In this episode of the Smarter Not Harder Podcast, Dr. Elizabeth Yurth and Dr. Abid Husain give us one-cent solutions to life’s $64,000 questions that include:

• What are the clinical concerns surrounding the overuse of statins, and how might current prescribing practices be reconsidered?

• How do alternative approaches to ACL reconstruction and joint replacement challenge conventional orthopedic treatments?

• Why is improving health span prioritized over extending lifespan, and how does this shift influence treatment strategies?

• What advancements in cardiovascular screening are emerging, and how can they improve early detection and disease prevention?

Who are Dr. Elizabeth Yurth and Dr. Abid Husain?

What did Dr. Elizabeth, Dr. Abid, and Dr. Scott discuss?

00:00 Why Statins Are Overprescribed: A Closer Look  
01:08 Meet the Longevity Docs: Dr. Yurth & Dr. Husain  
01:24 Longevity Docs Community: Collaboration Over Competition  
04:09 Real Debates That Change Practice  
07:33 Innovations in Longevity Clinics: What They’re Doing Differently  
13:11 Inside the HOMeHOPe Symposium: What to Expect in Boulder  
18:40 ACL Surgery, Joint Degeneration, and Healthspan Realities  
19:53 The Truth About Joint Replacements and Conventional Care  
20:54 Personal Stories That Shift Medical Thinking  
21:42 Why We Need Better Cardiovascular Screening  
24:04 New Tools That Detect Heart Disease Early  
31:20 Collaboration Is the Future of Longevity Medicine  
32:48 Final Thoughts + HOMeHOPe Symposium Details

Full Transcript:

 
[00:00:00] Abid Husain: There has been overtreatment or overuse of statins over the years. Mm-hmm. You know, lowering cholesterol is important, but we've been overtreating the population when it comes to lowering cholesterol. We've done a disservice to the, to the general public by just thinking that there, that there is one way to treat this, this very complex disease.

[00:00:20] Abid Husain: It's our job to gain their trust back and we've gotta give them evidence and alternatives. As to why and when they should be using certain medications instead of just a blind approach to just treating everybody because a number. 

[00:00:34] Dr. Scott Sherr: Yeah, like just getting your LDL to zero. That's, that's the goal. It's like LDL zero, that's the cardiology goal right now.

[00:00:39] Dr. Scott Sherr: I feel like sometimes 

[00:00:40] Abid Husain: this is perfect. Great lipids. It's a complex process and so, and it takes, you know, the reason why it's not. Being looked at this way is because it takes a lot of interpretation and handholding and, uh, you know, the, the current healthcare system doesn't allow for that.

[00:01:08] Dr. Scott Sherr: All right, avid, Betsy. How are you guys doing today? 

[00:01:11] Elizabeth Yurth: Great. Thank you Scott. Thanks for having us today. 

[00:01:14] Dr. Scott Sherr: This is, it's so good to have you both. Uh, I don't often do podcasts where I have more than one person. But you guys are, we're a collaborative group, right? That's what we do. Yeah. We're team on a regular basis.

[00:01:23] Dr. Scott Sherr: Yes. All of us. Right. And, and, uh, the first topic that I wanna talk about today was around actually collaboration and Betsy, before we got started rolling. Like the three of us are a part of a group called Longevity Docs. I think this only started maybe about a year and a half ago, uh, with, yeah, not 

[00:01:38] Elizabeth Yurth: long ago.

[00:01:39] Elizabeth Yurth: Right? Not long ago. And there's over grown from, I, I was like one of the first five people in it and now it's 250 people, you know? 

[00:01:46] Dr. Scott Sherr: Yeah. And all over the world, right. With all different types of, all in the world. Yeah. Especially. What have you guys felt have been like really great about this community so far, like, as being a part of it?

[00:01:56] Dr. Scott Sherr: Betsy, you wanna start and then maybe Abbi can go, I'll 

[00:01:58] Elizabeth Yurth: start. And then Abba kind of, because he joined a little bit later than I did, so he's kind of seen it, you know, emerge too. So basically, uh, Dr. David Liu, who is a previous cardiologist in his previous life, but now actually P pediatric cardiologist, but now he does more, uh.

[00:02:14] Elizabeth Yurth: Investing in businesses, starting businesses. So he kind of recognized the need to start bringing people, like all of us who are all sort of living in this little isolated world. Right. I think probably the, one of the biggest frustrations in what we do is that we're a little bit isolated. You know? I mean, I'm really fortunate that AB and I now work together, but that's only since January before it was me.

[00:02:33] Elizabeth Yurth: And everybody's got these little individual practices and people, you know, you go to lectures and you listen to people talk about what they're doing, but people aren't really working together that much. And so Dr. Lou really saw a need for bringing all. All of these people together. And so it was about five docs he initially asked to join and then it, it, it just has kept growing.

[00:02:52] Elizabeth Yurth: And now we have not only physicians, but you know, entrepreneurs, people from the tech world bringing in new [00:03:00] technology, people from the laboratory world, bringing in new lab work, and we all actually converge. We have this WhatsApp group that, you know, people are. Putting in a billion messages a day. We have these meetings that people are all really kind of trying to support each other, work together, see what's going on in everybody's lives, in everybody's worlds, what's going well, what's going not, because there's been never a place you could do that before.

[00:03:23] Elizabeth Yurth: Yeah. 

[00:03:25] Abid Husain: I think it's, uh, what I've really appreciated and, and enjoyed watching how it's been fleshed out and developed is just, there's a, there's a magic that happens when we put together all of these really intelligent practitioners and allow everybody to have a dialogue. No one, you know, no one's got, uh, a, you know, a dogmatic approach.

[00:03:46] Abid Husain: And if they do, they at least keep it to themselves. It doesn't become confrontational. But, uh, not usually. At least sometimes. Yeah, as you know, but it's a place where everybody gets in and share ideas and it becomes a, a much more, uh, I mean there, there's a magic that happens when you put really smart people in a room together and just let them, you know, work things out.

[00:04:09] Dr. Scott Sherr: Yeah, I know Betsy, you were talking about how you were at a recent longevity conference and some of the variations in ideas and having like very constructive discussions about certain topics was really cool for you. 

[00:04:21] Elizabeth Yurth: It was really, actually we, it was funny because there in our WhatsApp group there was this argument going on, uh, about oral estrogen versus transdermal estrogen, oral progesterone versus vaginal progesterone.

[00:04:36] Elizabeth Yurth: And these and, and very prominent doctors kind of discussing this. And I said to David, I go, oh, you need to put these, you know, particularly these two particularly, who were very verbal. I said, put them up on a panel together. I wanna hear them just hash it out on a panel. And he's like, oh, great idea. And then oddly, he threw me on the panel too, which I didn't, I, I didn't wanna be a part of the controversy, but, but it was good.

[00:04:55] Elizabeth Yurth: Um, so he used, say, put the three of us, and then he a very good moderator and we actually kind of panned out, you know, because, you know, one of the doctors, Dr. Coate, she only believes in trans, you know, transvaginal progesterone and others of us like, no, you need oral progesterone. And it was interesting that.

[00:05:12] Elizabeth Yurth: To understand that, you know, there's not a right or a wrong opinion, right? And to be able to sit there in a group setting where everybody's listening to this discussion going on, and then people can sort of formulate their own opinions. Usually you have one lecture up there giving you their opinion. I mean, I don't care how much scientific evidence people present to you when you're giving a le, you know, when they're up there giving a lecture, it is still their bias.

[00:05:35] Elizabeth Yurth: Right. And so how do we eliminate that? Or at least let people, judge, is to put people with different biases together. Let them talk about their science, the science, the science. 'cause there is science behind it all. And so then you can start to sort of formulate an opinion. So it was a really, I, I loved it.

[00:05:52] Elizabeth Yurth: Um, it didn't, you know, it, it got a little heated, but not too bad. And, you know, and it was, I think, you know, people said this was the, the best panel they'd seen because they [00:06:00] actually saw some valid discussion about things. 

[00:06:02] Hmm. 

[00:06:03] Elizabeth Yurth: Right. Yeah. That's, I think, you know, Abba, you know, like putting you on stage with somebody who is a big believer that the entire thing about cholesterol is to lower lipids down, to get a, you know, a cholesterol level down to 140 instead of just listening to that person talk.

[00:06:19] Elizabeth Yurth: And I'm like, okay, well yeah, they have a lot of science and I listen to you talk. I'm like, well, he has a lot of science. I would love to see you on stage together. Right. With so those people and, and you know, and on stage you can't get too mean. But they, but they can, I can then form an opinion on my own.

[00:06:34] Elizabeth Yurth: Right. Exactly. 

[00:06:35] Abid Husain: Yeah. Yeah. I, I, that's 1, 1 1 things I enjoy about the panel discussions. Uh, you know, there's a good right way of, uh, of getting that, that dialogue going. Yeah, that dialogue going. I, I mean, one, one of the things that I also appreciate about the conference is the, the industry leaders and what is happening in the leading front of the longevity industry is gonna show up at this conference because they have some eye and somewhat test, or they have some technology that they wanna roll out, and it's a great.

[00:07:06] Abid Husain: Environment for us to really look at this critically, uh, talk to the, to the company and see what they're testing. Uh, and oftentimes they're getting up on stage to try and to tell us about mm-hmm. What's happening too. What, what they're presenting. So we, we get to really get a much deeper understanding of what the, of the, uh, technology is and, and get it firsthand.

[00:07:28] Abid Husain: So our, you know, we have a much more informed. Uh, talk about 

[00:07:32] Dr. Scott Sherr: it. Yeah. What I love about the group, and I think kinda jumps into my next question, is that most of the people there, although it's kind of widening as you mentioned with other people, but in general, most of them are clinicians. So they are seeing patients on a regular basis and they have like real time feedback.

[00:07:49] Dr. Scott Sherr: Using various technologies, using various therapies and seeing what's happening. So if they're using GLP ones, for example, and they're doing it in certain populations, they'll, they can report back like, and somebody like you or I, any of us can say, Hey, I just have this patient that has this particular issue, and then all of a sudden there's like 75 messages about how to potentially look at this, which can be overwhelming, but in that capacity.

[00:08:11] Dr. Scott Sherr: Betsy, I know you're very active on there. Overall, is there anything that you guys can think of, like anything that's been in there that has been kind of revelatory for you or something that you've started using in your clinical practice? Anything that's changed your practice at all recently? 

[00:08:24] Elizabeth Yurth: That's tough 'cause I do feel like I'm, I'm trying research a lot of stuff and I'm a little ahead of the curve on most things anyway.

[00:08:29] Elizabeth Yurth: It's a lot of stuff that comes up, you know, oftentimes I, I've either heard of and said I'm not really impressed. I, I do love though, for instance, just. Today maybe it was, there was a discussion about somebody asking for tests, a company that just looked at senescent cell markers, right? And, and people threw out these different companies and, and their, their clinical use of them.

[00:08:54] Elizabeth Yurth: And what value they had been and, and, and then discussion back saying, [00:09:00] okay, well what did you actually do differently with those values? Right. And I loved, one of the docs came back, he said, he said, you know, oftentimes, you know, he goes, he goes, I'm a pilot, he said, and there's this old adage. To pilots that if you're looking too much at the gauges, you're gonna crash into the mountain.

[00:09:16] Elizabeth Yurth: And I think we get so guilty of that, right? People all love these fancy tests, so it's kind of nice to hear these people who are using it and then be able to say, okay, great. You love your fancy test. I want you to tell me I. You could actually be pretty, you know, vocal in these groups. And I said, I want you to tell me what you changed because you ran that test.

[00:09:35] Elizabeth Yurth: You know? Um, because I think we, we get so into testing and for the most part, we don't need a massive amount of expensive tests. We need to look at our good basic tests with a good scientific understanding of what. Knobs and levers we can turn with those. And that's gonna come down to the primary focus of where we're gonna be treating patients.

[00:09:58] Elizabeth Yurth: But I agree with you. I love that this is, you know, I, and I've seen this over and over again, where some really cool thing comes to market, right? And it's like, oh my God, this is the cast meow. This is gonna be the cure-all to everything. And they start implementing your practice and you're like, what? That did not budge one parameter.

[00:10:14] Elizabeth Yurth: No, my patients never felt better on it. And so now if I have a group of 250 doctors. I say that, um, I think like we were, we were just talking about a product for the Glycocalyx. Yeah. And you know, and they were talking about, you know, a product and said, okay, now I've got two 50 doctors, maybe 50 of 'em are using this product.

[00:10:34] Elizabeth Yurth: How did any of you see a result? If nobody did, probably that product's not great. 

[00:10:40] Abid Husain: Yeah, yeah. To, to piggyback off of that, that was, you know, that was one of the examples that came to mind. You know, this is a, we know that the glycocalyx is an important aspect of vascular health. You know, that's science. Is not getting, being debated here, but what, what do we do about it and what's the clinical implications?

[00:11:00] Abid Husain: We, we still don't know enough to know how often we should be testing it, what the best ways to test it are. And then, you know, and then we're giving a supplement for this kind of random, expensive supplement for this. Yeah, it's right. It's not cheap. And, and so, you know, you know, there's some claims that, oh, patients do really well with it and I have people on it all, all the time.

[00:11:19] Abid Husain: Alright, so what. Tell me what are the outcomes that you got outta it? Is, is there something tangible and something that's re testable or reproducible? And then, you know, people that do have the ability to test it will chime in and say, well, you know what? I've tried these and they didn't do much. They didn't change the testing, so I don't, I I'm not using them as, you know.

[00:11:38] Abid Husain: So it, it gives us a really wide, uh, informed, uh, population of, uh, practitioners to really make a decision at 

[00:11:46] Elizabeth Yurth: where else can you go for that? Right? Where you got 250 docs and you throw in, how many of you guys have used this product and what have you seen? Right, because you're, you're usually not getting that.

[00:11:55] Elizabeth Yurth: You're getting the company telling you, look, we have a study that showed two 50 patients did really [00:12:00] well. But if I have 200 doctors who say, nah, I had one patient who did well, then I, that's a lot more evidence to me. So where else can you go for that? Nowhere. 

[00:12:08] Dr. Scott Sherr: No, nowhere. Because like, we're also siloed in general, as you said, you guys are working together in the same office, but now you have these 250 docs that are working.

[00:12:15] Dr. Scott Sherr: Separately, but they have at least a venue to work on all these things together. Yeah. And with different, talk about different populations 

[00:12:20] Elizabeth Yurth: and different environments so we can really get this wide base, that's so clinically important. Right. It's, you know, you look at all these doctors who are doing something and thinking maybe it's working and, you know, and to get the evidence from other people, either justification that what you're doing seems to be working for most people Sure.

[00:12:38] Elizabeth Yurth: Or not, is really valuable. 

[00:12:40] Dr. Scott Sherr: Yeah. I, I love when somebody like. Brings up a topic and Betsy's like, I tried that five years ago. Don't, it doesn't work. It's funny 

[00:12:49] Elizabeth Yurth: that I've, you know, I've been in this world now a long time. I mean, I was at a four M when there was 200 people there. Right now it's 5,000 people.

[00:12:56] Elizabeth Yurth: So I got my certification in longevity medicine now 25 years ago. And so I've seen so much that like. Came and then went and keeps re it keeps raising its head again. Right. 

[00:13:09] Dr. Scott Sherr: Yeah. I love it. I love it. So, I mean, you guys are both gonna be coming. Oh, actually, you don't have to travel anywhere October 17th and 18th Yeah.

[00:13:17] Dr. Scott Sherr: To 

[00:13:17] Elizabeth Yurth: travel 

[00:13:18] Dr. Scott Sherr: and, and so our nonprofit. That that runs this podcast, it's called Health Optimization Medicine and Practice. Mm-hmm. And we're a nonprofit that we train practitioners on how to optimize health. It's more focused on the health optimization aspect of things and not sort of the interventional things that you guys are both doing.

[00:13:32] Dr. Scott Sherr: But I'm really excited for have to have you both here because it all goes together. When we're looking at working with people, we're looking at top down approaches, looking at bottom up approaches and everything in between. And so on. October 17th, 18th in at Chatauqua, we're gonna have a two day conference where you're both gonna be speaking and I'm really excited, number one, that you don't have to travel because I know we all have to travel for conferences all the time.

[00:13:53] Dr. Scott Sherr: I don't have to travel for a conference. That's really exciting as well. Um, because. We're all traveling all the time. But, uh, Betsy, what are you thinking about speaking about at the conference and where do you think that the largest impacts that you see in some of the work that you do on a regular basis is at the moment?

[00:14:08] Elizabeth Yurth: So, first of all, let me tell you guys, if you're not coming to this conference and you've never been to Boulder Chatauqua in October, it is honestly magical. It is such a beautiful venue. I mean, you're right there. The. You know, stock was built many years ago in the 18 hundreds, and, and it's, it's, and there's these incredible buildings all surrounded by the flatirons and the colors in October are incredible.

[00:14:33] Elizabeth Yurth: Honestly, it is worth coming, even if you have no interest in the conference. Just to see. To see it, and then, and then I think you'll learn a lot too. Also, lemme put a plug in for home Hope I had the opportunity to go to one of your conferences in Vegas and I do love, I, it's one of my, I love high tech things and talking about that, but, but you know, a lot of things really come down to some very, very basics, right?

[00:14:53] Elizabeth Yurth: Yeah. If you look at health, health optimization, I'm doing a quantum biology certification right now and going back to white and, [00:15:00] you know, and circadian rhythms and you know, and those pieces of our health that are. Paramount and still neglected a lot. So a plug for you guys for what you're doing and just your education and, and kind of this, the way you're looking at things.

[00:15:15] Elizabeth Yurth: And for this conference, which you guys, I think if you miss it, you'll be very sad. I'm hoping to talk a little bit. So my background is orthopedics. I spent 30 years in the orthopedic world. I still do a lot of regenerative orthopedics. I left the orthopedic world. One of, one of my partners came to me and said, you know, you gotta stop.

[00:15:32] Elizabeth Yurth: Doing lab tests. 'cause it's not what we do here. We don't do medicine, we do orthopedics. I was like, okay. Apparently we have a big dichotomy here, but I, but I was in practice with, you know, a, a, a group for a long time and then finally five years ago. So I did both practices for 20 years and then I, five years ago I just brought my regenerative orthopedics here and now I treat people more holistically and, and so my talk is actually on one of the big things we are neglecting.

[00:16:00] Elizabeth Yurth: All this health optimization in, in, in making sure our brains work wonderfully and our metabolic systems are in perfect control and that our, our hearts are perfect, is we're forgetting that joints wear out and joints wear out, you know? When they wear out and they become painful, people don't want to live anymore.

[00:16:19] Elizabeth Yurth: So if we want to extend health span, we have to focus on what's going on in joints and some of it overlaps. There's a big overlap. Interesting. Between joint health and cardiac health, the same. The same cytokines are elevated, interleukin one beta's elevated, and cardiac health and in joint problems. So there's a lot of overlap there, but people forget.

[00:16:37] Elizabeth Yurth: It's an inflammatory disease. We also are completely and utterly neglecting acute injuries. Hmm. And treating them appropriately so they do not develop into progressive arthritis. And so I'm gonna give you guys a whole paradigm of how to treat acute injuries so that, so that we are not seeing this rash of an escalating number of people with osteoarthritis.

[00:16:59] Elizabeth Yurth: I want to give a whole new understanding of how to treat an acute injury. So some very basic things that, that anybody can do to treat an acute injury so that we prevent this really epidemic of, of joint problems. And then a little bit of what we can do once the joint problems are there too. 

[00:17:16] Dr. Scott Sherr: I, I need to have a little bit of a foreshadowing to understand what your framework is here for us, Dr.

[00:17:21] Dr. Scott Sherr: U about. Injury, the acute injury prevention. Are there some like tips and tricks or things that, like a framework? So tips are everything 

[00:17:28] Elizabeth Yurth: you're doing is probably wrong. Yes. Um, rest is wrong. Ice is wrong. Compression's probably okay. Elevation Somewhat. Okay. But you know, icing and acute injury is the exact opposite of what you should do to acute injury.

[00:17:41] Elizabeth Yurth: Right. So the whole rice protocol, even the guy who invented the rice protocol said, actually I was wrong. Uh, you know, and it's still like, it's what everybody's taught, retrains taught, right? So if you ice and take your anti-inflammatories in the first three days after an injury, you've actually completely started the progress of making that injury become a chronic problem.

[00:17:58] Elizabeth Yurth: So we have to start in that [00:18:00] right after an injury. It's gonna be actually motion, it's gonna be, uh, adjusting. So we have the inflammation at the right time. So I'm gonna give you some tools that can do that. And then, and, and then sort of a, sort of a protocol, a basic protocol that this. Acute injury does not become a chronic problem.

[00:18:17] Elizabeth Yurth: 'cause chronic joint problems are a combination of both the acute event, but also your genetics and your inflammatory markers. So we need to look at all that piece. I'm gonna just teach you guys that this is an immune disease, so this is an immune mediated disease, so we have to treat it as such. So honestly everything, even osteoarthritis, right?

[00:18:34] Elizabeth Yurth: We're not even 

[00:18:34] Dr. Scott Sherr: talking about rheumatoid or anything like that. You're talking about pure arthritis. 

[00:18:37] Elizabeth Yurth: What everybody has wear tear joint problems, right? Right. So if you go and you get an ACL reconstructions, I've had four of 'em. So if you have ACL reconstruction, you know, you're like, okay, fit great. They fix my ACL, I'm all good.

[00:18:48] Elizabeth Yurth: No 80% of people with ACL reconstruction or going to develop severe osteoarthritis by 50. Right. So we're doing something wrong. Yes. You fixed the ACL, it didn't fix the problem. So we have to understand what should we do differently to help these people? Right? And for those of us who, like me, who are too late, I have already horrible arthritis, there's still things I can do to modulate my immune system.

[00:19:07] Elizabeth Yurth: So my arthritis is, is not an inflammatory state. It's not gonna progress. And I'm, I'm going to go along just fine. I mean, I watched my dad become debilitated by osteoarthritis. He was a really vital, healthy guy who could climb Fourteeners at 80, but you know, he, he got debilitated by arthritis and we, that's not what any of us want to spend our years dealing with.

[00:19:27] Dr. Scott Sherr: Yeah. You're so right that we forget about. The morbidity aspect of things, right? We of course, like there's longevity docs, longevity, longevity, longevity. We always talk about this, but, but, but if you have 20 years of extra life, but that's crappy life, like what's the use? Right? And so living longer has to, I think 

[00:19:43] Elizabeth Yurth: we all talk that, right?

[00:19:44] Elizabeth Yurth: We all talk, health span's important. Like I don't wanna live with my heart disease and things like that, but it's forgotten that joints are, the joints are forgotten. Big piece of that, right? Yeah. Yeah. You don't ever hear any of these doctors talking about joints and if they, they just think you can replace them.

[00:19:57] Elizabeth Yurth: Yeah. Yeah. Replace them. Yeah. And that's actually not a cure, you know? Um Right. 

[00:20:02] Dr. Scott Sherr: Like all the hips, hips done and need a new hip. Right. Or it's like, that's 

[00:20:05] Elizabeth Yurth: like saying like, to, to abed. Um, you know, that he would just say to his patients who came in with atherosclerosis, you know what, we'll do a stent when you're ready.

[00:20:13] Elizabeth Yurth: It's okay. We don't need to do anything for you now. You know? Or we'll do a transplant when you, I love that your heart fails. That's to do with joints. Hey, yeah. 20 years 

[00:20:21] Abid Husain: ago. Yeah, 

[00:20:23] Dr. Scott Sherr: that's great. I mean, that's a great analogy, Betsy. I, I think that's a fan. I hadn't really thought about that. Like, you don't, you don't like tell a heart patient that, oh, we're just gonna wait for a stent to go in before we do anything.

[00:20:32] Dr. Scott Sherr: Right, right. Like, that's what we're saying with joints at this point. Right. So, right. Exactly. From a conventional perspective, there's very little that's being done on the regeneration side. 

[00:20:39] Elizabeth Yurth: Yeah. It will be done steroids, which make things worse. The treatments are all actually inappropriate. And so I'll present some data on that, like actually what's happening when you're taking anti-inflammatory drugs, when you're doing steroids, when you're doing that, you know, visco supplements, what is, what are you actually doing?

[00:20:51] Elizabeth Yurth: Because the data is pretty. Compelling that you were having a bad effect's? Not good. Well, I mean, 

[00:20:54] Dr. Scott Sherr: one thing that comes to mind, you're talking about your dad. I was thinking about mine, like when I would get like an ankle sprain, like a nasty ankle [00:21:00] sprain when I was a kid. What he would do, I'm just interested if this is actually good or not.

[00:21:04] Dr. Scott Sherr: Like he would take, he would basically manually take out all of the swelling from my ankle and actually my foot would turn black and blue, but my ankle wasn't swollen and he would just basically move the stuff instead of like, he would like, he's a chiropractor. Yeah. Look. 

[00:21:16] Elizabeth Yurth: Right. Exactly. Like, yeah, you work on that.

[00:21:18] Elizabeth Yurth: You actually want that inflammation for the first three days. And then we wanna use some very subtle techniques to bring it down. So, you know, so yeah, we're just, we're like, immediately when you have an injury, ice it, uh, stop moving it and take a bunch of anti-inflammatories all wrong. 

[00:21:32] Dr. Scott Sherr: Yeah. And that's all setting us up for a chronic, for chronic issue with that joint over time for chronic condition.

[00:21:36] Dr. Scott Sherr: Yeah. 

[00:21:36] Elizabeth Yurth: Right. 

[00:21:36] Dr. Scott Sherr: Is that why my ankles make so much noise? Okay. Anyway, that's a, that's a, uh, so that's awesome. Abed. So tell us a little bit about what you're thinking about, uh, you presenting and speaking about at the conference. 

[00:21:47] Abid Husain: Uh, Betsy's gonna be talking about morbidity, I'm talking about mortality. Um, so, you know, 

[00:21:54] Dr. Scott Sherr: perfect.

[00:21:55] Dr. Scott Sherr: Yeah. Perfect combination. Yeah. 

[00:21:56] Abid Husain: So the number one cause of death globally is cardiovascular disease, and the largest chunk of that are the people that never make it to the hospital. People that still may get missed. They, they, they don't get screened. And, you know, we spend all of this time and energy screening for colon cancer, breast cancer, for all these different types of, uh, slowly developing or sometimes not slowly developing, but the, these, these, these types of conditions.

[00:22:25] Abid Husain: And we have tools to screen for the number one killer in mankind. And we're still not using it appropriately. You know, to be fair, these tools are now, are, are available now within the past five years, but they have not been in the past. And so, you know, my, my talk is about getting the word out about how to screen people appropriately and to really push that everybody needs to get screened.

[00:22:50] Abid Husain: It doesn't matter whether you have a family history of heart disease or you know, you're, you're or you don't have a family history. Sure. And, uh, you know, everybody, we all live in a more toxic environment. We all are susceptible to this, and if unless we get screened the right way, it's gonna get missed.

[00:23:10] Abid Husain: And it, it has been in the past, you know, the, the, the myopic approach of just looking at LDLs or looking at. One biomarker, maybe two, is not going to, is not gonna do it. It, it takes multiple disciplines, multiple types of data, and it takes understanding how to interpret and put that data together to really be able to, to isolate who's at risk and who isn't.

[00:23:37] Abid Husain: And then, you know, the, so if we can identify the person that might have that sudden heart attack, then we've saved a life. That's the first thing. And then we can use that same data, that same information to really determine who needs aggressive, uh, medical management and who does it too. So, you know, if we are looking, looking at how to, how to [00:24:00] prevent heart disease, um, you know, I, I think that, uh.

[00:24:04] Abid Husain: There has been overtreatment or overuse of statins over the years. 

[00:24:08] Mm-hmm. You know, 

[00:24:09] Abid Husain: lowering cholesterol is important, but we've been overtreating the population when it comes to lowering cholesterol and to be able to target the, the right population that needs that done, then, you know, we can. We, we, we can use these tests, these biomarkers to really isolate that population.

[00:24:27] Abid Husain: You know, I think that, uh, we've done a disservice to the, to the general public by just thinking that there, that there's one way to treat this, this very complex disease, and, you know, it's gonna, I think it's our job to gain their trust back and we've gotta give them evidence and alternative. As to why and when they should be using certain medications instead of just a blind approach to just treating everybody because of numbers.

[00:24:55] Dr. Scott Sherr: Yeah, like just getting your LDL to zero. That's, that's the goal. It's like LDL zero, that's the cardiology goal right now. I feel like sometimes. Right. This 

[00:25:02] Abid Husain: is perfect. You have great lipids. It's a complex process, and so, and it takes, you know, the reason why it's not being looked at this way is because it takes a lot of interpretation and handholding and, uh, you know, the, the current healthcare system doesn't allow for that.

[00:25:17] Dr. Scott Sherr: Yeah. So this is great. One thing, Abba, I hope you could maybe just give us an overview, is some of the newer screening that you're using and some of the things that maybe you'll present. I know some of this is diagnostics from like a imaging perspective, but others is other types of laboratory testing too.

[00:25:30] Dr. Scott Sherr: It's not just looking at the images, but there's other aspects of this too, right? 

[00:25:34] Abid Husain: Yeah, yeah. We, we, well, we can look at the specifics, uh, the specific types of LDLs that are being produced, and that gives us an indication of, of metabolic health because when our metabolism goes off, the LDLs change, change is the composition of them, and they become more prone to causing plaque.

[00:25:53] Abid Husain: So if we look at some of the specific markers, like the size of the LDL, the particle numbers, then that gives me an idea. Combine that with inflammatory markers. Uh, and, and these don't have to be, you know, really expensive panels. We can get a lot of information with some basic lab testing, look at some ratios and, and put a couple of things together.

[00:26:16] Abid Husain: Like c-reactive protein, like, uh, you know, PAC or lpp A two, like these are, these are inflammatory indicators that have a vascular specific component to them. Um, and they, they can give us an idea of risk factors. Uh, I can also look at, uh, yeah, I mean certainly insulin, some, uh, the hormones. Uh, the ratio hormones are big.

[00:26:39] Abid Husain: Yeah. 

[00:26:39] Dr. Scott Sherr: Yeah. 

[00:26:39] Abid Husain: Adiponectin and leptin. We can look into that. Give us me ideas of metabolic health. So there's a lot that's, uh, that can, that can go into it. Um, and that, and then combine that with, with, uh, A-C-C-T-A, which is a, which is a contrast enhanced, uh, CAT scan of the coronary arteries. So that's really what [00:27:00] we need to look at.

[00:27:01] Abid Husain: What's been done in the past is a calcium score. Um, and that's. Helpful, but it's not the whole picture. And, and what it'll do is to really only identify the person that's at super high risk. Um, but it can still, and, but it won't identify all of them. It may miss some because it doesn't, it doesn't look at cholesterol that's deposited.

[00:27:21] Abid Husain: It only looks at the calcium that's developed. And that's an old part, the old, uh, evolution of atherosclerosis. Um, when we're the, the most metabolically active stuff. The most metabolically dangerous plaque has half and half, maybe very little calcium, but a lot of inflamed cholesterol. That's the stuff that's, that would get missed, but it wouldn't get missed with A-C-C-T-A.

[00:27:45] Abid Husain: So, and then there's add-on AI testing that could also be used. Um mm-hmm. You know, even on a budget, these can be done and should be done. 

[00:27:56] Dr. Scott Sherr: I love it. I love it. I good. Can I 

[00:27:58] Elizabeth Yurth: ask abed? Um, yeah. Yeah. So when we're looking at like, so I recently ran labs on my 24-year-old son and he has, you know, a bad A OB ratio.

[00:28:08] Elizabeth Yurth: His A O B's high. He's got a higher lp, little A, so genetic high LP, little A. Obviously his PLAC is not high yet, none of that high. So when would you recommend starting to get, because. Is he just too young that his coronary arteries, he is not gonna show anything on CCTA anyway. Or will you actually start to see the beginning of disease, like on an AI with clearly scan?

[00:28:27] Elizabeth Yurth: Would you start to see beginning of disease, even at that age? So should we be screening people even at this young age when they have, you know, potential risk factors? That's 

[00:28:36] Abid Husain: a, that's a great question and it, it speaks to the still I think, a gap in our understanding of, of cholesterol LDL deposition and removal.

[00:28:48] Abid Husain: So it, you know, in that case in particular, somebody that's young, they may have a lot of LDL that's depositing and uh, but if their HDLs and the ratios are still reasonable or any of he's burning enough calories still 'cause metabolically active, he may still be able to. Have enough reverse cholesterol transport.

[00:29:07] Abid Husain: Yeah, that was good, man. And we, we don't have, you know, when we're taking the, these pictures, they're snapshots, and that could be a snapshot of a period in time where he's deposited the LDLs but maybe not removed them. So, you know, it, it's gonna have to take a few serial images to see what the progression is.

[00:29:26] Abid Husain: Uh, I think that starting earlier would be a good idea. And then you don't have to do it annually, but you could do it every years. And then at least that gives us a, an idea of, of progression. Uh, right. You know, and that's really what's more important because, and it seeing what's developing over time as opposed to a snapshot.

[00:29:44] Abid Husain: So in someone that's got, you know, the, the abnormal preliminary biomarkers and maybe not a lot of inflammation, I still think it's useful. 

[00:29:54] Elizabeth Yurth: Yeah. Okay. That's, and then, I mean, the nice thing about the clearly is you can so quantify [00:30:00] improvement with time. Right. That you can say, look, I, I've taken this plaque.

[00:30:04] Elizabeth Yurth: It's your, your low density plaque has turned into calcified plaque, which is good. We know that we've made this really and so quantifiable. That's right. 

[00:30:13] Abid Husain: And that's new, new, uh, platforms that are, uh, in the pipeline, uh, being, there's, there's some that are being used in Europe that I'm, I'm waiting to have to get rolled out into the United States.

[00:30:24] Abid Husain: Cool. 

[00:30:24] Dr. Scott Sherr: Cool. Which I 

[00:30:24] Abid Husain: think that adds some more to the, to the analysis and, uh, and yeah, I think that there's, there's gonna be ways to tease apart. Types of medications are gonna be optimal for what type of, sure. 

[00:30:37] Dr. Scott Sherr: That's, that's huge, right? Yeah, yeah, yeah. This, I wanna give a plug to, so we've, I've had you both on our podcast before with full episodes and ab, we talked about reverse cholesterol transport for a long time, and that's a super interesting concept that I didn't really have a good.

[00:30:49] Dr. Scott Sherr: Sense of until we spoke, which was really interesting. And then Betsy, you and I had a great conversation about, uh, repurposed drugs and, um, if people are listening, I would highly encourage you to listen to the whole talks, that whole conversation, because they were fantastic overall. And I learned a ton in two of our most popular episodes actually, both of you guys.

[00:31:07] Dr. Scott Sherr: Uh, because Cardiology's obviously a big topic and, and Betsy, you know, your capacity to take topics that are very complicated and bring them into, you know, sort of bite-sized aspects of clinical. Application is, you know, it's, it's not something that a lot of people can do. So I, I wanna thank you both for joining me today, uh, for this kinda short podcast to talk about like longevity, like the groups, but, and how that we're working in collaboration and, and how great that is.

[00:31:31] Dr. Scott Sherr: I think we all can agree, um, and that we're always. Here to educate. We're trying to educate as best we can, our fellow clinicians. Um, and, but learn from our fellow clinicians. Clinicians as well, right? Because there's so much we don't know. And so I guess my, my emphasis here would be try to find groups of people that you can collaborate with, right?

[00:31:47] Dr. Scott Sherr: Find people in your community. Um, look at the longevity Docs group, if that's something of interest to you. Um, and you don't have to be longevity doc as well. I've been trying to impress this upon David. I had a friend of mine just recently who's one of the first guys to get licensed in all 50 states. So he has, and he created a whole bunch of businesses around telemedicine practice, and he is doing, doing some longevity work, but he got, he got denied twice into the group.

[00:32:10] Dr. Scott Sherr: And I was like, David, why this guy knows so much about telemedicine, he can school us all on how to do telemedicine practice. And he's like, okay, fine. And he said, yes. You know, so, so, um, you know, so, um, so don't be afraid to, even if you're not in longevity. Field per se, but if you have Right. Things that, that are involved in sort of understanding things from a collaborative way.

[00:32:29] Dr. Scott Sherr: Like we're all in longevity medicine is what it comes down to, right? Yeah. Right. Tell me, it should be 

[00:32:33] Elizabeth Yurth: everybody's goal, right? Health span medicine. Yeah. 

[00:32:36] Abid Husain: That's what, uh, I mean that's what David preaches all the time. You know, the David Lu, you know, he taught everybody should be a longevity medicine physician, you know, and, and I agree with that.

[00:32:45] Abid Husain: I think we all agree, right? Basically. 

[00:32:47] Dr. Scott Sherr: Yeah. Okay. So, well, October 17th and 18th. Chatauqua in Boulder. As Dr. Yu just mentioned, it is one of the most beautiful places in the world anytime of year, but [00:33:00] especially that time of year. It's a small group setting, only a hundred seats, and we've already sold about half.

[00:33:04] Dr. Scott Sherr: So if you're interested, sign up soon. We're gonna have. Two and a half day, well, two days of lectures. We'll have events before, during, and after. We're gonna have people that special in, specialize in movement, yoga, performance. We'll do be hiking in the woods, of course, because everybody has to hike when they're there.

[00:33:20] Dr. Scott Sherr: Um, anything else you guys wanna say about Boulder or, or your talks about? Anything else? 

[00:33:24] Elizabeth Yurth: No, I mean this is a venue guys where you guys will be sitting in the conference room and maybe an elk will not walk by you. I mean, you know, there's, there's nothing else like it really is, it's, it's almost a look at pictures of it.

[00:33:35] Elizabeth Yurth: 'cause it's a very hard to describe setting. I mean, I, I love Boulder 'cause I live here. Um, yeah. But one of our favorite things to do from my house is I can walk over the top of a mountain over Flagstaff Mountain and then end up in Chatauqua and there's a great little dining hall there that there is.

[00:33:47] Elizabeth Yurth: You can try that. You can then we can bunch out and walk home and, uh, it's just. It's magical and I think it's a perfect place for talking about health and healing because, you know, you go to Vegas is not the perfect place to talk about health and healing, right? Yes. And you're to taco when you're around nature and light and, um, and, and people.

[00:34:09] Elizabeth Yurth: That's where you're gonna learn and also just heal. 

[00:34:13] Dr. Scott Sherr: I a hundred percent agree. Uh, this is why we had our nonprofits symposium last year in Vegas, right before A four M and we will never do that again. That 

[00:34:25] Elizabeth Yurth: was, it's very hard. Too much. It's hard to seem healthy when you're inhaling cigarette smoking. Yes.

[00:34:28] Dr. Scott Sherr: It's so many days in Vegas. Can't see a 

[00:34:29] Elizabeth Yurth: window. You know, sometimes Vegas, I realize I've not seen a window for like two days. 

[00:34:35] Dr. Scott Sherr: Yeah. And funny enough, the next time I'll see you both in a couple days. In Vegas. In Vegas, 

[00:34:39] of 

[00:34:40] Elizabeth Yurth: course. 

[00:34:41] Dr. Scott Sherr: But then after that, in October in Chatauqua, and hopefully sometime in between because even though we live in the same towns, it's always hard to see each other when we're not actually at conferences because we're seeing patients and doing other things and et cetera.

[00:34:50] Dr. Scott Sherr: But, um, thank you guys both for, for being with me today and uh, I look forward to having you in October. 

[00:34:57] Elizabeth Yurth: Yeah, we appreciate you, Scott. Yeah, thank you.

Find more from Dr. Elizabeth Yurth:

Website: https://boulderlongevity.com/about/dr-elizabeth-yurth

Instagram: https://www.instagram.com/dryurth/

Find more from Dr. Abid Husain:

LinkedIn: https://www.linkedin.com/in/abid-husain-md-facc-abaarm-00874419/

Instagram: https://www.instagram.com/dr_abidhusain/

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