Saturday, April 30, 2016

Update on Tubby Theory from Topeka 2008 to 2016

8 years later

A friend asks me:

"You have been talking about Coronary Calcium Score for a long time. Were you ahead of your colleagues, or in step? Is the Ultra Sound of ..."
07:52 AM - 29 Apr 16




I wrote the book The Tubby Theory from Topeka after I passed the lipid boards and Tim Russert died.
No one in NLA spoke on National media that his non-HDLc was not treated to goal.

I guess they were afraid of being sued.
I thus wrote a book about treating patients in my practice aggressively.
I used the teachings of my mentors at NLA.
I quote them (my mentors) throughout my book.

My only originality was to call non-HDLc the Tubby Factor because patients and physicians could not remember "non-HDL cholesterol" nor how to calculate it. 
I called it the Tubby factor because non-HDLc is usually discordant with LDLc in patients with metabolic syndrome.

Since my book in 2008 I have been gratified to see that CAC and CIMT have proven themselves as significant and independent risk predictors for CVD.
New AHA/ACA guidelines in 2013 by Stone use CAC or CIMT in low risk patients to determine if statins should be started or not.
Niacin is under attack as being a dangerous drug which I believe is just silly.  If low dose wax matrix niacin 1,000 mg/d is used with low dose lipitor 20 mg/d early in the disease of sub-clinical atherosclerosis for long term treatment I believe we can prevent most CVD.

I am very proud of my book and still stand by it. 
Even the low fat diet I suggest might be suitable for some folks who are insulin sensitive and hyper-absorbers of cholesterol.

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