Live Like a Girl with Dr. Mindy Pelz - Heart Disease, Hormones & LPa Explained by Dr. Darshan Shah

Episode Date: January 27, 2025

Dr. Darshan Shah reveals the shocking truth about the prevalence and danger of high Lp(a), citing personal anecdotes and expounding on how lifestyle changes, though beneficial, aren't always enough to mitigate the risks associated with this particular marker. The episode delves into modern testing methods, like the CLEERLY scan, and discusses revolutionary approaches such as Total Plasma Exchange (TPE) for managing Lp(a) levels and reducing overall toxic load. Get ready to be enlightened and empowered to take proactive steps in understanding and discussing these issues. To view full show notes, more information on our guests, resources mentioned in the episode, discount codes, transcripts, and more, visit https://drmindypelz.com/ep272 Darshan Shah, MD, is a health and wellness specialist, board-certified surgeon, published author, and founder of Next Health, the world's first and largest Health Optimization and Longevity clinic. Dr. Shah has performed over 20,000 surgical procedures, including trauma and complex reconstructive procedures. As a Longevity Medicine specialist, he advises patients on optimizing well-being and extending healthspan and lifespan. Dr. Shah earned his medical degree at 21, becoming one of the youngest doctors in the US, and completed his training at the prestigious Mayo Clinic. He opened medical centers, started companies, and published a book. His commitment to education and self-improvement earned him alumni status at Harvard Business School and Singularity University. Dr. Shah's passion is educating people on adding healthspan to their lifespan, with over 100 speaking engagements and hosting the acclaimed podcast Extend. Check out our fasting membership at resetacademy.drmindypelz.com. Please note our medical disclaimer.

On this episode of the Resetter podcast, I bring you Dr. Darshan Shaw. Now, this is a really interesting conversation and a very personal one. So a little background on Dr. Shaw. He is the founder of NextHealth, which is important because many of you have asked me, like, where do I go to get my IVs? Where can I go to get some functional health help? And NextHealth is, if you're here in America, and actually throughout the world, you may go check. But Next Health has franchised, they're getting close to 80 franchises where you can get

some really good root cause health care. So I want to point that out. But what's more interesting about Dr. Shaw is that he is a board certified surgeon. He is a longevity specialist. And he has stepped out of traditional health care to try to bring a more integrative approach to the world. I love what he's up to with Next Health. And I specifically met him at a dinner party, fascinating dinner party with a bunch of interesting humans. And he talked about a detox that he was really excited about called Total Plasma Exchange. Now, I did detox in my clinic for years.

A lot of supplement detox, a lot of heavy metal, mold. Detox was a big part of my clinic. So when I heard about total plasma exchange, I was intrigued. It is basically a therapy where it takes your plasma out of your body, which is where your toxins live, and then replenishes it. What came from that experience, we did pre and post blood work on me. And what we discovered in the pre and post blood work of this detox IV was that I had a a blood marker called L.P.A. L.P. Little A is a blood marker for cardiovascular disease. And if you have

this blood marker, what it can do is cause placking on your carotid and coronary arteries despite your lifestyle. And I had it very high levels of it. And that was concerning to me because my grandfather died of a stroke in his 60s. So what I wanted Dr. Shaw to do was to bring to you all two things. I wanted him to bring a conversation to you about what L.P. Little A is. I think it's really important because this is quickly becoming a better marker of cardiovascular risk than cholesterol. So we talk about that. I also wanted to talk about this total plasma exchange. and what we know about it, because some of you are going to find this to be an incredible tool for helping conditions like autoimmune situations, which you'll hear us talk about.

But when we're looking at longevity, when we're looking at the health of both men and women, but specifically women, cardiovascular disease and cardiovascular challenges are very common, and especially in the postmenopausal years with the loss of estrogen. What Dr. Shaw adds to this conversation is this genetic marker called L.P. Little A. And I want you all to know about it. I want you to hear what I'm doing personally about it because this is one of those conversations that could be life-saving.

I know it most likely is for me. You're going to hear what I'm doing about discovering this new genetic marker, but more importantly, I am bringing it to you. you to bring it to your attention and hopefully, again, some of you are going to hear yourself in this conversation and find another resource to improve your longevity. So as always, I hope this helps, Dr. Darshan Shaw. Welcome to the Resetter podcast. This podcast is all about empowering you to believe in yourself again.

If you have a passion for learning, if you're looking to be in control of your health and take your power back, this is the podcast for you. Okay. Well, first, I wanted to say welcome to the Resetter podcast, but we're here in your own studio. And I'm just so excited to have this talk with you. So welcome to my podcast, Arshund. So good to be here. So good to be here. Thank you.

Where I want to start this conversation, you know, for menopausal women, there is a lot of lot of concern about heart disease and there's a lot of concern in terms of low estrogen. But what I learned in the short period of time that I've been doing some work with you here at Next Health is that there's a whole other part of heart disease that we can measure, that we can look at that has absolutely nothing to do with hormonal health. And that's what I want to dive into today. But two things I want to tell you that has come from the blood work you've done with me is that, A, one of my dearest friends died of a heart attack a month ago. And he was one of the healthiest humans I knew.

He was 54 years old. He didn't have one single symptom. He lived an impeccable life. And in September, he literally was in his office, living, serving his people, getting ready to give a health talk. and he reached down to pick up something off the ground and he fell down and died. And no pain, nothing. They claim he had a heart attack and now I'm wondering if it's LPA. The other interesting thing is that my grandfather died at my age of a stroke, never had an indication as to why.

And I'm wondering now if it was LPA. So I would like to start this conversation with, please help us understand what LPA is. you found it high on my blood, that was shocking. And when I read about it, I was like there's no lifestyle cure for this. And it freaked me out. And it makes me wonder how many people out there are walking around with high LPA and they have no idea that they're one moment away from a heart attack. So talk a little bit about why this is such a pivotal marker.

It's such a great question for your audience to really understand. understand with LPA little LP little A is. Yeah. And the reason is, is this is something relatively new in medicine that we've now have a renewed focus on. And so, you know, the problem with medicine is us doctors, we got trained 20, 30 years ago in medical school and no one's even talking about LP little A. And then we kind of move forward in our lives and see patients.

And it's really not in the forefront of our mind to even check for this because it's so new. And so I'm so glad that you're bringing it up on your podcast because everyone needs to get checked for LP little A. LP. LP.A is a protein marker of cholesterol that is particularly bad for you because it can, it is number one, like you said, is lifestyle resistance. So it doesn't matter how clean your diet is, doesn't matter how much you're exercising. It can still have negative effects. And the way I like to describe it is also particularly very sticky. So what happens with LP little A cholesterol is that it can stick to not just the inside of your arteries of your heart, which leads to plaque that causes heart disease, but also to your valves, also to the arteries of your neck that supply your brain that can cause a stroke.

So this is a particularly bad form of high cholesterol. And here's the clincher to it is we're also used to looking at a cholesterol panel, which is LDL, HDL, HDL, sometimes VLDL, it completely misses LP-L-A. And the reason for that is that L-P-L-A doesn't fall into one of those buckets. Right. So another idea that people should get their head wrapped around is measuring APO-B. Okay. Ap-B is a cholesterol marker that is a combination of all of the bad, I'm putting in quotes,

bad cholesterol, LDL, V-L-D-L-D-L, and E-L-L-L-B is a combination of the combination of all of the bad, I'm putting, LPA. And so if your APOB is high, it's catching number one, potentially LP-L-A, but also it's telling you an overall status of how much of the bad cholesterol you have roaming around in your body. I want to be very clear, too, because a bunch of people are going to jump down the common throat of us when we talk about, oh, well, cholesterol doesn't mean you're going to have heart disease. And those people are absolutely right. It's not just high cholesterol that causes heart disease. You have to have a combination of factors, including metabolic disease, inflammation, high blood pressure, all these things work in concert to cause plaque in your arteries. However, L.P.

L.P. L.A is particularly bad as well because even in people that don't have metabolic disease or high blood pressure, it can still cause plaque. And so that's why measuring LP. L.P.A. is so important. About 15 to 20 percent of people have a high L.L.P. Little A, and they have no idea. Yeah. So it's interesting because my friend, TJ, who died of a heart attack, when they did an autopsy because he was only 54 years old, they found that he had a fibrodic valve. And they called it, his dad died of something similar. And they didn't know exactly why his dad died. So is there a familial genetic connection here? Absolutely. And everyone that I've seen with a high, LP little A, there's always stories like what you're mentioning of. someone in the family that died way too young with a heart attack or a stroke or a valve issue. Right. And, you know, unfortunately, just in general, heart attacks, 50% of people don't even know

they have heart disease until their first heart attack. And 50% of those are fatal. So people get diagnosed way too late with heart disease. Wow. So another important fact for all your audiences is to know this, that they need to be more proactive and asking their doctors to be more proactive and getting some of these blood biomarkers done? So therein lies a big problem.

And in bringing this to my audience, one of my concerns was, I don't want to freak everybody out. I want to create resources. So make sure those of you listening, we're going to at the end really talk about some of these resources. But it brings up a really interesting question that I deal with a lot with my following

is that people are not heard in their doctor's office. And so if they walk in and they're like, hey, I heard this podcast. I'm wondering if I should have LP, do you call it LP L.P. Little A? LP. L.P. Little A, yeah. L. P. L.P. Little A, checked. Doctors don't like to be told what to test for. And if it's that new, they may not even know anything about it. Is there any kind of advice we can give to the listeners on how do you talk to your doctor about testing this? Absolutely. They could even, if they do have a family history of heart disease, they could say, I'm at risk because I have a family history.

of heart disease, I'd like to be checked for this. And most doctors will probably say, okay, well, let's just check it, right? I think maybe 70, 80 percent of doctors will check it. This is what I'm hearing, you know, when I do a lot of these podcasts and people tell me, oh, my doctor actually checked it. He didn't fight me on it. Oh, wow. And he got educated. Now he's checking it on all of his patients. Amazing. So that's really good news to see, you know, the mindset shifting. However, if they're not going to check it on you, most people are seeing their doctor through their insurance, just look at other doctors in your area that your insurance will cover and go to somebody else and have them check it. You really want to have a relationship with your

doctor where you can challenge them, where you can bring them information and they will consider it and they will, you know, if it's a blood test, that's a very simple blood test, every insurance company should be paying for it. They should order it for you, you know, if it's something that you're concerned about. And so, you know, I'm very encouraged now to see more and more. more doctors are having less of a patriarchal kind of relationship with their patient. Great. I'm so encouraged to hear that. Me too. And I'm seeing this a lot. And, you know, I'm very happy to kind of see doctors working with their patients. Agreed. Instead of telling them, this is what you need, you know, and not even listening. I think that, you know, one of my favorite

books that I ever read was by William Davis, and it was a book called Undoctored. And it came out like 10 years ago. And I actually interviewed William on this podcast. And he, he, told me he got so many challenges on this book, like the profession came after him. And in the book, he talked about in this day and age, because we can Google search all this stuff, we can look up all these science articles, we can listen to conversations like this, that doctors need to be aware that they have a more educated patient coming in to their office and that they should be working together with them. And so I talk about this a lot on all my platforms and one of the most common questions I get is, well, how do I talk to my doctor? Because there's a level of I'm better than

you, and that's the way a lot of doctors have been trained. But is there anything else we can do to create better rapport with our doctors? Yeah, you know, I think another thing that you can do is you can get blood tests on your own now. So there's some new laws passed. They're not even new anymore. And now LabCore and Quest, you can basically go on their website, find what you want to order, and you can order a lot of blood tests on your own. And so that's really great too. And you can bring in some of these blood tests. You'll have to pay cash for it, unfortunately. But you have to, you can bring in these blood tests to your doctor. And I think a lot of doctors will appreciate you taking a pro act. There's also a company called Function Health that can do over a hundred,

I think 200 biomarkers on you for $500. I mean, it's, this stuff. is available now. Yeah. And it's so incredible to see people actually wanting to know their own data, right? I know. It's really fun. Yeah. So, and then my other question on LP Little A was really like, where does epigenetics fit

into this? Because, you know, and just to throw some numbers out there. When I did my test with you all, we did a preimposed after a detox treatment called TPE, which we'll go into here in a moment. but the pre was at 60. My LP little A was at 60. So I've done some research on that. And 50 to 60 is high.

And it was a little bit of a fear and a lot of a wake-up call. And I want to dive into what we're doing next to sort of evaluate where I'm at. But it did leave me like I'm always a believer lifestyle can cure everything. I'm struggling on this one to believe that there's nothing I can do. other than, you know, what we're going to talk about with just TPE. Like, what else? Is there anything you can do in lifestyle and where does epigenetics fit into this? That's a great question.

So L.P. L.A. is particularly resistant to lifestyle changes because it is so sticky. It is so virulent. It does cause so many blockages. However, that doesn't mean that lifestyle won't help, right? Because what lifestyle will do for you, things like, you know, focusing on a, diet that's beneficial for you, fasting, getting regular exercise, not being sedentary, avoiding ultra-processed food. That's going to lower your overall APOB, right? Your overall cholesterol burden if you're a risk for heart disease.

And if you lower your overall, it's less likely, or at least you slow the rate of developing plaque as well. So I still feel that lifestyle has a role here. One of the thing that we should mention is not everyone with high LP little A, but will develop plaque, and therefore it's necessary to do additional scans of the heart to kind of see what your actual plaque burden is. And we can talk a little bit more about that as well. Yeah. So, you know, just to give everybody a little background, so we ran these tests on me. We identified this L.P. Little A being high. And now you're moving me to the next step, which I think is

also a revolutionary thing that I did not know about, which is the clearly, is it called? the clearly exam. Clearly test, right? So talk a little bit about that because again, you know, somebody who has a grandfather on my maternal line who died of a stroke, this is something that I'm not going to turn my head away from because if I can know if that plaque is there and what that plaque looks like, it sure seems like it could be life-saving for me. Absolutely. And so, you know, for about 50 years, we've had this game. of your heart that we can do. It's called the coronary calcium score. This is a cat skin of your heart is very low radiation. And what it does is it scores how much calcified plaque you have in your blood

vessels. So this skin has been around forever. For some reason, insurance does not cover it. But almost everyone can get this at a local radiology office for like $100 to $150. So if you're a calcium score. Calcium score, right. So it's not very expensive. You can get it for a low price. And most people should consider getting this done prophylactively, especially if you have risk factors of heart disease. Now, the next level above that now is a clearly scan. So what they're able to do now is use a little bit longer of a cat scan of your heart. So it's not just 10 or 15 minutes. It's almost an hour or so. So there is more radiation. So you really want to make sure you really need this. But utilizing artificial intelligence, they can now look at your entire artery. There's four major arteries in your

heart, they can look at the entire artery and not just see calcified black, which is kind of older plaque, more stabilized plaque, but also see what's called soft plaque. And this is plaque that is not yet calcified. So when we do this test on you, Mindy, we'll be able to see all of your arteries and how much plaque you've had build up in your arteries, both soft and hard plaque. And we'll get a really good indication of where we need to focus our attention as far as the plaque build up in your heart. The other test we're going to do on you as well is the echo of your carotid blood vessels, right? The ultrasound of your carotid blood vessels to see if there's any plaque buildup there as well.

And we're also going to do an echo of your heart to check your valves to see if there's any plaque build up on your valves. Now, you know, we're being very complete with you. Yeah, thank you. Not everyone needs to do all of these tests. It's very important if you get diagnosed the high LP little A to work with your doctor, potentially even a cardiologist, to see which tests will be next. necessary for you. Right. Okay. So then that brings up the other thing that was surprisingly high,

and I'm wondering if there's a correlation, was my LDLs were high. Does LP. Little A also make your LDL cholesterol higher? No, LP. L.A and LDL are two separate buckets of cholesterol. And so, you know, the whole controversy of LDL. Oh, yeah. We don't know if LDL is really what leads to heart disease. And most people, some people live at a high LDL and they have no heart disease. I see this over and over again, many of my patients, and we're very thorough in everything that we check. However, if you have high blood pressure, if you have metabolic disease, the high LDL is a concern? Right. And so is a statin even helpful in this, either in this scenario at all? So statins are not helpful for everybody, and so I just want to say that up front, that not everyone needs to be on a statin. And so what I

will say is that statins themselves probably don't lower LP. Little A, but they do lower your overall cholesterol burden. Okay. And so there's other medications that we look at with people with LP.A, things like PCSK-9 inhibitors, which are an injectable medication that you can do to lower your overall APOB. There's also a Zetamide, which for people that are hyperabsorbers of cholesterol in their gut can actually lower your absorption of cholesterol as well. So usually, you were using some form of combination therapy with people with L.P. I did a bunch of research on this since my blood work and aspirin. They're back at like that take an aspirin a day. Is there any legitimate claim to take in an aspirin for any heart problem? There's so much controversy around

aspirin. And I hate to like dive into this without having like another hour long episode. But what I will say is definitely aspirin is not for everybody. So what we're talking about here is a lot of what we call primary prevention, right? Taking a medication, even though you don't have appreciable signs of disease to prevent you from getting disease in the first place. We know for aspirin that that's not a good idea because it does cause a lot of bleeding in your GI tract. Oh, yeah.

So not everyone needs to be on an aspirin. However, if you are one of these people with a lot of blockages in your arteries that are significant, your cardiologist might think aspirin's right for you. Right. Okay. And then the other interesting thing is this kind of. connection because I feel like on the heart disease conversation over here, we have LP little A, we have cholesterol, just in general, and all the LDL-HDL. But then on the other side of this

heart conversation for women, specifically, women going through perimenopause and into their menopausal years, is that you need cholesterol. You need cholesterol to be able to make estrogen and your brain requires cholesterol to be able to function normally. how do you how do you rectify that because in all the work that I've looked at for menopausal women is that we start to see signs of dementia and Alzheimer's when a menopausal woman starts to get on a statin because you've brought cholesterol down so much which has brought estrogen down even more and has created a damage in the brain so there's a lot of pieces here I don't know if you see where my brain is going there's a lot of pieces here that I hold as a 55 year old post

menopausal woman of like, okay, I'm taking some bioidenticals to make sure that my heart and my brain stay well, but then I also have this issue of LP. Little A, like, am I just doomed to have a heart attack? And where does that all fit together? You're definitely not doomed to have a heart attack. And so, you know, heart attacks happen most of the time because of an obstruction of the blood vessels that are going to the heart muscle, right? And so what we're really talking about, about is preventing obstructions and preventing if you have current obstructions, them getting worse. There's a lot of different ways to do that. It doesn't have to be, you know, lowering your cholesterol to minuscule levels. Now, what I will say, though, is that there are massive studies

that show lowering your cholesterol prevents heart attacks, okay? And so we do have to wrap our head around those studies in people with blockages of their blood vessels and then contrast that with the other problem that you're mentioning, which is brain. Not having enough cholesterol for your brain to do the work that it needs to do, right? Exactly. So I think that from what I've seen around the research is that there's giant studies done like the Cochrane Institute that takes major studies and compares them, that in general for most people, lowering cholesterol does not cause worsening of symptoms of cognitive impairment.

Okay. Okay. Now, here's the problem is that this is in most people, okay? And as we all know with every study, you have this bell-shaped distribution curve of what most people, what works for most people is in the middle of that curve. But then you have people on the outside of that curve that some people will have worsening of cognitive symptoms with cholesterol-lowering medications. Now, in those people, you're in a particular pickle. Right. Now, for you, though, we don't know if that's where you're you're at, right, right. We won't know until we actually figure out how we're going to treat your blockages and your arteries if you have them. Until we see the clearly. Exactly. And then what we can do

is we can change the dosage of the medications. We can change a form of the medications. Even different statins on different people will have different effects. And so you really got to go down kind of the diagnostic rabbit hole and the treatment rabbit hole with a skilled cardiologist that knows how to deal with all of these problems. So it's personalized. It's very personalized. Okay. Extremely personalized person to person. Yeah. So what I'm hoping people are gathering from this so far is that we really need to be checking L.P. Little A on our yearly blood work.

Right. Knowledge is power. The first thing is you have to know that there's an issue. Yeah. And then know that there's treatment for this. And so if you don't know that there's an issue and you don't do any treatment, you're going to be one of those 50% of people that figure out you have heart disease when you're first to have a heart attack. Right. And then if there is a high LP little A, then the next step would be to ask your doctor to do a clearly exam. Yeah. And then from the clearly exam, you can see if the plaque is hard or soft. And it's the soft plaque that we're the most worried about because that's what can break free. Right. Exactly. Okay. And so finding the right person to understand that, is that going to be hard for people or is that you think most people should be able to find a doctor who's willing to go into the clearly exam?

I think it shouldn't be hard for people. Okay. And just like we talked about with blood testing earlier, that if there is a physician that you're working with that kind of blows this off or tells you don't worry about it, there's definitely other, you should always get a second opinion. Of course, yeah. That's why it's called the second opinion. Yeah, everybody should get one.

Yeah. Right. The first guy just gave you his opinion or her opinion, right? Yeah. That's why you get a second opinion to see what are your options, right? You know, funny little side note on that. I was at a conference or I was speaking at a conference this weekend and Malcolm Gladwell was speaking. And he, you know, of course, looks at patterns.

And one of the patterns he's seen in the U.S. is that you get different medical care depending on the city you live in. And so he used the example. And I forget which type of medical care it was. But he's like the way they treat, let's just say high cholesterol in Chicago compared to the way they treat high cholesterol in Miami are completely different. based off the city and that actually it's the town you live in that determines the medical care that you're going to get. Have you heard that before? I absolutely believe it, and I've seen it in my own eyes. You know, I trained at the Mayo Clinic in Rochester, Minnesota, and the way

we practice medicine there is very different than how it's practiced in, like, Los Angeles, for example. It's crazy. Yeah, a lot of it has to do with just, you know, who you're talking to. Yeah. Because doctors are talking to each other a lot in. the Mayo Clinic. You're forced to because, number one, it's cold outside and there's nothing to do. So all you do is talk to the other doctors. The whole town is a town of just medical professionals. And so you have no one else interact with. So all you're doing all day long is talking about medicine. Oh my gosh. Yeah. Whereas in L.A., I feel that the practice of medicine is a little bit more isolated. So what you've learned maybe five years ago is what you're still, you know, that's your knowledge base still.

And so, you know, obviously there's great doctors in L.A. And those are the ones that are keeping themselves up to date. the latest technology, the latest thought processes, et cetera, and you just got to go searching for it. So it's weather dependent. Is that what I just heard? Because it's a matter of if you're inside or outside. Right. So the reason I bring this up is because I think, A, you know, I'm hoping people are gathering how to talk to their doctor about this because that's how important I feel like this test is. But also, I think we have a tendency to put our doctors on pedestals. And one of the things that I'm trying to do with my audience is, is educate them so they can be in collaboration with their doctors. And understanding that you may be getting a skewed answer based off the city you lived in is really interesting.

And I think it's something we need to, I think we should move medicine to this place where it's teamwork. It's not a hierarchy. And I don't know if I'm just a dreamer. And I know you're trying to do this with Next Health. But I feel like if everybody came together as a team, then the patient would win. Is that ever going to be possible? I think medicine is moving in that direction for sure. I think more and more people are realizing that every patient is an end of one.

Your biology is completely different than the average that every study is reporting on. So we have to hyper-personalize your care. We're going to learn a lot over the next few months as we're going through your LP little A journey. And you might be one of those people that don't really need any treatment because your heart is fine and we're going to keep a close eye on it. or it might be something else. And so we just really got to treat every patient as an end of one, not make blanket decisions for people. Right. You know, there's this whole thing in medicine called standard of care. Right. Yes. And it's really hard, in my opinion, to ever have a standard of care when everyone is so different. Yes. There has to be, of course, we want to hold ourselves

a certain standards, but that doesn't mean we do the same thing for everybody. Yes. And so it has to be a partnership for patient and doctor. Yeah. The other term that's being redefined is evidence. based. So evidence-based to me means we saw a study on it and now we organize everything for that patient around the study. For women, this is a loss because most of the time they're not studying us. I've recently heard the reframe as evidence informed. And I really like that because you can look at a study, maybe even on a man and you can say, that's interesting. Now let me become my own N-1. I just used the evidence to inform myself. Exactly. So I don't know if that's being brought into the medical world, or even into here at Next Health.

But I really feel like that's a more empowering statement because we throw evidence-based out. And then we're like, oh, I don't want to talk to you because it's not evidence-based. And you should only go to evidence-based doctors. And I think evidence-informed brings everybody into the conversation. Yeah, absolutely. Evidence-based, when I hear that term a lot of times, you know, Marty McCarie wrote an incredible book called Blind Spots in Medicine, a great book. And he basically, I might be misquoting him, but he basically says that people that throw out the word evidence-based all the time are people

that are really looking for that as an excuse for not having all the information. And so you're absolutely right. It has to be evidence-in-form, but understanding that every patient is a different biology, and we still need to consider that the evidence might tell us one thing, but this person might be on the outside bans of what that evidence is showing. That's right. That's right. Okay. So super helpful. Now, what I want to do is move to this new treatment that you are rolling out in all of your clinics. And what is so shocking on the conversation of LP little A was that mine was at my LP little A was at 60. And then I did one session of total plasma exchange. And the next day when we tested it, it went down to, I think, 32. So explain to me what

total plasma exchange is and why I think it's probably exciting for a lot of things. But it seems like from what I can tell off of searching this on, you know, doing Google searches and chat GPT searches, that they're really thinking of total plasma exchange as a real treatment for L.P. Little A. Okay, so Plasma Exchange, maybe it would be helpful to talk about a little bit of the history of it, and how it's done. Yeah, please, yeah, because that's interesting too. Yeah, so Plasma Exchange is a treatment that we've had in the hospital for about 50 years now.

I remember being in medical school, and we would use it for really severe situations, things like autoimmune crisis, where someone's autoimmune disease was completely out of control, and they were in the ICU, and they were intubated, and we need to do something to save their life. We also use it for things like drug overdosages when people took too much of their heart medication and to filter out the drug. Oh, interesting. So the way plasma exchange works is we basically hook you up to an IV. We're removing some of your blood and then we're putting it in a giant centrifuge.

For people that have seen PRP, they know that when you put blood in a centrifuge, it separates into those components of plasma and blood cells. Okay. And with this machine that does this for all of your blood, we're re-infusing your blood cells. Your red blood cells and your white blood cells, we're re-infusing those. And we're taking the plasma out completely. And that plasma is then basically thrown out. Right.

Okay. You were holding a bag of your plasma. Yeah. It's really interesting. Yeah. It's like three liters. We'll post pictures of that, especially on our YouTube channel where this will be visual. but it's really remarkable when you hold up all the stuff that just came out of you.

Right, exactly. And so the really important piece here is replacing that plasma with albumin. Albumin is a protein that our body naturally makes. And the reason we have to replace the plasma is that protein in your plasma creates what's called an oncotic grading in your blood vessels. So all of the fluid stays within your blood vessels. Okay. And so we have to replace it with albumin.

So that's what we did for you. It's about a two to three hour treatment. Actually, it's less than two hours from most people. It was like an hour and a half. Hour and a half, yeah. And during that time, we do one therapeutic exchange of one plasma volume. Okay. And so the treatment, as you had done, is very comfortable.

A lot of people have the misconception that we take out all your blood and you're basically laying there with no blood. That's not true. That wouldn't be possible. That wouldn't be possible. It's only about 100 ccs at a time. Someone asked me, like, what if the electricity dies and the machine? machine dies and all my blood is out of me. I'm like, no, it's only like 100 Cs at a time. So people have been doing plasma exchange for literally five, six decades. It's extremely safe.

It's an FDA-approved modality that's been used in hospitals. We're using it as an outpatient, which means you can have it done in our clinic. Right. And then you can go home right afterwards. And so it has a lot of benefits to it because what lives in your plasma is your cholesterol. So We use it a lot for what's called familial hyper-cholomia where someone has the genetic abnormality, the massively elevated levels of cholesterol. We use it for that. We're now using it for LPLA. We're using it for people that have high levels of toxins build up in their system,

from environmental toxins, immune disturbances as well, people with autoimmune conditions. So there's a lot of potential applications. And what's really cool about it is we're not giving you a medication. We're not adding something to you like a chemical. we're just removing the bad stuff in the way you like to describe it. So if I walked into my doctor's office and they're like, you need to go on a statin

because your cholesterol is high. And if I went and did a TPE, then is technically, would that be like cleaning my cholesterol system out? Can we use it? Like let's say I didn't want to go on a statin. Could I use it as a way to prevent going on long-term statins?

I don't think so. I think that, you know, the answer to that question is we don't know. Right. But in reality, doing plasma exchange over and over again to remove cholesterol for your bloodstream when you have a minimally elevated cholesterol, we don't really know if that's what the risk-benefit ratio for that is, right? Because this is a procedure.

Like, even though we're just putting an IV in you and we're doing this procedure, there's still risk of even putting an IV in, right? Which you don't have that risk by taking a pill. So the answer, that's a long way of saying, we don't know. However, I don't think that that would be an acceptable replacement for like a statin. Now, in certain situations like familial hypocholesterolemia where statins are not going to drive your cholesterol low enough for long periods, it's definitely very useful. And now we're also seeing with LP little A being useful as well.

In fact, the American Heart Association, I said to that, put out a guidance saying we should really think about using Plasma Exchange for LP Little A. So the other interesting thing is the nurse that helped me, Jojo? Jojo. Jojo told me that when he had his TPE, that his cholesterol was high, and then the post-blood work, the cholesterol went down. But what was shocking is he could no longer tolerate bad oils, that his taste buds, his smell, and what he used to eat was some of that stuff was packed with bad oils, which might have been,

you know, authentically increasing his bad cholesterol. he said that he really noticed that his cravings for oils change, which really made me look at this treatment as it's not just a quick fix kind of thing. It's actually changing. I mean, in my situation, I don't eat bad oils, but it could change the way in which you live your life because it changes what your behaviors are. Do you have any evidence of that in other areas? I don't, but, you know, I'm always surprised with a mind-body connection. and what our brain senses that we have no idea how it's sensing it. Yeah.

You know, it's just mind-blowing to me. It's fascinating. It really is. I will tell you, though, that we are seeing epigenetic changes with plasma exchange. So when we measure biological signs of aging using epigenetic markers, even markers of individual organ health, like heart health, liver health, et cetera, we're seeing age reversal of biological age for organs using epigenetic marker testing. Wow.

So that's really mind-blowing to see this. And also we're seeing people with high LP little A keep their LP little A low for 60 weeks. Wow. Yeah. And so this is something that we're seeing. We probably have like five or six people that we're currently treating with LP little A in Plasma Exchange. So it might not be true for everybody.

Everyone's biology is individual. how quickly you make it, how your body is naturally taking care of it. But it's been pretty long-lasting. Now, what we don't know, and I was talking to you about this before, is we don't have the research saying that plasm exchange prevents heart attacks and people with LLP little A. That's a study that has not been done, right? That's a massive study. It's going to take a lot of individuals, a lot of funding, a lot of follow-up to understand that.

However, we do know that LP. little A that's elevated, and a vast majority of people causes early heart disease. Right. And so anything that we can do to keep it down, I think is beneficial. Yeah. And I know that I'm coming in to get a second treatment that will be about four weeks from the first treatment. And so we'll see, I mean, we're kind of guinea pigging me as well to like see if that

LPA has stayed down because my lifestyle is pretty impeccable. I mean, the only thing I probably would change would be stress levels. But, you know, I do. All of us. Yeah, right. I live in a modern world. So I'm really encouraged to see how long-term this will work for people. And again, if it can save a heart attack or a stroke, it's just profound.

And, Mind, your mindset around this is perfect because you're looking at yourself as an N of 1. And you're also expecting that maybe we do a couple of these treatments and it might not make a difference. Then we need to seek out another treatment modality. That's how you have to look at all of this in medicine now. And, you know, we're so trained to waiting for the randomized controlled drug trial to tell us what we should and we shouldn't do. And I think that's been helpful in this whole drug development world or pharma world. But it's not helpful in the real world of medicine to treat everything that way. Yeah, well said.

Well said. So that leads me to the next intriguing thing about TPE. So how you and I even met was at an epic dinner party that you threw. and you said something that just really stuck in my brain because the question you asked the whole table was, what is something you're really excited about right now? And you brought up TPE and you mentioned that you felt like we live in the most toxic time in human history and getting the toxic load down of people is near impossible, which is honestly, I mean, we did detox in my clinic for over a decade.

You live this. Yeah, I lived this. And it was so depressing when you would run all these toxic tests on everybody and they'd say, how did I get this? And I would say you're living in the modern world. And I got actually so disheartened because I felt like I could not make any progress using supplements by themselves to detox. I couldn't make enough progress teaching people how to change out their beauty products and how to stop using plastics. Because a lot of people, especially my patients, were traveling all over the world.

And I really got disheartened. And when you said we're not going to be able to get the toxic burden down by changing behavior because so many toxins are coming at the human body right now. So things like TPE now become necessary to bring this environmental toxic and load down. And when you said that, my detox brain was like, oh, my God, what if everybody could do this? What if we, you know, we can't fight these big corporations that are pouring toxins into our food and our homes? What if we had some kind of daily detox or monthly detox or yearly detox that was effortless that could bring the load down? That's where my brain went with that statement.

So talk a little bit about where you could see TPE in taking the toxin burden down. And you mentioned 65% of toxins are filtered out with one session. Is that accurate? No, I would say that it's different for every individual. And so I had one, actually I've had a few patients now where one treatment I saw 60% reduction in some certain toxins, like Phaas, for example. Okay. But it's every single patient I've noticed difference in their percentage reduction in toxin. And I think that's because, you know, toxins don't just live in our plasma.

They live in our tissues, right? Right. And so, and people have different levels of constant exposure, too. Yeah. So they go home after a session and maybe they're like fully exposed again, right? And so you see this a lot with mold. Yeah. You and I both struggled with patients with mold toxicity.

Yes. Where until you move sometimes, you're not going to get rid of your mold exposure, right? Yes. And so it's just so different from individual to individual. Now, to be clear, like, I think that plasma exchange will eventually become a main state. in treatment for people with high levels of toxins. However, you know, you and I, you're one of the pioneers in this, and you taught me the whole bucket theory of how much toxins someone can handle, right?

That's right. We have an incredible biology where our liver and our kidneys and our sweat glands are all working together to detoxify us constantly. However, when your bucket spills over, as you describe, and you're now experiencing symptoms from high levels of toxins, or maybe you don't want to wait until then. Plasma exchange could be a modality to add to your overall treatment protocol. So I look forward, you know, especially because, once again,

we're not putting a drug inside of you with this treatment other than a little bit of a blood thinner that we reverse with calcium. This should theoretically, the price should come down on this treatment. And hopefully we get to a place where people can do this as kind of a maintenance if they have a high toxic load. Okay. I love that. Now, we need to do a lot of research to find out, number one, what does this all really mean? Right.

You know, we're running this mass experiment right now in humanity where we've poured 150,000 chemicals into the environment over the last 60 years. We have no idea of the level of, you know, just hormonal stress this is causing, physiological burden, mitochondrial dysfunction. It's massive. And we just don't even know. But to see that there is one therapy that could potentially, give our body that time to catch up a little bit.

Because when we take out one entire plasma volume of plasma filled with toxins, it gives our body and our biology a little bit of time to catch up. It gives us a couple weeks where a liver and our kidney can do its job a little bit better. And the way I always explained it to patients was your body knows how to do, well, knows how to do a lot. But when it comes to the toxin load, it knows how to filter it and get it out of your system. when it comes to things like pathogens like Epstein-Barr virus and Candida, it knows how to get rid of that. But then there becomes a point when the toxic load gets so high that all of a sudden it's overwhelmed and it doesn't detox well at all.

So with that mindset, I have been doing something called Eboo, which I know you guys are now starting or you're beginning to carry in some of your locations, which is really another level of pulling the toxic load out. With Eboo, they have stated that they believe it only pulls out the organic material. It pulls out like the lime, the mold, the EBV, but they don't believe it does heavy metals. And so what I've been doing is going once a month to get this Eboo treatment to just keep bringing my load down so that the body can detox the way it's meant to detox. I think where chronic disease, I think where problems tip over is when all of a sudden that toxic bucket, hits the top. And the body, the liver, the gut, the gallbladder, I mean, we have all these gallbladder that are being taken out. And the gallbladder is actually the house for heavy metals. It's when the liver is burden, it pushes those heavy metals into the gallbladder. And then the gallbladder

all of a sudden starts to act up. And medicine pulls the gallbladder up. But that was a detox sign that the body gave you. So I really think that the name of the detox game is bring the burden down. however you can bring the burden down so that the body can do what it's meant to do. I totally agree with you. And you and I, we've talked about how we struggle with people changing their behaviors. And I think people will struggle with changing their behaviors as it relates to toxins because they feel it's overwhelming. Like we have so many toxins on our environment.

Like it's a game that they're never going to be able to win. But I tell people that you can win a big piece of this game by detoxifying your air, water food and your skin products, right? Right. And so opening your windows, changing your air filters, even buying an air purifier. Step one. Step two, we're only drinking water that's been filtered or reverse osmosis and glass bottles. That's right.

Major difference. Step three is your food, trying to eat organic and not, you know, buy from your farmer's market and avoid all the ultra-process package food and then your skin products. You only have to do it one time. Find products that don't have all these chemicals in them. switch it one time and you'll be switched forever. And then over years this compounds and you have much less of a toxic burden than your neighbor who hasn't done all of this stuff, right?

Yes. I love the way you said that because, and I hope people really go back and re-listen to that because the number one rule to detox is stop toxifying yourself. So like even though we're talking about these fancy treatments and how they relate to cardiovascular health and other issues, the big overarching message here is stop toxin. define yourself to the best that you can do. Exactly. So the other interesting thing, and I don't know if I've brought this to your attention,

is how my clinic actually started to get into detox is because what we see through the perimenopausal journey is that estradial goes up and down and up and down in a very wild ride. Right. And that extreme high and low actually triggers toxins to be released from the tissues. So there's actually an incredible study that shows that lead lives. in the bones. And when estrogen goes extremely high and then drops extremely low, lead comes out of the bones and goes into the bloodstream. Well, what we know about heavy metals and toxins in general is they go to fat. And the most fatty place in our body is our brains. So it goes up into the brain and lead is a

dumber downer. And so all of a sudden you're losing your memory. All of a sudden you're depressed because these tissues, these toxins that have been stored in tissues that weren't coming out until you had this massive hormonal swing, they all of a sudden, I mean, menopause is a massive detox from your tissues. Wow. So I love everything you're up to

because I have been constantly searching for menopausal women to have resources that they can lean into when the memory goes off, when the depression kicks in. And I don't think we're talking enough about the toxic situation that's happening behind those.

symptoms. So I'm curious if you've heard that before, what you've seen in your clinic. Absolutely. I mean, look, we have a lot of menopausal women in our clinic. We have a lot of menopausal women and a lot of manapausal men as well. Same thing, yeah. And I think what we need to understand as just a civilization is that menopause and menopause, they happen. It's meant to happen. But our biologies used to be able to deal with it effectively. Yeah. Unfortunately, we've added so many toxins and stressors to our life in the last 50 to 60 years that we are no longer capable as humans to get through this without a little bit of help.

Right. Right. And so doing all the things that you talk about in your books and also augmenting them with supplementation, with therapeutics like this that we're discovering, it's almost necessary now as you're going through that time in life. Right. Yeah. And, you know, maybe back then in the caveman days, a little bit of lead came out of your bones when you're a woman.

It wasn't a lot of lead. You weren't exposed to a million other toxins in your environment, microplastics, etc. Your body was able and your brain was able to deal with it. That's not the case anymore. No, it's not. Unfortunately. And so we need to be able to, number one, remove a lot of the toxins from our day to day, but also number two, have therapeutics that we can seek out to help us with that burden.

I was recently on Jay Shetty's podcast, and I know that he's a friend of yours and you've been, and I know he comes to next health, like he and I had a whole talk about it. And there was a point in the conversation that we started talking about food toxicity. And, you know, I made a statement that now has turned into a viral reel that I still stand behind, which is that if you don't know how to read an ingredient label at this time in human history, you have signed yourself up for chronic disease. So we have hit a tipping point where detox used to be something that was optional. Detox was something that maybe you only went into if you had like a massive autoimmune condition or a problem.

I believe, and I'm curious if you agree with this, I believe that detox is no longer optional. That if you are not detoxing, same thing as I told Jay, if you're not detoxing, you're assigning yourself up for a chronic disease. And if you're a woman that's not detoxing, you're assigning yourself up for an autoimmune. condition and you're signing yourself up for some pretty gnarly menopausal symptoms. Do you feel like that is an egregious statement or would you, where do you line up with that thought? I not only fully agree with you, but I try to shout this from the rooftops do. We no longer can ignore the fact of the toxic burden that we live under, right?

We are doing cross-sectional microscopic views of arteries and seeing microplastic in our arteries. Like, we can't ignore that. That was not supposed to be there. No, no. And so I think that very quickly, we need to realize as humans that now our health journey has to incorporate not just the three legs of the stool, which is sleep, exercise, and nutrition, but also detoxification as one of those legs of the stool. The sooner you realize that, the better life you're going to lead.

And the older you'll be able to live to, but more importantly than that, the more importantly that, the more health you'll add to all those years. Because, you know, a lot of the toxins that we're exposed to now, even our parents and our grandparents had no, not even close to the levels that we're in right now. So the sooner you recognize this fact and accept it and make detoxification part of your lifestyle by some of the things that we talked about. Maybe you find a sauna that you can go to once a week, do some of these things. you're going to have much less of a chronic disease exposure.

But not only that, you're also going to feel better, more vibrant. You're going to have less brain fog. You're going to be able to keep weight off. You're going to be able to manage your hormones better just by detoxifying. Yeah. And, you know, it's interesting. As you were talking, I don't really tell this story often, but one of the reasons I fell in love with fasting is because it came out of all the supplement

detoxing I was doing with my patients. And I was like, okay, we have to find a way. way for the body to detox itself that doesn't cost any money because what are you going to do for the single mom that's working two jobs and is trying to just put food on her table and she wants to prevent chronic disease. And so when I learned the termitophagy, I was like, wait a second, the body detoxes itself. So I actually evolved from all this supplement detoxing I was doing in my clinic into fasting, which now is really fun for me to meet you because we're going to join forces and we're going to bring a combination of everything you're doing,

a combination of everything I did in my clinic, a combination of fasting, and put something together for people that becomes this preventative plan that will slow aging and really help them get out of the chronic disease cycle. So I just have to thank you for that because detoxes, toxins have been, it has saved my life once.

It may be saving my life, twice to detox. And yet it is so complicated. It can be ridiculously expensive. But at some point, we have to bring this into the mainstream. So talk a little bit about Next Health, just so people know who you are, what you're up to, because I love your vision, and talk a little bit about how people find a Next Health Clinic. Well, thank you so much for that, Mindy. And it's been such a pleasure meeting you. And, you know, we have a mind meld on so many things. so I can't wait to do our program together. But basically Nex Health is a new system of medicine.

It basically comes out of my frustration, being a Western medicine trained doctor. For 25 years, I did surgery, I worked in the emergency room, I did trauma, I did reconstructive surgery, and I could not get myself healthy with all of this deep medical knowledge, you know. And so I found that, like you found, our body has a natural ability to heal itself if you give it the tools it needs, right? Yeah. And so I decided once I healed myself to form a new kind of clinic where people can go to stay healthy and be healthy and be their most vibrant self.

And that's what Next Health is. A lot of people call it like the Apple Store of Health and Wellness. Feels like that. When you come in, it actually has a real fun vibe like that. Thank you. Yeah, because we want people to come every week, you know. And so what we have is we measure all the biomarkers that we're talking about so people are empowered with the knowledge.

Yeah. And then we create a plan for them utilizing the latest technology to stay healthy and to feel incredible. And so we have what we call the longevity circuit. It includes sauna, cryo, hyperbaric oxygen, LED light. We also have ebu. We have plasm exchange. We do a lot of biologics. And we just basically have a doctor and medical practitioners at every location to help guide your journey that understands this new form of medicine that we're practicing.

Yeah. And you have telemedicine too, right? which is really cool. So what's the entry point? We have people all over the world. But I know you are heavily, your clinics are heavily on the coast right now in America. But you're opening up over 80 of them in just in America. Are we worldwide yet? We're going to be worldwide, actually. And so we're starting. We have a clinic opening in Dubai in a few weeks. And we also have some clinics in Canada opening. We have about 60 locations opening in all the major cities, the United States, and some secondary markets as well. So basically, you know, the way medicine is practice in the United States is by state by state. So our goal is to have a clinic in every state. So even if you have to travel a bit, you can get to a clinic within an hour or two. And then once you get to a clinic, we can do all the testing.

It's not just blood tests. We're also doing urine tests. We're doing things like grip testing. We're going to be doing VO2 max testing. All the data we need to really understand your current health situation. So we can impact it 20, 30 years before you get a disease. And right now we are in L.A., New York, Maui. We're also opening very soon in Florida, in Chicago, in Texas, and Nevada.

Where else? Nashville. Nashville. Nashville. Yes, you're right, Nashville. So we'll have clinics everywhere. And so just keep your eye out. Our website is next-health.com.

And you can come to one of our clinics, established care. Then we can do everything by telemedicine, as you said. And very soon, we'll have a really. Well thought of detox program with you. I can't wait. And yeah, we'll just keep helping everyone as much as we can through spreading the message. Yeah, and we'll leave links for all of that. And we'll leave all the science too.

So I'm hoping that people can take this episode and take it to their doctor. You know, my whole YouTube channel is built off of me leaving the science. And so people took those videos to their doctors. And then their doctors started referring all their patients to the videos so that they can be in collaboration with, with the information I was giving. Amazing. So it was really cool. So anyways, I just could talk to you all day long.

I love it. I love your vision. I love your heart. Thank you. And I just love what you're up to in a world where I have been frustrated trying to figure out simple solutions. You have taken that and are bringing it to the world in a really easy way. So thank you for that. Well, thank you so much.

Yeah. You know, I was a very successful surgeon, but I decided this was so important. important that I wanted to change my career completely and just tell people how to be healthy, tell people that they have a place to go to be healthy. And so I really appreciate joining forces with someone like you that is so committed to women's health, to people's health. And yeah, let's do this together. Agreed. Agreed. Appreciate you. Thank you so much, Wendy. My pleasure. Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it, so please leave us a review,

share it with your friends, and let me know what your biggest takeaway is.