the academic literature and what a c- a practicing clinician is doing day in and day out, they do not have time to keep up on the literature.

Even if they do, they're generally reading just like the abstract or the headline rather than delving deep into the methodology.

So you end up with a, a system where it's really impossible to keep up with the literature unless that's your explicit job.

And if you're a healthcare provider, it becomes next to impossible, so then you get stuck in this tricky situation where, you know, the person in front of you, you want to do what keeps them the safest, but I don't necessarily think that perspective is always drawn from rigorous evidence assessment as much as just like what we as humans, when I say we as humans, I mean like medical professionals, scientists, are exposed to through our community.

It becomes a matter of group think and status quo just kind of snowballing.

I had some quote the other day about, you know, institutions protect, um, like the status quo longer than evidence does.

Uh, and I think we're in this uncomfortable situation where academia and information are kind of having a, like an incursion event where the science is moving faster than medicine can.

And because of access to information, the general public and the patients are figuring that out faster than medical systems, and it's creating a lot of friction and mistrust.

I absolutely.

I feel like a lot of people like yourself are wanting to be self-healers.

They're wanting to go educate themselves on information coming from people like you on your YouTube channel or sharing on other podcasts like this, where they're like, "How can, how can I understand? What is the mo- what is the latest information?" Especially with AI technology to be able to mine PubMed or to like r- gather, to do so much research that you couldn't potentially do on your own, um, to get to the information.

I read once somewhere that it takes about, on average, 19 years for, uh, uh, like the medical literature to end up in your doctor's office, which I felt like that's a long time to be sick, unhealthy, and not feel your best.

Yeah.

I mean, I can come up with many examples of this being the case.

We can use statins as a use case.

Um-