Log in

A Note From Neal: Hormones and Beyond 2019

August 14, 2019 6:21 PM | Rebecca Storms (Administrator)

Dear Colleagues:

The timing was perfect as it could not have happened at a more opportune time. Two articles in JAMA made claim to the fact that our treatment of diabetic patients with typical diabetic medicines increases the risk of MI and CVD. What? I thought that we needed tighter BS control to lower the risk of CVD and diabetic vascular disease? Later, the NEJM published a study that tight BS control did not improve CVD outcomes and even showed an increase in CVD events. What, how can that be?  Is everything that I/we have been teaching, preaching and doing for the last 30 years incorrect? Now, after reading Jason Fung’s book I understand why that is. It is true that the higher the HgBA1C level, the worse the prognosis and the sooner one dies from the foregoing diseases. However, just because high levels of HgBA1C are associated with increased morbidity and mortality, that does not mean that lowering the HgBA1C results in less disease, or that lowering the blood sugar is of benefit. It makes sense to lower BS and gain tighter control and lower HgBA1C levels if high levels increase the risk of disease, but the outcomes prove otherwise. Why? Maybe because what we have been doing, and falsely misled to believe, is wrong. Lowering blood glucose is correct and appropriate, however, how we lower it is the key to understanding why using one method improves but the other worsens outcomes.

A recent TV ad for a GLP-1 analog claimed that there was no increase in MI or CVD events with this medication; their selling point was that there was no increased risk of MI? Yay, yippee, finally a drug that does not increase heart attacks! Wait. What? Why are we giving drugs to lower BS that in turn increase heart attacks, cause significant weight gain, and increase morbidity and mortality?  I thought that lowering BS was good. For years I kept increasing diabetes meds, trying to maintain tighter BS control. But the patients all gained weight and their disease got worse.  So, I added more meds and started long-acting insulin and they gained even more weight. I once bet a patient that if he lost 20 pounds I would give him $10,000. He failed.  Then I went double or nothing. Not only did he fail but he gained weight. I blamed him but little did I know and realize that it was my fault and not his. This was before I read Jason Fung’s book The Diabetes Code and learned how and why DM meds made CV disease worse. My heart sank.

A recent video on Medscape made reference to the fact that “Cardio-Metabolic Disease” should be made a new specialty.  Based on all the GLP-1 analogs and sodium-glucose cotransporter 2 inhibitors reducing weight, disease, and MI risks, the specialty is definitely changing and gaining momentum.  So why are these new drugs any different? Although these meds work by various mechanisms to lower BS, lower HgBA1C levels, and improve CVD outcomes, the main importance is that they lower BS by different mechanisms other than increasing beta cell function, insulin levels, and driving glucose into the cell. These new wonder drugs decrease appetite, slow down glucose absorption, decrease gluconeogenesis, and increase glycosuria through the kidneys. The most important take away is the ability to decrease BS by different mechanisms other than driving glucose into the cell which all past drugs did, particularly insulin. By cramming all the excess glucose into the cell, the cell becomes overloaded with glucose which the cell must dispose of by storing it as fat and glycogen or converting it into triglycerides. Hence, the onset of fatty liver, fatty pancreas, fatty kidneys, dyslipidemia, NAFLD and NASH. I blamed all my patients for their weight gain and disease progression.  And I blamed myself for not being more vigilant in maintaining tighter BS control. I had no clue.  Mea culpa, mea culpa, mea maxima culpa.

In June, Reaven published in the NEJM that intensive glucose control in type 2 DM patients proved just as likely to cause a MI as standard therapy. Patients also gained weight and had worse disease outcomes. Perfect. There was no better outcome in MI, CVA, CHF, CVD, death, DM complications, or QOL scores. Even after 15 years of tight control, no benefit. So, what was their suggestion to improving outcomes? The researchers recommend treating DM even sooner and much more aggressively, as though 15 years of tight BS control was not enough? (Einstein said insanity is doing the same thing over and over again but expecting different results!) Professor Simmons stated that the data from the VADT study was consistent with findings from other studies. She finally admits that perhaps we should decrease medications if the risks outweigh the benefits. The authors do note that these results are before the GLP-1 receptor agonists and SGLT2 inhibitors were available. However, their treatment suggestion was to use more and more drugs that consistently do not work.  Hmmm. Those thousands of researchers need to read and grasp Jason’s book in order to see why they, and their patients, fail.

In the REWIND study, dulaglutide reduced MI risk by 12%. That’s relative risk and not absolute risk which was much smaller. (The RR was 12% but the absolute risk (AR) was only 1.4%, with 3.4% MI in control group and 2.0% in treatment group=1.4% AR).  It was the first major study that proved superiority over standard care, which has been consistently harmful. (An absolute risk reduction of 1.4% is quite underwhelming, but the researchers jumped for joy). So, there is less harm with the new drugs than in comparison to standard therapy (which increased risk), but what about with control groups? “In assessing the individual components of the composite outcome, Gerstein noted that there was no discernable effect observed for nonfatal MI with dulaglutide and a neutral effect observed for CV death.” You mean, no benefit? That is correct, no benefit. No benefit after spending millions of dollars on drugs and they do not work to reduce CVD? Hmmm. Their conclusion was that dulaglutide “could be considered for the management of glycemic control.” Could be? Why didn’t they state, “should be or must be?” Because the results were underwhelming and the cost $900/month!

There are better, safer, tried and true solutions to the above. That is what Part V Hormones and Beyond is all about. Jason Fung will review his secrets and insight for success. I will review all the medical literature demonstrating what we should be doing as well as what we should not be doing. Hope to see you in October.


Comments

  • August 21, 2019 10:58 AM | Dr. Charles Webb
    The problem is clear- our healthcare industry is broken. Chronic disease is on the rise, while private practices are closing at record pace. Practitioners are shackled to a corrupt system that forces them to stay in line if they are to get paid. “Keep your visits short, order your diagnostics and recommend treatments and drugs that keep the cash coming in.”
    Unfortunately, there is much biased research that attempts to move attention away from safe, effective and inexpensive alternatives.
    Thank you for bringing this to light. There is a new breed of doctor that is no longer willing to stay in line and accept dangerous and ineffective protocols for their patients. They are acting as guides who move empower their patients by dispelling myths and communicating the truth.
    Link  •  Reply
    • September 08, 2019 5:31 PM | Christine Quatro Ott, DO
      Thank you Neal for, again, keeping us up to date on the reality of modern medicine. Thank you Charlie for passing it on, the benefits will multiply exponentially.
      Link  •  Reply
  • March 27, 2021 1:17 PM | Jane
    Do you mind if I quote a few of your posts as long as I provide credit and sources back to your website?

    My website is in the very same niche as yours and my
    visitors would definitely benefit from a lot
    of the information you present here. Please let
    me know if this alright with you. Many thanks!
    instant online payday loans https://cashadvanceopd.com
    Link  •  Reply
  • April 02, 2021 10:48 AM | Mireya
    Hello, i feel that i saw you visited my blog so i got here to go back the desire?.I'm attempting to in finding things to enhance my website!I guess
    its good enough to make use of a few of your ideas!!
    viagra Price https://viagrasildenafilok.com/
    Link  •  Reply
  • April 07, 2021 2:04 PM | Ines
    Do you have a spam problem on this website; I also am a blogger, and I was curious about your situation; we have created some nice practices and we
    are looking to exchange strategies with others, why not shoot me an e-mail
    if interested. dating app http://onlinedatingdd.com/
    Link  •  Reply
  • April 08, 2021 12:17 PM | Luella
    A fascinating discussion is definitely worth comment. I believe that
    you need to publish more on this topic, it might not
    be a taboo subject but usually folks don't discuss these subjects.
    To the next! All the best!! best dating web sites https://onlinedatingtind.com/
    Link  •  Reply
  • April 09, 2021 5:10 AM | Lowell
    Hi, Neat post. There is an issue together with your
    site in internet explorer, might test this? IE nonetheless is
    the market leader and a big portion of folks will
    omit your magnificent writing because of this problem.
    Senior Dating https://datingsitesww.com
    Link  •  Reply
  • April 26, 2021 12:27 PM | Mose
    Why viewers still make use of to read news papers when in this technological globe all is accessible on net?
    free online slots https://playcasinoww.com
    Link  •  Reply
  • April 27, 2021 8:20 AM | Juanita
    Awesome! Its truly awesome piece of writing, I have got much clear idea regarding from this post.
    real money casino https://onlinecasinogamespcx.com
    Link  •  Reply
  • April 27, 2021 11:01 AM | Refugio
    Hey! I could have sworn I've been to this site before but after checking through some of
    the post I realized it's new to me. Anyhow, I'm definitely
    delighted I found it and I'll be bookmarking and checking back frequently!
    world class casino slots https://casinogamesmv.com
    Link  •  Reply
  • April 27, 2021 6:36 PM | Lula
    Useful info. Fortunate me I found your site accidentally, and I am shocked why this twist
    of fate didn't happened earlier! I bookmarked it. best online
    casinos https://playcasinosw.com
    Link  •  Reply
  • April 27, 2021 9:36 PM | Terrence
    Do you have a spam problem on this website; I also am a blogger, and I was wondering
    your situation; we have developed some nice methods and we
    are looking to exchange methods with other folks, please
    shoot me an e-mail if interested. real casino slots https://onlinecasinofbk.com
    Link  •  Reply
  • April 27, 2021 11:16 PM | Frederic
    You could definitely see your enthusiasm in the work you write.
    The arena hopes for even more passionate writers such as you who are not afraid to mention how they believe.
    All the time follow your heart. play online casino https://casinorealmoneydwq.com
    Link  •  Reply
  • April 28, 2021 1:49 AM | Laura
    Howdy! Do you know if they make any plugins to assist with SEO?
    I'm trying to get my blog to rank for some targeted keywords but I'm not seeing very good gains.
    If you know of any please share. Thanks! Vegas Casino Slots https://casinogamesww.com
    Link  •  Reply
  • April 28, 2021 7:20 AM | Augustina
    Terrific post however , I was wondering if you
    could write a litte more on this topic? I'd be very grateful
    if you could elaborate a little bit more. Thanks! big fish casino https://onlinecasinoslotsui.com
    Link  •  Reply
  • April 28, 2021 12:11 PM | Elinor
    Great article, totally what I wanted to find. online casino bonus
    https://onlinecasinos911.com
    Link  •  Reply
  • April 29, 2021 5:52 AM | Faustino
    I've been exploring for a little bit for any high quality articles or blog posts in this
    sort of space . Exploring in Yahoo I ultimately stumbled
    upon this web site. Reading this info So i'm satisfied to convey
    that I have an incredibly good uncanny feeling I came upon just
    what I needed. I such a lot no doubt will make certain to don?t overlook this web
    site and give it a glance on a continuing basis.
    big fish casino https://casinoonlineslotsww.com
    Link  •  Reply
  • April 29, 2021 6:01 AM | Alphonse
    Howdy! Someone in my Facebook group shared this site
    with us so I came to look it over. I'm definitely loving the information. I'm book-marking and will be tweeting this to my followers!
    Superb blog and outstanding style and design. vegas slots
    online https://playslotsndx.com
    Link  •  Reply
  • April 29, 2021 11:35 AM | Muoi
    Thanks for finally writing about >WorldLink Medical - A Note From Neal: Hormones and Beyond 2019 <Liked it! online casino https://playcasinovivo.com
    Link  •  Reply
  • April 29, 2021 8:05 PM | Cornell
    What's up, this weekend is nice in favor of me, as this moment i
    am reading this great educational paragraph here at my house.
    Online Casino bonus https://casinogamesjkk.com
    Link  •  Reply
  • May 01, 2021 2:07 AM | Lanny
    Your style is unique compared to other folks I've read stuff
    from. Many thanks for posting when you've got the opportunity,
    Guess I will just book mark this page. free slots games https://playcasinostm.com
    Link  •  Reply
  • May 03, 2021 7:24 PM | Christa
    Right here is the perfect website for everyone who wishes to find out
    about this topic. You know a whole lot its almost tough to argue with you (not
    that I actually would want to…HaHa). You definitely put a
    new spin on a subject that's been discussed for a long time.
    Excellent stuff, just great! how to check credit score for free https://creditreportsww.com
    Link  •  Reply
  • May 04, 2021 6:15 AM | Bobby
    Very good info. Lucky me I recently found your site by
    chance (stumbleupon). I have bookmarked it for later! free credit reports and scores https://creditscorecheckn.com
    Link  •  Reply
  • May 04, 2021 6:33 AM | Charolette
    Thanks in support of sharing such a fastidious opinion,
    post is good, thats why i have read it completely how to check credit score https://creditscoresetf.com
    Link  •  Reply
  • May 04, 2021 6:55 AM | Manuela
    Everyone loves what you guys tend to be up too.
    This kind of clever work and exposure! Keep up the
    excellent works guys I've incorporated you guys to our blogroll.
    annual credit report official site https://creditreportsps.com
    Link  •  Reply
  • May 04, 2021 4:36 PM | Marylyn
    I love it when folks get together and share views. Great site, stick with it!
    how to check credit scores https://freecreditreportww.com
    Link  •  Reply
  • May 04, 2021 4:58 PM | Gilda
    There's certainly a great deal to find out about this subject.

    I love all the points you've made. credit report score
    https://creditreportuss.com
    Link  •  Reply
  • May 04, 2021 10:15 PM | Lyndon
    My brother suggested I would possibly like this website. He was totally
    right. This submit actually made my day. You can not believe just how much time I had spent for this info!
    Thank you! free credit reports online https://fastcheckcreditscore.com
    Link  •  Reply
  • May 05, 2021 2:22 AM | Lynwood
    Superb, what a blog it is! This web site gives
    useful data to us, keep it up. triple credit report https://creditscoresws.com
    Link  •  Reply
  • May 05, 2021 4:34 AM | Stuart
    Hello there, I think your site may be having browser compatibility issues.
    Whenever I look at your web site in Safari, it looks fine however, when opening in IE, it's got some overlapping issues.
    I simply wanted to give you a quick heads up! Other than that, wonderful blog!
    credit report services https://creditscorechecknw.com
    Link  •  Reply
  • May 07, 2021 9:11 AM | Armand
    Thank you a lot for sharing this with all of us you really realize what you are speaking approximately!
    Bookmarked. Kindly additionally talk over with my web site =).

    We can have a hyperlink change arrangement between us online payday
    https://fastloanandpayday.com
    Link  •  Reply
  • May 07, 2021 8:41 PM | Rob
    I like the helpful info you supply to your articles.

    I'll bookmark your blog and test once more right here frequently.

    I'm relatively certain I'll learn many new stuff
    proper right here! Good luck for the following! Online Loan https://instantloansapp.com
    Link  •  Reply
  • May 08, 2021 1:26 PM | Maricela
    Hi to every one, for the reason that I am truly keen of reading this website's post
    to be updated regularly. It carries good material.
    online casino games https://onlinecasinosam.com
    Link  •  Reply
  • May 08, 2021 5:10 PM | Marissa
    I am truly pleased to glance at this web site posts which includes tons of valuable
    data, thanks for providing such statistics. vegas casino slots https://playcasinoslotsmatic.com
    Link  •  Reply
  • May 08, 2021 5:59 PM | Rich
    Thankfulness to my father who stated to me
    about this web site, this website is really remarkable.
    world class casino slots https://casinorealmoneybigbet.com
    Link  •  Reply
  • May 09, 2021 5:18 AM | Kelley
    Undeniably believe that which you said. Your favorite justification seemed to be on the internet the easiest thing to be aware of.
    I say to you, I definitely get annoyed while people consider worries that they
    plainly do not know about. You managed to hit the nail upon the top as well as defined out the whole thing without having side effect , people can take a signal.

    Will likely be back to get more. Thanks online casino https://casinorealmoneyai.com
    Link  •  Reply
  • May 09, 2021 5:52 AM | Jocelyn
    You ought to be a part of a contest for one of the most useful websites
    online. I'm going to highly recommend this web site!

    slots games free https://playcasinogamescast.com
    Link  •  Reply
  • May 09, 2021 10:50 AM | Maxwell
    Excellent blog post. I certainly love this site. Keep it up!
    play casino https://casinoslotsms.com
    Link  •  Reply
  • May 09, 2021 11:53 AM | Bradley
    Why people still use to read news papers when in this
    technological globe all is existing on web? free casino https://freecasinoslotsmatic.com
    Link  •  Reply
  • May 11, 2021 11:45 PM | Myrna
    I'm really impressed with your writing skills and also with the layout
    on your weblog. Is this a paid theme or did you
    customize it yourself? Either way keep up the nice quality writing,
    it's rare to see a nice blog like this one today.
    my credit scoring https://creditscoresids.com
    Link  •  Reply
  • May 20, 2021 4:58 AM | Alena
    I've been surfing online more than 3 hours today, yet I never found any
    interesting article like yours. It is pretty worth enough for
    me. In my view, if all webmasters and bloggers made good content as you did, the web will be a lot
    more useful than ever before. argumentative essay https://essaywritermsm.com
    Link  •  Reply
  • May 20, 2021 7:21 AM | Kennith
    Hi there friends, its enormous paragraph regarding educationand fully explained, keep it up all
    the time. write my essay https://essaywritingeie.com
    Link  •  Reply
  • May 20, 2021 9:05 AM | Jerri
    I have read so many articles or reviews about the blogger lovers however
    this article is genuinely a pleasant post, keep it up.

    paper writer https://collegeessaylke.com
    Link  •  Reply
  • June 01, 2021 3:15 PM | Noelia
    Everyone loves it when people come together and share
    thoughts. Great blog, stick with it! edit My Essay https://paperwriterkjd.com
    Link  •  Reply
  • June 02, 2021 11:56 PM | Celsa
    I'm really enjoying the theme/design of your web site. Do you ever run into any internet browser compatibility issues?
    A few of my blog audience have complained about my site not operating correctly in Explorer but looks great
    in Chrome. Do you have any advice to help fix this issue?
    cashman casino slots https://casinorealmoneyeyu.com
    Link  •  Reply
  • June 03, 2021 3:09 AM | Elke
    This design is incredible! You definitely know how to keep a
    reader entertained. Between your wit and your
    videos, I was almost moved to start my own blog (well, almost...HaHa!) Excellent job.
    I really enjoyed what you had to say, and more than that, how you presented it.
    Too cool! online casino games https://casinogamesejk.com
    Link  •  Reply
  • August 07, 2021 5:51 PM | Arlen
    Дом Гуччи смотреть онлайн
    Link  •  Reply
  • August 10, 2021 1:04 PM | Florian
    Дом Гуччи смотреть онлайн фильм
    Link  •  Reply

Join the Interest List

Get emails on the latest news, updates, blog posts, webinars, quizzes and an abundance of information surrounding preventive and innovative medicine.

Contact Us

Phone: (888) 222-2966

Accredited by: 




Address:

669 W 900 N
North Salt Lake, UT 84054

  © Copyright 2019 WorldLink Medical | Advisory Board  Privacy Contact 


Powered by Wild Apricot. Try our all-in-one platform for easy membership management