Dhru Purohit Show - Becoming Heart Attack-Proof By Protecting Your Endothelial Health

Episode Date: May 11, 2023

This episode is brought to you by Birch Mattress by Helix, Cozy Earth, and Lifeforce.  In today’s minisode, Dhru discusses the lessons he’s learned on his heart health journey and the critical role our endothelial health plays in our risk for heart disease. He shares what damages the endothelial lining, which coats the inside of over 60,000 miles of blood vessels, and how you can strengthen it by supporting your mitochondria, circadian rhythm, sleep, and more.  Dhru also discusses his personal experience navigating high cholesterol despite making diet and lifestyle changes and how working with Dr. Michael Twyman and getting a series of lab tests helped him get a deeper look into what’s going on with his heart health. In this episode, Dhru dives into: -Crazy heart disease statistics (00:42) -Endothelial dysfunction as the root cause of heart disease (4:30) -The three events that lead up to a heart attack (6:28) -How plaque forms in our arteries (11:30) -Important lab tests for cardiovascular health(12:37) -Dhru’s heart health history (13:40) -Simple strategies to protect your endothelial lining (18:53) -Supporting and protecting your mitochondria (19:57) -Tips for programming your circadian rhythm (21:06) -Sleep hygiene and heart health (22:09) -Stress management and heart health (22:36) -Dietary factors (24:37) -Smoking and vaping (27:15) Also mentioned in this episode: -Sign up for the Try This Newsletter here. -Try This: Becoming Heart Attack-Proof by Protecting Your Endothelial Health -Try This: The Miracle Molecule You Need To “NO” About -Episode 158 with Dr. Louis Ignarro -Episode 383 with Dr. Michael Twyman -Dr. Michael Twyman’s website, drtwyman.com.  -Dr.Michael Twyman’s @drtwyman -Episode 378 with Dr. Sunjya Schweig Sleep Master Class Birch mattress by Helix is made of organic latex, cotton, New Zealand wool, and American steel springs. To get 20% off your Birch Living mattress, head to birchliving.com/dhru today. Cozy Earth has the most comfortable, temperature-regulating, and non-toxic sheets on the market. Right now, get 40% off your Cozy Earth sheets. Just head over to cozyearth.com and use code DHRU Lifeforce is a revolutionary new health platform that’s changing the game when it comes to personalized performance and longevity-based action plans. Right now, get 15% off your first purchase at Mylifeforce.com with code DHRU. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi everyone, Drew Prode here with a solo episode. We haven't done one of these in a while, and we're talking about how to become more heart attack proof by protecting your endothelial health. It's a fantastic topic today that's based on a newsletter that we wrote for our try this newsletter. By the way, if you aren't signed up for our try this newsletter, you can click on the show notes below and visit drew perot.com and click on the tab that says try this newsletter, and you can sign up today to get more newsletters like this sent to you every Friday. Now, on today's topic, endothelial health is all about cardiovascular disease. Let's read some top line numbers that are out there just so we get how big the problem is when it comes to art attacks. In the United States, did you know that 700,000 people die of cardiovascular disease every single year? Half of these cases have no symptoms before the individual experienced their cardiovascular event. Half of them had no symptoms at all before they had a heart attack. Endothelial health plays a vital role in protecting against heart disease.

What is that? We're going to get to that in a second. Your endothelial lining coats the inside of over 60,000 miles. of blood vessels inside of your body. And lastly, protecting your endothelial lining is key to reducing your risk of a cardiovascular event. Let's jump into today's topic. If you care about being heart attack proof,

you need to learn about your endothelial lining and most importantly, how to protect it. Your endothelial lining is a single cell layer that coats the inside of 60,000 miles of blood vessels. The endothelium acts as the air traffic controller, deciding what substances in the blood will have access to the underlying tissue in the arterial wall. Our endothelial damage, when damage takes place to our endothelial system, is the first step in leading to ultimately plaque formation in the arteries, which is what we call atloskerosis.

Now, I'm not a cardiologist. I'm synthesizing this information from a recent episode. that we did with my cardiologist, Dr. Michael Twyman. And Dr. Michael Twyman is an incredibly skilled cardiologist who has a knack for breaking things down and making sure that they're well understood by the population. In today's newsletter, which I'm reading out here for you to get you excited about this topic, but also to get you excited to sign up for our newsletter, I'm going to break down Dr. Michael Twyman's top suggestions on how you can begin to think

about endothelial damage in the context of heart health. Spoiler alert, some of the suggestions that Dr. Twyman has for you might actually surprise you. So we've already mentioned it before. More than 700,000 people die from cardiovascular disease every year. And the other shocking fact, more than half of those cases have no prior symptoms before experiencing a heart attack or stroke. That doesn't mean that heart disease just shows up one day. A lot of people feel like it does, but it doesn't do that.

It's the results of decades of damage. In fact, the first signs of heart disease can occur in your early teenage years, depending on your lifestyle habits and genetics, of course. Here are the three main events that happen before full-blown heart disease develops. Number one, endothelial damage. Our endothelial lining is super sensitive to insults. Some of the top contributors that damage it include high blood sugar and insulin levels, high blood pressure, high sodium levels, chronically high sodium levels, alcohol, of course,

lack of sleep, physical or mental stress that builds up to chronic physical and mental stress, and exposure to heavy metals, polluted air, or as we've written about in past, PM2.5 or higher, toxic chemicals, and bacterial endotoxes. Now, the second thing that builds up to eventually full-blown heart disease is endothelial dysfunction. Your endothelial cells are the primary site where nitric oxide, NO, is produced in the body, a super important molecule that promotes vasodilation and smooth blood flow.

Fun fact, for those who listen to the podcast, and we're listening a couple years ago, I had on Dr. Lou Ignaro on the podcast to discuss the role of nitric oxide in cardiovascular health. And we wrote a topic based on his episode that we've linked to in the show notes below. And it's titled, The Miracle Molecule You Need to Know and O about. And what's great about that newsletter is that nitric oxygen is so key, according to Dr. Michael Twyman's education when it comes to protecting our endothelial health, that it's important to understand what drives us to produce less of it as we get older and why it's so important. And by the way, one of Dr. Twyman's favorite sayings is ED equals ED.

Now, nitric oxide plays an important role in erectile dysfunction. But if you have erectile dysfunction, then that's a good indication that you have endothelial dysfunction. And when you read that newsletter, you'll get a chance to understand and why it's so important how nitric oxide is the common link between endothelial dysfunction and erectile dysfunction. You can find those in the show notes below. Oh, and I don't think I completed the thought. The fun fact was that I had Lou Ignaro on the podcast, Dr. Lou Ignaro, and he discussed the role of nitric oxide in cardiovascular health. And by the way, this discovery was so groundbreaking that he was awarded the Nobel Prize in Physiology and Medicine in 1998 for his

understanding of the role that nitric oxide plays in vasodilation. Now, when our endothelial cells undergo damage, they produce less nitric oxide over time, which causes our blood vessels to constrict and slows circulation. This allows a greater chance for lipoproteins, which carry cholesterol, ultra-glesteroids, phospholipids, and fat-soluble vitamins, white blood cells, and platelets to stick to the endothelial lining, kicking off a process of inflammation, plaque formation, and athelosclerosis. Now, the last stage of ultimately building up to full-blown heart disease, we talked about the first one, which is endothelial damage. We talked about the second one, which is endothelial dysfunction. and now we're talking about the third one, which is atherosclerosis.

So the plaque in our arteries sort of resembles a pimple, and it can either be soft or hard depending on whether it's calcified or not. As the body continues to try to heal the pimple, it forms scar tissue and calcifications. The medical field used to think that hard plaque was the only plaque to worry about because it accumulates in the arteries, blocks blood flow, and causes chest pain. But soft plaque is worrisome too. When soft plaque builds up, it can rupture and form a blood clot in the artery, which can lead to a heart attack or stroke.

The challenge has been that for a long time, the main test that people were encouraged to get was a traditional CT scan. For anybody over the age of 40, you probably have heard of a CT scan. In fact, you've gotten one done yourself. I got one done a couple years ago. Now, a CT scan only identifies hard plaque. But now, this is one of the reasons that I had Dr. Twyman on the podcast, there's functional cardiologists like him who are putting the spotlight on tests like the Clearly scan,

which can also identify soft plaque, helping patients identify the earliest stages of endothelial damage and dysfunction. By the way, if you missed it, and in case you missed it, I actually got my clearly scan done. I have no affiliation with the company at all whatsoever. I got it done based on the encouragement of Dr. Gabriel Lyon, who was the one who introduced me to Dr. Michael Twyman. And Michael Twyman ordered it for me, and we discussed the results together on the podcast that I had for him.

Now, we discussed my results in context of my full-blown cardio-metabolibes. So we did the blood work as well as the clearly scan. And one of the reasons that I wanted to have Dr. Twyman on the podcast to talk about my results is that I'm one of those individuals who genetically is predisposed to hyper-cholesterol production inside of my body. In fact, my whole family has something that maybe you've heard about before. It's called familial hyper-cholestrallemia. It's basically a genetic predisposition to producing and being a hyperproducer of cholesterol, which my entire life I've had a higher than normal LDL, higher than normal total cholesterol, although total cholesterol is not something that people are really worried about these days.

But recently, as a lot more individuals like Peter Tia have been sounding an alarm on things like ApoB, lipoprotein B, I've also started tracking that number and I've seen that my levels of APOB over the years have been quite high. And even with dietary interventions, I've not been able to get the number to come down significantly. So one of the things that Dr. Twyman suggested is that we get my latest blood work done, which we did through Boston heart diagnoses. And that includes all my lipids that are related to, you know, heart health, total cholesterol, direct LDL, HDLC, triglycerides, non-HDLC, APOB, so on and so forth, that goes quite in depth. Of course, if you're interested in this, you need a doctor to run the test for you.

But more importantly, you need a trained doctor to understand how to go through the diagnosis with you. We also ran to understand the type of genetics that I'm dealing with. Dr. Twyman introduced me to a company called G.B. Health Watch. G.B. Health Watch is a genetic testing and analysis company that broke down. It went way over my head. I'm glad I had somebody like Dr. Twyman to walk through it with me. But it walked through the main genes and snips that I have that are related to, in this case, cardiovascular health. And the summary of it is that pretty much I had every single one that makes me a hyper producer, which means that most likely, of course, my family is also having a lot of those

genes as well, too. They haven't done the test yet, but most likely they probably have because they also are individuals that even with the clean diet have higher and elevated APOB and LDL. In addition to that, as I mentioned, we did the clearly scan, which is a contrast test that's done. And as I mentioned, we had also ordered for myself a clearly scan so that we are not just looking at hard plaque build up inside of the body. I many years ago, not many years ago, probably three years ago, got a CT scan done, knowing that I was turning 40. and my CT scan, like a lot of individuals who eat pretty healthy, showed up as zero. And a lot of times your CT scan, this is not medical advice, this is me talking about my own journey, a lot of people who have a predisposition to high cholesterol or may want to figure out how to improve it,

even though their blood markers are off a little bit, they get their CT scan done and it shows zero and they think that they're in the clear. But as I mentioned to you before, for my best synthesis of being able to explain the knowledge, it's been taught to me by individuals like Dr. Twyman, CT scan is only looking at hard plaque. So I needed to get the clearly scan done to see the soft plaque buildup. And the clearly scan is an AI-driven CCTV analysis that allows for the earliest detection of soft plaque inside of the arteries. and it was kind of mind-blowing to see. Dr. Twyman walks you through my report and some of the findings inside of this podcast episode

that I'll link to in the show notes. But he also has a YouTube video where he walks you through just the clearly scan as a whole. We'll make sure to link to that as well if you're curious about it. By the way, you do need a cardiologist or physician to order this test for you. But again, most importantly, you have to find someone who's trained in reading it. So we'll link to Dr. Twyman's contact information for his clinic. And you can reach out if you want to work with him to get yours done as well too. So let's come back to the newsletter and I'll tell you a little bit more about my scan.

We'll come back to that in a second. So after you have endothelial damage, which is stage one, then stage two is you have endothelial dysfunction, where your endothelial cells are producing less nitric oxide from damage, right? from different types of damage from pollutants, toxins, ultra-processed foods, and you aren't producing enough nitric oxide, that leads to stage three, which is athrosis, which is the plaque inside of the arteries, soft or hard, and then the final stop after those three is hard to seize. And so if plaque begins to accumulate in the arteries, our risk of cardiovascular events

increases dramatically. But there is good news. We can intervene with strategies to protect our endothelial cells and lower our risk for heart disease by reducing our exposure to factors that can damage it. So let's talk about protecting our circadian rhythm and protecting our mitochondria, because that's the message that Dr. Twyman, in addition to, of course, staying away from ultra-processed foods, not smoking. Of course, anybody who's smoking here today or vaping, you know, those things are extremely damaging to your endothelial lining. We want to move away from them. And of course, too much alcohol consumption, which we're starting to learn more and more by individuals like Dr. Andrew Huberman, that pretty much even what people thought of as safe alcohol consumption should really

be reanalyzed. And we should understand that the health benefits of alcohol have been vastly overstated. Anyways, this isn't about alcohol. So let's get back to Dr. Twyman. So Dr. Twyman suggests that you can protect your endothelial cells. And surprisingly, his first priority is not nutrition, but supporting and protecting our mitochondria. Your cardiovascular system is densely packed with mitochondria, which are super attuned to our light environment, so they know when to make energy and when to repair themselves. Because we need healthy mitochondria for our hearts to function optimally, providing them with proper light cues is imperative. So these are some of Dr. Twyman's suggestions that are part of his normal repertoire that he talks

to is patients about. And I've adopted them myself. A lot of them I was doing previously, even before I met him, but I've doubled down on them and the importance of them because I've understood the connection between my mitochondria and my heart help. Number one, get morning sun. Step outside within the first hours of waking up and get morning sun in your eyes for a few minutes. This signals to your brain that it's time to wake up and tells the body to start making energy and daytime hormones like cortisol. Number two, take sun breaks throughout the day and avoid junk light at night.

Light signals to our mitochondria, as we mentioned before, to produce energy. But light exposure at the wrong times causes confusion and confusion. damage to our mitochondria. Dr. Twyman recommends getting outside for frequent sunbreaks during the day and minimizing blue light at night. If you have a dimmer switch, try lowering the overhead lights in your house so that you can bring the intensity down and to start telling your body that it's time to start winding down and get ready for sleep. And this is a nice little bonus, something that I do, wear blue light blocking glasses at night. This is a big one. that Dr. Twyman swears by, I swear by it as well, wearing blue light blockers an hour before bed

helps protect your mitochondria and circadian rhythms, which means you'll fall asleep faster. I generally myself put my blue light blocking glasses on about an hour before bedtime, and it really helps my nervous system quiet down and start to calm down and get prepared for bed. Now, let's talk about sleep, stress, and dietary recommendations. sleep hygiene. We need to prioritize getting high quality sleep to give our mitochondria time to repair and rejuvenate. Make sure your room is cool, dark, and quiet, with the exception of maybe a sound machine, if you use those, like a light noise machine, to muffle out any noise and to improve your quality of sleep. There's been so many episodes that have been done on sleep. We have a

fantastic one, which was done by Dr. Sanja, which we've linked to inside of the show notes. Now, number two, find healthy ways to manage stress. Entire books have been written on this, but chronic stress causes endothelial damage and significantly reduces nitric oxide levels. Shift your nervous system into a rested and relaxed state by engaging in activities like walking, reading, journaling, time in nature, or meditation. Here's the thing about stress and chronic stress specifically, is that the interventions to tackle stress are generally straightforward. The challenge that I've seen in my own life from watching friends,

family is they don't get serious about addressing stress. And sometimes they don't get serious because there's underlining root issues that they haven't addressed, maybe traumas for when they were younger. And those traumas shape their nervous system. And their nervous system is constantly in a fighter flight state, and they've never unwound that. In some instances, doing a weekend program like the Hoffman Institute, which is a nonprofit that's based out of here in California, and they have these weekend retreats where they really help you understand how you show up in the world, which is a lot of how your nervous system shows up in the world, and they help you begin to unwind the stories that you tell yourself that keep you in this super

stressed out place. I highly recommend it. I haven't done it personally, but I've had a bunch of my friends do it, and it was one of the most meaningful and transformative experiences of their lives. So the Hoffman Institute, check it out. I've done similar work from other organizations, but today, the Hoffman Institute is the one that I recommend. Yes, I haven't done it, but again, I've had a bunch of friends do it, and it was powerful for them and helped them significantly shift their stress and start moving away from chronic stress in their life. Okay, let's talk about diet. So, of course, diet matters. And according to Dr. Twyman, it's more important to focus on the basics, sleep, stress, and balancing your circadian rhythms to protect your endothelial lining than thinking

that there's a perfect diet for everyone. Now, that being said, our diet is still important. And of course, moving away from ultra-process foods is going to be the number one recommendation for people who are literally starting from scratch. Moving away from ultra-process, moving away from fried foods is a regular part of your diet, ultra-process foods is a regular diet part of your diet, fast foods is a regular part of your diet. Those are going to be the basics. I don't think that a lot of people listening here today are consuming more than, you know,

10% of their calories coming from those foods. but if you are, that's going to be one of the first steps and you can do something like Whole 30 to begin to reset your system. In addition to reducing your consumption of ultra-process foods, when you eat is at least important as what you're eating. And this is based on the work and research of Dr. Suchin Panda. Your body is better at metabolizing and digesting food during daylight hours, at least it seems, based on his work.

So trying to not eat super late. does seem to be a better way to support your mitochondria. And this will also be something that helps protect your sleep, not eating too late, especially not eating a couple hours before you go to sleep. Now, everybody goes out to dinner sometimes, catches up with friends, don't worry about those instances.

Think about the stuff and the habits that you have on a regular and weekly and daily basis. And of course, eat a primary Whole Foods diet. The backbone of your diet should be made up of whole foods that include healthy fats, high quality protein, and fiber. And of course, your heart will thank you. I hope to have Dr. Twyman back on the podcast in the future to chat a little bit more about diet and some of the questions that people have had in our audience around diet and what might

be more specific things that they want him to dissect. So we'll keep that for the future. And I mentioned it before, smoking, vaping. It seems to be that the reduction in smoking, as a public campaign is a big part of what's helped us reduce our total cardiovascular health burden and the amount of heart attacks that are out there. I believe that I heard Dr. Asim Mahotra talk about this recently on the Joe Rogan podcast. So anybody who is still smoking, people who are vaping, there's a lot of genuine concern about the new version of smoking these days, which is vaping.

People think it's healthy. Oh, it's not a cigarette. I'm not burning paper. I'm just, you know, heating up this oil super hot through this coil. There's still a lot, a lot of concern around that. And generally people like Dr. Twyman think of that as a super unhealthy behavior. And it's very sad to see so many teens, especially in young adults, vaping on a regular basis because we think that it's going to be catching up to them one day and that it's currently damaging people's endothelial lining inside of the body. So let's talk about the status of my heart health journey.

So after working with Dr. Twyman and doing the clearly scan, I've learned that the things that I'm doing to protect my endothelial lining, like eating clean, staying away from ultra-processed foods, exercising. Oh my gosh, exercising is a big one. We didn't even touch on exercising. It probably is going to be one of the biggest, if not the biggest lifestyle factor that's out there to strengthen your endothelial lining and to increase your night. electric oxide production inside the body. So we skipped over exercise, but there should be an entire newsletter. And speaking of Peter Attia and his new book, that is a fantastic resource to help you understand that exercise is truly a drug.

And that drug has a ton of upside inside of your body and low to basically no downside that's there. What's the saying that if exercise was the drug, it would be the best-selling drug in the entire world for its effects on the body. So don't discount exercise. So in my case, eating clean, staying away from ultra-process foods, exercising and getting into strength training, which I have significantly gotten to in the last couple of years of my life, sleeping well, and taking care of my circadian rhythms and protecting my mitochondria, wearing things like blue light blocking glasses, those are all paying off. and my arteries, according to my clearly scan, are virtually plaque-free, both from soft-plac as well as hard plaque. Not only that, but Dr. Twyman said my clearly results were the cleanest he'd ever seen of any

man that he's worked with. So not to do my own horn, but that's pretty major considering my South Asian background and being genetically predisposed to high LDL and APOB levels. Now, I'm still working on improving my lipid panel. I still want to get my numbers for like my LDL and my APOB in better range. And I'll keep you posted on that in a future newsletter. There's been a lot of talk these days of individuals, you know, taking on statins. And again, I'm not a medical doctor.

I'm not an expert in this category. But I've started to ask a lot of questions. And one of the questions that I've gotten a chance to ask and learn more about from Dr. Twyman and doing my G.B. Insights, which is the insights on my genetic background, is that I actually learn that even if I was interested in taking a statin, statins would not work for me based on my genetic breakdown that's there. Now, some other drugs, which potentially have less side effects than statins, could actually work. But again, we're going to save that for a future episode. And again, this is not medical advice. This is me just talking about my own experience.

I'll make sure to bring on Dr. Twyman to talk about that choice if I end up making that choice and what the results ended up being and how I weighed those pros and cons of deciding to include a drug intervention or even other natural interventions if I include those to bring my LDL and APOB down into a range that's not super high right now. So needless to say, there are many different factors that contribute to our cardiovascular health. And just because you might be predisposed to heart disease, like me, it doesn't mean that that's your fate.

Now, some final thoughts. I'm super incredibly happy that I got connected to Dr. Twyman because his message is so unique and powerful, even if your lipid panel is perfect, if your endothelial health is poor, you could still be at high risk of cardiovascular event in the future. I'm just going to say that again, even if your lipid panel looks fantastic and your doctor says, great, your numbers are all in range, if your endothelial health is poor and your endothelial lining is not strong, you could still be at high risk for a cardiovascular event in the future. And really, besides doing something like the Clearly scan and looking in your arteries and getting a chance to look at soft plaque buildup,

unfortunately, there's no other real way to know right now what your heart health actually looks like in your body. Now, just a couple of things. The Clearly scan is not cheap. Out of pocket, my insurance company, you know, didn't pay for it. I think it was. was like $2,300. That's not cheap. For me, though, I would rather save up a little bit of money and not spend it on some random nonsense than invest in my heart health to get a real sense because, honestly, I was so confused by this topic.

Why is my, you know, knowing that I have hyper cholesterolemia and knowing that South Asians in my Indian background were more predisposed to developing a heart attack, I really wanted clarity. That's why I sought out and I'm so glad that Dr. Gabriel Lyne introduced me to Dr. Twyneum so I can actually get a little bit more insight and understand that, you know, what I'm doing is actually working and I could test instead of guessing. Even in the past, they've had holistic health providers that have encouraged me to start on a statin, but they weren't aware of a test like the GB Insights test, the genetic testing, and I could have ended up on a statin without it actually being the right thing to work for my body.

This is all part of the personalization of health. This is all part of the figuring things out, surrounding yourself with the right team and getting more insights so that you can be in the best health possible and protect your heart ultimately. So in conclusion, try these strategies out to shore up your endothelial lining or at least learn more about it and improve your chances of becoming heart attack proof today. If you're interested in following Dr. Twyman, I've linked to his Instagram below, or you can check out his website, D-R-T-R-T-W-Y-M-A-N dot com. And you can also find the links in the show notes for our article on nitric oxide and some of the other great resources that are there. All right, that concludes today's solo episode on the topic of becoming heart attack proof by protecting your endothelial health.

If you enjoyed today's newsletter that I read out for you, go to drewproet.com and you can stay posted by clicking on the Try This tab and signing up and getting my insights from myself and my team where we synthesize a lot of things that we're learning from the medical experts that are out there like Dr. You can sign up today. I don't think you'll regret it. It's a free newsletter that comes out every Friday. It's a true purit. I'll see you back again next week.