The use of statins and other lipid-lowering drugs is a valuable tool to prevent cardiovascular disease when dietary changes alone are insufficient.

“And if you remember what I just said, if you took everybody in their 20s and reduced them to a level of that of a child, you'd make ASCVD an orphan disease.”

Fibrates can effectively reduce major adverse cardiovascular endpoints in patients with insulin resistance.

“it reduced several microvascular endpoints in those trials to retinopathy amputations peripheral neuropathy renal disease even though you know fiber can raise creatinine a little bit GFR improved and renal outcomes improved”

High-dose EPA (4 grams daily) is a valuable adjunct to statin therapy for reducing residual cardiovascular risk.

“lo and behold and we haven't come up with much in the world so far at least it has a big trial saying we lower residual risk with a statin isetami did it in acute carne syndrome survivors to a certain degree but this high-dose epa two grams twice a day with food because it is an ethyl ester theoreti”

Medications should not be viewed as cures but as tools that can help manage symptoms or increase distress tolerance to facilitate therapeutic engagement.

“When we think about them that way, we think about them as tools that we could apply for short term or long term. We don't see them as fixes, right? And we don't see them as then substitutes for the human to human work that needs to be done.”

The speaker identifies several significant risks associated with weight loss drugs, including muscle mass loss, pancreatitis, and potential unknown long-term brain effects.

“one of the ones that was most disconcerting and was explained to me by a brilliant scientist called Greg Stanwood who Florida State University and is researching these drugs the biggest risk is what he called unknown unknown”

Treating Parkinson's disease with L-dopa can inadvertently trigger compulsive behaviors in some patients because the medication increases dopamine levels non-specifically throughout the brain.

“it binds non-specifically throughout the brain so that means that that that dopamine I gave you is now binding to dopamine receptors in the reward pathway and we see is about a quarter of people treated with l-dopa for Parkinson's end up with some kind of compulsive consumptive Behavior”