Tag Archives: Medicine

Treating Populations, Not People

I’ve been following Nick Norwitz, MD/PhD, for a while now. He’s quite the researcher, that’s for sure. And his latest video covering his cholesterol situation is wild: I Bet My Life Against Cholesterol Dogma (And Won)

In the past Nick had severe inflammatory bowel disease, which altered his life significantly. At one point he dropped below 100 pounds, ended up in intensive care, and drove him to question his life. I totally understand. I’ve been there a few times myself. So, out of desperation he tried a therapeutic ketogenic diet, which sent his disease into full remission. Now, that fact alone isn’t supposed to be possible, but it’s actually the side story at the moment.

The real issue here turned out to be his cholesterol. As a result of that new diet, Nick’s LDL (low-density lipoprotein) climbed from a so-called healthy 90 to near 600, while his total cholesterol tapped out at 700! Under traditional medical science, those numbers represent an emergency right now and over time a death sentence from a heart attack or a stroke. Treatment was needed right away. But Nick made a different decision. As he says, for seven years he has been “running an experiment that should be killing me.” But he kept at it because “the thing that is causing my cholesterol to go so high is also saving my life.” That’s quite a position to be in. But it’s also one in which many people find themselves when dealing with two intractable medical conditions that doctors can’t simultaneously treat without side effects.

Since Nick’s been dealing with massive LDL for so long while also declining standard treatment with statin drugs, I was curious why he hadn’t yet gotten a cardiac calcium scan. Those scans are fast and relatively inexpensive. Why wouldn’t he want to check for plaque in his coronary arteries? It just seemed odd to me given how comprehensively he researches his own conditions.

Well, recently, he finally went ahead and got his scan. The result? Zero! No plaque at all! Personally, I wasn’t surprised because I’m familiar with his research, and I know others who have had similar results from similar conditions. But I’m sure he was relieved given his own history and also living with being attacked constantly for his unique approach. The result of zero plaque “doesn’t just poke a cholesterol dogma, it shatters it,” he says. It does, indeed. But medicine changes slowly. Perhaps in a hundred years or so the protocols will change to embrace new research. For now, though, he’ll likely remain an aberration, just like all the other aberrations out there. The difference here, though, is that Nick publishes prolifically, so he’s leaving a detailed scientific paper trail that other researchers are noticing.

Anyway, it’s a good story on its own for Nick’s gut and his heart. But the part I want to point to comes later when he steps back and explains why he thinks this happened. His argument concerns context. A single blood marker like cholesterol, or even height, only means something within a particular person’s situation. For example, Nick uses basketball superstar Shaquille O’Neal to illustrate the point. Shaq is seven foot one because of lucky genes. But Nick says that other people could be the same height because of a tumor messing with their growth hormones while the tumor eventually quietly kills them. Same measurement, different reality. “Context is everything.”

Then Nick makes the point that stuck with me because I’ve experienced it many times myself dealing with the medical industrial complex. It’s a very real phenomenon. Modern medicine, he says, often misses context entirely when dealing with individual patients. The context of the person gets traded away for algorithms that let the system run efficiently at scale as it implements particular protocols or policies. And as much as individual doctors may want the best for their patients, and Nick believes they do, “modern medicine treats populations, not people.”

That’s the line right there. I got it right away. Experienced it many times. Painfully. Nick says that treatment protocols get built on averages drawn from large groups of mostly sick people. That may work well enough for most people most of the time to get them out of some acute condition or to enable them to live longer with a chronic condition. But it fails the outliers. These are the people whose numbers on one test look alarming for a reason the average never accounts for while their other markers are exceptionally healthy. In Nick’s case, that reason is high cholesterol driven by a therapeutic diet rather than any other known disease. He returns to the idea near the end and tells us this: “Don’t settle for being treated like the population average, because almost none of us are.” He’s right. But the “settle” bit is challenging because the medical community as a system isn’t so warm and fuzzy when confronted with people who question it.

There’s much more in the video. He briefly reviews his experiment where he added Oreo cookies to his diet that cut his cholesterol sharply, which he offers as an indicator that his fat-burning metabolism may be the real driver to his cholesterol markers breaking the established reference ranges. He also explains why he walked away from a traditional medical career to instead work as a medical communicator. On placing that bet against decades of established cardiology, he says, “The data judges the ideas, not the credentials backing them.” His YouTube channel has over a million subscribers now, so he’s touching more people on any given day than would be possible had he gone into clinical medicine.

Systems are built to scale. But they rarely consider individuals, especially individuals whose conditions don’t fit published protocols. That’s why it’s critical to always do your own research, question your doctor, and act in your own interest. The doctors may care about you to a certain degree, but the protocols they implement don’t.

Good luck!

Aaron Siri at Kennedy

Imagine a world where American drug companies were required to prove that their vaccines were “safe and effective” by testing them against inert placebos? And then imagine that those companies were liable for their vaccines and patients were allowed to sue the companies if those vaccines turned out to be not “safe and effective” but instead caused harm? That’s not this world, that’s for sure. Not even close. To explore the details of these issues, see Aaron Siri’s presentation at the Kennedy Center — An Evening with Aaron Siri – Millennium Stage (March 23, 2026) where he reviews data in his new book Vaccines, Amen. Also, here’s his new YouTube channel. Fair warning up front, though: if you’re not familiar with this topic, you’ll be shocked. I’ve been following the issue for decades so nothing in this content surprises me one bit.

The Decline and Fall of Peter Attia

Over the years Dr. Peter Attia built a reputation as an influential voice in popular longevity medicine. He’s been pervasive online. And recently he was hired by CBS News based on his credibility. So, he’s big time. His podcast draws millions of listeners, and his book became a bestseller. People trust him with their health decisions. I was an active follower until about 2018 when his arrogance finally got the best of me and I just got tired of him. It wasn’t much of a loss for me to dump him because there are plenty of other excellent people in the field who question the established medical paradigm. But Attia kept going and getting rich in the process, which is common among the top tier people in the field. But apparently, he got himself in way over his head. Hopefully, he’ll come crashing down as fast as he rose. It’s unlikely. But I can still hope.

Check out this report about Attia from Joseph Everett — Hidden Data: How the Top Longevity Doctor tricked us all — that reveals a pattern of overconfidence, selective data presentation, and dismissiveness toward ideas that challenge his worldview. In the video, Everett analyzes Attia’s claims and public statements and does several on-camera interviews with Dave Feldman, Dr. Nick Norwitz, and Dr. Chris Masterjohn to provide some scientific context and to counter some of Attia’s most confident assertions. Here’s a review of Everett’s report. 

The Epstein Connection

I never thought Attia would fall based on his association with Jeffrey Epstein because until last week no one even knew he was hanging out with that crowd. But that’s where we are. The Epstein files revealed more than 1,700 PDFs mentioning Attia. The emails show a close relationship that continued even after Jeffrey Epstein’s crimes were publicly known. Attia met Epstein in 2015 through Epstein’s ex-girlfriend. He called Epstein “literally one of the most interesting people I’ve ever met.” He expressed interest in visiting Epstein’s island, and he stayed at Epstein’s apartments. He attended dinner parties with Epstein and his so-called famous friends. 

Attia’s timeline with Epstein is particularly striking. According to Attia’s own book, on July 11, 2017, his wife rushed their one-month-old infant to the hospital because the baby had stopped breathing and his heart had stopped beating. His wife stayed in the hospital for four days, pleading with Attia to come home. He said he couldn’t because he was in New York with “important work.” The next day, July 12, Attia emailed Epstein confirming he could meet him. That’s difficult for any parent to imagine. But it provides a view into the dark space in which Attia lives so freely.

When the Miami Herald published its piece on Epstein in November 2018, Attia claimed he was “repulsed and nauseated.” Yet he stayed in touch with Epstein for at least four more months. In December 2018, he asked Epstein about the “fallout from recent story.” In February 2019, he was still emailing with the subject line “Where are you these days?” There are many other disgusting exchanges between the two in those files. Read them if you want.

The connection to Epstein itself might not be damning. Time will tell. Plenty of people got caught up in Epstein’s orbit but haven’t been implicated with crimes. But the same overconfidence that led Attia to maintain this relationship shows up repeatedly in his health claims.

The VO2 Max Problem

Attia built much of his longevity framework around VO2 max. He called it “perhaps the single most powerful marker for longevity.” He was emphatic. He brought it up on podcasts constantly. The claim appeared on 60 Minutes. It’s in his book. He says everyone should know their VO2 max and track it.

But there’s a problem. The studies he cites to support this claim never actually measured VO2 max. In Everett’s video, Chris Masterjohn, PhD, points out that you can search some of these papers for the word “oxygen” and find nothing. What the studies measured was how long people lasted on a progressively harder treadmill test. That’s not the same thing. I remember people online questioning Attia on this issue and many other issues. Attia generally ignored them. My impression was that Attia grew to be connected and protected. Or at least he was acting that way. 

And when Attia made a table for his blog showing VO2 max levels, he simply relabeled data from a paper that measured something else entirely. The table made it into his book. He tells people they should spend $200 annually to have their VO2 max measured at an exercise science lab, when all you actually need is a treadmill, according to Masterjohn. 

Masterjohn explains that most people in the general population can’t even reach their VO2 max during these tests. They give up because of heart palpitations, leg pain, or feeling like they’ll throw up. They’re never hitting their actual maximum oxygen consumption. But Attia presents this metric as if it’s the single most important thing you can measure. It shows how Attia grew to become totally disconnected from regular people just trying to get healthy. It’s clear in retrospect that Attia was focused on other clients who could pay him millions. Everett points out in his video that Attia would show up on video podcasts wearing several different $300,000 watches. 

The real problem is that focusing so intensely on VO2 max could lead people to spend hours doing one repetitive motion instead of diversifying their training. As Masterjohn says, gymnasts and pole vaulters have eight years on the general population for lifespan. That’s a testament to the breadth of functional training, not endless cardio optimization.

Hiding Inconvenient Data

Now let’s move to cholesterol and statins. When a major study in Cell Metabolism showed that atorvastatin (the most profitable drug in history) slashed GLP-1 levels while worsening glycemic markers and insulin resistance, Dr. Nick Norwitz (MD, Ph.D.) started discussing the issue online. Two weeks later, Attia published a newsletter that appeared to be responding to Norwitz’s analysis. That seems like Attia’s back handed style. 

But Norwitz noticed something strange. Attia’s newsletter tried to discredit the study, but it completely ignored the most relevant graph. As Norwitz puts it in Everett’s report, “There’s one graph of relevance. An 8-year-old can tell you what’s going on. There’s a big red line. It goes down.” Attia showed the figure that contained this graph but clipped out the specific panel that showed the problem. It’s hard to think that wasn’t intentional, Norwitz says. 

Nick Norwitz and the New Generation

Norwitz himself represents exactly the kind of rigorous, open-minded research Attia claims to support. At age 30, Norwitz has already published 54 peer-reviewed papers. His scientific impact score is higher than Thomas Dayspring, the lipidologist Attia regularly cites as his go-to cholesterol expert. And Dayspring is 50 years older. Norwitz is prolific online, too, but he embraces the conversation with both technical and non-technical people — unlike Attia. 

Norwitz recently gave some credibility to another researcher, Dave Feldman, who is a popular software engineer who has been researching LDL cholesterol for years now. Feldman developed an alternative cholesterol model by conducting his own personal experiments and publishing the results online and in scientific papers. Norwitz tested some of Feldman’s views and lowered his LDL cholesterol from 384 to 111 by eating Oreo cookies for 16 days. When he tried statins for 6 weeks, he only managed to lower his LDL from 421 to 284. The Oreos worked better than the drugs. Why the Oreos worked at all is interesting.

The point isn’t that people should eat Oreos instead of taking statins. The point is that our understanding of cholesterol metabolism is more complex than Attia presents it. And when young researchers like Norwitz demonstrate this complexity, Attia either ignores them or dismisses their work outright.

Dismissing Dissent

Perhaps the most revealing episodes with Attia involve Dave Feldman. When Feldman appeared on Attia’s podcast in 2018, the exchange revealed something troubling about how Attia pushes his influence and bullies people. He interrupted Feldman a staggering 66 times, according to Everett’s count. He called Feldman’s investigation “brain damage.” His treatment was arrogant and dismissive to say the very least. He told people interested in cholesterol questions to “sit down, shut up for a minute, and pay attention.” I remember listening to that episode. It was infuriating. And it was clear that it was actually Attia who was out of his league — not Feldman. I mean, when a software engineer goes up against an MD you’d expect the engineer to lose in a fair fight. But Feldman more than held his own in the match. In fact, he was really impressive. Ultimately, though, when some so-called “expert” reacts like Attia did, it’s likely an indication that they have been exposed. I was mostly done with Attia at that point, at least on the cholesterol issue.

The irony is that Feldman’s questions were reasonable and backed up with some excellent, albeit early, data. According to Feldman and Everett, Most research showing that LDL cholesterol is dangerous comes from studies of metabolically unhealthy people. But what happens to people who have high LDL and also have high HDL and low triglycerides, which are both markers of good metabolic health? Do they still die early? What about the many other biomarkers that demonstrate good health in these people? These questions were totally dismissed by Attia.

Attia further said that this line of inquiry was pointless. He challenged Feldman to crowdfund research if he thought his ideas had merit. Feldman, always up for a good challenge, did exactly that. He raised $350,000 for the Lean Mass Hyper-Responder study. The results showed that metabolically healthy people on a keto diet with sky-high LDL didn’t develop more arterial plaque in their hearts. Imagine that. Attia’s response? Silence. And when invited to co-author a journal editorial about the findings by his own former head of research, Bob Kaplan, Attia declined and said there were people “far more reputable” to discuss it with. 

Meanwhile, Feldman went on to publish eight peer-reviewed papers on the subject and continues to work closely with Norwitz on cholesterol research.

The Real Issue

The pattern is clear. Attia presents himself as committed to open-minded scientific inquiry and he strongly lectures people about that. Yet his own behavior says otherwise. He once stated we should “go back to our original ideals: open minds, the courage to throw out yesterday’s ideas when they don’t appear to be working, and the understanding that scientific truth isn’t final.” But when faced with obvious data that challenges his positions, Attia either ignores it or attacks the messenger, many times in childish, unscientific ways. You can see him online repeatedly rolling his eyes, smirking, shaking his head, raising his voice, and using harsh language when he’s simply questioned by anyone. From his powerful platform, he still maintains extreme confidence in his claims, which seem more shaky than ever. That’s not science. That’s ego. And it’s the same attitude that kept him emailing Jeffrey Epstein months after the world knew what Epstein had done.

I wonder how many online health gurus who called him a friend will come out publicly and question Attia now. So far, too many are silent. I wonder, do these people think we’ll not notice?

Zoopharmacognosy

Here are two articles I wrote way back in 1992-1993. Ages ago.

But the topic still lives and is more relevant than ever. As long as there’s advanced life on Earth this topic will be important. The life bit is the catch, though. It’s zoopharmacognosy. It’s how wild animals when they are sick seek out and use medicinal plants to heal themselves. It’s really wild stuff. 

The first piece below I did as an intern at Animals Magazine while going to Northeastern University at night. Animals Magazine was published by the Massachusetts Society for the Prevention of Cruelty to Animals (MSPCA), which is also the home to the famous Angell Animal Medical Center in Boston. The article was part of my final project at school, too. It only took three drafts, but I like the edit very much and the piece really resonated with people. So it worked well. It also led to a fund-raising promotional campaign at the magazine, it helped me get hired on staff as a full time employee, it peaked the interest of an editor at MIT’s Technology Review, it generated many letters to the editor, and it was also cited as a source in a letter to the editor in the British Medical Journal (Can animals teach us medicine? Page 1, Page 2). I never thought I’d see my name in such a prestigious medical publication but there it is. Pretty cool. I just tripped over the reference while doing some research for another article, actually. A happy catch for sure. But the larger point is the subject matter. It’s really critically important and wildly unique. Almost unbelievable. And that’s what really drove all the attention.

Looking back at this article now after all these years, I think it holds up pretty well. I’d only change a few bits, but then again I rarely have the desire to re-write stuff. I’m just not that critical. But I do remember at the time arguing with the editors for another page of space because I had so much material. But this particular issue in the magazine was already full. And I was too junior to get an extra page of that prime real estate — remember this was a time when magazines were designed via paste up boards and printed on real paper. So I had to cut. It’s always painful to cut your own work. That’s why we have editors, I suppose. But cutting is a seriously good skill to develop.

Anyway, I said earlier that the article in Animals Magazine caught the attention of an editor at Technology Review. That’s the second piece below. That was a big surprise. It was a tough thousand words to craft on such an insane deadline — which was immediately. I had to cut so much material that I struggled to make it all hang together. For skilled science writers this article would be just a straightforward little news piece. But for me at the time it was a very big deal. I had mountains of research and very little experience hacking it all down to just one page, basically. But with a little help from the editor I made the deadline. And just like the Animals Magazine article, this one in Technology Review got a lot of attention at the time. It made it into the San Francisco Chronicle and about 10 other daily newspapers around the United States. I was pretty happy, I must say.

The topic of how endangered wild animals seek out and use rare medicinal plants to heal themselves fascinated me back then and it still does today. Back then it was an emerging field in science that could have dramatic implications for human health and the global environment well into the future. Imagine wild animals teaching domesticated humans how to cure some of our nastiest diseases. Could we be humble enough to engage in such a learning exercise? Unlikely. Just look at how the world has matured in the last three decades regarding natural treatments to diseases. Just look at how we treat the wild animals and wild habitats generally. I guess it’s too much to ask to stop killing the animals and their medicinal plants and also the habitats in which both live. Modern humans and the complex cultures we’ve constructed are almost totally detached from nature — and from reality as well. Not to fear, though. We’ll be saved with virtual reality. Coming soon.

Nevertheless, back 30 years ago I started my writing career with two nice pieces here. And then I became depressed. But when I figured out all the time invested in thinking, researching, interviewing, writing, editing, and iterating, I made under $1 an hour. I knew right then that my writing career would have to be killed as soon as possible. I just didn’t have the time to grind it all out earning pennies as I grew my skills and contacts. This was a second career for me because the first one ended in a long hospital stay and five years out of work with no insurance (you gotta love the American medical system, eh?). I simply owed too much money and had no method to pay it all back. And I needed to eat too. It’s really that simple. It took a few years to dump the second career and move on to the third (btw: I’m now on my fourth) but it was necessary. So I guess I shouldn’t judge too harshly all of humanity as I just did in the paragraph above. The irony isn’t lost on me, I can assure you.

See both articles below. Click on the images for pdfs for reading or download.

Zoopharmacognosy
Animals Magazine: September/October 1992: Fur-Bearing Pharmacists
Zoopharmacognosy
MIT’s Technology Review: August/September 1993: The Monkey’s Medicine Chest

Here are some old links related to the two articles above:

Here are some recent links unrelated to the two articles above but related to zoopharmacognosy generally: