Ask Dr. Drew - Ozempic vs. The Carnivore Diet: Dr. Shawn Baker on GLP-1 Agonist Drugs, Healthy Meats & Bug Burgers – Ask Dr. Drew – Ep 308

Episode Date: January 12, 2024

While breakthrough drugs Ozempic and Mounjaro have been celebrated as weight loss miracles, many of their users report severe side effects like hair loss, paralysis, and – according to a recent lawsuit – “projectile vomiting unlike anything I’ve ever experienced.” “Oddly, steak doesn’t paralyze the stomach!” Dr. Shawn Baker tweeted in response. Is an almost-all meat diet a safer and healthier weight-loss alternative? Can modern “bug protein” burgers compare to the nutrition found in real meat? Dr. Baker discusses LIVE and joins Dr. Drew to answer your calls. Dr. Shawn Baker is an orthopedic surgeon, bestselling author of “The Carnivore Diet” and a cofounder of Revero. He is widely known as a leading authority on treating disease through medical nutritional therapy. Follow him at https://x.com/SBakerMD and learn more about the carnivore diet at https://carnivore.diet/ 「 SPONSORED BY 」 Find out more about the companies that make this show possible and get special discounts on amazing products at https://drdrew.com/sponsors • PROVIA - Dreading premature hair thinning or hair loss? Provia uses a safe, natural ingredient (Procapil) to effectively target the three main causes of premature hair thinning and hair loss. Susan loves it! Get an extra discount at https://proviahair.com/drew • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get 15% off your first order at https://drdrew.com/paleovalley • GENUCEL - Using a proprietary base formulated by a pharmacist, Genucel has created skincare that can dramatically improve the appearance of facial redness and under-eye puffiness. Get an extra discount with promo code DREW at https://genucel.com/drew • COZY EARTH - Susan and Drew love Cozy Earth's sheets & clothing made with super-soft viscose from bamboo! Use code DREW for a huge discount at https://drdrew.com/cozy • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at https://twc.health/drew 「 MEDICAL NOTE 」 Portions of this program may examine countervailing views on important medical issues. Always consult your personal physician before making any decisions about your health. 「 ABOUT THE SHOW 」 Ask Dr. Drew is produced by Kaleb Nation (https://kalebnation.com) and Susan Pinsky (https://twitter.com/firstladyoflove). This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. 「 ABOUT DR. DREW 」 Dr. Drew is a board-certified physician with over 35 years of national radio, NYT bestselling books, and countless TV shows bearing his name. He's known for Celebrity Rehab (VH1), Teen Mom OG (MTV), The Masked Singer (FOX), multiple hit podcasts, and the iconic Loveline radio show. Dr. Drew Pinsky received his undergraduate degree from Amherst College and his M.D. from the University of Southern California, School of Medicine. Read more at https://drdrew.com/about Learn more about your ad choices. Visit megaphone.fm/adchoices

and in just a few moments i'll be welcoming my colleague dr sean baker uh into the program sean is an orthopedic surgeon he is the author of the carnivore diet he was just recently once again on the joe rogan podcast where he stirs it up a bit you can follow him on twitter at s baker md learn more about the carnivore diet also at carnivore uh is it carnivore diet? Carnivore.diet, I think it is. I'll confirm that website for you. Carnivore.diet, that is it. Again, the book is The Carnivore Diet. Obviously, we're going to be talking

about the carnivore diet, something that I've followed for quite some time. And Sean has a lot of really interesting data. He is really one of the leading experts on the foolishness of avoiding meats uh and the advantages of carnivore diet particularly on um wellness and autoimmune disorders that sort of thing something jordan peterson has been advocating for quite some time so we'll get right to it also your calls uh after a little bit with sean baker after this our laws as it pertains to substances

are draconian and bizarre. The psychopath started this. He was an alcoholic because of social media and pornography, PTSD, love addiction, fentanyl and heroin. Ridiculous. I'm a doctor for f***'s sake.

Where the hell do you think I learned that? I'm just saying, you go to treatment before you kill people. I am a clinician. I observe things about these chemicals. Let's just deal with what's real. We used to get these calls on Loveline all the time. Educate adolescents and to prevent and to treat.

If you have trouble, you can't stop and you want to help stop it, I can help. I got a lot to say. I got a lot more to say. Well, most of my career I've been urging people to kick habits, change habits. Well, this time I'd like to suggest getting into the habit of adding Paleo Valley grass-fed bone broth protein to your daily nutrition regimen. Here's CEO Autumn Smith. It's made from cows with 100% grass-fed and finished and bones. They're bones rather Rather than the hide, most bone broth or collagen powders are made from hides or hooves, but ours is actually made from

the bone. It'll contain additional nutrients. Bone broth is a way to bring back those nutrients, those minerals, and there's glucose aminoglycans, and then there's collagen, which helps us prevent wrinkles and joint pain and actually heals our gut. There's collagen, which helps us prevent wrinkles and joint pain and actually heals our gut. There's gelatin and there's just all of these ingredients that the modern diet has kind of left by the wayside. Susan and I have been mixing the chocolate-favored bone broth literally into our coffee every morning for months. And we've noticed a difference in our energy, appearance of our hair, skin, nails. Susan's particularly very happy with this. The bioavailable protein also helps us feel satiated that's the part i'm happy with paleo valley bone broth also comes in vanilla and pure

unflavored and can easily be added to your coffee smoothies yogurt go to drdrew.com slash paleo p-a-l-e-o for 15 off your first order again that is drdrew.com pale paleo. So that Paleo Valley is a very appropriate advertisement for the topic of the day. I've used Paleo Valley products for a long time in order to maintain a carnivore diet. I had my bone broth today. And even when I graduated to a more sort of traditional dietary practices, I'm still consuming their stuff, especially that bone broth. We just love that stuff. Beef sticks and the super green.

And one of the things that Caleb promoted today is that we would be talking about the GLP-1 medications like Ozembic and Manjaro and things like that and how these things, well, it'd be interesting to hear what Sean Baker has to say about those things. He's been advocating for the carnivore diet for quite some time. I first heard him on Joe Rogan's podcast and I just thought I would love to talk to that guy. And I have since, I've been following

him very carefully. So let's, and again, after I talk to Dr. Baker, I will be taking your calls. So do bring requests, bring your hand up, click the little mic in the bottom of the left-hand corner. Caleb has a little cartoon about that. And I want to also, before I bring Dr. Baker in here, remind everyone that we are going to be with James Corbett on Tuesday, talking about Gilman amnesia, Roseanne Barr on Wednesday, and Dr. Paul Alexander on Thursday, Peter McCullough coming in next week. A lot of really very interesting guests coming your way. There it is. What are you going to talk to Roseanne about?

When you talk to Roseanne, you talk about whatever she wants to talk about. That's what you're talking about. And so she, I think I will start with them, that she has a lot of talk of them them trying to figure out who they is. And, and not only that, but she has a theory that there will be no election this year in 2024.

So she, well, it's when you hear, I mean, listen, Roseanne gets a lot of grief for having some extreme views, but they're not as wild as you think. And then also she talks about her own, what she calls craziness.

That's her own words. And I enjoy talking to her a lot. You think you have a lot to say. You should see what she has to say. Oh, yeah. My job when I talk to Roseanne is to sort of keep up with Roseanne. That is my job. Daytime talk show host.

Yeah, yeah. And she and I have a long history together. So, all job. Daytime talk show host. Yeah, yeah. And she and I have a long history together. So, all right. I want to get Sean Baker in here. You're going to get follow Sean at SBakerMD on X. And the book is The Carnivore Diet. And there's 288 people on X. Welcome.

We can see your comments. So if you have any comments, put them on the post-it. Fair enough. Dr. Baker, welcome to the program. Hey, thanks for having me on. Good to see you again. So I think maybe if you don't mind, just do a little recap of how this happened to you, how you got so involved with this and how you ended up on Rogan's podcast. I know it's a long story, but just give them the beats so people understand who you are and where you've come from.

Yeah. So I was a traditionally trained orthopedic surgeon and was spent my career, you know, replacing knees and hips and fixing fractures and whatnot. And my mid forties, I started to realize I wasn't where I wanted to be health wise, even though I was a very sort of high level athlete at the time. So I started playing with different dietary strategies and, you know, eventually ended up on a low carb diet. And then I got exposed to these crazy nutty people eating all meat. I thought that was absolutely nuts and sane like everybody does.

But I was open minded enough to try it myself. And I was really just impressed at how effective it was for me. And so I persisted on that for, I think, 30 days at one time. And I was really like, this is really legitimately the best I felt in quite some time. Went back to a regular diet and immediately felt worse and said, you know, all things being equal, I feel I prefer to feel better. And so I persisted on that. And then, you know, Joe Rogan got wind of it and brought me on the show to talk about

it. And then that obviously exposed me to a lot more people. And a lot of vegans started, you know, claiming me as public enemy number one, I suppose. But over the time, and I've been doing that, this is my eighth year that I've been doing this diet. And I've obviously, there have now been literally tens if not hundreds of thousands of people who have experimented with this. Many of them have seen pretty impressive results. I wrote a book on this called The Carnivore Diet, which you mentioned.

We formed a company, Rivero, which is licensed in all 50 states, which we basically treat people at the root cause. Not necessarily everybody gets a carnivore diet, but I mean, it's part of the treatment algorithm when indicated. I think there's some specific therapeutic interventions where it works really effectively. And I think it's something that is a legitimate way to treat certain disease. I don't advocate as all humans are carnivores or anything like that. It's not a commentary on the state of humanity. It's just, this is a therapeutic option, which I think is particularly effective in certain individuals in certain cases for sure. So that's, I guess, the overview. And I'm still here.

I ate three or four pounds of red meat a day, and I'm getting close to 60, and I'm still doing okay. So that's a short version. I love the – I don't know if it's on Instagram or I guess probably Twitter, where you're carving up a couple of pounds of meat and six eggs. And I'm just like, it makes me so much want to go have a steak. I can't even tell you. It's like, it's so fun. And usually you're side by side with a video of somebody who looks like really they're not well eating a vegan diet typically or bugs maybe. Yeah. I mean, it's one of those things where sometimes you just let people speak and they can sometimes dissuade you by their own actions. And so sometimes you don't need to say a lot

to get the point across. But yeah, it's fun. I eat a lot of steaks, I literally, I literally eat three or four pounds of it every day and I enjoy it. So. And you, and your athletic performance has gone up, right? You've, you're, you're, you said you're a high level athlete before you've never really performed at a high level. Yeah. I mean, it's interesting. You know, I turned 57 next week and I mean, I'm literally stronger now than I was in my mid forties, which I, and I wasn't weak then I mean I've always been a very you know the guy that trained a lot and competed very at a high level and I just broke another American record on enrolling just the other day and I'll probably break three or four more world records in the next couple weeks uh so uh yeah I mean that's I

you know I'm still getting after it how How do you, this is a personal question. When you came and you visited us here in our home last time I interviewed you, I was complaining to you about my shoulders and they got much worse. And I just recently had stem cells injected, some mesenchymal stem cells from my fat and bone marrow. And my question really is,

how do you avoid shoulder problems? Oh my God, there's a whole story here for me, but I'll ask the shoulder issue first. Well, I mean, some of it's going to be luck, obviously, but I mean, I do think that, you know, I mean, obviously being smart and how you train and how you utilize the joint, I do think strengthening it is generally a good strategy.

I know there's people like, oh, you're going to hurt your back by deadlifting and things like that. I'm like, I've literally taken care of thousands of people with back problems and none of them, most of them are couch potatoes and they got a big belly. And I think being metabolically healthy, eating a good diet, eating a low inflammatory diet, and then of course doing the preventive maintenance stuff physically is really the best you can can do and whether or not stem cells offer some additional benefit i think it's controversial i would i think that's a fair statement to say yeah i uh i had an ultrasound of my soft tissue on the shoulder and it was like yeah torn calcified you know inflamed torn calcified inflamed, every major tendon group. And I thought, yeah, yeah, I can feel it.

I know the soft tissue is just a mess. And the orthopedist goes, well, you want to take an x-ray? And I go, I don't have arthritis. I have, you see it, it's a mess, the soft tissue. He goes, well, I'm going to take an x-ray. Oh my God. I had huge spurs. The cartilage surface was gone.

I couldn't believe it. I thought, oh, I have to do something because I'm heading for a shoulder replacement. Yeah. Well, I mean, on the good side, I mean, the shoulder replacements have gotten a lot better. Not that I would desire that, but I mean, if it comes to that,

they're pretty good. And they've got some, it used to be they were kind of, I think FDA approved them back in like 2004. And they've certainly evolved since that time. And the techniques have gotten better with that. But hopefully you can avoid it. And even if it goes to that route, I would still recommend, I don't know what your particular surgeon would say,

but I would recommend continuing to do the strength training. And I think that's always a benefit. I'm going to. But I have to kind of recover from the procedure and stuff, but it is better, that's for sure. And so I went on carnivore probably, I think I was probably on it last time we spoke. And the reason I went on it was somebody was hassling me. I was doing a sort of fitness podcast and my partner said, you got to go, you have to address diet. I'm like, who am I trying to impress? Come on. And he started talking about carniv and my partner said, you got to go, you have to address diet. I'm like, who am I trying to impress? Come on.

And he started talking about carnivore. I said, I think I can do that. And I went on it and I loved it. I loved it. You know, kind of being able to eat what you want.

It was just like, whoa, this is not something I'm used to. And I leaned out immediately. It was a very, it was very interesting. I had a, within a week had a reaction

and my HDL went up about 40%. My triglycerides went down like 70%. My LDL's always been sort of where it is. But I could never get my HDL up or my triglycerides down until I got rid of the carbohydrates. And I wonder if I have an LP little a problem or something that is really highly insulin dependent. But it was striking.

It was striking. So I was on it for about four years. But the only downside for me was because of my shoulders, I lost the ability to do the heavy weightlifting. And I think that kind of really vigorous exercise is an important adjunct, at least for me, with this diet. And I gained like 14 pounds. It turned out. So I had to kind of turn back and go on a more traditional kind of- I'm just wondering if you, were you including a lot of dairy at that time when you did that? No, no. I mean, I would have some heavy cream in my coffee in the morning, and that was about it. I could eat a lot of meat.

I could eat a lot, a lot, a lot of meat. Yeah, you'll eat meat too. That's what I announced it. Yeah, I got the bills. Yeah, that was the other thing. It's expensive, and it's worth pointing out, right? If people can't, I mean, we have to acknowledge it, but for some people,

this may not be financially a reasonable diet. It was something that- I cooked a lot of bacon too. There was always bacon somewhere. Okay. Okay. Well, I mean- I gained weight because I was snacking on bacon in between. Yeah. I mean, there's- But I'm a big fan. I'm a fan of it. I am a big, big, big fan of it.

Yeah. Well, I mean, it's one of those things that, you know, at the end of the day, how much you eat does matter. I mean, there's, obviously there's different hormonal impacts on going from donuts to, to, to, you know, you know, a piece of salmon clearly. But at the end of the day, if I want to gain weight, I eat more food. If I want to lose weight, I eat less food. I mean, it's as simple as that. That's right. It's the same thing. You know, like I said, I'm right now I'm sitting at about 265. So I'm pretty, I'm actually on a little on the heavy side right now, just because I'm trying to poison myself for these, these wrong records. Then I'll lean back out, you know, probably in about three or four months.

But, um, you know, it's interesting cause you, you brought up the GLP one stuff and it's interesting with most people, you know, if you look at the way these, these, these incretin hormones work, you know, the GLP ones, you know, basically the, the distal small intestine, primarily line, the ileum through these L cells secrete these GLP one at GLP-1 hormones, and they act as a brake. They kind of slow the digestive tract down is one of the mechanisms by which they work, and it leads to satiety. And I think meat does that naturally. And it's kind of interesting because you look at the way... I don't know if you saw a recent paper came out

talking about protein, how much protein can we absorb in one sitting. Did you see that recent paper that came out, Drew? I did not see that. I saw some stuff about kidney disease and protein, but no, I didn't see the… Yeah, this is on the muscle building side. So traditionally, we've always heard 30, 40 grams is all you can absorb at one time with regard to muscle protein synthesis. So you need to space your protein out into three or four meals throughout the day. But this new study that was done out of, I think it was out of the Netherlands, and they looked at up to 100 grams of protein compared to the standard 30-gram dose.

And they were using dairy protein in this particular instance. But they showed that there was no upper limit to how much protein you can utilize towards building muscle. So that kind of shows that if I eat a big old steak, you know, if I sit down and eat a pound and a half ribeye, which I often, you know, often do pretty much all of that's going to go to be utilized. It's not going to be wasted. Whereas before we thought it might've been, you know, it's better to space those meals out. So, but that goes to the way these incretin hormones work is because when you eat a steak, the body will slow down its digestion.

You know, it'll take, you know, normally gastric emptying times about four hours. And then there's an intestinal transit time that occurs. And that becomes slowed down when you introduce the appropriate foods there. And meat does that. You know, it works in temporal sequence like it's supposed to. But when you're throwing a GLP-1 receptor ag and this drug on there and you're eating cookies and cake, that's all backwards. Yes, it slows down digestion, but it's not supposed to.

Those foods are supposed to be processed very quickly. And that's why we have some of the issues with obesity with all this rapidly absorbed calories. I mean, there's a microbiome component that goes into this as well. But I mean, I think you're seeing some of these side effects where people are having gastroparesis and vomiting and intestinal obstructions and things like that, which are occurring at what level and what frequency, we don't really know yet. I mean, there's some people who think it's happening more than others.

The manufacturers, of course, saying it's always the same thing. The drug companies always over-deliver, over-promise and under-deliver. And then we have to sort it out as clinicians in the end and see what the real incidence is. That's right. That's exactly right. That is precisely how it works. And I thought when I saw that Weight Watchers had now become a sort of a distribution system for these medication and Oprah's in it, I thought, oh, it's going to be, there's going to be a lot of bad stuff. When you have so

many people using a medication that is designed for a disease state, overweight diabetics, where the risk might be worth the reward, right, because these are serious conditions, then you proceed. But if it's, hey, I want to lose 20 pounds and that's it,

wow, now I'm scared. Now I'm scared. And particularly if I want to lose three pounds to do a movie or something, now I'm extra scared. You know what I mean? It doesn't make any sense to me. Well, and you know, the interesting,

you see how they're sort of changing the language. As we had, the interesting, you see how they're, they're sort of changing the language as we had, you know, you saw the last few years, a lot of definitions got changed, right? We were the definition, you know, everything got changed. Right. And so now they're reclassifying obesity as saying obesity is something that lifestyle has no impact. You saw, was it Dr. Fatima Stanford at Harvard talking on 60 Minutes?

Obesity has nothing to do with exercise or diet. I mean, that's absurd. I mean, that's clearly, I mean, you and I know that's not true. I mean, we lived around long enough to remember when people weren't, when 40% of us weren't obese. So, I mean, we're getting these new definitions. And so they're saying, well, yeah, maybe being over 20 pounds is a disease. And it's not a lifestyle issue.

And you need to be on these drugs and advocating for this in six-year-olds. And mind you, that's all in the U.S. NovoNordisk, which was in Denmark, they're not advocating that in their own population. It's on the U.S. population, which is kind of interesting. It is interesting. And I suspect something about our diet and the way our food is processed has a lot to do. There's a number of things, but I think it's odd that we are being subjected to sort of a really problematic diet, and then as a result of that, taking a medication to deal with the diet that we are being exposed to.

What's a good business model? I mean, if you just think about it from that standpoint, you feed everybody, you feed everybody kind of a substandard diet, they all get sick and you sell them drugs. I mean, and everybody's happy. I mean, from the financial shareholder standpoint, but the population is at risk. And we see that, and again, this goes to my point where they are trying to get us to consume less meat. They're trying to, for whatever reason, it's bad for the environment, it's bad for your health, which I think both of those are really kind of not really accurate, you know, arguments. I think there's a lot of nuance behind that that's being left out and they're really sort of pulling the wool over a lot of

people's eyes. And, you know, you look at the, what is it, USDA just came out with this NOVA analysis study saying that, you know, you can have a 91% ultra-processed food diet and be healthy, which, you know, on its surface seems like it's just absolutely bizarre and insane. But they're trying to position us to say that ultra-processed food is actually fine and healthy and don't worry about it when, you know, there is a significant backlash against that, which I think is justifiable for sure. Oh my God. If we were starving, it'd be a reasonable diet, but we are not in a starvation state. Right. Well, we're eating right now, we're currently somewhere around 70% ultra-processed food for the average American, which is

I mean, it's mind-boggling to think that that's what we're eating. Oh my God. That is not good. Let's talk a little bit about lipids. Lipids and gut. Maybe people love the idea of the microbiome. How does carnivore affect the gut?

Well, I mean, there aren't any clear-cut studies on that. They've looked at some sort of meat-heavy tribes, indigenous populations, Inuit and some of these other ones, and they found they had very good gut diversity. It's not been shown to decimate the diversity, which is some speculation. Now, one of the major, there's a nice paper that Tommy Wood out of University of Washington and Dr. Mailer did looking at the gut sort of metabolic flexibility of the gut, so to speak. It shows that a high-fiber diet, the gut can respond

to and it can produce the appropriate healthy sort of short-chain fatty acids. But so can a diet that is ketogenic, animal-based, they show the same thing. So it doesn't seem to be directly deleterious, at least in some of these studies. And then clinically, what I see every day is people's gut health just improves dramatically by going carnivore. We see people with inflammatory bowel disease. In fact, Harvard is going to release a case study on inflammatory bowel disease, ulcerative colitis, and Crohn's disease coming out probably in a month or two. I've helped organize that series.

And then we're going to do an interventional trial on that as well. And hopefully we can do a carnivore versus vegan diet. That would be a great randomized control trial to run that because I think that will be quite impactful to show that. But in general, depending upon how you want to judge gut function, and to me, as most gastroenterologists, they're based on symptoms anyway. I mean, there's a few confirmatory tests. They can look at fecal calprotection, inflammatory markers, and they can do various imaging studies and whatnot.

But I mean, it's a lot of it is bloating, distention, gas, reflux, diarrhea, constipation. And all those things get better for most people when they go on a animal-based diet, a carnivore day diet so that would you know pretty you know to me it makes sense that that would probably lead to a healthier overall you know digestive tract what you include the microbiome oh for sure it can you talk a little bit about the notion of maybe I should ask you this way the mechanism of action how do you think it reduces inflammation you have a theory about that I should ask it this way. The mechanism of action, how do you think it reduces inflammation? Do you have a theory about that?

I do think it helps to limit gut hyperpermeability. I do think that is a real thing, the so-called leaky gut. I think there's lots and lots of research. Alessio Faisano at Boston Children has written extensively about that. He feels that that is one of the origins of autoimmunity. And I think there's some pretty good evidence to support that. So the researchers in Europe have looked at this and they've actually studied carnivore diets in the context of gut permeability. And they've shown conclusively through something called PEG-400, polyethylene glycol 400, that when you put somebody on a carnivore diet and you administer PEG, polyethylene glycol, that the absorption is decreased dramatically, which is consistent with an intact, you know, gut barrier.

I mean, our gut is semi-permeable. There's obviously things have to get in and we never absorb food, but there's a issue where it becomes hyperpermeable. And I think that is probably one of the major things that occur. Also, I think it's just good nutrition. And I think also just the elimination of the garbage because I think 70% of our diet is garbage these days. And as you probably noticed on carnivore, there was some level of lack of cravings.

I don't know. I mean, most people will comment on that. Oh, yeah. Oh, no, that was one of the great advantages. I didn't want to, I just, when I ate when I was hungry and that was that. It was a great, it was one of the great advantages. I didn't want to, I just, I ate when I was hungry and that was that. It was a great, it was a freedom. Yeah, it is freeing in that regard.

And that's the problem. We have so many people that are addicted to these hyperpalatable foods, which are absolutely 100% designed with that intent. I mean, these guys, these food chemists are out there designing food to make you addicted to it. There's no doubt about that. And this allows you to not want those things because a lot of people struggle with that every day. And it's, you know, I think there's nutritional consequences to that. I know you

have dietitians out there that are being paid by these processed food companies to say that there are no bad foods and everything in moderation, which I think is, you know, I think that's a real unfortunate message. Yeah. And I want to emphasize again, it's again, the diet you'll do is the diet that will work and it's not everything for everybody. But carnivore is one of the options out there. And I also think the effect on lipid metabolism may have something to do with this inflammatory piece. When people talk about inflammation, I think about things like the leaky gut. I think about endothelial functioning. And of course, lipids are figuring into that because I think some of that inflammation is really an endothelial inflammation. And I also worry about mitochondrial

health and the oxidative state of mitochondria. Is there any effect on that? Well, I mean, undoubtedly there is, I mean, or there are, I mean, it's, I mean, I mean, you know, everything affects everything in some regard. And so I think, you know, your point about the lipids, and I think that's one of the big sticking points about people's resistance to do this, because in many cases, low carb diets in general, particularly if there's a decent amount of fat in there, will raise, you know, serum, LDL cholesterol, ApoB, total cholesterol, things like that. And so that has been traditionally a very large obstacle for most people willing to adopt that.

And I think we're starting to figure out mechanistically why that's happening and if it isn't truly a bad thing or not. And I think that's still debatable. I mean, there are people out there in the traditional cardiology realm who will say it's 100% high ApoB or LDL, and that's all that matters. And it's the end of the discussion, and it's 100% causal, and it's 100% necessary and sufficient, and end of story. Whereas I think there's some nuance there, and I think we're discovering that. And I don't know, we talked about off-camera some of these new studies that are being published and about to be published, which may call into question some of those sort of lipid.

We'll talk about Oreos and lipid hypermetabolism. There's a, I call him a kid, Nick. He's a PhD out of Harvard University. He got his PhD at Oxford and now he's at Harvard. And there's this sort of, you know, we see this phenomenon where there's people that are really lean. They look great. Everything looks great on paper. They go on a low-carb diet, but their LDL cholesterol just skyrockets. We're talking, you know, LDL cholesterol, 200, 300, 400 milligrams per deciliter, you know, the stuff that your primary care physician would

say, oh my God, you know, they think it's an FH scenario, you know, familial hypercholesterolemia when it's really not. And so there's this sort of, they developed this, what's called a lipid energy model. So that when you are lean and your cells are relatively not overstuffed with energy like most of us are, most of us are just over, we have overabundance of energy, that's why we have all this body fat. But when you're lean, and in particular when you're in a in a relatively carb depleted state you know you know you know by a low carb diet um the the liver notices that and tries to distribute energy to the cells and so we just traffic a higher amount of lipids in that situation so you have higher amounts of free fatty acids and lipoproteins that are floating around and therefore you know

cholesterol is associated with that and that is a physiologic reason that's occurring. And that's been demonstrated in this, this is the, this, this was a, you know, if that theory is correct, and this is what Nick and others, and this study, this has been confirmed now in three or four different studies, but Nick did this outrageous study where he said, you know what? I bet if I have my LDL cholesterol super high, I bet I can eat a dozen Oreos a day and I can bring it down. You know, and you know, you think, well, that sounds pretty silly. I mean, Oreo cookies, we all know are garbage for us, right? But he did it.

He spent three weeks eating Oreo cookies, a dozen Oreo cookies a day extra. Normal diet, just added the cookies in there, didn't change his exercise at all. And his LDL cholesterol went from an astronomically high 484 milligrams to deciliter all the way down to 111 just by eating Oreo cookies, right? So you're like, does that mean Oreo cookies are now a health food? Should we call Oreo up and tell them to put a healthy label on there? Maybe they will. I don't know. But I mean, that study was published in a journal and he compared that to a statin.

And the results are in, but I'm not allowed to share that. But what I will tell you is, it's probably what you expect it to be. And that the Oreo cookies are, you know, maybe we should be prescribing Oreo cookies as physicians. I don't know. I mean, obviously, I say that tongue-in-cheek. There may be people that take somebody up that. Yeah, but that supports this lipid energy model. I think that clearly in that, and I don't want to extrapolate this to the general population. It doesn't mean everybody with high cholesterol should be eating Oreos or adding carbs in. Right.

But it just explains why this is occurring. And we understand mechanistically why someone's cholesterol might go really high in that situation. Now, the question, the real question is, is that indeed harmful? And that is where this analysis that Matt Budoff at UCLA is looking into. And so they took 100 people with super high cholesterol, just like Nick had. They're older folks. They're my age, mid-50s. And they scanned them with a CCTA, which is a corneic CT.

Yeah, right. So really high precision, high-level testing. And what they found is in that 100 people who on average have been on these high-fat diets for at least five years, actually no significant increase in cardiovascular disease. They had pretty much almost all of them had zero plaque. A few of them had a little bit. And they compared it to this Miami heart population, which is an age match equivalent. Everything was matched as close as possible. And they found out that there was no difference. And so, LVL cholesterol in that sort of healthy population didn't seem

to impact this. And this echoes the work that was done by Mortensen in the Netherlands last year, where they looked at zero CAC scores. And people that had no calcium, it did not matter what their LDL cholesterol is when it came to the so-called MACE, major adverse cardiac events, whether it's heart attack, stroke, or revascularization or death. LDL cholesterol didn't matter in that way. It seems to indicate that while LDL cholesterol is probably causal, that is, it's part of the pathologic process, it might be a dependent variable that you need to have it, but there might need to be some other things in place, some level of inflammatory process, maybe glucose problems, maybe oxidative stress or something like that. So it's an interesting, I think it's going to teach us something. Yeah. So I, yeah, the, the, I mean, certainly the statin literature

is controversial in the sense that, you know, a thousand people on statin decreases what one event per 10 years or something cardiac. Yeah. It's not impressive at all. It's not impressive. Right. But it's not zero. It's not zero. And one thing I've noticed in my recent years of practice is that if somebody has even mild to moderate coronary disease, let's say their coronary calcium score is 40% or something, I really feel like the statin has utility. It almost makes me wonder

if there's some anti-inflammatory process in the whole thing that we're not really identifying because that's where it right there is where I feel like I'm doing something. Yeah. Yeah. I think that's a fair, I think that's a very reasonable approach to that. Again, I'm not a cardiologist, but I'm just, you know, I have intense interest in this because I see a lot of people that are in that situation. I want to know what the best advice to tell them is. And so I think, first of all, number one, get some imaging so you know where you stand.

You know, if you're zero, you probably have a little more breathing room than if you've got a CAC score. A little more. 200 or quite a bit. Mine was zero. Just out of curiosity. Yeah, so there you go. Just out of that information. But I think that, yeah, for sure.

I think, you know, you have whatever it takes to develop heart disease. And what that combination probably is is some combination of metabolic disease, whether undiagnosed or not, and then obviously the requisite cholesterol floating around in your blood. And so, I mean, we can't, I mean, there's interesting, there are people that are now advocating

for LDL cholesterols of sub 30, you know, 20, 20 or less. I know, listen, I remember the data that showed increase in all-cause mortalities you get down under 60. I mean, that data is still flying around, but they ignore it. Well, they attribute it to reverse causality.

They say, well, if you've got cancer and you're dying, your LDL is getting sucked up anyway, so that's what that is. But I mean, you've got data where it's like 20 years before. It's like, you mean you've had cancer for 20 years, you've been dying for 20 years? So I wonder about it. Again, this is associative associative data so you have to take that with a grain of salt but uh all-cause mortality

cancer instance infection instance uh depression from the mental health standpoint depression violence suicidality all associated with low cholesterol so you gotta wonder what are we doing here are we going to create this well i i worry and so worry, and there's a very big difference between preventing any heart disease and say, preventing a restenosis after stent placement. Those are completely different things, you know, and with different endpoints and different biologies, and we mix and match these things. I worry about on the prevention side, making that LDL so low that you can't manufacture, or some people won't be able to produce sex hormones. I mean, that's the backbone about on the prevention side, making that LDL so low that you can't manufacture or some people won't be able

to produce sex hormones. I mean, that's the backbone of testosterone and estrogen. And maybe that's where all the adverse events are coming from in terms of suicide and mood and that kind of stuff.

I mean, low testosterone is not a good thing. Yeah, I liken it to, you know, if you make the argument that, you know, LDL is necessary for heart disease, so we're going to get rid of it so there's no heart disease. Well, I'm like, well, having genitals is a prerequisite for sexually transmitted disease. Let's just, you know, do penectomies on people and say, guess what?

You're not going to have an STD now, you know? Well, now we've given the people that like attacking you a perfect little soundbite to give them that they can use to attack you. You're advocating for a genital excision, genital rules. I'm doing that tongue in cheek, obviously. So, but anyway. I'm going to change the subject.

Hey, Drew. Yeah. I have to go in a couple minutes. Yeah, yeah, yeah. But I want to know what Dr. Sean thinks about V-Shred. Oh, okay. So, and also I got to wrap up.. Sean thinks about V-Shred. Oh, okay. And also, I got to wrap up. I know you want me to go on to call soon, so I will wrap up with Dr. Baker in just a second. So the V-Shred, we've been working with, or I've lost about 14 pounds again, going

back to a more traditional balanced diet, which is lower calorie, more vegetable, cycling carbs in, which actually surprised me. Cycling carbs actually helped me with my diet, my appetite management. And so I went on it and it's sort of based, it's that old theory about it being based on body types, you know, the mesomorph, endomorph, ectomorph stuff. And it worked very easily for me.

It's another good diet. I mean, for me, it has worked very effectively. And I switched my workouts. Some of it was because of the shoulder issues to much higher reps, HIIT cardio, that kind of stuff. And it felt like this was all more appropriate for my age with my shoulders messed up the way they are and whatnot. I was no longer able to really push the very, very heavy weights.

It's just not for me right now. Any thoughts about that? Well, I don't specifically know his pro. I've seen the guy. He's been advertising heavily for many, many years now. And I mean, certainly, I mean, like you said, there are different strokes for different folks. And I think in my view, a diet that's going to fail is one where you don't like the food or you're constantly hungry. I mean, that's a recipe for failure no matter what it is. And so some people like the simplicity of a carnivore diet and the satiety it produces and they're fine with it. Other people prefer more variety. And I think, you know, again, if it is providing you food you enjoy and it's satietyoking, and it doesn't lead you to constantly thinking and

ruminating about all these other foods you're thinking about, then that's fine. I mean, again, I think that, as I've said before, I think a carnivore diet is very effective, and it's a great tool. Does everybody need to be on it? No. Are there other ways to do there? I think if you're illuminating ultra-processed foods and sticking to whole foods and getting plenty of protein and being active and not being sedentary, that is a good formula for, for, for a lot of people. But I think the problem is we have so many other food addicts and it's, it's tough to get away that sometimes it requires absence. Like you went through a period of abstinence, sort of solve that root problem. And now you have more flexibility and that's why that might be something that's more palatable yeah and i during the holidays went ape shit wild and uh and was having all kinds of cravings and compulsions and this and that and i said we've got to go back on their

diet plan because well it's not a diet it's a program all right the program but the but the recipes the menus i got on it and immediately I leveled out. It was just, I can't go on the- See, I told you. The insulin spikes. He's so worried. He's like, I gained a bunch of weight. I go, well, after one day, it'll just come right off.

It really did. I was shocked how fast I got my appetite level. It's weird when you eat and then you lose weight. But the workouts are great. Yeah. That's the biggest part of it. As far as workouts go, like I said, you got to play with the cards you lose weight. But the workouts are great. Yeah. And that's the biggest part of it. Yeah, well, I mean, you know, as far as a workout, yeah, as far as workouts go, I mean, you know, like I said,

you got to play with the cards you're dealt. And if you got a bum shoulder, you got to figure out how to mitigate that. And, you know, I'm very fortunate, knock on wood, I don't have any really broken parts. I mean. Yeah, I'm jealous. I'm jealous. But I like that medical term, bum shoulder.

Is that what the PETA's call what I have? Yeah, that's exactly. That's an exact term for it. I lost eight pounds and Drew lost 15. Okay, all right. But listen, also what I like about this, and I'm going to give a little shout out to P-Shred because we love them.

Vince is awesome. When you're traveling like we do or you have to work out from your home or you have to work out, we have a gym in one city. We have an okay gym in another city. They work the program around you so that you can work out from your home or you have to work out. We have a gym in one city. We have an okay gym in another city. They work the program around you so that you can work out anywhere. So that really worked too.

That is, you know, it's what I've always said. It's like what trainers have always told me. And I would say, you know, as we're talking diet, you know, I'm known for diet. But I mean, I think the most important variable, what distinguishes people that age in a healthy fashion versus those who don't, are those that are physically active and fit and do work out. I think that is the biggest thing you can do, irrespective of diet. I mean, I'm a huge proponent of that.

I am sure you're familiar with Peter Attia. I was talking to him and I was asking about metformin and all this stuff. And he finally snapped him and he goes, vigorous exercise, vigorous exercise. That is number one. That is the number one prevention or sort of intervention for aging that's it and i was like okay i can do that i i i would echo that i i've been on that you know like i said i've been training hard for 45 years and i don't foresee ever stopping you know knock on wood right but yeah it's super important and he's very big on the preventing the the fall off in uh muscle

mass and uh sort of functionality that happens in our 80s and 90s yeah it's not good it happens it's inevitable you want to push that back as far as possible if you don't have in your 50s and 60s you ain't gonna have in your 80s and 90s so get after it early yeah well that that is that is a really important point is that this is all, so many of these anti-aging interventions, you've got to be on this stuff for 20, 30 years for it to have a really significant effect. But last thing I want to ask you before I let you go

is why is this politicized? It's so bizarre to me that, again, people have this weird religious, that's why I think one of the reasons I wanted to sort of talk about various diets and various ways of working out because it's not a religious issue. It's not, the fact that there's politicizing

even of this is sort of disgusting to me. Yeah, it is a shame. And I have tried to distance myself. I think meat is, I don't care what your your race religion sex orientate sexual orientation color whatever political beliefs are meat is a health food and i i you know but i mean still we have this sort of vegetarians and vegans are on the left and people that eat meat are on the right and that's that i mean i think the media sort of sort of promotes that i mean i was interviewed by vice a while ago and they they came at me with that angle i said look i'm not political on this stuff i'm not political at all

generally i i don't i try to stay out of that stuff but you guys are trying to you guys are trying to force the issue i mean i've got people that do carnivore that are transsexual liberal whatever i don't care i'm just like go for it you know have just get healthy i mean because i think really i mean you know one of the problems we have such a, you know, as you're, I'm sure you're aware, right now the U.S. is as divided as it's been in, I can't remember. I mean, probably my entire lifetime. And I think some of that has to do with the fact that everybody's got a damn mental health disorder. I mean, either clinically or subclinically. I mean, what is the percentage number of people that are on, you know, psychiatric meds is huge, like 25% of the population.

Oh, yeah. That is, a lot of that is nutrition, I think. psychiatric meds is huge, like 25% of the population. Oh yeah, it's ridiculous. A lot of that is nutrition, I think. I think nutrition plays a huge, I mean, the brain is an organ just like the liver and the heart, and it still gets blood flow and it still is affected by the nutrition we have. And so I think if we can start fixing our diet, we can start to heal people's minds and bodies, and then we can heal the country as a whole. I mean, I think that's a valid strategy in my mind. Well, Sean, I'm all in and I appreciate the work you're doing.

It is carnivore.diet. Is that the website? Is that correct? Yeah, carnivore.diet is that. I mean, I also want to talk, you just mentioned rivero.com. You know, this is, again, this is a 50-state. If you're looking for a doc that's going to do root cause stuff that, you know, you're tired of fighting with your doctor about not talking about nutrition or doesn't understand that or doesn't understand the low-carb stuff.

Revera.com, we're licensed in all 50 states. And, you know, there's at least an outlet for people that are tired of the – I think, you know, I think this particular last three years has really made a lot of people skeptical. And I think the mistrust in the healthcare system is at an all-time high. And I think that's a shame and we need to fix it and i think you know there are people who are doing it and you know we're one of them and i know you're involved in some other stuff and you know i think that's what we have to do is it's really as simple yeah it's as simple as empowering the patients to to control their lives and their health care and and not treating your customers like you don't like them or that you have disdain for them.

That's the oddest thing in the world that so much of this country is being treated like they don't like them. And they just want somebody they can trust. They want to take control of their health, their healthcare. Good, that's what they should do. Patients should do that.

Yeah, I agree 100%, awesome. And then the book, of course course is The Carnivore Diet and follow Dr. Baker at sbakermd on X and Sean I hope to talk to you soon likewise thanks have a great 2024 I think it's going to be a good year

I have a new slogan we can do better in 2024 and diet is a big part of that so pay attention I agree thanks john baker everybody so when we come back for this little break uh i am looking at calls here let me see what i've got yet yep got a few hands up you know i've got several hands up and uh i will get to calls immediately after this uh break when you don't you listen carefully the people that help us do this show. Are you one of the millions of American women and men dealing with premature hair thinning and hair

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G-E-N-U-C-E-L dot com slash D-R-E-W. All right, let's get to some calls. Before I do, I'm just looking quickly at the restream seeing if you guys have any questions there you will eat insects and be happy somebody says who is that richard no uh james uh yeah that seems to be what the world health organization is telling us we'll be happy because they'll be in control you know one of the things uh i wanted to point out is something I mentioned before, but Mark Cianchese, I think it was,

I heard him say this with clarity that made sense to me, is that people that tend to be right-leaning, I see this because I'm in the middle, I see both sides of it. People tend to be right-leaning, think that people are sort of universally good and that they can be trusted to make decisions and be autonomous and unregulated.

And that when you centralize authority, only bad things creep in. And that's where evil gets focused. The left-leaning folks have a feeling that humans are by nature not good and they need to be governed and they imbue the centralized authority with all good. Now, of course, neither is exactly reality,

but I don't know. I think generally the idea that people are good is a little more of a healthy bias. Just call me crazy. All right, let's get some calls here. This is Philip. Let's bring him up as a speaker. And don't forget to unmute your microphone, the lower left-hand corner there.

And you can ask me really anything you wish right now. We'll get some calls in here. You got to unmute that mic, Phillip. You're up. Caleb, am I doing anything wrong? And watch his cartoon there. He shows you how to do it. Caleb, am I doing anything wrong? Watch his cartoon there. He shows you how to do it. There you join, and then you get the request,

and then you unmute down there in that same button. Philip, I may have to throw you there. I have to throw him back for a second. Caleb, what do you think? Yeah, it looks like it's loading. Yeah, this is the problem. Oh, really? It's that you think? Yeah, it looks like it's loading. Yeah, this is that problem. Oh, really? It's that problem again?

Yeah, yeah, yeah. Well, okay. As long as it's loading, we can wait it out a little bit. But isn't that interesting? Mark Czankiewicz, if you don't remember, he's a cognitive science. I've interviewed him a couple of times here.

And he makes a lot of sense. He's also, by the way, a physicist. He has multiple degrees. Guy's a very smart dude. And he has been trying to make sense of the present moment. And I sort of feel sometimes like guys like him and a deeper understanding of our cognitive systems and guys like Gleb Siburski, that these are the guys we should look to to help I've interviewed here a couple times. Sabersky. Yeah, Sabersky. That these are the guys we should look to

to help us sort of buffer against some of the excesses of the present moment. All right, I'm going to throw Philip back in and I'm going to ask for ERM, which again, I'm not sure what that means. And Philip, I'll try you again in a minute to ask you to come back up. I wonder if we're having just a general problem here. ERM is happy memories.

Caleb, I think, can you call people up from your... I'm trying to. It's Twitter. It's uh twitter spaces acting weird yeah let's see i'm adding as a speaker it's okay i know i saw philip has requested again too so he's he's fighting the good fight i appreciate that yeah all right let's see and you have to unmute yeah so happy memories oh there we are

happy memories what's going on I didn't request I don't know why it did that I'm sorry okay do you have any questions yeah anything on your mind? No, thank you.

All right. You got it. I'll remove you and see if we can get Phillip back up since we've got the system sort of working again. Phillip. Yeah. Hi. I got a couple of questions for you medically.

Not only personally, but for others. There's so much food with so much garbage in it. High fructose corn syrup is one. A lot of the additives. I'm a guy with cardiomyopathy, mild pulmonary hypertension, asthma, digestive diseases. I was one of the guys at Crown Zero. I wolfed in over eight days of dust. The World Trade Center program treats me with like 11 different drugs. Maybe I'm on too many,

but it seems to be the right amount because I'm able to breathe once again and my color is back. I had a septal myectomy. Okay. So what can I do to help preserve my life longer and stay healthy? Do you know what your ejection fraction is now? Yeah, I can pull it up. It's like 76.

Okay. Have you ever had cardiac rehab? I did. I also had pulmonary rehab. I did both. Did you continue doing those exercises? No. No, because of the pain from the gout and the spinal stenosis.

Okay, well, gout should be... All right. So gout should be a completely manageable condition these days so if your gout is still active there's something wrong with the treatment and gout of course is urate crystals being deposited actually getting inside the white cells in your joints and they lice the cells and the severe inflammation occurs it's severe but it is a highly highly treatable condition. So there are some newer medications for gout

as well that are extremely effective. So the gout should be treated. The spinal stenosis... Are you on painkillers? No, I use medical cannabis. I won't use anything else. Cannabis. Okay, good. So listen,

walking is going to be a really important thing for you. You get the gout under control and then get back on the pulmonary rehab. I understand the spinal stenosis is kind of miserable, but people do tend to be able to push through that. And deconditioning only makes that worse. And you've got a 30 plus percent ejection fraction. Some people get better. We didn't used to think that could happen, but there's some people actually get better with a proper amount of exercise. And I'm not saying go out and do vigorous exercise,

which is something I was talking about earlier, but exactly the guidelines you've got on cardiac and pulmonary rehab. Now they may want to monitor you again. I don't know how much your monitoring needs are. So you could always go back if Medicare will continue to cover it. But you want to monitor you again. I don't know how much your monitoring needs are. So you could always go back if Medicare will continue to cover it. But you want to do things.

And obviously, you've mentioned diet. Limit your carbohydrates. Insulin is the enemy right now. Lose weight if you can. And try to eat real foods, which is like fresh fruits and vegetables. And that gets expensive, I understand. And fish and meat. And if you can live off away from any of the processed foods,

that's only going to be an advantage. In terms of whether or not you should be under a program of what's called de-prescribing, right? Those of you that are elderly, generally speaking, older folk in this country tend to be on too many medications. And the pharmacy world in particular has been advocating a program of de-prescribing. And I completely support that. Usually, the more medicines, the more potential for harm.

So you can usually streamline people's pharmacology or pharmacological interventions with some focus on some of the... There are actually guidelines out there for deprescribing. So talk to your doctor about deprescribing. And when you have heart failure and pulmonary hypertension, as you said, you've already bought yourself five to seven medicines just right there. And those are, as you said, so you can breathe again.

And they also are life prolonging interventions. So yeah, Philip, hang in there, man. These are not for the faint of heart. Let's get Josh up here. Josh has a question. Anybody else has a question? Just raise your hand. I'll bring it in.

Yes, sir. What's happening? Not much. So I just wanted to ask you about kind of the way the politics are going. A lot of people are saying that this is like an inflection point, that it's almost like they're talking about the end of the world, but more scientists are talking about sort of an inflection point. And they're talking about how they're not sure how the next few years, five, ten years will go.

They're talking about, it's almost like end of the world stuff except for it doesn't have that religious piece. It's more scientific kind of posturing by really smart people. We'll be a little more specific. They call it like a meta-crisis or something?

Have you heard the meta-crisis concept? I have not. I will certainly look into it, but there's no doubt that that's what's happening i mean you we can all feel and see it right but the question is is this just what humans do across the historical sweep every so often that they go through these trends is it something like the fourth turning? If the fourth turning, if you've read that book, that there, that tends to be these generational shifts. I don't know. Although I have become preoccupied with history because it does seem to be something that happens every so often. And, and I'm not, I'm not willing to concede that it's all bad. What, what I worry about is when it spirals out of control uh then it becomes all bad so if you get a lenin or you get a robespierre or you get these people that are able to somehow

it's why it's so important for all of us to speak up and not to just kind of go along with things that that is clearly how bad things happen in these big moments of change. Otherwise, we can listen. Just talking about it the way we're talking about it right now. Yeah, exactly. And also not putting up with stuff that doesn't seem right to us. If really things don't seem right,

that's why I'm saying 2024, my call to action is we can do better. Because we can. I mean, there seems to be a lot of corruption. There seems to be a lot of enmeshment with the, you know, as we've talked about many times with the regulators. There's, you know, I'm not sure that the motivation of people and the way the money is adulterating things, it feels like there's something's off kilter right now and we can just do better. And maybe it's just focus on, you know, basic principles of what the country was founded on. Maybe it's a return to some sort

of spiritual life, whatever it is, we can do better. And we need to focus on it and not just roll over, do not roll over and do not allow people in authority to tell you what's right for you. That's a gigantic mistake. That really feels good to me. I mean, you're the guy to ask about it, obviously, because you talk to such a large range of people. And I feel like it's hard to like, how do you find happiness in that environment? If it's true that we're really in trouble, how, how does someone be, how does someone live happily? You know? Well, uh, Josh, you are asking a question that I do not think you are alone in asking. I, I've noticed a lot of young people with a sort of why bother? What's the use kind of attitude.

And that, that is heartbreaking to see any of that. People should be excited about life. They should be excited about engaging and building and creating. And the fact that we've created a circumstance where people have to feel beaten down or as though there's no purpose or meaning. So the one, to answer your question, Josh, I think the issue is to turn away from the cries for safety, right? Safe spaces,

safety, uber alice. No. And start to focus on what it means to lead a good life. If Jesus had been focused on safety, things would not have worked out the same way, right? He threw caution to the wind to a certain extent because he was leading a good life and he believed that what he was representing was more important than safety. And there's a lot of things more important than safety and engagement and contribution. And it's not grandiose caring.

It's not, I care so much. That is not caring. That is narcissism. If you care, do that one person at a time. That's actually a good little rule of thumb. If you find yourself caring massively, fine, but that's not real caring. That is, I mean, again,

I don't want to discourage people from trying to make large change, but don't put it under the category of you care more than other people because it's just not so. It's just not so. Spence, I'm going to bring Spence in here. Spence, have at it. Again, we hear you. Can you hear me?

Hey, Spence. I do. What's up? How's it going dr drew i've been listening to you for so long um i remember i used to listen to love line probably like 20 years ago when i was a kid probably that was with me and adam yeah it was with you and adam and uh and i've got a funny story about that actually, but I'll save that for later or probably won't say it. Anyway, that's not my question. You were a caller. I mean, yes, you were a caller. Right.

I, I, I wasn't a caller, but I listened to someone else. I don't want to get into that. It's a little, not super appropriate, but it was hilarious and a great show, but, um, not my question. Obviously you're, you're familiar with the, the, the trend of cold plunging going on right now. Yes, yes. I just got out of about a five-minute cold plunge. It was pretty intense because I haven't done one in a while and definitely spiked my dopamine. I've got a specific question and maybe you could help me out with it.

Okay. So one of the benefits that I'm hearing about cold plunging is it does spike your dopamine and it lasts throughout, I don't know, however many hours through the day. Now, my question is this, why is a dopamine spike sometimes really good for something like cold plunge, but then scrolling on Instagram or something like that, which also spikes your dopamine, why is that considered bad? Right, right. So there's great, grave, that's a great question. There are grave misconceptions about neurochemicals and dopamine in particular. Really, the chemical itself is not important. What's important is the pathways it activates. And there are stimulatory pathways, and there's suppressing

pathways, and there are regulatory pathways. Dopamine, and by the way, I am not convinced that you're even talking about a dopamine increase. I think you're talking about endorphins and noradnergic chemicals, noradnergic pathways, which are the sort of the awakening pathways, the stimulating pathways. Dopamine has many different functions, but the primary function we talk about is reinforcement, which is the part of the brain that says, do that again, that is good for survival.

I'm not sure that's what happens during a cold plunge. It may actually be the opposite. You may get sort of aversive, aversive kind of chemicals going. And so what you're feeling is endorphin release because when your body is overwhelmed with stimulation and has to tolerate it, you get surge with endorphin. It's a way of regulating discomfort. And those are the high chemicals. And then you get noradnergic

stimulation, which is the alert chemicals on the frontal parts of the region, to some extent, the frontal part of the brain. But dopamine, I don't believe when people get a dopamine surge, look, I've dealt with drug addiction forever, which is about the dopamine pathways in the medial forebrain bundle. And I don't believe that people, when they have a massive dopamine release, feel anything other than do that again. That is the function of dopamine, do that again.

And you can see it most clearly with crack cocaine, where when people lose all the happy parts of cocaine, the part that feels good, the endorphin part, the stimulation part, that all goes away with time. And every crack cocaine addict knows it's going to go away in about 10 hits. But you are completely consumed by the dopamine system for days afterwards, which is saying, just do that again, do that saying just do that again, do that again, do that again, do that again. And so it is the survival system that becomes overtaken by drugs of addiction and other behaviors sometimes,

like you said, scrolling on Instagram. And it just is, you get lost in this do it again cycle and it has to be interrupted sometimes. So dopamine, and I do, I was going to get, I may get a little more into cold plunges and sauna and stuff. I'm kind of fascinated by that. The really interesting question about,

Adam and I have been talking about cold plunges for a long time and cold showers and that kind of thing. And he says something very interesting. He says, at very minimum, forcing yourself to do something uncomfortable that you don't want to do and tolerating it longer than you'd like to has purpose, has meaning, right?

It making yourself do something you don't want to do is a good way to start your day at very minimum because we do a lot of things we don't want to do in your day. And that's how we build and that's how we build character and that's how we delay gratification, all those good things. So at minimum, it's doing something you don't want to do that's uncomfortable is good for your psyche and good for your soul, number one. Number two, whether or not it causes something called hormesis, which is a – people have a theory that it affects immune function. I'm going to look into that a little more carefully. I know there's debate about it, but it might actually affect your

immune, how robust your immune function is. Let's put it that way. Thank you, Spence. Very quickly here, I'm going to get to, let's see, this is, I think a carrot, carrot, carrot five. And then we're going to have to wrap up pretty soon. I'm going to try to get a couple more, you guys. Carrot five. Excuse me. I've got this crazy cough that, oh, and Shabria, I've asked you to come up if you want to, to give your appraisal for the new year. I'd love to hear from you. Carat 5 is connecting. We've got the crazy, what do they call that when the wheel is spinning, Caleb?

It's sort of processing. Latency processing. Latency. Rendering. Boy, that seems to be going nowhere. Shabria, come on up. Hey, Chavan, how are you, Drew? Happy New Year.

How are you, man? Happy New Year. You sent me a very nice note. I appreciate that. What are your thoughts? You always are very astute in terms of your assessment of the landscape in medicine, infectious disease, sort of where we're at. What's your assessment for the new year?

I'm just trying to maintain sanity one day at a time. We're all doing that. Help us do so. Help us maintain society. Trying not to get sucked into the vortexes and whirlpools of my own cognitive bias and, you know, it gets increasingly difficult to keep. That's worthy. That's worthy. Are you subjected to any mask mandates presently? Yeah, I'm on the inpatient service, so it's all masks all the time.

And not in the outpatient, but... Is there any way to push back on that? Is it just the way it is now in hospitals? Yeah, it's basically... I was speculating yesterday. I think we've entered

an era where there's an elaborate bureaucracy that is tasked with doing busy work to justify their own existence. Oh, for sure. This is way beyond science or way beyond a couple of individuals saying, this doesn't make sense. We are at a point where, you know, these people will turn on the mask and they'll say, look, it worked. They'll do it for like three months. And then the seasonal, you know, the seasonal down, the down peak will be their grand revelation. Oh, look, it worked. And this whole seesaw is going to continue ad infinitum. And I think it's going to need this,

it's either going to need a bureaucratic overhaul, or it's going to be one of these things like the Surgeon General of Florida, someone at that level saying, okay, we are not doing this, it should be individual responsibility, let people decide to do what they want to do, but we are not going to be mandating stuff. Well, not only that, there's zero evidence that,

it's one thing if you want to protect yourself, but it's zero evidence that a mask protects anybody else. There's just zero evidence. There's never been evidence of that. Like that you can protect somebody else from your virus. Like, no, you can't do that. But I do agree with you. Go ahead.

I said that the patients are not wearing masks. So I'm like, you know, how does that work? Am I protecting them? Are they protecting me? None of that really. Don't ask for logic. Just shut up and do it. That's where we are now.

Well, we have to stop. I'm afraid we have to stop that. We really do have to stop that. And the bureaucracy, I've said this for a couple of years now, bureaucracy is the enemy. Centralized authority is the enemy. And they need to be dismantled to some extent. And I don't know if it's the markets that's going to do it.

I don't know how it's going to happen or just people being sane and standing up and saying enough. Something like that has to happen. Absolutely. But listen, I appreciate you fighting the good fight, and we'll keep checking in with you, all right? Thanks so much. Have a wonderful day. Bye-bye.

We can do better in 24. That's my call. Caleb, I see you're pushing Roseanne's picture there on the bottom of the screen. Let's bring up the schedule for the upcoming week. We have James Corbin. We're gonna talk about Gelman amnesia, Roseanne on Wednesday, and Dr. Paul Alexander on Thursday,

on January 11th. He's been going, he's been on them very aggressive lately. Peter McCullough, a week from Wednesday, I believe. Yep. And a lot of great guests coming in. Check it all out. Don't forget to sign up at Dr. Dot TV.

You get the blast there. Caleb, anything from your standpoint? Let me check the restream. Dr. Latipo is coming in on the 31st as well. That's going to be interesting. He was just in the news. Yes, and Siobhan mentioned that. Yes, he just mentioned the Surgeon General of Florida.

That's Dr. Latipo. He is on the record saying that he believes that the mRNA vaccines should be taken off the market. I got to say, I've seen some, you know, the thing that we had to maybe get a Seymour Hotter back on here, because I have seen some of the stuff that he was worried about

with this sort of accelerated heart disease, where I don't understand it any other way. And it's just, again, it may be a bias I'm seeing. I'm open-minded about this, but I've been concerned about supraventricular arrhythmias in young people. And now I'm starting to worry about accelerated heart disease in middle-aged folks.

And I don't know if you noticed, if you saw Dr. John Campbell's post from today, it turns out that in England, they're seeing a marked increase of like a 44% increase in excess mortalities. And I think it's the 50 to 65 year old and the majority of that is cardiovascular. So that is gravely, gravely concerning. And why? And again, please, why? Let's just answer the question. Is it COVID? Is it the vaccine? Is it both? Is it none? Ask the questions, figure it

out. It's just so astonishing. You can't ask certain questions, just too much, too much. All right, well, thank you very much, everybody. Thank you, Dr. Sean Baker. Thank you for all for participating. I will make an effort in terms of doing better in 2024 and try to take more phone calls from y'all. I will try to do that. I get very interested in the guests

and we get caught up in what we're doing there. So we appreciate it. We appreciate you. And we appreciate the people that support the show that make it possible for us to do it. So we appreciate you supporting them. And look out in the future. Oh yeah, drudy.com slash sponsors, where they are all.

But we're going to set up a shop, a store on my website soon where I've got some interesting things planned that are like the TWC emergency kit that I am specifically generating for you all. And I think they're gonna, it reminds me of the old days of Loveline where there are things that people should have access to

that they've just not been given access to. And I wanna provide that. So we'll see how that goes. Keep an eye out for that. And we will see you Tuesday, Wednesday, and Thursday next week. I believe it's all regular time, three o'clock Pacific. Sure, I'm looking at that right now. And we will see you then. Ask Dr. Drew is produced by Caleb Nation and Susan Pinsky. As a reminder, the discussions here are not a substitute for medical care,

diagnosis, or treatment. This show is intended for educational and informational purposes only. I am a licensed physician, but I am not a replacement for your personal doctor, and I am not practicing medicine here. Always remember that our understanding of medicine and science is constantly evolving. Though my opinion is based on the information that is available to me today, some of the contents of this show could be outdated in the future. Be sure to check with trusted resources in case any of the information has been updated since this was published. If you or someone you know is in immediate danger, don't call me. Call 911. If you're feeling hopeless or suicidal, call the National Suicide Prevention Lifeline at 800-273-8255. You can find more of my recommended organizations and helpful resources at drdrew.com slash help.