He’s Treated Heart Disease for 36 Years. Here’s What He Wants You to Know | Dr. Joel Kahn

Always put it number one on your priority list to assess what is your heart health. You can say, but Doc, I go to yoga and I eat my chickpea salads and I sleep 8 hours. My BMI is 23. But never guess if you have heart disease. Just find out. Blood work and imaging. We need to talk about the test. Everybody listening Today must have Musd. Must have. Hello.

Welcome back to the Dr. Joy Kahn podcast. Welcome. You know, I'm here to help you live longer and healthier. And I'm inviting really wonderful experts in health and longevity field, or any field in medicine to come in and inform you to give you the best tips so you know what to do. Today I have the distinct pleasure of inviting Dr. Joel Kahn, a cardiologist, to come enlighten us on everything about the heart. So, Dr. Kahn, thank you so much for being here.

Well, I'm a big fan of yours. I learned a lot from you. So let me give you a little payback, hopefully.

Oh, thank you so much. That's very kind of you. Yeah. Let me introduce you to the audience a little bit. So Dr. Khan is based in Detroit, Michigan. He is a clinical professor of medicine at Wayne State University School of medicine. And Dr. Kahn has triple board certification in internal medicine, cardiovascular medicine, and interventional cardiology. He was the first physician in the world to certify in metabolic Cardiology with a 4am he founded the Kahn center for Cardiac Longevity in Michigan. So, Dr. Kahn, and you also wrote multiple books. So I'm sure you have a lot to share about heart health. And you probably were trained conventionally. You know that there's a whole set of parameters that how we were trained in medical school is definitely focusing on disease models. So we're, we're experts at diagnosis and using drugs. But I think you have veered away from that, that box.

You know, I've been practicing cardiology for 36 years. And about 10 years ago, I opened this specialty boutique, preventive cardiology, integrative cardiology office in suburban Detroit. I'm also in Miami, in Boca Raton in the winter. I'm not done. It gets cold and uglier in Michigan in the winter. I still have to at times. I saw patients. Today I have patients that had bypass a month ago and stents, and they're on prescription drugs. But the overall emphasis is to catch you 10, 15, 20 years before you're in trouble. Set up a program of lifestyle predominantly. Could be some supplements, could be some peptides and keep you out of trouble long term and hopefully keep you out of the drugstore too. If I can get by without, you know, pharmaceutical agents, we'll do it. But when we're dealing with heart disease, there's so much of it. So many of the listeners today have heart disease and don't know it. And we need to tell them how they need to get checked while they're on the longevity journey. Peter Diamandis, A lot of people know that name. Peter Diamandis, M.D. anti Aging Longevity expert says, while you're working on your longevity, don't die of something stupid. And I actually agree with them because we talk about peptides and bioregulators and stem cells and, you know, blood transfusions and the rest, and we don't talk about heart disease. So if we leave your audience with nothing more than a free, decent, easy plan to ask the question, how old is my heart and is my heart on a anti aging journey while the rest of it is, we'd be, you know, making good progress.

Yeah. And of course, the heart is the foundation for, for every organ in our body. We have to have a healthy heart. But I think as far as the, the medical model is focusing more on treating heart diseases. So I don't think we were very well equipped to really prevent them from ever getting heart disease. So where do you think are lacking like, you know, what's the state of heart health in America?

Well, number one, it's absolutely key that people know that it still is the number one most common cause of serious disability and death, men and women. And it can attack and affect anybody. A yoga person, a thin person, a person taking bioregulator peptides, a person fasting. I mean, you can do cold plunge, you can do infrared sauna, you can do anything, red light therapy. You can still have heart disease and have a heart attack or drop dead. Always put it number one on your priority list to assess what is your heart health. And you need to have a plan how to check that. Number two, along with the statistic about how frequent heart disease and somebody dies every 34 seconds in the United States of heart disease. Somebody has a heart attack every 40 seconds in the United States. These are such huge numbers that we just, they fly by so quickly. Number two is you do not have to have symptoms to have heart disease. You do not have to have symptoms to have severe heart disease. Maybe you're having burning tightness, pressure, maybe you're getting short of breath on the pickleball court more than you used to. Maybe, you know, you're tired and fatigued and you got to Take a break in tennis that you didn't used to. You're kind of lucky if that's the case. At least you're getting a warning, although that's usually in somebody with very advanced heart disease. But for the majority of people all those years are developing clogged arteries, they have no symptoms. You cannot be satisfied that you worked out this morning and feel well. And you conclude I don't have heart disease. That will get you burned in the long run if you make that assumption. And third, I think, you know, you talk about a preventive model. We learned early in the game, in the 60s and 70s, so 50 years ago, that smoking, diabetes, high blood pressure, high cholesterol, and mom, dad, brother, sister having an early heart attack, bypass or dropping dead were all risk factors that we are also going to develop heart disease. Well, that is still the medical model to ask about, calculate and have a list of five or six things that you inquire with a patient. In reality, the list is about 20, 25, 30 things long. Psoriasis, lupus, taking a lot of protonics or other acid blockers, taking a lot of non steroidals like Motrin and other agents like that. Obviously your diet, I mean needless to say, obviously your sleep quality, needless to say, and on and on. Your dental health, your oral health, your gum health, on and on. That you really want somebody to go deeper in a broad blood panel, real broad blood panel, usually covered by insurance or some people are using, you know, Lifeforce or Function health or Life Extension or some of the other companies, you know, that will do that. And I'll you, you want extensive labs as a minimum. That's not enough, but at least it's a start. So those are some of the, the big point. You know, I go by a hashtag test, not guess, never guess. If you have heart disease, just find out blood work and imaging. I haven't talked about imaging, but we need to talk about the test. Everybody listening today must have M U S T must have.

Okay, so which are the labs that you would recommend everybody to get?

I could make a very long list, but you know, at a minimum you need a cholesterol panel. I'd suggest you get what's called an advanced cholesterol panel. $25. All the labs offer it. It offers things like, it's called your LDL size, your LDL particle number. But you know, you either order yourself or you ask your primary care doctor to order an advanced cholesterol panel. You want to know at least your hemoglobin A1, C, three month blood sugar. But you want to know your fasting blood sugar. You probably should know your insulin level. These are all widely available. You want to know, of course, your liver, your kidney, all the things a doctor is going to do, your vitamin D, your Omega 3. But your primary care doc is probably not measuring your homocysteine level. I have so many patients at 1 this morning in the office. And when I do the blood work, you know, These are people 50, 60 years old. They haven't had one moment of methylation in their whole life according to their homozygote level. So we put them on B complex vitamins and they're much more efficient methylators, and their homocysteine level comes down. You want inflammation tests, at least one high sensitivity C reactive protein, also known as chest CRP. In reality, there's three or four other critical ones. MPOLP L A2, but get one at least. And the last one I'll throw at you is the topic of one of the books I wrote. And I'm going to show this mainly because it's such an awkward word.

Yeah. It says lipoprotein A. Yeah.

And it has to be pronounced little, a little A, lowercase A. And a lot of people ask for this and they get a different blood test that has a capital A. So what a pain in the rear this is. But this is a genetic cholesterol. Every lab offers it for 20, $30. I mean, it's not a big deal.

And you call that heart's quiet killer?

Yeah, it's a genetic cholesterol that one out of every five people, sometimes one out of every four, inherit the ability to make it from mom and dad from the moment they're born. So they're two years old on the playground and they're making extra toxic cholesterol. This is a toxic cholesterol. This is more toxic 6. Toxic. More toxic than LDL cholesterol for causing atherosclerosis, hardening the arteries, for causing one of the four heart valves to get scarred and calcified. So you can say, but, doc, I go to yoga and I eat my, you know, chickpea salads and I sleep eight hours on my Aura ring. And, you know, my BMI is 23, but, you know, nobody's ever checked this. And you find out it's sky high. And you find out you might or might not, but you might have clogged arteries so that that would be the last.

What do you do about it when you have a high level of this.

Is a tricky one. And you know, regular cholesterol responds to exercise. Regular cholesterol responds to a fiber rich plant, strong diet, of course lower in saturated fat. And everybody who's a carnivore hates to hear that, but it's true. There's a ton of supplements for regular cholesterol. There's all the prescription drugs for regular cholesterol. Hospital right now, Lipoprotein A is a tough one. There is no FDA approved drug to lower it and you want to lower it, but there is no FDA approved drug. Statins like Lipitor don't work and they actually make this worse. They cause it to go up the opposite of what we would want to do. There are three drugs in the pipeline. One was supposed to be released this year, but now it's been delayed a year. We don't know why. 8,000 patient double blind randomized study of a drug you inject once a month that lowers the heck out of lipoprotein A. Like 90%, 95% seems to be working pretty safely. But the company Novartis out of basal Switzerland delayed the results for a year. So we're all scratching our heads and saying, you know, you told us it would study would be done. So we don't know why that is. We don't have a drug available at this point.

Do we know if it actually correlates lowering lipoprotein A? Does it correlate with the protection?

There's hints of it in the medical literature. It certainly makes sense that it should, but it's not a proven fact. And if people listening don't know, the FDA doesn't care only about does the new drug lower the level of lipoprotein A. And it does. We know that from phase one and phase two study. They care about is it reducing heart attack, stroke and you know, cost to the country. And that's where we think the results so far maybe were surprisingly a little disappointing because we thought the results would be available in May of 2025, not available in the meantime. And I'm a bit of an oddball. Since the 1950s, Niacin has been used to lower cholesterol. This happens to be a brand. It's not my brand, it's just of extended release. And it turns out in the 50s, 60s, 70s, niacin was found to lower cholesterol and about 20 years ago it was found that it lowers lipoprotein A. I use it in my clinic. Most cardiologists, what would be the dosage you use? Usually 500 milligrams with breakfast, 500 milligrams with dinner. Unless somebody's skipping, you know, breakfast. And you can do lunch and dinner. It can cause a hot flush, red face feeling. This particular brand barely does that at all.

I don't mind it. I kind of like it.

I took, I do funny stuff and I took plain old fashioned niacin this morning. I. This is usually what I take myself. This I can tolerate. Oh my God. My wife said, you're a lobster. And every time I take plain niacin. And that's what we use for years and years, although this brand has been available for about 40 years. So there's a lot of experience here.

Yeah, very interesting.

So we're struggling, but you should know, and if you're high, you know, and if you've gotten function health labs, you know, your lipoprotein little A level, if you've gotten lifeforce labs, otherwise, just go to your primary care doc and say, you know, I could be one of 25% of people and I need to know. Certainly if you have heart attack, strokes, bypass in the family, my aunts, uncles, grandparents, parents, sibling, do it either way. And then if you find out you're high, tell your siblings, tell your parents, tell your kids and maybe get checked. You know, if they're four years old, I don't check them, but If a kid's 21 years old, I think they ought to know what they got.

And people are always puzzled. So many people die suddenly, right? It's, it's not, it's not a. It happens a lot with young, healthy athletes. I mean, that's pretty scary.

It happens with healthy athletes, but it also happens with a person that wouldn't know the inside of a gym if you, you know, walk them in there. The, the unhealthy. It's actually one of my favorite sad topics that in the United States alone, a thousand people a day die called sudden cardiac death. SCD.

That's a lot.

10% of the time they're sitting. That's not a really like noble place to have your last moment of life. And that's where that. Or they're in their car, maybe they just left the gym and they got some heartburn and they're trying to jo. Just rest and they're dead. I mean, 90% of the time, even if somebody's around and starts CPR, 90% they die. So we're trying to pick up heart disease. So let me just say this. If Bobby Kendi Jr. Calls me right now and says, you know, cardiologist what are we going to do for American health? Nobody's talking about this in the maha movement, unfortunately, we're talking about beef tallow versus sunflower oil, but that's a really small topic. Personally, I would say at age 40 to 45, everybody listening or older, get these blood tests and then get one more thing and the. And again, I'm not here to sell my books. I'm really not. I will never make a living selling my books. I wrote this book about 14 years ago, and then I rewrote it.

Yeah. Back it off a little bit. It says dead execs don't get bonuses.

And it's basically a plea that everybody listening. Hopefully, you know about stem cells, you know about telomeres, you know about epitalon and other amazing topics. But do you know the health of your heart? And do you know that your local hospital has a CT scanner that you can pay about 100 or $150 and go get a heart CT scan? No injection, no allergy, no pain. About the same radiation dose as a mammogram. And this CT scan tells you the age of your heart arteries. So that person with those white spots in the circle, very old heart arteries. That person is in some trouble. They're in a pickle. This person, same test doesn't have those white spots. That's called calcified plaque.

Back up a little bit so we can see. Okay.

It doesn't have any of that. And this test takes 5 to 10 seconds. It doesn't matter if you're at Harvard or Cedar Sinai or University of Michigan or your local hospital in a town of 10,000. Almost all hospitals offer coronary artery calcium scan and that they calculate using software. A result, a number. And you want your number to be zero. I'm 66 years old and my heart score is zero. So now I can go work on peptides and bioregulators and, you know, fasting programs and cold plunges, because I know I'm not going to die of something stupid. I also do. I do my gallery cancer screening, and I do my total body mri. And yeah, of course I have colonoscopy or cologuard. I mean, I do all the basics, but, you know, check your heart first.

So the calcium score is mostly available in the hospitals.

Yeah. Or freestanding CT scanner. It is ct. MRI is kind of sweet because there's no radiation. But MRI doesn't give you this information. Ultrasound. Ultrasound is sweet. No radiation can give you this information.

So you want the score to be zero, which Means there's really zero calcification or blockage really.

Right.

So what if somebody has a score that's not zero? What do you do?

One, it goes back to basics if they haven't had all the lab work, you know, what's her homocysteine, what's her inflammation panel, what's her lipoprotein little A, what's her vitamin levels? So hormone levels, you know, is it a guy with a testosterone of 110? Is it a woman who probably should be on hormone replacement therapy? Turns out hormone replacement therapy at menopause lowers this cholesterol too. So I'm a big fan of women getting a serious high level consult. A lot about starting HRT around the time of menopause. It's one of the few things that lowers that lipoprotein. So we're going to do all that. We're going to, you know, I want to know what breakfast, lunch, dinner, snacks. Are you drinking water, are you drinking soda, are you drinking, you know, energy drinks and are you drinking out of plastic bottles? And when you get, when do you last go to the dentist and had your gums examined and how many silver fillings? And on and on and on. 2. We're going to talk about the science that not everybody likes to talk about. And again, I've written a few nice books. I still got one more. But one of the books is called the Plant Based Solution. Goes through the science of people like Dr. Dean Ornish and others, Mr. Nathan Prin and others about how a predominantly or completely plant based quality diet, it can't be all the frozen impossible burger, beyond meat burger junk out in the world, but how that does favor the chance of avoiding or even reversing heart disease. Of course, Mr. Pritikin wrote articles in the 90s, Dean Ornish wrote articles in the 1990s. With good scientific evidence you can reverse plaque in your heart, arteries and other arteries by shifting your diet more and more to the plant side.

Well, the carnivore people are not going to be happy hearing that. Do we know what happens when a person sticks to a carnivore diet?

Well, we got our first clue which is there was a paper published about three months ago that incited a storm online. There was one very well known academic cardiologist, author Matthew Budoff from UCLA harbor. Some other interesting people that do research, Dave Feldman, who's actually more of an engineer but he's got a big following and they took a hundred people that they call lean mass hyper responders, people that eat an Extremely low carb diet. They actually shove their cholesterol up into the 3, 400 range by eating such an extreme high fat, low carb diet. And they claim that they were immune to developing atherosclerosis. So to finally put it to the test, it was not a randomized study. There was no control group. They just grabbed a hundred of these people. They did a CT of their heart arteries, one more advanced than the pictures I showed you, but called a CT angiogram. And they repeated it at a year with the idea that we're going to prove that the keto diet, almost carnivore diet, does not lead to plaque forming over 12 months. Well, that was the headline, but that wasn't the results. And it's created, you know, a hundred podcasts about the keto CTA disaster study and how it wasn't presented. Honestly, now there's a whole lot of manipulating and all to backtrack and try and salvage the work they did on that study. It'll never be perfect. It was not a randomized study. There was no control group, but they.

Were testing one year prior and then a year later. Right. So that's a person serving as his own control.

You're right. Right.

So they showed actually more calcification.

Really looked at it, you saw that plaque was increasing over the 12 months more rapidly than expected. So any. That's about the only data we have right now.

And that definitely should give people a lot of pause.

You know, if you want to eat a carnivore or a ketogenic or a paleo diet, God bless you. There's a lot of advantages.

People can do keto and still eat a lot of plants again.

And, you know, and they can do carnivore and eat some plants if they want to, whatever. But check your heart, get the lab test, see if your cholesterol went up to 440 on a ketogenic.

Mine definitely did. I've tried the Atkins diet before. Ate a lot of meat and cheese. It shot through the roof. Yeah, sure.

Your heart arteries are as close to perfect as possible. So if you're going to do one of those diets that has essentially no data that it's good for the heart, make sure you're not putting yourself at risk. I've seen so many patients that when we ultimately check the arteries, their carnivore and keto diet was not a good decision. They've got to decide what they want to do moving forward.

Hmm. Okay. Yeah. So plants, I guess the phytonutrients that are very protective of the heart, the.

Fiber, the phytonutrients, the high water content, the low saturated, you know, fat content, maybe less. Pesticides, herbicides, some of the crap that, you know, 95% of people are not eating grass, finished organic, regenerative farming meat, they're eating meat. And you know, a lot of it is made under absolutely horrible circumstances.

There's bioaccumulation from the, the, the plants that were, that had pesticides, et cetera.

Right, yeah, all that. And you know, fish, fish love to bioaccumulate toxic metals, particularly mercury, of course. But now PFAs and. PFAs and BPA and phthalates and the whole dirty soup that we live in.

So were you always interested in prevention?

Sort of. I actually adopted personally, this is my bias. I adopted a whole food plant based diet at age 18. So that's 48 years. I've never, never done anything. I haven't had a piece of cheese in 48 years and I'm still alive. So when I was going through medical school, it seemed irrelevant what I was eating, my fellowship. But then I started noticing that there were some papers coming out, certainly Dr. Dean Ornish and Mr. Nathan Pritikin being two of the big names that I read back in the 80s and 90s. Dr. Ornish had a publication in 1983, Nobody Remembers. That's the year I graduated med school. And I said, whoa, he's actually treating heart disease with a plant based diet. I didn't know you could do that. Nobody did. And then I read books by John Robbins that died for New America. So my career was a cath lab cardiologist. I treated your heart attack, I put in your stents, I sucked out your clots. You know, we have all kinds of cool devices in interventional cardiology. I'm still board certified in interventional cardiology. I don't practice it anymore. But my patients would be told, this is the last time you're getting a stent because here's your diet plan. And then it extended to teach him about fitness and sleep and stress management and, you know, joy and love and biotoxin. Yeah. So about 13 years ago, I went back and got certified in integrative cardiology and sort of threw the other life away. I just recreated a life number two. We're allowed to do that.

Hmm. What do I know about stress in the heart?

Well, it's huge. I mean, it's absolutely huge. We've known it for a long time. We know that stress ages us and you can measure it by the epigenetic age tests or test telomere age test. You know, the woman that won the Nobel prize for telomeres in 2009, Elizabeth Blackburn, and a great book, Telomere Fact, I think, you know, show that probably the strongest factor whether you're aging aggressively prematurely is various measurements of stress. So, you know, we all need a tool. You know, some people it's church or synagogue or faith. Some people it's nature, some people it's music. Some people it's unfortunately alcohol and cannabis. I'm not anti everything, but you know, I wouldn't call them effective stress management strategies. I like breathing, I like yoga, I like tai chi, I like qigong. You know, I like heart math, I like respirate. These are more tool based ways of managing stress and lowering your blood pressure. It's a huge factor and it's a little hard to measure, you know, measure a cortisol level, but that's, you can, you can learn more about stress just talking to your patient. Of course.

And of course, so many people under high stress actually die, right? They have a sudden heart attack, like during time of emotional stress.

Yeah, we own for about 40 years that maybe 5 or 10% of heart attacks start during extreme stress. A family argument, a car accident, you know, kind of like Sanford and son, somebody grabbing their chest after a big family altercation. But there's a unique syndrome in women, way more than men, rarely men, called broken heart syndrome, where women get bad news, husband's leaving them, kid got injured at a baseball game, something really big, and they start to have a full blown heart attacks and tightness, sweating, shortness of breath, nausea. And they go to the emergency room, 9, 1 1, and it looks like a heart attack on EKG. So they go right to the cath lab. We don't find any blockage. All the other people we find a blockage and we fix it. And that's been called the broken heart syndrome. Extreme stress, probably extreme discharge of adrenaline, noradrenaline maybe causes the arteries to clamp down briefly. And these women tend to recover, but they're prone to having it on a repeated basis. And it can have some consequences for your longevity. So a tool to manage stress. You know, a lot of people have heard of I like 4, 7, 8 breathing maybe you know that one, Dr. Andrew Weil made 4, 7, 8 breathing popular.

No, tell me about it.

Breathe in through your nose, four seconds or count of four, hold it for seven seconds and breathe out through your mouth for eight seconds or a count of eight if you do it four times in a row. It's 76 seconds. And it's in that 76 seconds. You can restore some HRV balance. You can lower your heart rate, lower your blood pressure. A lot of people do it. Like, I gotta go on stage and give a talk, and I don't want to give a talk. I get. Do 4, 7, 8, breathing while they're on the stage, behind the curtain and step out and nail it. It's a real simple tool. Kids do it.

It's so simple. Yeah. There's only a little over a minute. And you can.

Real simple.

Yeah. Have a reset.

Yeah. So we gotta manage stress. We gotta, you know, be honest that we have it and manage it.

What do you think of the. I mean, so many people are on statins. So what's your verdict on these medications? Would you put anyone on it?

Yeah, I do use statins, but I also joyfully. Before you throw tomatoes at me, he's a statin seller. Of course. Statins are generic. They are some of the cheapest drugs on the planet. There was a time that they were the best selling drug on the planet. But they're all generic now, so statins hardly make anybody a penny, let alone a nickel. Um, they definitely have side effects. Muscle aching, blood sugar, elevation, brain fog, you know, in 10%, 15% of people. The problem is people are on statins that don't need them. That's the biggest problem. And nobody talks about that. There was a proposal 20 years ago that if your cholesterol's high, but you go for one of those heart CT scans we Talked about for $150 and it comes back perfect zero. It was proposed by a bunch of academic doctors that you don't need statins, you need lifestyle, you need gym shoes, you need a blood pressure cuff, you need, you know, a bowl of lentils. That's what you need. And it took 20 years. But that is actually the recommendation is not to start statins in people that have no atherosclerosis. So I take a lot of people off. They're really wary. Doc, are you sure you want to stop my statin? My doctor, my other cardiologist. I say I absolutely want to. And I show them the scientific background, why you'd have to treat so many zillions of people. Calcium score zero to hope one day you're going to save one of them from having a hospital visit or a heart attack. It's not a reasonable decisions, so. But I saw a guy today who had bypass surgery three months ago, and he's already changed his lifestyle dramatically. This cholesterol is still off the wall. It's probably genetic. I can't let him just walk around on planet earth with a cholesterol of 300.

Okay, so you put him on statin.

Let me just say, you hear about microdosing, you know, GLP1s talk about microdosing statins. If you, you can get a lot of cholesterol lowering with a super low dose. And there is a second medicine that's been available for more than 20 years, generic, very inexpensive, called Zetia Z E T I A. And if you use a statin with Zetia as a combination, you can keep the statin dose ridiculously low. You can get great results. Studies say you get more plaque reversal when you use the combination. And now places like the Mayo Clinic published two months ago, nobody should ever be on a statin. Oh, that's shocking. But what they said, everybody who needs to be on something should be on a statin plus Zetia to keep the statin dose as low as possible. And that's what I've been doing for a zillion years. It works really well.

And I want to ask you about a subject that may be a little controversial. What do you think of what happened with COVID or COVID vaccine? What, what does that do to the heart?

We were lied to, we were misguided, we were abused. You know, some of us were forced to get, you know, a gene therapy we didn't want to get to maintain our job and livelihood. And all those people lost jobs. I have colleagues in medicine that lost practices. It was an insane time. And I don't, you know, we're starting to dig out of it now with senator Ron Johnson and you know, Bobby Kennedy Jr. And his committee. And I'm all for that. I did not find Dr. Fogchi to be my medical hero. I did not buy Dr. Fauci pajamas like some of my colleagues were posting on social media. Doctors. So I didn't take a vaccine. I had Covid once before the vaccine and I said I'll trust my overall health and my natural immunity. And I think that's what should have been done. I didn't have any high risk features. And of course now the recommendations have shifted a lot already and hopefully they'll keep shifting away from using those agents. Do I see myocarditis? I do. I don't see a lot. I saw last week, 35 year old gentleman who's since one week after his Covid vaccination has had myocarditis recurrently, really challenging. I put him on Ivermectin and some other programs and told me recently he's starting to feel better. But we'll see. Blood pressure can spike after Covid. Blood pressure can spike after the COVID vaccines and become a real problem or it wasn't a problem. Or arrhythmia. Palpitations can spike after Covid. They can spike after the COVID vaccine. Even though most people haven't had a vaccine in three to four years, they're still developing and having persistent problems.

So it could be developing down the road.

Yeah. Yes, yeah, yeah, absolutely. Do we need more data? We need more data. But do we have a lot of data? Absolutely. And how do you tell a person who started feeling bad, you know, three days after vaccine that it's all in their head? Well, that's what they're told until they see a doctor who's open minded like me, and they almost break out in tears. Oh my God, I can't believe you're listening to me. And you actually think I'm not crazy.

I actually know a highly respected and very, very well published cardiologist here in Los Angeles. He was telling all his patients to get the vaccine until he himself developed arrhythmia. And he said he had perfect heart, never had an issue in his life.

He.

And then after the vaccine he developed, you know, problems. So he told, he told everybody to stop. So it is interesting that sometimes.

Interesting.

Yeah, yeah.

You know, and that's how medicine supposed to be. I mean, there were reasons to be excited in 2020 that warp speed was going to protect us because a lot of us were reasonably scared. But. And it didn't take long. You know, anybody that was following the vaccine adverse effect reporting system bears seeing all those cases of vaccine injury in early 2021. A lot of us think the program should have been shut down in less than 90 days and we rethink the safety of these things. Of course nobody was going to shut down the program.

And there are a lot of sudden deaths after the vaccine from young, healthy people. Yeah.

I got to say, you're on social media. I'm on social media. I take it pretty seriously. I try and be responsible. I mean, in 2025, if you post anything about COVID vaccine injury on Tik Tok TikTok, they will shut you down. They, they do not want to hear anything about COVID vaccine in this. I'm, I'm permanently banned from LinkedIn. I couldn't get back on LinkedIn if I bought Roses for the executive secretary. I have been kicked off so many times for public for posting medical research, you know, journal but if the topic wasn't in line with those people. So anyways I'm.

Yeah, it's very shocking especially coming from a country like China where people think that oh, you don't have freedom of speech. And I thought I could come to this country and that this is the freedom. That's what this country offers. And I was just shocked at what happened during. During COVID The doctors could not be. Doctors cannot investigate and. And give any kind of medical opinion. Yeah, that's contrary to what the. What the official verdict is. Yeah, it's very interesting. What do you say to people who are. Are suffering from cardiac issues after the COVID or COVID vaccine?

Yeah, I mean we try and make a firm diagnosis. There is a relatively new blood test called a spike antibody level. You can't differentiate if it's from the vaccine or from the native illness. There are other tests. You can get a clio capsid antibody to try and figure that out. Well, so we try and document that inflammation numbers. There is a pathologist who has a more advanced immuno immunology lab panel specific for long Covid he believes is accurate. Some people do that. I blanking on his name for a minute. I've sent a lot of people to him for the testing. There's an interesting HIV antiviral that he uses called Merovirac that under his guidance I've got some patients taking pretty safe drug. So try and document it. You know we might have to do an ultrasound of the heart, an MRI of the heart, all whatever needs to be done. I use ivermectin in patients. I used ivermectin in 2021. I got in a lot of trouble with my state but I used it because it got people better in 24 hours. I didn't use much hydroxychloroquine. There are a couple vitamins out there for people that may be Covid injured. COVID vaccine injured. They have nattokinase and curcumin and some other natural products in them. Spiked supports. Some people are wearing nicotine patches, half of the nicotine patch. There's some effect on the heart that seems to be favorable and all. So that's interesting. Most people don't know about that. You know, not a lot of data. There is a little data beyond that. It gets tough. Yeah, Colchicine maybe people know the name is an old gout drug that's still used anti Inflammatory drug. So sometimes you gotta do that. You know, there are organizations that have protocols that are suggested, but we just don't have enough research, like large randomized trials.

Yeah. So you, your approach to heart health is number one, lifestyle, diet, exercise, sleep and you know, reduce tox exposures. Then you mentioned something like bioregulators or peptides and you will, will be that sequence.

Correct, Right. Yeah, I'm fascinated. You know, certainly the peptides with the most data are semaglutide and tirzepatide, obviously known as Ozempic, Wegovy, Mounjaro and Zeppelin and they are peptides. And I have a lot of patients pay cash. I have patients that have insurance coverage, most of them because they're either diabetic or obese. Some are doing it a little bit more for the vanity route and particularly for semaglutide. WeGovia the data that these are actually very protective heart drugs is very compelling. In fact, there was just a report, a real world report on semaglutide for heart patients, or tirzepatide, which is Mounjaro Zeppa. And actually semaglutide seemed to work a little better to protect heart patients from outcomes. It was not a randomized study, it was a big database study. So we got lots to learn. When you get past that BPC 157 or kisspeptin or you name it. There's not a lot of data in the heart world. I mean, you know, nearly none.

What about epitalon that. I, I remember one study was showing how it reverses. Just been on it for three years. It reversed people's cardiac age by seven year, a bit by nine years.

Yeah. And I think you know, that one, you know, pineal gland bioregulators and thymus gland bioregulators, they, they have the longest tradition being used in Russia. Not a lot of data, but they have data including some longevity data from Dr. Cavinson in Russia. So they are considerations, of course, if people don't know. Of course most bioregulators are ground up animal products. My vegan heart bleeds over the thought of taking ground up animal heart capsules or ground up thy gland capsules. But if we knew for sure that it was a important part of a treatment program. Bring it on. And there are synthetic bioregulator peptides that aren't just manufactured in a petri dish because they're such simple little two and three amino acid strings. So yeah, I, I think, but in the, I mean it'll catch on. But do we need research? Do I see people every day that mad? Do I tell them to go spend some bucks and buy regular peptides for their blood vessels in their heart when there's, you know, very, very little data for. I think it's called Kilo Heart. I'm blanking on the name of the peptide for the, the bioregular for the heart. We need better therapies and maybe those are better therapies, but they're going to have to come with some research in some studies, without a doubt.

So in your book, I, I love that title. The Debt Execs don't get bonuses. So what, what's the, what's the main teaching from that book?

Well, main teaching is test, not guess. Get the lab work. But even if you forget the lab work, you know, go to your primary care doc, ask for a prescription for a heart calcium CT scan and I'll give you a little extra bonus information here in a minute. Schedule it at cedars Sinai, at UCLA, at Santa Monica St. John. Just get the test done all over the United States, really all over the world. A little bit tricky in Canada, but even in Canada you can get it done and make sure you're a zero or nearly a zero. And if you're not, find some preventive doc that knows what the heck they're doing and we'll do that extra blood work and we've got some data we don't have enough that we will probably save lives. I have no doubt we save lives. But when I'm talking about actual randomized studies to show we save lives. They're starting. The technique is over 30 years. You'd think we'd have abundant double blind randomized studies by this point. We don't. There's not much money in this test and you know, it's not driving a big industry because there's barely any profit when you're charging $100 for the CT scan. I don't own a CT scan. There's no profit for me. I just recommend it because it really helps identify a high risk patient. There is a more advanced CT scan. A lot of people have heard about it, particularly in la. And I'll call it Clearly Health Coronary CT Angiogram. Clearly C L E E R O Y Health ccta. It's just like the other CAT scan I showed you in the book. But you have to inject dye, iodine. Iodine is not radioactive. A few people are allergic to it. You feel hot for 20 seconds and then the hot feeling passes and you go Home with a band aid, but you get a hundred times more information about your arteries. But it's not a hundred dollar test, it's a seventeen hundred dollar test. It's not less radiation than a mammogram, It's a little more than a mammogram. So you probably want to be guided by somebody. I saw a 48 year old gazillionaire in the office this morning. He had never had any testing. And we're going to start with the $100 quick CT scan because if it comes back zero, I'm going to reassure him, 99 plus percent that right now he's in good shape and we're going to lab work. But if he had told me, doc, I wanted to go right to the fancy test, I wouldn't have argued with him either.

I see. So as a cardiologist, what is your regimen to make sure that your heart is functioning at tip top shape?

It's a good question. And it goes back anything I mentioned today. I do, I get that I have a calcium score zero at age 66, but I started checking at age 40.

What is the percentage, I'm curious, percentage of people age 66 that have zero calcium score?

Probably about 20%, 15%. It's not one in a million, but it's. You can calculate that and find out and I might even try and do that for you real quick, but it's not real important. And I do an ultrasound on my carotid arteries, which is called a cimt. It also lets me see if I'm developing plaque very simply, without radiation. I do all those crazy lab work. I'm gonna go shut a door if I don't get that little creature to quiet down. I do all the lab work on myself twice a year, three times a year. I mean, you gotta know your APOE and your homocysteine and I've had a lot of genetic testing because we're all crazy in this field. And telomeres and you know, you know, epigenetic age tests. My favorite is glycan age. Nobody talks about that one. I test incredibly well at that one. All the others not as crazy about, I get seven, eight hours sleep. I create a schedule where I'm in bed by 10 o' clock to get seven, eight hours sleep. I get 30 minutes a day of exercise, seven days a week and I rotate flexibility and strength and cardio. I'm never going to win the Arnold, you know, muscle building compound. But you know, I do my strength training, I take my creatine Supplements. I eat a healthy diet. You're not going to find any soda or junk. You're not going to find any plastic in my house or my car or my office. You know, we really upgraded. We got air, you know, air filters in the house, in the office. We got RO systems in the house. In my office. I use infrared sauna pretty regularly. I'm not much of a cold plunge person. I a big sunshine person. I love sunshine when I can get it in Michigan. That's a rare commodity. That's why I opened an office in Florida, for God's sakes. You know, I take 45 supplements a day.

Oh, wow.

And they vary. They vary. I worry a bit. I was taking taurine, which was having a good run as a new anti aging supplement. Now there's a very preliminary paper about something to do with taurine and leukemia. So maybe we shouldn't take it every day. Maybe we shouldn't take it such high dose. Nobody knows the answer. I was taking spermidine. A lot of, you know, your listeners have heard of spermidine as a longevity agent. Well, there was a paper out recently that sperminine might have a pathway of promoting cancer. You know, they're so complex and aging is so complex. I really like another Los Angeles researcher, Dr. Valter Longo.

Oh, okay.

You know the, and I do that program, the Prolon fasting, mimicking diet pretty regularly. If you said to Dr. Longo, you're going to live longer with taurine or spermidine. And I am on pretty good terms with him. We talk a lot. He would, you know, look at you like you're from another planet. Say, how do you know? How do you know which pathway? You know, even. And I'm a bit concerned, we don't know for sure if lengthening telomeres is really benign because there are, there are a few cancer syndromes with, you know, longer than average telomeres. I'm not anti lengthening them or measuring them or trying to at least maintain your telomere length, you know, over time. But do we really know for sure that there's zero risk with, you know, purposely going in there and lengthening your telomeres? Now Dr. Bill Lawrence, who you mentioned, you know, his data, where, you know, it's not just the telomeres lengthen with biopeptide regulators, but bioregular peptides. But, you know, the epigenetic age tests are improving and the pace of aging tests are improving. It looks pretty, you know, solid, like that's all a good plan that he's teaching and we talked about privately before, but, you know, paying a little attention to any new science coming out about lengthening telomeres and cancer risk is. It's on my radar of stuff I read.

I see. What about hormone replacement? Are you utilizing it? Nope.

Yeah, Big fan. I. I'm personally not. My levels are good. Testosterone's in the 600-700-700s. I mean, there's no reason to add more. But, you know, in the women that approach menopause, I'm for all them getting a high level expert evaluation and a trial and keeping it going long term. My mother's 92. She's still on her estrogen patch and her oral progesterone and, well, she's. Her brain's amazing. And my wife's been on good quality HRT, you know, for 15 years and she has clearly benefited from it. She's a young person. Yeah.

Amazing. Yeah. Thank you so much. Are there any parting words that you have for people who are seeking to improve their heart or cardiovascular health? It's not just the. Just the heart is the entire blood vessel system. You know, the blood system.

No. You know, you don't have to adopt my diet. I'm not going to judge you. But you do have to check your heart arteries. You know, it was in the 1600s that an English physician named Thomas Citingham said, you are as young as your arteries. And here we are 400 years later, and we still got the number one killer of men and women being sudden cardiac death, heart attacks, heart disease. And we could make huge inroads starting right now if everybody listening gets the heart CT scan, gets the advanced labs, whether they pay for them, and they're paid for through insurance. And get serious about longevity of the heart. It's really an important topic.

Yeah. Yeah. Thank you so much for that. I'm inspired. I'm going to my clinic shortly. I'm going to run some of the labs. Please do get a new set of labs. Yes. Thank you so much.

Thank you for all you do. And it's good that we're fighting this war together.

Yes, yes. It's wonderful. Thank you so much for sharing your knowledge. I learned a lot from you, I'm sure, listeners as well. So thank you again and good luck in all your endeavors and cheers for a long, healthy life.

Thank you. And my dog Lucy wants to thank you, too. That was her barking in the background, that little creek. I apologize.

You're welcome, Lucy. Okay. All right. Thank you, Dr. Khan.