[Transcript] – Ben Greenfield Gets A “Young Blood Transfer” Therapeutic Plasma Exchange, How To Melt Plaque, Testing For Cancer & More with Dr. Darshan Shah, MD

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From podcast: https://bengreenfieldlife.com/podcast/darshan-shah-nexthealthlife/

[00:00:00] Introduction

[00:00:57] Topics lately on Ben’s mind

[00:02:41] Therapeutic plasma exchange

[00:13:10] Is cholesterol bad?

[00:17:12] How often should TPE be done?

[00:19:51] What is CT angiography?

[00:26:51] Can extreme training and the keto diet make things worse?

[00:29:25] The HART test

[00:31:23] Other data from Ben’s test

[00:40:11] Colone cancer and liquid biopsy

[00:47:21] How important is it to avoid red meat?

[00:51:44] Other things Dr. Shah does

[00:56:15] Closing the Podcast

[00:57:21] End of Podcast

[00:57:43] Legal Disclaimer

Ben:  My name is Ben Greenfield. And, on this episode of the Ben Greenfield Life podcast.

Darshan:  The negative effects of high cholesterol, one of them is atherosclerosis. Atherosclerosis due to three things. Number one, inflammation, right?

Ben:  Right.

Darshan:  Number two is due to damage to your arterial wall, mostly from hypertension, high blood pressure. And, lastly is apoB particles. Okay. So, it's only part of the equation. So, high cholesterol is not bad for everybody, it is a problem for many people, and that's why heart attacks are the number one cause of death in United States.

Ben:  Fitness, nutrition, biohacking, longevity, life optimization, spirituality and a whole lot more. Welcome to the Ben Greenfield Life Show. Are you ready to hack your life? Let's do this.

Well, folks, if you are watching the video version of this show, then you'll notice that me and my fine friend here, Dr. Darshan Shah, he's been at my podcast multiple times, are sitting down here at Next Health. We look like bionic men. You feel a cyborg right now?

Darshan:  I definitely feel like we've been taken over by the cyborg.

Ben:  I'm cyborg-ish. I've got like a blood pressure cup, a heating pad, a tube of blood coming out one arm, a tube of blood coming out the other arm, these massive machines that we'll talk about in a little bit.

So, first of all, elephant in the room, there's going to be a lot of resources for you guys. And, the shownotes for this show are going to be at BenGreenfieldLife.com/NextHealthLife. That's BenGreenfieldLife.com/NextHealthLife. The reason for that is I've been thinking about a lot of things relative to lifespan and life extension lately. Few things in particular that I really wanted to delve into are your immune system and your detoxification. Meaning, what you might consider to be a cleanup of your body; the heart and what we don't currently look at when it comes to heart health that people should know a lot more about. We're kind of in the dark ages, in my opinion, with the way that we care for people's hearts. And, I've learned a lot of very interesting things about that lately. And then, finally, cancer. I don't think it's any secret now that I've had a family member, my father namely, struggling with colon cancer. It's also been a topic hot of my mind, and it just so happens that Dr. Shah have some experience with a lot of this stuff.

And so, I figure right off the bat, I want to ask you Darshan, why the heck are we hooked up like robots to these machines? What's going on?

Darshan:  Yeah. So, Ben, you and I have been talking a while about the latest in health care and health optimization and longevity, and I really feel like this is the pinnacle of what we can offer right now. This is called therapeutic plasma exchange.

Ben:  Therapeutic plasma exchange, TPE.

Darshan:  TPE, therapeutic plasma exchange. And, what we're doing with these machines and being all hooked up here is blood is being removed from one arm, is going through this machine, which is separating the blood into its components of plasma and blood cells. And then, the blood cells are being reinfused into this other arm over here.

Ben:  And, remind people real quick what plasma is.

Darshan:  Exactly. So, your blood is made up of two components. Well, multiple components, but 55% of it is plasma. And, plasma is where all of the ions, all the toxins, all the growth factors, all the communication factors in your blood lives. And then, the other 45% is red blood cells, white blood cells and platelets. So, have you ever seen PRP when you take a tube of blood and you spin it?

Ben:  The platelet-rich plasma. Yeah, they stem and they inject the platelets back into the joint or the injured area, right?

Darshan:  Right. Yup, exactly. And so, when you spin a vial of blood in a centrifuge, it'll separate into this top yellow layer and this bottom red layer. And, that's exactly what this machine is doing here for a large volume of blood. And so, when you separate–

Ben:  This is a full-body PRP?

Darshan:  Exactly.

Ben:  Interesting. Okay, I didn't think about that.

Darshan:  That's what this machine is doing, full body PRP

Ben:  Okay.

Darshan:  So, this machine is basically a giant centrifuge but it's very specific. It can pull out individual types of blood cells. It's extremely complicated and calibrated to do what we're doing here. So, what we're doing is removing the plasma, and the plasma is going to be in that bag. You can kind of see my bag full of old plasma over there. And, we're reinfusing albumin where the plasma was. And, the reason you need albumin is because the plasma is a lot of proteins in it, you need to maintain that protein gradient, that osmotic gradient. And, that's where you have to put the albumin back in.

Ben:  Where do you get the albumin?

Darshan:  The albumin is donated albumin. It's been tested, it's been donated and it has no immune factors in it. Albumin doesn't have any immune factors, so you don't have to worry about an immune reaction or allergic reaction. So, albumin we use, album in hospitals, every single day, I've been using it for years. And, this machine actually has been used in hospitals for many years as FDA-approved. But, just like most of Western medicine, we only use this technology when you're really, really sick. And, what we're doing here is bringing it out into health, wellness, longevity. And, using this technology has been around forever, basically, in Western medicine, but bringing it to helping us live longer lifespan.

Ben:  I didn't know it actually been around for that. So, what diseases would traditionally have been used to treat?

Darshan:  So, traditionally this machine is used for autoimmune crisis. Okay. So, when people form autoimmune complexes, those complexes live in your plasma and this extracts it from your plasma. And so, that's what this would be used for is in the ICU for autoimmune type of diseases that have gone kind of out of control.

Ben:  Okay. So, you get these autoimmune complexes in the blood if you have a severe autoimmune disease, which technically would kill you if you didn't remove those. And, this would normally be used to filter those out of the blood to remove them and then to replace what's gone with albumin, which helps to replace the proteins that would naturally be present in blood.

Darshan:  Exactly, exactly.

Ben:  Okay. Now, for somebody who doesn't have an autoimmune disease, why would they do this? What's it accomplishing?

Darshan:  Okay. So, great question. There's a lot of stuff that lives in our plasma. And, I have a chart up over here that you can show. We have ions and nutrients that live in our plasma, of course. And so, when we take that plasma out, we need to replace that back with IV therapy. So, we basically have an IV bag also going with your sodium, potassium.

Ben:  Okay. So, that's replacing all my electrolytes and my nutrients that I'm losing in blood.

Darshan:  Exactly.

Ben:  Okay, so we got that covered. That's good.

Darshan:  Growth factors. So, we have hormones and growth factors in our blood as well. Those are going to be regenerated by your body in 24 to 48 hours. So, you do have 24-48 Hours where you don't have those hormones in there, but they do regenerate immediately. They start regenerating immediately and they get back to normal levels within 24 hours.

Ben:  And, by the way, what would a growth factor normally do? Like, if you had out of your system, what kind of things would you not be able to do?

Darshan:  Well, I mean, for the short amount of time that you don't have a growth factor in your body, it doesn't do anything really. But, if you had no growth hormone for a long period of time, that's an issue.

Ben:  Okay. So, you'd see reduction, anabolism, that then get regenerated.

Darshan:  Exactly.

Ben:  Okay. That makes sense.

Darshan:  Okay. So, coagulation factors also live here. So, if after this therapy, it takes 36 hours to regenerate your coagulation factors. So, we always tell everyone, be a little bit careful the next 36 hours that you don't bump your head or fall or anything like that. You still have some coagulation factors so it's not too much of an issue, but we just help people to be careful.

Ben:  Okay. So, no Monty Python skits where somebody's cutting off your arm because it's going to really squirt.

Darshan:  Exactly, exactly. And then, we have immune globulins. Okay. So, these are what detect infections, and we replace those with this called IVIG, IV immunoglobulin. So, at the end of this, we give IVIG as well. So, that's for your body to recognize infections. Okay.

Ben:  I could probably also have a colostrum smoothie. That's good for growth factors. I actually love colostrum. It covers some of these things you're talking about. It's interesting.

Darshan:  Yeah. We go right next door and get one over [00:08:24] _____.

Okay. And then, proteins. We talked about proteins. We're replacing that with albumin.

Ben:  Okay.

Darshan:  And then, you have these exosomes that travel in your blood as well from your stem cells and from other cells that we can replace with exosome therapy after doing this as well.

Ben:  Okay, interesting.

Darshan:  But, also your body will regenerate all of this stuff. It's regenerating it right now as is being removed. Your body's able to regenerate immediately. But, to get to normal levels takes about 24 hours.

Ben:  Okay. What am I getting rid of that would be considered bad?

Darshan:  Now, this is the key. Okay. So, another reason that people have been using this machine in the past was for familial hypercholesterolemia. Okay. So, when people's cholesterol levels are out of control like 400 or 500, this machine is removing cholesterol as well. So, we're using usefulness in this machine to remove LPa. So, some people have a genetic tendency to have really high LPa. And so, we can remove that with this machine as well. So, if you have high cholesterol, this is an expensive high maintenance way of removing that cholesterol, but some people need it if they have a familiar reason for this.

Ben:  And, the LPa, would be associated with these smaller cholesterol particles that will potentially be more atherosclerotic?

Darshan:  Exactly. LPa is a genetic condition. By the way, everyone listening to this needs to get their LPa measured. 20% of people have disordered LPa, and you have a genetic condition that causes high LPa, which causes atherosclerosis basically. And, I can't tell you the number of people that we discover LPa in. And, the hard part about LPa is it's genetic. It's also not manageable by lifestyle factors. So, it doesn't matter how healthy you are, which you don't by the way. We've checked yours and you don't have this. But, one out of every five people have high LPa and they have no idea and they're running around with severely stenotic blood vessels and they don't know it.

Ben:  How's that compared to apoB?  Because you hear about apoB is a highly atherosclerotic marker as well.

Darshan:  So, apoB is a protein marker on all the bad cholesterol particles. So, VLDL, LDL, triglycerides, LPa. So, I look at apoB as a sum total of your cholesterol that is atherogenic. And so, I would say we treat for apoB, we want to look at apoB, we want to get your levels managed of apoB. We'll talk about this more when we talk about your Cleerly scan, by the way. But, yeah, so cholesterol is one of the things that are being removed.

Now, the main thing that this is removing is inflammatory cytokines, inflammatory molecules, toxins in your blood, so heavy metal toxins and other toxins, and protein complexes as well that are deleterious. So, removing those from your blood is detoxifying you at a very, very high level.

Ben:  Now, compared to something like, let's say, chelation or one of these metal detoxification protocols, is this considered pretty effective for removing metals?

Darshan:  Oh, yeah. So, chelation, what you're doing is you're binding those metals and you're trying to pee them out and remove them that way. What this is doing is actually directly removing particles that live in your plasma.

Ben:  What about these chronic stealth coinfections like Lyme or mold or Epstein-Barr, any effect on those?

Darshan:  So, there's a lot of research being done in all these things now finally, and we're actually treating patients and monitoring their levels as well. So, hopefully, we'll see some effect there. So, right now, this kind of therapies are a little bit of a leap of faith because we don't have large randomized control studies on people there on humans, but I mean the way I look at it is absolutely this stuff lives with your plasma. Absolutely removing it is going to be helpful. So, let's give it a shot. Let's try. This machine is extremely safe. This procedure is super safe because we're not treating you with any medicines, we're not putting any chemicals in your body, we're not treating with any medicines, all we're doing is removing the bad stuff.

Now, you know those experiments where they hook up two mice and one is old and one is young.

Ben:  Yeah. Where they exchange blood. I believe the young one gets older. I don't think the old one gets younger. I think the young one gets older, isn't it?

Darshan:  And, the older one gets younger.

Ben:  Okay, it goes both ways.

Darshan:  Exactly. So, that's called parabiosis. That's why you have these people up in Silicon Valley that are doing plasma exchange with young people. You know what I mean?

Ben:  Yeah, with young healthy donors.

Darshan:  Exactly. But, what we're finding now–

Ben:  You can't have any of my blood, Darshan.

Darshan:  But, what we're finding now though is not really the young blood that is making the old mouse younger. What's happening is is removing the plasma from the old mouse that's making them younger.

Ben:  Oh, so when the plasma comes out, it's not that you're replacing it with the young plasma, it's that you're removing the old stuff.

Darshan:  Exactly.

Ben:   Which is exactly what we're doing right now.

Darshan:  Which is exactly what we're doing right now.

Ben:  Interesting.

Now, what do you say to the people who are, not that I want to throw anybody under the bus, but some paleo, primal, carnivore type of enthusiast who's listening and who's screaming at you right now, “Darshan, cholesterol is good, why are you sucking cholesterol out of the blood? We need that.”

Darshan:  I think that unfortunately the whole cholesterol debate has created two camps, which it is so much more nuanced than that as we know. Cholesterol is not bad for everybody. Having too high of a cholesterol is not bad for everybody and we do have overprescribing of cholesterol-lowering medications in general in the United States. We see that. I agree with that.

Ben:  We have overprescribed.

Darshan:  Overprescribing. However, what I will say is that there are many people in the world that do need cholesterol-lowering medications. We talk a lot about population-based medicine versus personalized medicine, right?

Ben:  Yeah.

Darshan:  And so, when you make general statements like cholesterol is good or cholesterol is bad and apply that to an entire population, you're really doing each individual a disservice. So, we're going to dive in later once again with your heart scan and how we're going to manage your cholesterol because you do have some of the negative effects that are building up of high cholesterol. So, we do need to treat this for you. And, the negative effects of high cholesterol, one of them is atherosclerosis. Atherosclerosis is due to three things, is due to, number one, inflammation. So, this is reducing inflammation.

Ben:  Right.

Darshan:  Number two is due to damage to your arterial wall mostly from hypertension, high blood pressure. And, thirdly is apoB particles.

Ben:  Or excessive very hard exercise as well.

Darshan:  Exactly.

Ben:  Yeah.

Darshan:  Yeah, like your lifestyle for many years, you've accumulated a lot of damage to the endothelium of your blood vessels. And, lastly is apoB particles. Okay. So, it's only part of the equation. So, high cholesterol is not bad for everybody, it is a problem for many people, and that's why heart attacks are the number one cause of death in the United States in the Western world. And so, we do need to manage for that, but yeah, I try not to get into these debates that people are so one-sided about it because it's so much more nuanced and every individual is a different person and we got to look at each individual.

Ben:  What do you think about the idea that when it comes to cholesterol you actually need to be more concerned about tissue cholesterol levels versus blood cholesterol levels? They're a clue but they don't really tell you what's going from a tissue standpoint.

Darshan:  Right. So, what do we use cholesterol for is every cell wall needs cholesterol. And so, cells are producing cholesterol and your liver is making extra cholesterol for the cells that don't have enough inside of it. And so, really if we had a measure of cellular cholesterol levels, that would be the best measure. So, blood cholesterol levels is only used as an indicator for treatment. It's a biomarker that we use when we're instituting treatment and it's a risk factor for disease. So, it's not causing disease but it is a risk factor we know from massive studies that have been done, a risk factor for heart disease and other types of atherosclerosis.

Ben:  Probably because if it's elevated in the blood that's a clue that it could be accumulating as plaque or contributing to plaque accumulation in the heart, but that doesn't mean that high cholesterol is doing that. However, it's a pretty good sign that it might be.

Darshan:  Yeah.

Ben:  Yeah. And, that's where other imaging might come in.

Darshan:  Exactly. That's why I try to reframe this whole cholesterol thing with my patients. I'm like, “Look, if you have damaged blood vessels and if you have inflammation, having a lot of apoB particles is not good because those are the ones that going to get into the vessel wall and cause blockages of your vessel wall. But, if you're super healthy and you have a higher apoB, it might not happen.” And, that's why, once again, you have to treat each individual looking at what their status is.

Ben:  Yeah.

Darshan:  Yeah.

Ben:  And so, that kind of leads me into what I wanted to ask you about in a second. But, before we get off the topic of this TPE, this therapeutic plasma exchange, how often would somebody do something like this? If you do it once in a lifetime, you're getting good effect, that you'd come back in a yearly basis or?

Darshan:  Yeah. So, I'd like to describe it as an oil change for your body really. And, a lot of the studies have been done on six treatments protocols. No one knows right now. Let's talk about the studies a little bit too on therapeutic plasma exchange.

Ben:  Yeah.

Darshan:  There's some really great work being done by a Dr. Kiprov, up north who we've interacted with and visited with on Alzheimer's disease. Okay. And, I've talked to Dr. Dale Bredesen about this as well. And, when you remove the protein complex or the tau protein and the amyloid complexes from the plasma-like we are right now and you put albumin in the body, you can suck some more of these protein complexes out of the brain as well. And so, what Dr. Kiprov has studied is using therapeutic plasma exchange with six treatments over the course of, I think, 12 weeks, six to 12 weeks. And, he showed a decrease in progression of Alzheimer's by somewhere between 15 to 30%.

Ben:  Wow.

Darshan:  Massive slowing of Alzheimer's using this treatment. Sadly, insurance doesn't cover it. It's pretty expensive right now. But hopefully, we get to the point where we can offer this to patients who are developing Alzheimer's to slow their progression and potentially reverse where they're at.

Ben:  Wow. And, it's literally removing a lot of the proteins that would normally cause damage to the brain from Alzheimer's.

Darshan:  Exactly.

Ben:  That's crazy. Wow, incredible.

Darshan:  Yup. So now, there are blood test for tau protein and amyloid protein that you can do. And, they have a very strong correlation with PET scans which are what are diagnostic for Alzheimer's. So, it goes to follow that if you can measure these proteins in the blood, removing them from the blood can be helpful, and Kiprov studies are showing effect.

Ben:  How many times have you done TPEs?

Darshan:  This is my fourth time doing it.

Ben:  What do you notice after?

Darshan:  I don't really notice a lot of physical sensations other than it's kind of like cryo. You just feel more energetic. You feel clear for a few days. You just feel you're able to sleep better. You're able to get more done, exercise more, lift more weight, et cetera. And, I feel that probably for like, I would say, seven to 14 days potentially, but yeah, it's not something you're necessarily going to feel.

Ben:  Right. It would be more like a pretty hefty preventive lifestyle strategy.

Darshan:  Exactly.

Ben:  Yeah.

Darshan:  Exactly, exactly.

Ben:  Now, we talked briefly about the heart thing, I want to talk a lot more about that. And, let me lay down a background for folks a little bit here. If you look at the research, probably James O'Keefe is the guy who's done a lot of the studies on this or brought this to common knowledge. We know that there's a law of diminishing returns with exercise. Meaning, once you exceed somewhere around about 120 minutes of moderately intense exercise during the week, you see arterial stiffness, you see increased risk of cardiovascular disease, increased risk of stroke, et cetera. We also know that exercise is great for the heart. It lowers blood pressure, lowers blood sugar and within moderate amounts it's good. We know that from what James O'Keefe has looked at, a lot of ultramarathoners, Ironman triathletes, and people who basically fit into the category of what I did for 20 years, they tend to have a lot more heart issues than what you would expect from an aerobically fit population.

Darshan:  Absolutely.

Ben:  It's too much of what might be a good thing in moderate amounts. So, it turns out that, I don't know, Darshan, it was probably three or four years ago, you and I met up with this Dr. Dandillaya down. We did a whole battery of heart test. We had flow scan, we did EKG, we did a ultrasound echocardiogram. And, amongst that battery of test was included what's called calcium scan score.

Darshan:  Exactly.

Ben:  And, I got my calcium scan score and even though just about everything else on my heart looked pretty good, I had elevated calcium and it was very tightly packed, somewhat stable, the type of patterning you might see in someone who's more fit, but it was concerning nonetheless. And then, nine months ago, I found out about this new test that's even better than the calcium scan score. It's called a CT angiography known as the Cleerly scan for diagnostic imaging. I'll let you explain in a minute what that test is looking at, but layman's explanation here. Sorry, ladies, laymen's or laywomen's, is that it tells you the amount of plaque that you have in your heart whether it's stable or unstable and where it might have accumulated. My score was very high, was concerningly high. 

And so, over the past nine months, I have been doing a lot of things to see if I could get it to lower. Namely, endothelial glycocalyx support, certain sulfur-based supplements that help to support the lining of the blood vessels, nitric oxide precursors and nitric oxide support for vasodilation, more infrared sauna, more magnesium, less intake of a lot of the saturated fat cuts from the ribeye and the pork, et cetera, a lot more fish and olive oil. And then, I also have been using red yeast rice, which is kind of nature statin, little CoQ10 and niacin. That's a pretty hefty stat. And, I feel great. I feel great. However, I came into the repeat test and not only has the plaque not budged, it's gotten a little higher.

So, we'll address why that is, what we might be able to do about it in a moment, but I'm saying all this to tell you that, folks, when you hear about the natural healthy lifestyle, you just take the supplements type of approach, there might be cases where you need to do a little bit more digging than that. And, if you haven't yet done a scan like this and you're only looking at your lipids, you might have to do a little bit more digging with that too. But, first of all, Darshan, I know I just gave a little mini Ted Talk, what is the CT angiography, this Cleerly scan actually looking at?

Darshan:  Absolutely. Okay. So, the first test I get all my patients to do–I think I pushed you into doing this CT calcium score as well. I think you were 35 when we did it, right?

Ben:  Right.

Darshan:  You were pretty young.

Ben:  I was 35 and by the way, I was very much high fat diet, keto, fat, fat, fat, cholesterol is good, had elevated LDL, high HDL, low triglycerides, but also somewhat elevated apoB, a slightly elevated LPa, not super high. But, one of those lipid panels that, I don't know, someone in the Ancestral Health Community would stand proudly about, and I actually did at the time.

Darshan:  Yeah, exactly. And, I was like, “Look, let's just check a CT calcium score on you.” And, we saw the calcification. So, what a CT calcium score is is a CAT scan of your heart. It's super quick, it's 10 minutes, it's minimal radiation, and is the most underutilized diagnostic test in healthcare today because insurance doesn't pay for it and God knows why. And, I love that test because it gives us an indicator of if you're forming plaque or not. Now, what that's showing you is little bits of calcium in your blood vessels. And, when your blood vessels have plaque and it gets calcified, that's an advanced more stabilized plaque. So, when I see calcium and someone's calcium score come back positive, I know that they have plaque, number one. Number two, they've had plaque for a while. And, number three, it's getting pretty advanced.

Plaque always starts off as soft plaque. It doesn't have calcium inside of it. And, it's soft, meaning that it's just cholesterol in the blood vessel wall that's lowering the diameter of that blood vessel wall. So, what the Cleerly scan does is a CT angiogram. Now, this is a longer scan. It takes probably about 30, 45 minutes to do, and there is more radiation associated with it, but it's still within tolerable levels. You don't want to get this done every quarter or every month, you want to do it once every few years. But, it gives us an indication not just of calcified plaque but also the soft plaque. Soft plaque in my view is still treatable; whereas, hard plaque is more difficult to treat because it's calcified.

Ben:  So, would soft plaque be considered stable and hard plaque unstable?

Darshan:  Opposite.

Ben:  The opposite. So, hard plaque is stable, soft plaque is unstable, more likely to break loose and cause problems.

Darshan:  Exactly, more likely to get a clot in it, more likely to expand rapidly, et cetera. So, what we have on the screen here is your left main and left anterior descending–

Ben:  Oh, these are my results from the one that I just did yesterday?

Darshan:  Exactly.

Ben:  Yeah.

Darshan:  Yeah, this is actually your left main and left anterior descending artery.

Ben:  Left main and left anterior descending artery in my heart.

Darshan:  Exactly. Now, how cool is that though that it can lay out the entire artery and show you exactly where the plaque is? And so, you could see that yellow stuff at the beginning over there. Your proximal left anterior descending artery is non-calcified plaque. So, that's plaque that we know is narrowing your artery right now. And, from your previous Cleerly scan that we did a few years ago, that's actually become worse.

Ben:  Yeah, and non-calcified is not good.

Darshan:  Exactly.

Ben:  That would be unstable.

Darshan:  It's unstable and also it's in a bad spot. It's called a widow maker, right? 

Ben:  Yup.

Darshan: Because that can expand rapidly. And, if you block your left anterior descending artery, most of your heart is supplied by this blood vessel, you can die. So, this is how a lot of people find out that they have heart disease the first time is their first heart attack.

Ben:  They actually get their first heart attack.

Darshan:  Exactly. 

Ben:  Yeah.

Darshan:  50% of people find out at their first heart attack and 50% of those people die.

Ben:  We are looking at the left main and left anterior descending arteries of a heart that was under extreme amounts of stress for 20 years. So, I mean maximum heart rate or above for multiple minutes per day combined with honestly a lot of lifestyle, stress, et cetera, and this is notable for folks, eating what could be considered a pretty healthy diet, at least not a standard American diet, being aerobically fit, getting in the sunshine, et cetera.

This is a question I'm very curious about, kind of a bigger picture of your question. If you were to be into CrossFit maybe two a days and ultra-endurance triathlon and marathon, do you think that you would actually aggravate this issue if you were kind of eating a higher fat, high saturated fat, keto type of diet because you'd have more cholesterol to potentially become oxidized?

Darshan:  Yeah. I can tell you, everyone I see has a different story. You're one of the healthiest people I know, and you created a lot of inflammation, I think, by having that endurance athlete lifestyle.

Ben:  Right.

Darshan:  Combined with the moderately elevated cholesterol levels as well, yes, I think for you, we can definitely see that this has affected your arteries. Now, we see a lot of athletes here and I could tell you this is a pattern I see over and over and over again. So, anecdotally, I could say the answer to your question is probably you're heading in the right direction with that.

Ben:  And, do you see it over and over again in athletes of all varieties or primarily do you see more notably in endurance and ultra-endurance athletes or people who would be considered over trainers?

Darshan:  Yeah. I would say it's more the over-trainers. Exactly. And so, I think there's a point in your life that you really have to look at the amount of exercise you're doing and how it's positively or negatively affecting your inflammation levels and your metabolic health and your apoB levels. Those three things are, for many people, that exercise like an endurance lifestyle, they do cause damage for years and years that builds up. And then, we have to encourage them to have a different path for their exercise routine, but we talked about. So, yeah. I think, once again, population medicine will tell you to not check these tests. I think all the people listening out there, if your doctor says, “Ah, you're fine, your cholesterol level's low, don't worry about it,” I think getting a CT calcium score the very least is a good idea for anyone who's 40 years old and above.

Ben:  Yeah. But, what if somebody can't afford it or their Uncle Jerry who wears a tinfoil hat told them they get more radiation than a thousand plane flights or whatever. There's reasons that they might not get a CT angiography.

Earlier, you and I pulled up on your laptop this other test that can give you markers that could be predictive of this same type of plaque accumulation. It's called Prevencio HART test. What do you think about something that?

Darshan:  Yeah, some of those tests are actually really good. They're indicators of heart stress. Okay. And so, when you have blockages in your blood vessels, you cause more stress in the heart and then you can pick that up in protein biomarkers. That blood test actually is more expensive than a CT calcium score. The CT calcium score you get for 100 bucks. So, just call local [00:30:16] _____.

Ben:  That was north of 400, I think.

Darshan:  Right, exactly. So, I think the calcium score combined with that blood test is great workup for atherosclerosis disease, but at the end of the day, when you see a cardiologist, they're going to do a stress test on you, they're can do an echo. There's other testing needs to be done. And, the cardiologists are experts at testing for this stuff, but most people never get referred to the cardiologist until it's too late. And, that's why I try to promote and harp on being the CEO over your own health and getting some of these markers done early, so earlier, and you could talk to your doctor about referring you to a cardiologist.

Ben:  Most people are at the expression this type of diagnostic imaging is prohibitively expensive or only available on executive health panels, you said less than 100 bucks, around $100. Yeah, with which to me for the knowledge that we're getting from this is incredible.

So, we're looking on left main, left anterior descending. By the way, again, for those of you who are wanting the video, the images, I'll even put downloads of this if you guys want them, go to BenGreenfieldLife.com/NextHealthLife.

What else can we glean from this data here?

Darshan:  Yeah. So, what's great here too is that we can see your other blood vessels that are supplying your heart. You have a few lesions here in your right coronary artery that are fairly minimal.

Ben:  And, when you say a lesion, is lesion synonymous with plaque accumulation?

Darshan:  Yeah.

Ben:  Okay.

Darshan:  Yeah, plaque accumulation. And, you actually get these scores here that are helpful for us to follow as well. So, you can see that you have different plaque stages, you have a plaque score, atheroma volume. And, we can follow these numbers over time. And now, precision medicine is going towards treating these numbers and actually reversing plaque with newer therapeutics like PCSK9 inhibitors.

Ben:  Yeah, I want to talk about that.

Darshan:  Yeah, exactly. So, we can do a combination of cholesterol-lowering medications. And look, I'm not trying to push statins on everybody. I think statins are some of the most overprescribed medications in the world. However, there is a combination of statin and Zetia and PCSK9 inhibitors that's right for each individual patient.

Ben:  Okay.

Darshan:  And so, there's testing that needs to be done to see what's right for you. And then, we can potentially reverse some of this damage that's been done. 

Ben:  Okay.

Darshan:  Combined with all the things that you're doing already, like you're taking the right supplements. One diet that's been shown and extensively studied to reverse plaque is actually the Mediterranean diet

Ben:  Absolutely, the one with the unlimited breadsticks and the canola oil, [00:32:50] _____.

Darshan:  No breadsticks.

Ben:  Or the one with the religious and systematic fasting periods of protein restriction and really good extraversion oil consumption from the actual Mediterranean.

Darshan:  Yeah, I think it's from the amount of vegetables being 500 to 800 gram of vegetables, high fiber, olive oil.

Ben:  Flavanols and polyphenols. Yeah, I agree and I'm gradually moving more and more into that type of dietary protocol, especially the more I learn about my heart and some of these studies.

Now, a couple of subtle nuances here. On this atherosclerotic chart, you can see I'm stage two out of stage zero, one, two and three. You and I were in Maui at your guys' location down there where you got a Next Health inside the Four Seasons, which is pretty cool. And, when we were there, we were at a dinner one night and you told me about this study that you later texted to me that showed the type of proven protocol from a medication standpoint that would be used to actually treat a stage one, stage two, stage three, and it's like a statin combo or something like that, right?

Darshan:  Yeah.

Ben:  How does that work?

Darshan:  So, it's a combination of statins and Zetia which lowers the absorption of cholesterol.

Ben:  What's Zetia, again?

Darshan:  Zetia is ezetimibe. It's a pill that you take that lowers your absorption of cholesterol and a PCSK9 inhibitor as well. So, the combination of these medications can be very helpful in reducing plaque volume if you get to it early enough before it calcifies. The Cleerly scan is great because it tells us how much non-calcified plaque you have. And now, we actually have really good numbers to follow and treat towards. So, I'm not cardiologist, but we work with Dr. Dandillaya that you've met. And, he's a cardiologist and he can institute the right protocol for you to turn back some of this gamut in that really bad spot. That left descending spot is a bad spot. So, we want to closely monitor and turn that around.

Ben:  Yeah. And so, you got Zetia, the ezetimibe. What's the other statin that you would take in combination with that?

Darshan:  Crestor.

Ben:  Crestor.

Darshan:  Yeah.

Ben:  What's the–I think it starts with n R.

Darshan:  Yeah, rosuvastatin.

Ben:  Yeah, rosuvastatin. [00:34:56] _____.

Darshan:  Yeah.

Ben:  Yeah. So, rosuvastatin and ezetimibe. And, you would take those, I think what you told me was 5 mgs of the rosuvastatin.

Darshan:  Right, exactly.

Ben:  And, 10 mgs of the ezetimibe, but–

Darshan:  And, you can go up on the dose, too.

Ben:  Yeah. But later, you actually got me a prescription for that. I didn't quite start it because someone told me that some people are genetic non-responders to statins. So, I went and tested my genes, and lo and behold, I did one of these tests, SelfDecode I think is the one I use for this and any test, StrateGene, DNA Company, maybe these tests will show that. It showed I was a statin non-responder. Is that common?

Darshan:  It's not common, but it is definitely a problem for some people. By the way, I just did a podcast with SelfDecode yesterday.

Ben:  Oh, with Joe.

Darshan:  Yeah, with Joe. He's great. Yeah, he's done such a deep dive into this stuff. It's amazing.

Ben:  He likes to take his shirt off a lot now. All of a sudden, I'm not the guy who's half-naked all the time.

Darshan:  That's awesome. Yeah. And, he looks great, but he really has a great platform where we can find these genetic non-responders just using a simple gene test or even you can upload your 23andMe.

Ben:  Yeah.

Darshan:  So, in the absence of those tools, we learn by prescribing not making a big difference, moving towards a different class of medications. But yes, now you can do gene testing and see that there's actual non-responders, yeah.

Ben:  And so, then I talked to Dr. Dandillaya and he said, well, then the PCSK9 inhibitor would be a good idea for you. So, what is a PCSK9 inhibitor?

Darshan:  So, this is an injectable medication that actually works in your liver to inhibit an enzyme called PCSK9 that breaks down a receptor that catches cholesterol in your bloodstream. Okay. So, once you inhibit the breakdown of that, you have more of those receptors, you remove more cholesterol from your blood, you metabolize it in your liver.

Ben:  Okay. Would there be, and I know some people are going to ask this, “Well, the body has LDL receptors for a reason, why would you want to decrease the degradation of those or somehow stop the body's normal process of breaking down LDL receptors so you have more to catch the LDL?”

Darshan:  Because there's massive studies show that lowering your apoB by removing LDL, LPa, the LDL particles from your bloodstream reduces your risk of dying from a heart attack. And now, we have more studies using things like CT angiogram showing that using the right treatment protocol could actually reverse plaque, which is massive. I mean it used to be damage is done, the only way we can treat you now is to put a stent in your heart or do bypass surgery. Now, we know that with therapeutics, we can actually reverse some of this damage.

Ben:  For something like a plaque reversal or what, I think, they call melting away plaque–and again, I got in all the natural stuff recently and I read the studies about pomegranate juice melts away plaque. And, I've been doing tons of the reds and the polyphenols obviously didn't make it dent, but the PCSK9, would that have to be combined with a statin and with Zetia or could that be effective on its own?

Darshan:  So, this is where you really got to get into that personalized medicine part using that study I sent to you. I believe for you, it's a combination therapeutic modality but I just need to look at exactly how much plaque you have, what the research shows, and what that treatment protocol is.

Ben:  I remember the chart that you showed me. It was 5 mgs of the rosuvastatin, 10 of the Zetia, and then the PCSK9 inhibitor as a twice-a-month injection.

Darshan:  Yup, there you go.

Ben:  And so, that would be the next step for me to actually start to melt this away.

Darshan:  Exactly, exactly. Yeah, it's very targeted now and I think that armed with this data, which you would never had if we not got that calcium score, we can potentially prevent a heart attack that you might have had when you in the 50s.

Ben:  Oh, yeah, my wife is going to give you a big hug. The PCSK9 inhibitor, any side effects?

Darshan:  Very minimal rate of any side effects. I've had probably about 100 people on PCSK9. I've never seen anyone have a unboard reaction to it.

Ben:  Okay. Alright, and that's just an injection you can pick it up from the pharmacy, take it home. Okay. This is really good information.

The apoB, no surprises here, mine was elevated. It was up near 120. What do you like to see apoB be at if someone's testing that in conjunction with this?

Darshan:  Right. So, now that we know that you have a lesion, I would try to lower your apoB to 50 or lower.

Ben:  50 or lower.

Darshan:  50 or lower.

Ben:  And, you said a PCSK9 can help with that.

Darshan:  It's incredibly effective with [00:39:46] _____.

Ben:  Yeah, you think that's one of the best things to lower apoB?

Darshan:  Yes.

Ben:  Okay. Okay, good to know.

Darshan: It's definitely the most effective, the most targeted for many people, in what I've seen with my patients. Now, different people respond differently to different medications. And so, there is a little bit of a discovery time period that we have to go through with people to see what's going to work for them. And so, it's not like a one protocol fits everybody, but at least we know where to start.

Ben:  Okay, alright. So, you've saved me from dying of heavy metal accumulation and autoimmune diseases. You have stuffed my widow maker in its tracks, so we're two out of three here, but the last piece here is obviously a concern for a lot of people as well and that's cancer.

Darshan:  Yeah.

Ben:  And, specific to the conversation I wanted to have with you today, colon cancer. And, you have a history with colon cancer, right?

Darshan:  Yeah. Well, I spent the first half of my life being a surgeon and I've removed probably over 200 colon cancers in my life surgically. So, a lot of history with colon cancer. I know you said your dad just had surgery for colon cancer.

Ben:  My dad had surgery for colon cancer. I have two cousins who have passed away of colon cancer. Another one who has a colonic resection. My grandfather died of colon cancer.

Darshan:  Wow.

Ben:  And, it is on both my mom and my dad's side. And, my genetics show a high risk of colon cancer. So, I realize some people say, well, just do a coffee enema every week and you're good to go. But, there's got to be a little bit more to it than that. So, I'd be curious about your take on this.

Darshan:  Yeah. I was going to show you a picture, but I can just talk to you about it.

Ben:  Okay.

Darshan:  So basically, colon cancer is incredibly underdiagnosed as well. Whenever I talk about cancer, I always say cancer's biggest enemy is being diagnosed in Stage 1. And, most people don't find out about cancer until they're symptomatic. Symptomatic cancer is almost always Stage 3 or Stage 4. Now, instead of talking about cure, we're talking about five-year survival rates with chemo and radiation. So, you never want to get to that point. And sadly, Western medicine is so geared once again those population medicine. You can't do some of these tests on everybody. Not everybody in the country can get an MRI. We just don't have the facilities to do that and it's expensive. However, we would have a much lower spend on treating advanced cancer if we did do stuff like that.

Now, cancer in general, there's different ways of diagnosing cancer. And, for different types of cancers, there's different diagnostic protocols. For colon cancer specifically, the most effective way is to do a colonoscopy as you know. And, everyone needs to get their colonoscopy because not only can a colon cancer be diagnosed before it even reach Stage 1 —

Ben:  Because it's a tiny little polyps.

Darshan:  Exactly because it starts inside of a polyp. When you do a colonoscopy, you can see the polyp and you can actually remove it. And so, now, you're diagnosing and treating colon cancer at pre-Stage 1. So, for you with this extensive family history of colon cancer, rather than waiting until your tummy hurts or you have severe constipation or even worse, why not just do a colonoscopy once every couple of years and remove these polyps?

Ben:  Because people say they're risky, that's why. They say you're getting a colon perforated or there's issues with anesthesia. This is just a few days ago, I read that you should talk to your physician because they don't properly clean a lot of the equipment used in colonoscopies, and all sorts of fear or fearmongering at least out there about colonoscopies.

Darshan:  Yeah, there's so much fearmongering. And, I can tell you that the equipment cleaning thing, I mean someone probably read one article about that somewhere. If you go to a reputable gastroenterologist, they are excellent of cleaning their equipment, their perforation rate, you should always ask what is your perforation rate is minimal. And, the anesthesia is the most minimal anesthesia you can get and it's extremely safe. Look, not everyone needs to get a colonoscopy every couple years, but your extensive family history, my advice to you would be to do them more frequently than not do them.

Ben:  Yeah, yeah. When you say more frequently, you think if you have a high family risk of a certain type of cancer like colon cancer, like yearly?

Darshan:  Every couple years.

Ben:  Every couple of years.

Darshan:  Every two to three years, I would say.

Ben:  And, I recently interviewed Dr. Ahvie Herskowitz from San Francisco about this, and I'll certainly link to that podcast in the shownotes. We had a very frank discussion about the rate of cancer growth and how it can be accelerated and also the increased rates of cancer in young populations. We talked a little bit about liquid cancer biopsies like being able to diagnose cancer from a blood like RGCC or GRAIL test or something like that. You ever messed around with any of those?

Darshan:  Oh, yeah, our cancer diagnostic protocol for our executive physical patients is to do a full-body MRI.

Ben:  Okay.

Darshan:  Combined with a liquid biopsy, okay, a full skin evaluation, and then all the regular cancer screening stuff too. So, your mammograms and your OBGYN exam for women, for men, it's a PSA level prostate exam and colonoscopy for both men and women. Yeah. So, we cover the full gamut.

Now, the important thing to realize about the liquid biopsy, which I think is a game changer in medicine–let me just talk about what that is real quick. It's a blood test where you're finding cell-free DNA of tumors. So, tumors actually shed DNA when they first develop into your bloodstream. These can now be detected in your bloodstream utilizing DNA sequence analyzers. It's a massive step forward in medicine and cancer diagnostics. It can diagnose some of the highly lethal forms of cancer very easily like a pancreatic cancer, for example, or liver cancer, bile duct cancer. And, these are all cancers that are very difficult to diagnose until it's too late. I always say if Steve Jobs was around a few more years, we would have benefit of this technology and he' still be alive because we would have found his pancreatic cancer Stage 1.

Ben:  Yeah, yeah.

Darshan:  So, you need that combo of these tests: Full body MRI, liquid biopsy, and the regular screening in concert to be truly 21st century in cancer diagnostics. 

Ben:  Some people will say, “Well, that's too much, you're going to be finding a bunch of stuff that would normally be benign, would never be an issue. You find little spots and you go in and cut something out. You never would have had to do that because it wasn't an issue in the first place.” I've heard people say it.

Darshan: Absolutely. So, there's this thing in MRIs called incidentalomas. And, incidentalomas are finding incidental findings and having to figure out what is that you might need a couple of extra diagnostic tests like an ultrasound or something else. But, once you diagnose an incidentaloma and you know it's there, the next time you do the MRI you don't go down that pathway again, it's just a one-and-done, you've figured it out. Same thing with the GRAIL test.

Now, what I will tell you is you have to have a certain psychological fortitude to be able to handle a false positive diagnosis. It's not really a false positive, there's something there, we just don't know if it's a cancer or not a cancer.

Ben:  Right.

Darshan:  Does that make sense? So, yes, you need to have that mental fortitude, but I would say that the flip side of that is that you don't diagnose it, you live in blissful ignorance until it's too late.

Ben:  Yeah, yeah.

Darshan:  And so, I think it's in my view, from myself, my family, my friends, I encourage doing some of this testing just so you know earlier rather than later.

Ben:  How important do you think it is to avoid red meat as far as a cancer risk? And, I know this is a loaded question, so I'll just hopefully not softball this up for you too much. But, I think that heavily processed smoked preservative laden meat is an issue but I've always wondered if there's something about red meat specifically beyond the way it's processed that would make it a risk or if you're having a grass-fed, grass finish cut of beef you don't have to worry about it.

Darshan:  I think that the WHO made red meat a cancer-causing substance, and it's all because all those studies were done on heavily processed irresponsibly grown meat. And, I think as long as you're sticking to super organic, well-raised red meat you're going to be okay. Most pork is not raised responsibly so I stay away from pork for that reason. However, I'm a big fan of grass-fed beef.

Ben:  Yeah, grass-fed, grass-finished.

Darshan:  Grass-fed and grass-finished, right, exactly, beef. And, I use this company called KOW, K-O-W. I use them.

Ben:  It's a great name though.

Darshan:  Yeah, they have incredible beef. ButcherBox is incredible too. And, I don't limit myself on red meat. And, I think the opposite is not getting enough protein, which is worse than not getting enough.

Ben:  Yeah, because protein, this is I think something else, it's vilified in the industry. Excess activation of mTOR, and it's insulinogenic, and it's got too much methionine in it, which could be anti-life extension. And, the problem is that protein is so satiated, so associated with the drop in frailty, so good at stabilizing blood glucose levels. You ever tried to eat yourself full-on chicken breast or a leg of turkey?

Darshan:  Yeah.

Ben:  There's no way you're going to eat as much as if you had cheesecake or a bowl of cereal. I even had dinner last night with a very smart guy. He said he thinks that within 10 years, nutrition standards will be adjusted up to 1.5 grams per pound of protein for the recommended intake of protein. And, even though that sounds high, I think that more people would benefit from higher protein intakes from good clean protein sources, especially just look at frailty sarcopenia muscle protein synthesis. So yeah, I think there's a little bit of protein phobia that goes on that's just unnecessary.

Darshan:  Yeah. And, once again, it's become those religious kind of things like this one side versus the other side. I have a lot of patients that are vegans and vegetarians, and I still talk about getting enough protein. You don't have to eat red meat to get enough protein. There's other protein sources, but I do absolutely believe that we're underfed in protein in general. And, that's what's leading to a lot of chronic conditions, a lot of chronic disease, frailty like you said as well in sarcopenia. And so, I think definitely we do need to revisit how much–the RDA of protein is nothing. It's like 0.4 milligrams per kilograms.

Ben:  My current recommendation is 0.8 grams of protein per pound of body weight. Try to get some of that from amino acids, gelatin, or collagen like hydrolyzed protein sources or even whey protein. If you're older, use digestive enzymes like a protein-digesting enzyme to break it down. And then, if you want a little bit of icing on the cake from a muscle standpoint, vitamin D, fish oil, and creatine.

Darshan:  Exactly.

Ben:  And, that would be what I'd tell an old person who wanted to maintain or build muscle to actually use.

Darshan:  I love it. You always break down the exact protocol.

Ben:  Yeah.

Darshan:  That's exactly what you need.

Ben:  Like follow the rules.

Darshan:  Grab some creatine a day or 5 grams creatine.

Ben:  5 grams although creatine can assist with executive function and cognition in a state of sleep deprivation, but all the studies on that use 10 to 20 milligrams or 10 to 20 grams a day. So, use higher dose creatine if you need it for the neurological effects and that would be one-off because it'll honestly give you diarrhea using that much frequently, but then just 5 grams a day and it works perfectly, this pure old creatine monohydrate.

Darshan: Yeah, yeah. And, I saw one study 8 grams a day decreased risk of cognitive impairment in Alzheimer's as well, neuroprotection.

Ben:  Yeah. So, that was as low as 8. I said 10 to 20, but it sounds like you see as low as 8.

Darshan:  Yeah.

Ben:  Yes, that's impressive.

Darshan:  Yeah.

Ben:  So, we've got therapeutic plasma exchange, we've got this Cleerly scan, we've got the cancer and the liquid cancer biopsies, the MRIs, the screenings. You guys do a lot more than that at Next Health with your executive panels, and we've talked a lot more about this in the past as well, I'll link to all the previous shows I've done with Darshan at BenGreenfieldLife.com/NextHealthLife.

Anything else exciting coming down the pipeline, whether it's technologies, events, tests that you think would be cool for people to know about and give them a preview of?

Darshan:  Oh, yeah. So, we're doing a lot around managing for metabolic disease. And so, we're providing patients with advice around how to manage metabolic disease. And, I love the continuous glucose monitor. If you don't have one–

Ben:  Wear one right now back there somewhere hidden behind all the tubes of blood.

Darshan:  Yeah. Truly understanding how your metabolism works is key. So, we're doing a lot with that, we're doing a lot with the full body MRI scanning as part of our executive physical. We do a lot of functional medicine as well. So, for people out there that don't have a functional medicine doctor, look into that. About hormone balancing, gut health, also around brain health and detoxifying your life. We live in the most toxic environment ever in human history right now. So, understanding how to detoxify the air you breath, the water you drink, the food you eat, these chemicals you put on your skin is super important.

And then, as far as longevity technology goes, this is the cutting edge right here. We combine this with stem cell, exosome therapy as well after the plasma exchange is done. We do a lot of ozone therapy as well for people that are struggling with things like Lyme disease or mold poisoning, et cetera. And, I think there's a huge uptick in education around all these things with podcasts like yours, mutual friend Huberman, Tia, all these guys are really talking on scientifically based protocols to improve your health, wellness, longevity. And, I really appreciate that like looking at the science.

And, we're doing an event in April that's sold out unfortunately but hopefully, we'll do it on a yearly basis, kind of bringing all the thought leaders like yourself together in Los Angeles.

Ben:  You guys are going to record that at all?

Darshan:  Unfortunately, a lot of the guys won't allow us to record.

Ben:  Oh, man, those bastards. You can record mine. I don't care.

Darshan:  Alright, awesome. We're definitely going to record yours and put it up then. That's fantastic. Yeah. But, we will record as many as we can because there's so much good knowledge out there. And, I think everyone should just know that the amount of knowledge that we're gaining is incredible right now. The uptick and the amount of science that's being done, I really believe that the singularity is going to happen where we're going to figure out how to live many, many years longer. So, get yourself educated, understand what's coming out, and just start doing some of this stuff.

Ben:  Yeah.

Darshan:  And, I think a lot of people get caught up in the controversy like we're talking about, the religious aspects of meat, no meat, apoB. Don't worry about your cholesterol. I think it's super individualized. You have to discover what works well for you rather than to hang your hat on one camp, right?

Ben:  Yeah. I've always said that I like to think of myself as having one foot in the realm of modern wisdom or ancient wisdom, the other foot in the realm of modern science. And, I think part of that comes down to accepting both natural, naturopathic, alternative, hippie remedies like, I don't know, tying a chicken around your neck and eating chicken noodle soup, and also modern allopathic diagnostic precision medicine that tells you the type of stuff that we talked about today. I think you can have both. Like you said, eat a Mediterranean diet but can get a CT angiography too. And, I think that's a takeaway for me from this show is embrace a lot of this stuff that you might not think you need to do because you're healthy, bro, but it turns out that that could be an entirely different story than what's actually going on.

Darshan:  Yeah. You're a living example of everything. And, that's right but also you do everything right. But, we can still find stuff, and that's where Western–I'm a reformed Western medical doctor, right?

Ben:  Yeah.

Darshan:  I used to be a surgeon doing everything western medicine taught me to do, and I found that that doesn't necessarily lead to optimal health. And so, I totally changed my career into functional medicine, nutrition, exercise, and learning more about that. And, you're absolutely right, these things work together. And so, you got to use the best of both worlds.

Ben:  Yeah, yeah. Well, Darshan, thank you so much. Shownotes, folks, are going to be at BenGreenfieldLife.com/NextHealthLife. I'll link to all the other shows I've done with Darshan. You can leave your questions, your comments, your feedback there. Thank you so much for watching. If you saw the live version, hello, and I'm Ben Greenfield along with Darshan Shah of Next Health signing out. Have an amazing week.

Darshan:  Thanks, everybody.

Ben:  Hey! So, just a quick thing before we wrap up today's episode, Darshan let me know after this fascinating podcast we recorded as we both became younger that Next Health is actually franchising internationally and already has 30 locations signed up internationally for franchising. And so, if you are interested in Next Health from a business standpoint, go ahead and go to the shownotes, contact Darshan and you'll be able to go to their website when you access the shownotes. And, you can actually be operating a Next Health facility yourself potentially if you're a physician or a clinician who's interested in getting involved with Next Health. So, heads up and thanks for listening.

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Previous podcast with Darshan Shah:

Dr. Darshan Shah

Podcast with Dr. Ram Dandillaya:

During this discussion, you'll discover:

-Topics lately on Ben’s mind…05:20

  • Lifespan and life extension
  • Immune system and detoxification
  • Heart health
  • Cancer

-Therapeutic plasma exchange…06:55

  • Ben and Dr. Shah are hooked up like robots to machines
  • TPE – Therapeutic Plasma Exchange
    • Separates blood into it's components – plasma and blood cells
    • A giant centrifuge
    • The machine is FDA-approved
    • Traditionally, was used for autoimmune disease but also used for persons without autoimmune diseases
    • In the past, the machine was used for familial hypercholesterolemia
    • Removes cholesterol in case of high LPL
  • 55% of blood is plasma
  • Where all of the ions, toxins, growth factors, the communication factors are
  • 45% is red blood cells, white blood cells, and platelets
  • Dr. Shah’s machine is like a  full body PRP
  • Reinfusing albumin – plasma is replaced by albumin
    • Albumin is donated albumin
    • Filtering autoimmune complexes and replacing them with albumin
  • Taking plasma out of blood and replacing it with electrolytes
  • What the machine removes:
    • Inflammatory cytokines
    • Inflammatory molecules
    • Heavy metal and other toxins
    • Protein complexes that are deleterious
  • Parabiosis
  • Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise
  • Advantages of exercise:
    • Lowers blood pressure
    • Lowers blood sugar
  • Podcast with Dr. Ram Dandillaya:

-Is cholesterol bad…17:33

  • The cholesterol debate is very nuanced
    • Having too high cholesterol is not bad for everybody
    • Many people need cholesterol-lowering
  • Negative effects of high cholesterol
    • Atherosclerosis
    • Damage to the arterial wall, mostly from hypertension
  • Tissue cholesterol levels versus blood cholesterol levels
  • Every cell wall needs cholesterol
  • If we had a measure of cellular cholesterol levels, that would be the best measure
  • Blood cholesterol levels are only used as an indicator for treatment
    • It's a risk factor for disease, not a cause for disease
  • How often should TPE be done?
    • 6 treatments over 12 weeks – a decrease in the progression of Alzheimer's by 15 to 30%

-What is CT angiography…24:14

  • Ben’s experience with CT Angiography (Cleerly scan)
    • It tells you the amount of plaque that you have in your heart
  • Ben’s score was very high
    • After a lot of measures to decrease it, it has gotten even higher
  • Measures Ben implemented to lower his Calcium score:
  • CT calcium score is a CAT scan of your heart
    • 10 minutes, minimal radiation
    • The most underutilized diagnostic test in healthcare today
    • It gives us an indicator of if you're forming calcium plaque
  • CT angiogram
    • 45 minutes, more radiation, still safe
    • Shows if you have soft plaque
    • More treatable than calcium plaque
  • Soft plaque is unstable, and more likely to cause problems
  • Can extreme training and the keto diet make things worse?
    • Every individual has a different story
  • Athletes very often have inflammation and elevated cholesterol levels
  • Over-training can affect your health negatively
  • HART test
    • Indicators of heart stress
    • More expensive than a CT calcium score

-Other data from Ben’s test…38:47

  • Seeing other blood vessels that are supplying the heart
    • A few lesions on his right coronary artery (plaque accumulation)
    • Different plaque stages
  • Statins are some of the most overprescribed medications in the world
  • The Mediterranean diet has been extensively studied and is very successful at reversing plaque
    • From the amount of vegetables, high fiber, and olive oil
  • On the atherosclerotic chart, Ben is stage 2
  • A combination of statins and Zetia is great for soft plaque
    • Crestor (rosuvastatin) statin
  • Some people are genetically non-responders to statins
  • Ben did a genetic test and  it showed he was the one
  • Joe Cohen Show – Podcast with Dr. Darshan Shah 
  • He was recommended PCSK-9 Inhibitor
    • An injectable medication that works in the liver
    • Inhibits an enzyme PCSK-9
    • It breaks down a receptor that catches cholesterol in the bloodstream
  • Plaque reversal using therapeutics
    • CT angiogram, with the right treatment protocols, has been shown to reverse plaque
  • Recommendation for Ben to reduce plaque
    • 5mg of Rosuvastatin
    • 10mg of Zetia
    • Twice a month injection of PCSK-9
  • Elevated ApoB should be lowered to around 50 or lower with PCSK-9
    • PCSK-9 is very effective in lowering APLB

-Colon cancer and liquid biopsy…47:34

  • Dr. Shah was a surgeon and removed more than 200 colon cancers
  • Ben has a high risk of colon cancer
  • Colon cancer is incredibly underdiagnosed
  • Symptomatic cancer is almost always stage 3 or stage 4
    • At this stage, instead of talking about cure, we're talking about a 5-year survival rates, with chemo and radiation
  • For colon cancer, the best diagnosis is a colonoscopy
    • Some people say colonoscopy is too risky to do regularly
    • There's so much fear mongering
  • For high risk individuals like Ben, once every 2 years
  • Ben talked with Dr. Ahvie Herskowitz about cancer
    • Increased rates of cancer among the young population
    • Liquid cancer biopsy
  • Podcast with Dr. Ahvie Herskowitz:
  • Dr. Shah’s cancer diagnostic protocol
    • A full-body MRI
    • A liquid biopsy
    • A full skin evaluation
    • All the regular cancer screening stuff
      • Mammogram and OB-GYN for women
      • PSA level and prostate exam for men
      • Colonoscopy for both men and women
  • Liquid biopsy is a game changer in medicine
    • Blood tests to find cell-free DNA of tumors (tumors shed DNA when they first develop into the bloodstream)
      • Detected in the bloodstream using DNA sequence analyzers
    • A massive step forward in medicine and cancer diagnostics
    • Can diagnose highly lethal forms of cancer like pancreatic or liver cancers
  • Incidentaloma in MRI and false positive diagnosis

-The importance of avoiding red meat.54:44

  • WHO made red meat is marked as a cancer-causing substance because the studies were done on processed and irresponsibly grown red meat
  • Organic, well-raised red meat is OK
    • Grass-fed, grass-finished
  • KOW
  • ButcherBox
  • Protein is vilified
  • Not getting enough protein causes a lot of chronic conditions
  • Ben’s recommendation:

-Other things Dr. Shah does…59:29

  • Next Health protocols
  • Doing a lot around managing metabolic disease
    • Understanding how your metabolism works is key
  • Full-body MRI scanning
  • A lot of functional medicine
  • Hormone balancing, gut health, brain health
  • Longevity technology
    • Stem cells
    • Exosome therapy
    • Ozone therapy
  • Upcoming event in April with thought leaders

-And much more…

Upcoming Events:

  • Unlock Longevity: February 24, 2024

Join me in Austin, Texas, on Saturday, February 24, 2024, for the Unlock Longevity event where I'll be presenting on “The 5 Elements in Your Environment That Will Make or Break Your Health.” Check out more by going to bengreenfieldlife.com/unlock-longevity (use code Greenfield10 for $10 off your ticket).

Resources from this episode:

– Dr. Darshan Shah:

– Podcasts And Articles:

– Other Resources:

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