I wrote about statins on here before, with the caveat that I am a layman with limited knowledge of the space.

I’m certainly not a Harvard/Oxford trained doctor, like Dr. Nick Norwitz who was featured by The Telegraph today in an article titled “This Harvard doctor believes we’ve been getting cholesterol all wrong”. This popped up on my Apple News+ feed while drinking my morning coffee.

Dr. Norwitz’ social media presence1 seems to be fuelled by cholesterol denialism and anti-statin positions. Clickbait YouTube videos like “I Changed My Mind on Cholesterol Medications (After 7 Years)” and “The Oldest Woman Had “High” Cholesterol — Here’s What That Really Means”2. The comments are filled with exactly the sorts of commentary that you would expect because he is aiming for exactly the audience he wants.

And of course he’s pitching magic longevity vitamins with his own special discount code.

His whole gimmick is that he had high cholesterol so he tried statins but found he’s one of the people who have bad muscle pains — statins aren’t a good option for everyone — so he did a 180 and decided his new angle was to be yay-cholesterol man, leaning far into a ketogenic, ultra-high cholesterol causing diet while casting FUD about medical science and statins. And now he holds himself as the anecdote that proves the consensus wrong, which isn’t how anything works but whatever.

It’s the attention through contrarianism thing, and this is a common tactic on social media. Always monetizing this into some magical powder or vitamin sale.

Here’s the thing, though: He’s 30 years old (and has been doing this through his 20s). Having plaque measurable on a CAC or more invasive CCTA at 30 years old would be devastatingly bad. Like, some sort of genetic condition bad. A you’ll-be-dead-by-50 bad. Arterial plaque is a long-developing condition that takes decades to form (most of the early stages being unmeasurable by current tools, not to mention that when you’re young the body is more capable of clearing the issue), with high cholesterol being an extremely well proven influencing factor for most people. Even the most sensitive CCTA doesn’t detect plaque until the 40s-50s for most.

That this guy constantly returns to the fact that his arteries are clear (“My arteries are perfectly clean: why should I subject myself to both the known and lesser-understood side-effects of statins?”, an ironic comment given the well known and lesser-understood effects of high cholesterol, including dementia), at least via the normal diagnostic tools, is just silly3.

This is the three-pack-of-cigarettes a day guy telling you that they don’t currently have measurable lung cancer, ergo smoking is safe. And the area under the curve builds.

His position on insulin resistance via high carb diets is the overwhelming scientific consensus4, just as it is true that arterial plaque is multi-factorial with a lot of influences including inflammation and genetics, and that LMHR are a thing that are worth study. Just as it’s true that LDL is a hugely imperfect measure and ApoB is a better measure that is less commonly used because the test is more expensive, and that statins are not the best choice for everyone.

But Dr. Norwitz purposefully leans into his audience to pad his pockets, and that’s just morally reprehensible. He does the contrarian act for his own enrichment, while trying to ride the fence and hedge just enough to avoid censure from medical peers.

Gross stuff. And this is precisely the sort of guy who’ll be posting a “Why I was wrong about being wrong about” video in ten years once the consequences of his terrible advice — if he actually follows it — comes due.

Peter Attia’s Podcast

Peter Attia’s podcast returned to airing new episodes rather unceremonially after the whole Epstein thing. I wrote about my feelings on Attia’s rather pathetic messages to Epstein — he was clearly being a slovenly bootlicker trying to get in the good graces of the ultrarich by shamelessly pandering — and while it’s pretty gross, it doesn’t change my opinion that Attia is a great science communicator.

A recent episode of his — Thinking scientifically: why it’s hard, why it matters, and a practical toolkit — is fantastic. A+ episode from start to end.

I already abide by many of the recommendations made in the podcast. For instance, I’m fully engaged to incorporate new knowledge on cholesterol and statins, but people like Norwitz have so many grifter red flags it just demolishes any influence they have on my knowledge.

Footnotes

  1. Google categorizes him as an “internet personality”, which is interesting.

    If Google reduces your many impressive degrees down to “internet personality”, that’s probably a sign that you’re a grifter. ↩

  2. In the report on a 117-year-old woman they noted in one of many tests that her total cholesterol and LDL was slightly above the recommended range at the moment they tested her. Dr. Norwitz even added a conspiratorial note like this was suppressed information that only his deep investigative work revealed…by looking at test results they included with the study. LOL.

    And the funny thing is that her LDL was 122 mg/dL, which is below even what is considered “borderline elevated”, which is why he scare-quoted “high” in his title, because he knew he was misleading his rubes. And her HDL was excellent, because of which her “total cholesterol” was slightly above normal, but for a good reason. Her VLDL and triglyceries were fantastic. This woman had what most would consider very good bloodwork. ↩

  3. He frequently returns to the claim that he’s a medical marvel that defies all the textbooks. At one point he claims that his heart should be “clogged up” given his cholesterol levels. In another that he should be “dead”. Again, this guy is 30 years old. Absolutely zero medical textbooks predict what this guy keeps claiming they do, and he knows it. But they do predict what he’ll probably be like at 50, so I guess wait and see?

    He does another sleight of hand when he refers to “cardiovascular disease as a leading cause of mortality”, implying that this disproves the consensus as a failure, providing an opening for fanciful contrarianism. Quite aside from the fact that circulatory system deaths are down dramatically in just about every nation per capita (Canada has dropped CVD deaths by over 75% over the past several decades), the more progress made by medical science the longer people live. The longer people live the more the old causes of death are waiting for their opportunity to shine. People are still going to die of something.

    This is similar to rates of some cancers and dementia “rising”, which grifters use to fear-monger about whatever current thing they’re targeting (vaccines, 5G, seed oils, etc). Only these are largely a result of a lot more people living long enough that they can suffer such results. ↩

  4. The article twice points to a “growing number of experts” in a rather comical fashion. The first are the statin nay-sayers, which sure whatever you can find contrarians for quite literally anything. But the second is a comical “Norwitz has joined the growing number of experts who believe that a high-carb Western diet leads to insulin resistance”. Is this a joke? It is an overwhelming consensus that a high-carb diet is a problem, particlarly one filled with simple carbs that are so common in our menus, which is why advice is for a well-rounded, balanced diet. Pretending that the only alternative to a bad diet is another bad diet is misleading framing, but this fake dichotomy is a go to. ↩

See Also