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Dave Feldman came into my studio and we went through Simon Hill's critique of the KETO-CTA data one clip at a time — high LDL, "rapid plaque progression," the retracted paper, the new preprint. We disagree, and we do it honestly. At the center is the new KETO-CTA preprint: 100 lean mass hyper-responders, two coronary scans a year apart, and a real fight over what the numbers mean. Why the first paper was retracted, the measurement "noise floor" that makes one-year plaque data so slippery, whether 21–29% "rapid progressors" is alarming or expected, and if NATURE-CT is a fair comparison or a borrowed control group. Long and in the weeds on purpose. Watch and decide for yourself. ⏱️ CHAPTERS  0:00 Why I brought Dave Feldman on 3:30 "We only care about LDL because of drugs" 5:28 Why the film resonates: mistrust of medicine 7:19 Biology vs. drugs, HDL, and admitting when medicine is wrong 11:21 What a lean mass hyper-responder actually is 16:00 "Cautiously optimistic": Dave answers for the phrase 19:54 KETO-CTA: 100 people, two scans, one year 21:35 The retraction and the Cleerly anomalies 26:45 The new preprint: same data, Q-angio and HeartFlow 28:02 Reading the abstract: "15% regressed" and the bias question 30:18 The noise floor: what one year of imaging can't tell us 32:56 Which endpoint matters: total vs. non-calcified plaque 40:39 Percent atheroma volume, and defining "rapid" progression 47:11 Where the 1% comes from: PARADIGM and MACE 52:59 NATURE-CT: 3% vs. 21–29%, and my rebuttals 1:01:04 "Integral over time": LDL of 400 and lifetime exposure 1:03:30 Population vs. individual prediction 1:09:25 Gambling on being an outlier, and the comment-section problem 1:12:45 The film clip: Eric's story, and who to treat 1:16:53 The hard question: treat high ApoB with no plaque? 1:20:26 The "business model" question — and Dave's answer 1:23:35 My takehome: debate is healthy, the science isn't settled 📚 STUDIES DISCUSSED  NATURE-CT (the comparison cohort): Aldana-Bitar J, et al. NATURE-CT. J Cardiovasc Comput Tomogr. 2026. https://www.sciencedirect.com/science/article/pii/S1934592526000973 PARADIGM registry (where the "1%/year = rapid progressor" definition comes from): Lee SE, Chang HJ, et al. Effects of Statins on Coronary Atherosclerotic Plaques: The PARADIGM Study. JACC Cardiovasc Imaging. 2018;11(10):1475-1484. doi:10.1016/j.jcmg.2018.04.015. PMID: 30093065. https://pubmed.ncbi.nlm.nih.gov/30093065/  ▶️ WATCH NEXT: My reaction to the KETO-CTA retraction: https://youtu.be/w8XxoqUoVJc ⚕️ DISCLAIMER This channel is for education, not medical advice. I'm a board-certified vascular surgeon, but I'm not your surgeon, and nothing here replaces a conversation with your own physician. If you have high LDL or ApoB — on a ketogenic diet or otherwise — don't start, stop, or change a medication based on a debate you watched on YouTube. Bring it to your doctor and decide together, with your own numbers and your own history in front of you. 💬 If this kind of respectful, in-the-weeds debate is useful to you, subscribe — Dave and I floated doing a round two on the lipid hypothesis itself, and your comments help me decide what's worth the deep dive. Pre-Order my book Disconnected here: https://www.amazon.com/Disconnected-Surgeons-Search-Healing-Broken/dp/B0H86K1T7R Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

In this comment-response episode, I break down what I eat in a typical day as a vascular surgeon focused on cardiometabolic prevention. I also discuss the reliability of CIMT testing, why I plan to repeat my own scan, and what first drew me to preventive health. More on CIMT—and a conversation with the CardioRisk CEO—coming soon. For educational purposes only; this is not individualized medical advice. Pre-Order my book Disconnected here: https://www.amazon.com/Disconnected-Surgeons-Search-Healing-Broken/dp/B0H86K1T7R Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

My CIMT results came back—and one number moved in the wrong direction. In this video, I walk through my own carotid intima-media thickness (CIMT) scan, explain arterial age, plaque burden, IMT progression, and measurement variability, and talk about what a “worse” CIMT result actually means. If you’ve had a CIMT test or are considering one for cardiovascular risk assessment, this is a practical look at how to interpret the report without letting one scary-looking number hijack the whole story. Pre-Order my book Disconnected here: https://www.amazon.com/Disconnected-Surgeons-Search-Healing-Broken/dp/B0H86K1T7R Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

In this video, Dr. Lily Johnston addresses viewer questions about lipid panels, heart disease risk, and diagnostic testing. Key topics include: Coronary Calcium Scans vs. CCTA/CIMT: Why calcium scores may not be sufficient for younger patients and the benefits of soft plaque detection. Exercise and Lipids: Clarifying that while exercise is vital for longevity, its impact on LDL-C numbers is often minimal. MRI vs. CT for Plaque: Why MRI is generally not the preferred tool for assessing arterial plaque buildup. Inflammation and Cardiovascular Risk: A discussion on the "Zeus" trial and the ongoing relevance of inflammation in heart disease. LDL-C to ApoB Ratios: Explaining discordance and why both particle count and cargo matter for risk assessment. ApoB Particle Size: Debunking myths about "large fluffy" particles and emphasizing the importance of total particle burden. N=1 Experiment: Dr. Lily reveals she will be testing both Dihydroberberine and Ezetimibe to observe their effects on her own lipid levels, starting with Dihydroberberine. Chpaters 00:00 - Introduction and reaction to lipid panel comments 00:33 - Coronary calcium scans: Scores, age, and soft plaque risk 01:58 - CIMT and CCTA: Better alternatives for soft plaque detection 02:28 - Does exercise move the needle on your lipid numbers? 03:51 - Is MRI better than CIMT for assessing plaque? 05:14 - Why a community poll for a personal medical experiment? 06:05 - The Zeus Trial: Inflammation vs. Lipids debate 08:46 - Understanding the LDL-C to ApoB ratio and discordance 12:24 - Small vs. Large LDL particles: Does size really matter? 15:05 - Dr. Aloe and the "sole predictor" stance on LDL-C 18:14 - The Verdict: Starting the Dihydroberberine experiment Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Can a simple 5g scoop of creatine do more than just build muscle? In today’s video, I’m reacting to Thomas DeLauer’s insights on how creatine might “spare” your body’s methylation cycle—and then diving deep into the actual clinical data to see if it really lowers homocysteine. As a vascular surgeon, I’m always looking for ways to reduce cardiovascular risk. We know that high homocysteine is a major red flag for heart attack and stroke, but the evidence for using creatine to fix it is surprisingly nuanced. In this video, we cover: The "Metabolic Cost" of making your own creatine. How methylation impacts your DNA repair and neurotransmitters. My breakdown of the 2015 Journal of Nutrition study on creatine and homocysteine. Why the "MTHFR mutation" changes the whole conversation. My current stance on methylated B vitamins vs. creatine. Chapters:  0:00 - Reaction to Thomas DeLauer’s Creatine Theory  1:15 - How Creatine Synthesis Drains Your Body  3:02 - The Glycine Connection: Joints, Skin, and Detox  5:42 - Implications for MTHFR and High Homocysteine  8:18 - Does Creatine Lower Homocysteine? (Open Evidence Search)  12:28 - Deep Dive: Bangladesh Randomized Controlled Trial  18:10 - The Verdict: Folic Acid vs. Creatine  21:30 - My Recommendations for Patients Let me know your thoughts on creatine in the comments! Are you taking it for more than just the gym? Do these suggestions align with the direction you want to take for this video? Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

What do you do when your "bad cholesterol" (LDL) flags high, but your other metabolic markers look great? In this video, I’m sharing my personal lab results to explain why standard lipid panels only tell part of the story. We’ll dive deep into the world of lipoproteins, exploring why ApoB is a more precise measure of cardiovascular risk than LDL-C alone. Using a highway analogy, I’ll show you why the number of "cars on the road" (particles) matters far more for plaque formation than the "cargo" (cholesterol) they carry. In this video, we cover: Standard vs. Advanced Testing: Why I look at the Triglyceride/HDL ratio and ApoB. The Concept of Discordance: What it means when your LDL and ApoB numbers don't track together. Metabolic Health: How inflammation and insulin resistance act like "potholes" on your arterial highway. The 2026 Guidelines: How to put your numbers into the context of your overall risk. Beyond the Lab: Why I’m prioritizing imaging (CIMT) over blood work to decide my next steps. 🔬 JOIN THE EXPERIMENT! I’m going to run a 90-day experiment to see how different interventions affect my numbers, and I want YOU to choose the path. Vote in the comments: Dihydroberberine: A supplement known for lipid and glucose support. Ezetimibe (Zetia) Monotherapy: A medication that targets cholesterol absorption. Drop your questions about lipids below—I’ll be answering as many as I can in an upcoming Q&A! #Cholesterol #ApoB #HeartHealth #MetabolicHealth #LDL #VascularHealth #PreventativeMedicine Chapters: 00:00 – Introduction: My cholesterol results are in  00:24 – The standard lipid panel: Total cholesterol vs. Triglycerides  01:22 – Why the Triglyceride to HDL ratio matters for metabolic health  02:11 – The myth of raising HDL: Trials and outcomes  03:08 – Understanding LDL calculations and limitations  04:18 – The deep dive into ApoB: Why lipoproteins matter more than cholesterol  06:02 – The highway analogy: Particles vs. cargo  07:49 – Two types of ApoB (100 vs. 48) and their roles  10:20 – Road conditions: The role of the endothelium and inflammation  11:32 – 2026 ACC/AHA lipid guidelines and risk assessment  13:41 – Understanding discordance: Why my LDL is high but ApoB is normal  16:56 – Advanced testing: NMR particle count breakdown  21:09 – LPIR: Assessing insulin resistance through lipids  22:38 – Why numbers aren't enough: The importance of imaging (CIMT)  24:38 – The Experiment: Help me choose between Berberine and Ezetimibe Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She practices at Scripps Clinic and is also the founder of CorSight Health, where she is a passionate advocate for reimagining how medicine approaches chronic disease.

After I walked through my own labs last week, you had sharp follow-ups — Vascepa versus a mixed omega-3, why my lab screenshots had no reference ranges, which lab company I actually use — so the first half is me answering them. Then I count down my real top 10 tests for catching cardiovascular disease early, from hemoglobin A1c at number 10 up to my number one, which isn't a blood test at all. Watch the countdown and let me know in the comments how many you've already had! ⏱️ CHAPTERS  0:00 The top 10 tests, and why I'm ranking them  0:19 Vascepa (icosapent ethyl): EPA vs. DHA, and why I skip it  1:59 "Where are the units?" Normal vs. optimal ranges  3:14 Methylated B complex for high homocysteine  4:14 Which lab company I actually use 5:07 hs-CRP's day-to-day swing, and the GlycA question 7:20 Top 10! Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com ⚕️ DISCLAIMER This channel is for education, not medical advice. I'm a board-certified vascular surgeon, but I'm not your surgeon, and nothing here replaces a conversation with your own physician. The "optimal" ranges I use are tighter than what a lab flags as normal, and they're the targets I set for myself and my patients — yours may be different. Don't start, stop, or change anything based on a single number without talking to the doctor who knows your whole picture. 💬 Found this useful? Subscribe, and leave your LpPLA2 and inflammation questions in the comments — those are getting their own deep dive soon. Until next time, take really good care. Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

How to read your blood test results — from a vascular surgeon using her own bloodwork. I go line by line through the complete blood count (CBC), fasting glucose and insulin, kidney and liver panels, thyroid, inflammation (hs-CRP), ferritin, and a lipid panel that's getting its own video. This is exactly how I read labs for my metabolic patients, with all my own numbers on screen: the good, the bad, and a couple that genuinely disappointed me. Along the way: why my hs-CRP finally dropped under 1 after years of nagging me, the omega-3 result I'm not proud of, what fasting insulin and A1c say about insulin resistance, and how a "high" calculated LDL can sit right next to a normal ApoB. Pull up your own blood test results and read along. ⏱️ CHAPTERS 0:00 The good, the bad, and a little ugly 0:26 CBC: blood counts and what red-cell size hints at 3:28 Platelets, and my inflammation hunch 5:44 The differential, quickly 6:53 The fasting glucose that annoyed me (and the post-call excuse) 10:06 Kidney function, and the tests I skipped 13:41 Calcium, and the vitamin D catch 14:53 Uric acid: gout, fructose, and purines 16:07 Liver "dysfunction" tests: AST, ALT, bilirubin 17:43 My vitamin D, homocysteine, and MTHFR 21:22 Ferritin and my iron stores 21:56 My worst result: the omega-3 balance 24:58 Metabolic markers: A1c and fasting insulin 25:34 Thyroid, read on replacement 26:37 The hs-CRP win: from 3 down to 0.6 27:44 Lipid teaser: 209 total, ApoB 86, and the next video ▶️ WATCH NEXT 7 Life-Saving Tests Your Doctor Might Skip!: https://youtu.be/vPw38B9QzjM 5 MORE Tests That Reveal What's Really Happening Inside Your Body: https://youtu.be/vwORTxzeEMg Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com ⚕️ DISCLAIMER This channel is for education, not medical advice. I'm a board-certified vascular surgeon, but I'm not your surgeon, and nothing here replaces a conversation with your own physician. One lab value is a single snapshot in time; reference ranges, timing, and your own history all change what a number means. Don't start, stop, or change anything based on one result. Bring your labs to your own doctor. 💬 Found this useful? Subscribe, and tell me in the comments which panel you want me to break down next. We'll get to as many questions as we can. Until then, take really good care. Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Dr. Abs pulled bloodwork from 50 of his carnivore patients — cholesterol up, triglycerides down, A1C and CRP better across the board. It's a genuinely good data set. It's also the best-case scenario, not the average one. I'm reacting to walk through what those numbers actually mean, why cherry-picked wins don't tell you what happens to everyone on this diet, and what two Virta Health trials add to the picture: LDL-C did rise over two years, but it was driven by a shift toward larger, less atherogenic particles, and carotid imaging showed no progression of arterial disease. Original video: https://youtu.be/CygSkDzDOHE Studies referenced: Bhanpuri et al., 2018, Cardiovascular Diabetology — PMID 29712560 — https://pubmed.ncbi.nlm.nih.gov/29712560/ Athinarayanan et al., 2020, Cardiovascular Diabetology — PMID 33292205 — https://pubmed.ncbi.nlm.nih.gov/33292205/ Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Chapters:  00:00 The Replication Crisis & Messy Science  02:11 Why the KETO-CTA Study Was Retracted  03:25 Mediterranean Keto vs. Standard Keto  06:14 Cholesterol Balance: Absorption vs. Production  10:50 The Million-Dollar Question: What Causes Plaque?  13:07 Small Studies & Statistical Manipulation  15:03 Addressing Bias, Personalities, and Grifters  16:56 My Position on ApoB and Personalized Care In this video, I dive into the "spicy" comments from my recent keto reaction video to address the complexities of heart health, the reality of the scientific replication crisis, and the nuances of personalized medicine. We discuss why a major keto study was retracted, how to think about cholesterol absorption vs. production, and why "testing, not guessing" is the only way to truly understand your own cardiovascular risk. Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

The KETO-CTA trial got retracted this year, and most of the internet treated it like a takedown. The authors pulled their own paper because they found real errors in the analysis. That took integrity. I react to how other creators have covered this retraction, walk through what the errors actually were, and make the case that watching scientists correct themselves in public is what good science looks like. 📚 STUDY DISCUSSED Soto-Mota A, Norwitz NG, Manubolu VS, Kinninger A, Wood TR, Earls J, Feldman D, Budoff M. Longitudinal Data From the KETO-CTA Study: Plaque Predicts Plaque, ApoB Does Not. JACC Adv. 2025;4(7):101686. PMID: 40192608. https://pubmed.ncbi.nlm.nih.gov/40192608/ (Retracted Publication) Expression of Concern: "Plaque Begets Plaque. ApoB Does Not: Longitudinal Data from The KETO-CTA Trial" [JACC: Advances, Volume 4, Issue 7, July 2025, Article 101686]. JACC Adv. 2026;5(3):102607. PMID: 41906601. https://pubmed.ncbi.nlm.nih.gov/41906601/ ▶️ WATCH NEXT Is Ezetimibe the Secret to Preventing Dementia? Surgeon Reacts to @nicknorwitzMDPhD: https://youtu.be/Rzz2g9gRL_8 Is Lower LDL Actually Better? New Research Has an Answer: https://youtu.be/Q2lvd9ND7rA ⚕️ DISCLAIMER This channel is for education, not medical advice. I'm a board-certified vascular surgeon, but I'm not your surgeon, and nothing here replaces a conversation with your own physician.Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

Dr. Abs pulled bloodwork from 50 of his carnivore patients — cholesterol up, triglycerides down, A1C and CRP better across the board. It's a genuinely good data set. It's also the best-case scenario, not the average one. I'm reacting to walk through what those numbers actually mean, why cherry-picked wins don't tell you what happens to everyone on this diet, and what two Virta Health trials add to the picture: LDL-C did rise over two years, but it was driven by a shift toward larger, less atherogenic particles, and carotid imaging showed no progression of arterial disease. Original video: https://youtu.be/CygSkDzDOHE Studies referenced: Bhanpuri et al., 2018, Cardiovascular Diabetology — PMID 29712560 — https://pubmed.ncbi.nlm.nih.gov/29712560/ Athinarayanan et al., 2020, Cardiovascular Diabetology — PMID 33292205 — https://pubmed.ncbi.nlm.nih.gov/33292205/ Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Chapters: 00:00 - Introduction & AMA Catch-up  00:28 - Does Fibromyalgia Affect Heart Health?  01:43 - Advanced Markers for Inflammation (hsCRP, oxLDL)  03:04 - Upcoming LIVE AMA Details  03:48 - Is it Safe to Stop Lipitor for High Cholesterol?  05:23 - The "700 Point Drop" in CAC Score: What is Plaque-X?  07:51 - Testosterone & The FDA Black Box Warning Update  08:33 - Deep Dive: Do Viagra and Cialis Impact Mortality?  09:54 - Study Funding and Conflicts of Interest  10:51 - How PDE5 Inhibitors Actually Work  12:53 - Observational Studies vs. Clinical Trials  14:41 - Understanding the Dataset (TriNetX)  16:41 - How Patient Cohorts are Defined  19:54 - Comparing Cialis vs. Viagra for Heart Benefits  21:26 - Why Prostate Health Matters in This Research  24:21 - Breaking Down the Five Key Outcomes  26:30 - Statistical Matching: Making the Groups Fair  30:03 - The Results: Mortality, Stroke, and Dementia Risk 33:57 - Absolute vs. Relative Risk Reduction  37:29 - Tadalafil’s Half-Life Advantage  39:18 - Crossing the Blood-Brain Barrier  41:04 - Study Limitations: What We Might Have Missed  42:24 - The "Partnership" Factor in Longevity Data 43:32 - Final Thoughts: Is it Time for a Label Change? In this session, I'm diving into your questions from our last AMA and taking a deep look at a fascinating new study on PDE5 inhibitors like Cialis (tadalafil) and Viagra (sildenafil). We explore whether these medications could have a role in longevity, heart health, and even dementia prevention. I also address questions on fibromyalgia, stopping statins, and the latest on testosterone and cardiovascular risk. Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Two hours, your questions, and no script. You brought the good stuff: when it's actually safe to come off a statin, whether the enzyme supplements are worth it, what sleep apnea does to your arteries, how I build and read a full lab panel, and which heart-imaging test to get if you can only get one. I answer fast, and I answer honestly — including the parts where the real answer is "we don't know yet." If you want the short version of how I think about metabolic and vascular risk, this is a good place to start. Grab a coffee, skip around with the chapters, and take what's useful for you. ⏱️ CHAPTERS 0:00 Welcome, and how these AMAs work 0:33 Shockwave therapy for ED, and how it grows new blood vessels 3:05 Can an ultrasound tech get CIMT-qualified? Why CardioRisk controls quality 6:52 Aspirin after a stent: how long, and who actually needs it 11:04 Small vessel disease and brain bleeds: the stroke signs to watch 13:01 Nattokinase, lumbrokinase, serrapeptase: do the enzymes work? 16:20 The genetic lottery: 45 years of partying and still standing 18:15 How long does a statin take to work? (and the clotting angle) 21:02 How often should you really see your preventive cardiologist? 25:23 Soft plaque, leg cramps, and the statin-intolerance playbook 29:52 Age 73: when can I stop my statin, aspirin, and lisinopril? 33:47 Supplements worth the money: magnesium, creatine, D3/K2, fish oil 40:05 Why all the statin hate? Relative vs. absolute risk, and trust 45:15 Lp(a): who should test, and why it matters for your family 49:48 Will Lp(a)-lowering drugs be covered for prevention? 53:36 Thyroid and heart health: why I check free T3 and free T4 55:26 Sleep, sleep apnea, and metabolic health 57:32 Walking after meals: GLUT4, meal timing, and insulin resistance 1:06:50 Testosterone and heart disease, for men and for women 1:10:51 What sleep apnea physically does to your arteries 1:13:31 The real problem with long-term PPIs 1:16:52 Is a carotid ultrasound worth it? It depends who reads it 1:19:35 Is plaque stabilization real science, or a gamble? 1:23:12 Nitric oxide lozenges, ADMA, and the oral microbiome 1:30:44 Building a lab panel: the tests I want, and how I read them 1:35:31 Microalbumin (UACR): the underused early-warning test 1:41:50 Why there's no one perfect diet (and why nutrition science is so hard) 1:53:25 Retatrutide, peptides, and the "just buy it online" problem 1:59:35 CAC vs. CIMT vs. CCTA: which imaging should you get? 2:14:18 CAC of 8 at 47, LDL 110: do you need a statin? 2:15:32 Wrap-up, and where to find me 📚 STUDIES & TERMS REFERENCED JUPITER (rosuvastatin lowers events via hsCRP): Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-2207. PMID: 18997196. https://pubmed.ncbi.nlm.nih.gov/18997196/ Multivitamin and cognition (COSMOS-Mind): Baker LD, Manson JE, Rapp SR, et al. Effects of cocoa extract and a multivitamin on cognitive function: a randomized clinical trial. Alzheimers Dement. 2023;19(4):1308-1319. PMID: 36102337. https://pubmed.ncbi.nlm.nih.gov/36102337/ ▶️ WATCH NEXT AMA #2 — Why a "Perfect" LDL Won't Save You: https://youtu.be/v2Pa7UUTLO8 AMA #1 — Lp(a), Microplastics, Testosterone & CAC: https://youtu.be/r1p-LpCruHc Try THIS Instead of Nattokinase (the enzyme deep dive): https://youtu.be/yA26H0_7-_U My video on statins and the brain: https://youtu.be/pgfNT7o08_g ⚕️ DISCLAIMER This channel is for education, not medical advice. I'm a board-certified vascular surgeon, but I'm not your surgeon, and nothing here replaces a conversation with your own physician. Supplements and medications carry real risks, including bleeding. Talk to your doctor before starting, stopping, or changing anything — especially statins, aspirin, or any supplement if you take blood thinners or antiplatelet medication. 💬 If you got something out of this, subscribe and share it with a friend.  Every new viewer helps our small channel grow one curious mind at a time. ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

Chapters:  00:00 The Replication Crisis & Messy Science  02:11 Why the KETO-CTA Study Was Retracted  03:25 Mediterranean Keto vs. Standard Keto  06:14 Cholesterol Balance: Absorption vs. Production  10:50 The Million-Dollar Question: What Causes Plaque?  13:07 Small Studies & Statistical Manipulation  15:03 Addressing Bias, Personalities, and Grifters  16:56 My Position on ApoB and Personalized Care In this video, I dive into the "spicy" comments from my recent keto reaction video to address the complexities of heart health, the reality of the scientific replication crisis, and the nuances of personalized medicine. We discuss why a major keto study was retracted, how to think about cholesterol absorption vs. production, and why "testing, not guessing" is the only way to truly understand your own cardiovascular risk. Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ 🧬 About Dr. Lily Johnston    Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.    #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota