Transcription
I barely know how to start this. Um, I guess I'll introduce myself. My name is Dr. Nick Norwitz. I'm an MD PhD and metabolic health scientist and for the last 7 years, I've been running an experiment that should be killing me. And today, we're going to find out if it is.
But, I guess I should back up. This all started when I was finishing up college. Life was sitting pretty for me on paper. I had a full ride to Oxford to do my PhD with a cozy little spot at Harvard Medical School and set for me afterwards. That was on paper. Behind the scenes, my life was falling apart. I had developed a severe inflammatory bowel disease that ripped through my life like a wildfire. Physically, I became malnourished, at times dropping below 100 lb and ending up in the hospital because I just couldn't eat. Psychologically, I was chronically in fear and socially, I can't believe I'm going to say this, but I couldn't even go on a date because it was a coin toss chance that I would have an episode of violent, painful, bloody diarrhea before the entree arrived. That's a little bit of a mood killer, if I'm going to be honest. It got to the point where I honestly wanted to die. And I was actually almost there. I was in and out of intensive care while I was trying to start my PhD in a country by myself.
But, this is not my sob story because something did work. And it's not something I expected to work. When I was at my lowest, when I was really desperate, I tried [music] an extreme diet, a low-carb ketogenic diet. To my surprise, my disease went fully into remission. Not just in the way I felt, but in my biomarkers and on colonoscopy [music] with biopsy of my intestinal tissue, there was no disease activity. It was incredible.
But, that salvation came at a price. My cholesterol exploded. It went from healthy normal levels with an LDL cholesterol around 90 and it blasted through the roof. My LDL cholesterol neared 600. My total cholesterol topped 700. And for 7 years, I have lived like this with cholesterol levels so high that every textbook we read in medical school says my heart should be clogged [music] with plaque. I should be dying. And I've accepted these risks because the thing that is causing my cholesterol to go so high is also saving my life. So on the one hand it's saving me, on the other hand it might be killing me. So today we're going to find out the truth. I'm going to get an advanced scan of my heart to see what's actually lurking inside my arteries. Is my high cholesterol killing me? Or is there more to this story? That doesn't just poke a cholesterol dogma, it shatters it. Where does that leave me as a patient? Context is everything. That's the hypothesis, right? But that's the beautiful thing about science. That was me. It's probably you, too. You can't beat this. All right, I'm really nervous. Moment of truth. Let's get this scan.
So it's 5:04 the morning of the scan. I have my scan at 8:30 and I've actually been [music] up for 2 hours. I'm anxious, but I'm also really excited. [music] I just want to get the data. Um this is going to be a big day. Hope it turns around fast. All right, I'm running a little bit late. The whole parking lot was full. I was looking for parking for 20 minutes. It's 4° in Boston and there was a giant snowfall, so a lot of the parking spots are filled up with snow. All right. On my way. I did. Just need to go to the bathroom first because honestly the contrast dye makes you feel like you're peeing your pants and I want to [music] be confident that I'm not. You know, good to see what happens next. >> [music] >> Little briefs. Make your patches on. Might make working out afterwards a little bit [music] more tricky. A few moments later. It's zero. It's a zero. Oh my god. This is better than I could have expected.
Let me catch you up. Yes, I know I'm young, but this scan I got was not your average coronary artery calcium scan. This was an advanced scan looking for all the plaque in my arteries, calcified and soft. When advanced artificial intelligence read to quantify plaque down to the lowest millimeter cubed. Now, little side quest. To give you a sense of how this fancy medical machinery works, basically it works like this. You get injected, I got injected with a contrast dye, which by the way makes you feel like you're going to pee your pants, it's the weirdest feeling. Anyway, that dye then circulates throughout your body, including in the vessels of your heart, my heart. And at the same time, you're sitting in a massive tube with an x-ray scanner spinning around you rapidly taking images from multiple angles. The key is this, the contrast absorbs the x-rays very strongly. So, instead of the x-rays just bouncing off different tissues, different tissues absorb different amounts, which makes the contrast-filled arteries light up bright on the scan. So, the machine is taking hundreds of cross-sectional slices and then reconstructs them into a full 3D image of my heart, which you can see here. It's actually really cool. And then from there, expert readers and artificial intelligence, I did get both for a double check, can trace each artery and quantify how much plaque exactly there is and whether there any narrowings in the arteries. And my results, you can't beat this, are a flat zero.
And let's be clear, there are people around my age, in their 30s, who do have plaque in their arteries. It's actually pretty common. I even talked with the CEO of the AI company that did the read, and he clarified this for me. There are even discussions going on on social media right now with influencers in their 30s quibbling about what caused their 61.3 mm cubed of plaque despite their decades-long rigorous adherence to cholesterol-lowering diets. And what's more, with cholesterol levels like mine, the medical textbooks we read tell you kids children should be having full-on heart attacks by around their 10th birthday. Not just a little plaque in their arteries that you can read on a fancy scan, but enough plaque to cause heart attacks. The fact that I objectively have zero measurable plaque in my arteries, that doesn't just poke a cholesterol dogma, it shatters it. And now it's probably a good time to mention we also published a peer-reviewed case study on this whole video, on this case. We paid for the open access fee because you deserve it. The link's below so you can check it out.
So now put yourself in my shoes, the patient. If high LDL is always so dangerous, and after the better part of a decade having LDL levels in the stratosphere, I have no plaque whatsoever in my arteries, where does that leave me as a patient? As a person? And am I alone? What's going on here, and what can we learn? Well, I'm going to answer those questions, but we're going to start with another little side quest that starts with a fundamental truth in biology, one that is grossly underappreciated, but universally true. In biology and medicine, context is everything. Context is everything. What I mean by this is a marker, be it cholesterol or something as mundane as height, which admittedly I don't have a ton of, exist in a particular individual context. Let's take height for that example. Think about Shaq, Shaquille O'Neal. He is 7'1". In his case, it was just lucky genetics, and the result was he ended up famous with lots of money and an excellent NBA career. But someone else can be the same height, the same 7'1", but for a very different reason. Maybe they have a brain tumor that's secreting growth hormone, and if left untreated is going to kill them. Same measurement, same 7'1", very different outcomes, NBA or death. And the same is is of cholesterol. There are many different reasons cholesterol can be so high. Sometimes it's broken genetics, like in those kids with familial hypercholesterolemia. Sometimes it's poor metabolic health, obesity, insulin resistance. And sometimes, ironically, it's excellent metabolic health and a metabolism that's relying on fat as fuel because you're on a therapeutic low-carb diet for medical need, like me. There's actually a term for this. It's called the lipid energy model. And I'm not going to get into the nitty-gritty here. I'll probably bore you. But if you do want that, you can check out this open access paper we wrote on PubMed. And if you really want to get into the deep nuances of me on heart health, jump over to the heart health archives linked below at stakeyourmetabolism.com. It's our best-selling science newsletter, and we have hundreds of hours of content for you, literally, and it's growing every day.
But back to my case and my cholesterol. The bottom line is my high cholesterol is caused by my body adaptively responding to the nutritional and metabolic circumstances that I placed it in for my own medical need. And if you want really bizarre proof that it is my fat-fueled metabolism that's driving my cholesterol so high, in theory, all I'd have to do is add carbohydrates into my system because then I'm burning more carbs, less fat, and the driver for my high cholesterol should be removed, my cholesterol should go down. That's the hypothesis, right? Spoiler, I actually did this. With Oreo cookies. It's a paper on PubMed. You can look it up. Oh, and also, the cookies even outperformed high-dose statin therapy in a crossover trial. A drop of 273 mg per deciliter, or 71%. And I suppose that's how the cholesterol cookie crumbles.
Okay, but back on track with our main storyline. Modern medicine doesn't think like [music] this. It often forgets context. Context is lost for the sake of algorithms that allow the system to work seamlessly. And as much as individual doctors might truly want the best for their [music] individual patients, and they do, modern medicine treats populations, not people. >> [music] >> And I know what it's like to be that patient that feels misunderstood in the doctor's office. [music] That is a feeling that generalizes across genders, race, and educational level. When I developed my extremely high cholesterol, I knew [music] I knew it wasn't like anything I'd been taught about. It was different. I was different. >> [music] >> And that inspired in me a curiosity that washed over the fear like water over a rock. The fear that was truly there. And it gave me the courage to place a bet [music] on what might happen. And I know it's audacious for a 20-something-year-old at the time, I was like 23, to place a bet against decades of cardiology built by physicians and scientists with far more experience than myself. But that's the beautiful thing about science. >> [music] >> The data judges the ideas, not the credentials backing them. In this case, the data was what showed up or didn't show up in my heart. [music] After having cholesterol over 700 for 7 years. And I had an idea. I had a hypothesis, and [music] I needed to see what would happen. And lo and behold, I was right.
Now, here's the thing about cholesterol, and we're going to get on my soapbox a little bit. It's a variable that takes up all the oxygen in the [music] room because of history, not because of biological importance, because we have tools to target it, because there's a business model wrapped around [music] it. And that's not to spread any conspiracy theory. It's not even to say that LDL isn't important at all. It's to say that when medicine monomaniacally focuses on individual variables and loses the larger context, people can and do get hurt. Now, let me pause and make a really important point. Because this is where I could get myself into a lot of trouble. Some will say, not even might say, some will say that by challenging the idea that high LDL is always dangerous, people might misinterpret me and put themselves [music] at risk. I actually understand this concern. But I also think it disrespects [music] your intelligence. What we're trying to do here is respect the whole person, the full context, the patient in the room. That was me. [music] It's probably you, too. These are complex issues. They're not meant to be easy, >> [music] >> but you deserve a seat at the table. Don't be a renegade just for the sake of it, but recognize that you are a unique individual. I am, you are, we all are. And you don't just have the right, but you have the responsibility to [music] advocate for yourself, to ask questions even when it feels uncomfortable, especially when it feels uncomfortable. For you, it might not be cholesterol. It might be something else. So, [music] don't settle for being treated like the population average because almost none of us are.
And that brings me back to a question I asked earlier, am I alone? The answer [music] is an unequivocal no. And if you want evidence of that, I'm going to direct you somewhere else because we actually just made a whole movie about people like me, the not the population averages that medicine misunderstands and often mistreats. It is incredible, a completely different view of cholesterol. I think there's a lot of things out there that may not necessarily be what we're told. People are starting to question. I have to know if this is a problem. There's no money without industry, and there's not an industry [music] for ketogenic diet. It's on Amazon. Go check it out.
Okay, um I took a step away from recording this video because I needed to get in a different headspace because now I want to be incredibly vulnerable with you. This wasn't [snorts] just any scientific experiment. It was literally a bet on my life. And luckily, I won. I'm happy about that. Uh but there's also another bet that I need to tell you about, one that in some ways was even harder for me to make. You see, I spent my entire [music] life training to become a doctor and scientist. I grew up in a household with two parents who were both MD-PhDs. [music] One's a Marshall Scholar, one's a Rhodes Scholar. You can imagine what our dinner table conversations were like. And from the earliest age, I've worked on achieving that goal, going to an Ivy League college, graduating valedictorian, medical school, PhD [music] program to become a physician scientist. And when all of this, all my hard work, everything everyone told me I should be doing and was proud of me for doing was about to culminate, I walked away. I chose not even to apply to a medical residency, >> [music] >> to not become a traditional clinician. I stepped off the path entirely. Why? Because my personal experience taught me that the system, for all its strengths, and it does have some, is not built to solve root cause problems for many people. It wasn't built to ask and answer the kind of questions that could have saved my life. We didn't leave medicine exactly. I think medicine is evolving, that it needs to evolve to treat what people need today. I think it needs people willing to think differently [music] and play different roles. And one of those roles is as a communicator. So, what I'm trying to do here [music] is give you the tools and perspective I wish I had. Because you do not need Ivy League degrees to understand your body. [music] You have that power intrinsically, in your autonomy and your curiosity. That curiosity is human. It's built into your DNA. It is a superpower. >> [music] >> And that is why I'm here. Not to give you some secret formula, but to help you uncover that spirit of curiosity that is possibly the most powerful medicine in existence. >> [music] >> That is why I'm so passionate about that. That is why I keep showing up. And as it turns out, my experiment isn't killing me. So, I'll be here to be curious with [music] you a little while longer. Stay curious and stay healthy, too. And thanks for a million subscribers. I actually have a little surprise for you. All your tremendous support has given me the resources to buy [music] a space to build out a proper studio. So, no more bedroom recording. We're about to design something epic, and you're going to see a level up. Stay curious. >> Mhm.