497 | Dr. Damon Forbes | Understanding Lipoprotein(a) and Cardiovascular Risk

Dr. Erin Faules joins cardiologist Dr. James Min to discuss how coronary CT angiography can identify coronary artery disease before symptoms appear. They explain why plaque itself—not cholesterol levels or stress tests—is the underlying disease, how plaque type and burden shape cardiovascular risk, and why many heart attacks occur without prior warning. The conversation explores how imaging can guide more individualized prevention, inform treatment over time, and shift cardiology toward earlier, disease-focused care.

Dr. Erin joins Wild Health coach Steve Holt to unpack VO₂ max—what it actually represents, why it's closely tied to all-cause mortality, and how heart, lung, vascular, and mitochondrial function all contribute to it. They walk through practical ways to build an aerobic base, use interval work to raise your threshold, and apply zone-based training with or without wearables. The conversation focuses on evidence-informed methods to improve cardiorespiratory capacity in a sustainable way, whether you're new to training or already well-conditioned.

Dr. Michael Snyder joins Dr. Forbes to discuss research showing that Type 2 diabetes represents multiple metabolic subtypes rather than a single condition. He explains how glucose curve patterns, oral glucose tolerance testing, and continuous monitoring can help identify differences in muscle insulin resistance, beta-cell function, hepatic signaling, and incretin response. The conversation explores how these physiological patterns may guide individualized nutrition strategies, medication selection, and earlier detection in people with emerging dysregulation. 

Dr. Kyle Gillett joins Dr. Erin to break down the physiology behind testosterone regulation, including how SHBG, free versus total testosterone, and androgen receptor sensitivity influence symptoms, metabolic health, and treatment decisions. They discuss why men with similar lab values can feel very different, how lifestyle and insulin resistance affect hormone metabolism, and when tools like TRT or aromatase inhibitors are actually warranted. This episode focuses on practical, evidence-based mechanisms that help patients and clinicians make informed choices about hormone optimization

Dr. Erin Faules speaks with Dr. Damon Forbes about Lp(a), a genetically influenced lipoprotein linked to cardiovascular disease risk. They discuss how Lp(a) differs from LDL, its role in plaque and clotting, and why a one-time test can help clarify long-term risk. The conversation covers who to screen and when, interpreting Lp(a) alongside apoB and metabolic health, evidence-based ways to lower overall cardiovascular risk, and emerging Lp(a)-lowering therapies

Dr. Erin Faules speaks with Ashleigh Di Lello, creator of Bio Emotional Healing®, about how trauma, stress, and chronic illness can reshape the nervous system and how the brain's capacity to rewire itself supports recovery. They discuss the science of neuroplasticity, the connection between belief and biology, and practical ways to move the body out of chronic stress toward restoration and balance.

Dr. Jeff Graham speaks with Dr. Danny Firth, a Wild Health physician who transitioned from hospital-based medicine to precision and integrative care. They explore what led him to leave reactive "sick care" for a preventive, data-driven approach using genomics, biomarkers, and lifestyle to keep patients healthy before disease develops. Dr. Firth also shares how he balances work, family, and personal wellness while practicing what he teaches.

Dr. Jeff Graham talks with Dr. Mattias Bernow, a physician, economist, and CEO of Cellcolabs — about the current state of stem cell therapy. They discuss how mesenchymal stem cells (MSCs) function through signaling rather than cell replacement, where evidence supports their use today, and why good manufacturing practices (GMP) are essential for safety and efficacy. The conversation explores clinical data on cardiovascular, autoimmune, and neurodegenerative diseases, and what large-scale, evidence-based production could mean for the future of regenerative medicine.

Dr. Erin Faules and longevity expert Nathalie Niddam discuss how peptides and bioregulators can help the body maintain equilibrium at the cellular level. They unpack how these small protein molecules influence signaling and gene expression, the difference between supporting adaptation versus overstimulation, and how thoughtful use of these tools fits into a holistic approach to health and aging.

Dr. Jeff Graham sits down with Dr. Damon Forbes to explore the emerging concept of "lean mass hyper-responders"— fit, low-carb individuals who present with unusually high LDL levels. They unpack the physiology behind this pattern, discuss how it differs from familial hypercholesterolemia, and review new data on cardiovascular risk. The conversation offers a nuanced look at how metabolism, diet, and lipid transport intersect in precision medicine.