Uploaded June 2020 | Updated September 2026, 54 minutes ago
0:00 Intro and brief overview of Lean Mass Hyper-responders
Producer Note: Please see the accompanying post on CholesterolCode for the graphics shown.
Site mentioned: Lean Mass Hyper-responders facebook group
facebook.com/groups/LeanMassHyperResponder
1:30 How does Philippa’s view on Lean Mass Hyper-responders differ from Dave’s?
3:11 How Philippa found the Lean Mass Hyper-responders facebook group
6:39 Philippa’s history with Hashimotos and perspective on thyroid function in LMHRs
Producer note: Hashimotos Thyroiditis is an autoimmune condition affecting the thyroid often resulting in an underactive thyroid
7:52 Does Philippa feel Lean Mass Hyper-responders have a thyroid dysfunction?
11:05 In accordance with the lipid energy model, wouldn’t you need lower T3 in order for higher levels of lipolysis to take place?
13:43 Does higher relative delivery of Free Fatty Acids to the liver result in higher production of VLDL? Does it depend on context?
17:31 What is futile cycling of fatty acids? Does it make sense?
21:18 The distributed object network model of energy potential trafficking, and how VLDL and fat tissue repletion, may play a key role.
26:58 Is it possible for someone who has never had hypothyroidism symptoms who went on a low carb diet and developed a Lean Mass Hyper-responder profile to completely erase the profile with medication?
30:35 Example of a Lean Mass Hyper-responder reversing the profile from diet
Producer note: To provide a little additional information, having been in close communication with the LMHR in question, the drop of LDL to 140 mg/dL from 800 mg/dL+ was after increasing weight by ten pounds, increasing meal frequency from one meal a day to two meals a day, decreasing exercise intensity and frequency and including “carb ups”. So macronutrients did change as did multiple other factors. As Philippa said, these are consistent with the lipid energy model, and her thyroid/anabolic signaling model.
33:06 Is the loss of a menstrual cycle in female Lean Mass Hyper-responders a red flag, and/or common?
36:37 Review of triglyceride and fatty acid metabolism in adipose, skeletal muscle, and liver and how it relates to the lipid energy model.
Producer Note: Please see the accompanying post on CholesterolCode for the graphics shown.
Study mentioned: Fatty acid metabolism in adipose tissue, muscle and liver in health and disease - Keith N. Frayn, Peter Arner and Hannele Yki-Järvinen 2006
pubmed.ncbi.nlm.nih.gov/17144882
44:13 What are the commonalities and differences between lipid profiles in people with hypothyroidism and Lean Mass Hyper-responders?
Study mentioned: The effects of thyroid dysfunction on lipid profile – C.V. Rizos, M.S. Elisaf, and E.N. Liberopoulos 2011
ncbi.nlm.nih.gov/pmc/articles/PMC3109527
47:50 Common reasons for high triglycerides in Lean Mass Hyper-responders, and generally for those on a low carb/carnivore diets.
Post mentioned: High triglycerides on low carb and what to do about it.
cholesterolcode.com/high-triglycerides-on-low-carb-and-what-to-do-about-it
Producer note: Going by submitted data on CholesterolCode, triglyceride levels of 200+ are not that uncommon from coffee sensitivity. Although a pull of the data we have would be necessary to see exactly how frequent it is, anywhere between 150-250 is what I most commonly see, from memory.
51:05 HDL and triglyceride inverse correlation and relation to Lean Mass Hyper-responders and the thyroid dysfunction hypothesis
53:11 Are there other things to look out for that may help suggest a non-favorable situation relating to the Lean Mass Hyper-responder profile?
55:40 Dave’s data on IGF-1 and LDL-C compared to predicted correlation
Producer Note: Please see the accompanying post on CholesterolCode for the graphics shown.
58:27 Overview of thyroid markers, their structure, and function
1:02:33 Does Philippa have any additional thoughts to share before wrapping up?
Blood marker changes of interest in Lean Mass Hyper-responders mentioned: MCV (Mean Corpuscular Volume) in 90s-100s, RBC (Red Blood Cell count) decreasing slightly, RDW (Red Blood Cell Distribution Width) increasing slightly
1:05:05 Context of blood markers being studied and how correlation with pathological contexts may be relevant
1:07:29 Leptin levels in the context of low carb, the thyroid dysfunction hypothesis, and the lipid energy model
1:12:50 Will Lean Mass Hyper-responders show signs of insufficient anabolic signaling, such as low bone density, over time?
1:17:37 Dave’s thoughts on investigating potential downsides to the Lean Mass Hyper-responder profile.
Link Mentioned: Philippa’s google doc on the thyroid dysfunction hypothesis
dropbox.com/s/8aqmntirz6t0fat/document%20for%20facebook.docx?dl=0
1:23:08 Outro
0:00 Intro and brief overview of Lean Mass Hyper-responders
Producer Note: Please see the accompanying post on CholesterolCode for the graphics shown.
Site mentioned: Lean Mass Hyper-responders facebook group
facebook.com/groups/LeanMassHyperResponder
1:30 How does Philippa’s view on Lean Mass Hyper-responders differ from Dave’s?
3:11 How Philippa found the Lean Mass Hyper-responders facebook group
6:39 Philippa’s history with Hashimotos and perspective on thyroid function in LMHRs
Producer note: Hashimotos Thyroiditis is an autoimmune condition affecting the thyroid often resulting in an underactive thyroid
7:52 Does Philippa feel Lean Mass Hyper-responders have a thyroid dysfunction?
11:05 In accordance with the lipid energy model, wouldn’t you need lower T3 in order for higher levels of lipolysis to take place?
13:43 Does higher relative delivery of Free Fatty Acids to the liver result in higher production of VLDL? Does it depend on context?
17:31 What is futile cycling of fatty acids? Does it make sense?
21:18 The distributed object network model of energy potential trafficking, and how VLDL and fat tissue repletion, may play a key role.
26:58 Is it possible for someone who has never had hypothyroidism symptoms who went on a low carb diet and developed a Lean Mass Hyper-responder profile to completely erase the profile with medication?
30:35 Example of a Lean Mass Hyper-responder reversing the profile from diet
Producer note: To provide a little additional information, having been in close communication with the LMHR in question, the drop of LDL to 140 mg/dL from 800 mg/dL+ was after increasing weight by ten pounds, increasing meal frequency from one meal a day to two meals a day, decreasing exercise intensity and frequency and including “carb ups”. So macronutrients did change as did multiple other factors. As Philippa said, these are consistent with the lipid energy model, and her thyroid/anabolic signaling model.
33:06 Is the loss of a menstrual cycle in female Lean Mass Hyper-responders a red flag, and/or common?
36:37 Review of triglyceride and fatty acid metabolism in adipose, skeletal muscle, and liver and how it relates to the lipid energy model.
Producer Note: Please see the accompanying post on CholesterolCode for the graphics shown.
Study mentioned: Fatty acid metabolism in adipose tissue, muscle and liver in health and disease - Keith N. Frayn, Peter Arner and Hannele Yki-Järvinen 2006
pubmed.ncbi.nlm.nih.gov/17144882
44:13 What are the commonalities and differences between lipid profiles in people with hypothyroidism and Lean Mass Hyper-responders?
Study mentioned: The effects of thyroid dysfunction on lipid profile – C.V. Rizos, M.S. Elisaf, and E.N. Liberopoulos 2011
ncbi.nlm.nih.gov/pmc/articles/PMC3109527
47:50 Common reasons for high triglycerides in Lean Mass Hyper-responders, and generally for those on a low carb/carnivore diets.
Post mentioned: High triglycerides on low carb and what to do about it.
cholesterolcode.com/high-triglycerides-on-low-carb-and-what-to-do-about-it
Producer note: Going by submitted data on CholesterolCode, triglyceride levels of 200+ are not that uncommon from coffee sensitivity. Although a pull of the data we have would be necessary to see exactly how frequent it is, anywhere between 150-250 is what I most commonly see, from memory.
51:05 HDL and triglyceride inverse correlation and relation to Lean Mass Hyper-responders and the thyroid dysfunction hypothesis
53:11 Are there other things to look out for that may help suggest a non-favorable situation relating to the Lean Mass Hyper-responder profile?
55:40 Dave’s data on IGF-1 and LDL-C compared to predicted correlation
Producer Note: Please see the accompanying post on CholesterolCode for the graphics shown.
58:27 Overview of thyroid markers, their structure, and function
1:02:33 Does Philippa have any additional thoughts to share before wrapping up?
Blood marker changes of interest in Lean Mass Hyper-responders mentioned: MCV (Mean Corpuscular Volume) in 90s-100s, RBC (Red Blood Cell count) decreasing slightly, RDW (Red Blood Cell Distribution Width) increasing slightly
1:05:05 Context of blood markers being studied and how correlation with pathological contexts may be relevant
1:07:29 Leptin levels in the context of low carb, the thyroid dysfunction hypothesis, and the lipid energy model
1:12:50 Will Lean Mass Hyper-responders show signs of insufficient anabolic signaling, such as low bone density, over time?
1:17:37 Dave’s thoughts on investigating potential downsides to the Lean Mass Hyper-responder profile.
Link Mentioned: Philippa’s google doc on the thyroid dysfunction hypothesis
dropbox.com/s/8aqmntirz6t0fat/document%20for%20facebook.docx?dl=0
1:23:08 Outro








![#CholesterolScience Show - with Dr Joel Kahn
Note: to view slides, see the accompanying blog post at https://cholesterolcode.com/cholesterolscience-show-with-joel-kahn/
0:19 Intro
1:32 Dr. Joel Kahn’s backstory – past career, health, and how he came to understand cholesterol and heart disease.
5:56 How and why Joel started a plant-based diet
7:44 Joel’s thoughts on experimentation and guidelines from a clinician’s perspective
10:25 Health from a nutrition-based perspective, and Joel’s observations on the history of nutrition
Study mentioned: Mortality from circulatory diseases in Norway 1940-1945.
https://www.ncbi.nlm.nih.gov/pubmed/14795790
Study mentioned: Reduction of Mortality Rate in Coronary Atherosclerosis by a low Cholesterol-low Fat Diet.
https://www.sciencedirect.com/science/article/pii/0002870351901500?via%3Dihub
16:45 The difficulties and ambiguities involving studies done on diets impacting health
Study mentioned: Anti-inflammatory Effect of Whole-Food Plant-Based Vegan Diet vs the American Heart Association - Recommended Diet in Patients With Coronary Artery Disease: The Randomized EVADE CAD Trial
https://www.ahajournals.org/doi/abs/10.1161/circ.136.suppl_1.23081
18:40 Devil’s advocate intro
18:50 Is there any value of any kind in having high values of LDL particles in the body and, if so, do studies account for this when looking at disease outcomes?
Study mentioned: The low-density lipoprotein pathway and its relation to atherosclerosis.
https://www.ncbi.nlm.nih.gov/pubmed/197883/
21:09 Is there a possible immunological benefit to high LDL particle count?
23:19 Many who go on a LCHF diet see their LDL go up but will likewise many see their HDL climb and their triglycerides drop. Is it possible that this could result in lower risk of CVD?
Researcher mentioned: William Roberts
27:52 many studies tout changes in risk for CVD mortality yet show no difference in ACM. Doesn’t this run the risk of assuming there is an overall benefit where there is none?
Study mentioned: Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease.
https://www.ncbi.nlm.nih.gov/pubmed/3313041
31:30 discussion on PESA study and silent atherosclerosis in apparently healthy people
Study mentioned: Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study.
https://www.ncbi.nlm.nih.gov/pubmed/25882487
[Slide mentioned: Slide 1]
34:18 The impression of the intention of scientists from the public
35:25 The importance of the data concerning HDL and triglycerides to the public
Study mentioned: Intensive Lifestyle Changes for Reversal of Coronary Heart Disease
https://www.ncbi.nlm.nih.gov/pubmed/9863851
38:35 The impact of money in medicine
40:44 Possible tunnel vision in engineering and research
42:22 Audience Questions Intro
42:30 Aren’t all apoB lipoproteins atherogenic?
NOTE: “apoB lipoproteins” is short for “apolipoproteinB containing lipoproteins”. ApolipoproteinB is an identifying protein on lipoproteins like chylomicrons (from the gut), and VLDL, IDL, LDL, and lipoprotein(a) (from the liver).
45:46 Could there be a case where HDL could be lower without increasing risk?
47:07 Apart from heart disease, what is the main concern you see with being a hyper-responder?
48:51 None of the risk calculators use LDL at all. Why? Why do they all show low risk as long as HDL is high and no blood pressure issues, etc.?
51:39 What do you make of the data showing LDL-C going up during fasting?
56:43 Why is high LDL bad if there is no oxidation or inflammation present? Is TG/HDL a better marker for coronary disease?
[Slide mentioned: slide 7]
1:00:59 Why does atherosclerosis only develop in certain spots, and not evenly throughout the arterial vascular system?
1:06:32 Is there data on heart attacks and strokes in people with high LDL-P and LDL-C but with good [Atherogenic Index of Plasma], no Type 2 Diabetes, no elevated BP, low inflammation, CAC 0, etc
1:09:53 The importance of testing beyond CAC
Note: Joel Kahn mentions CIMT (Carotid Intima-Media Thickness) which is an ultrasound of the carotid arteries in the neck and can be used as an additional marker of CVD risk/progression.
1:13:12 Kudos to Dr. Joel Kahn
1:14:23 Doctors as consultants, and taking ownership of your own health
1:16:06 What comes along for the ride with meat that you find to be a problem for humans?
1:23:03 Any comment on LDL levels and infection risk
1:25:02 Mendelian Randomization and what they say about LDL and risk, and issues with genetic studies
[Slide mentioned: slide 5]
[Slide mentioned: slide 4]
Video mentioned: A Century of Cholesterol and Coronaries
https://www.youtube.com/watch?v=aRT2tqmzlog
1:32:46 Final thoughts and outro
1:35:25 Where you can find Joel Kahn
Twitter: @DrJKahn
Website: https://drjoelkahn.com/ #CholesterolScience Show - with Dr Joel Kahn](https://i.ytimg.com/vi/JHzfU7TgcGo/mqdefault.jpg)

