The Surgeon Defending Statins, GLP-1s, and Ancel Keys | Dr Terry Simpson

Hosted by Simon Hill Guest: Terry Simpson 32 recommendations extracted ▶ Listen ↗

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In transcript order

Endorses COVID-19 mRNA vaccines supplement · Terry Simpson ▶ 8:25

Terry got the COVID mRNA vaccine as soon as available and says mRNA versions proved classically more effective than non-mRNA versions.

“
The mRNA has been more effective classically

Caveats
Efficacy varies by variant (90% wild type, 60% Delta, 40% Omicron); boosters needed
Certainty
explicit
strong endorsement

VaccinesCOVID-19Infectious Disease
Endorses 38TERA Daily Microbiome Nutrition supplement · Simon Hill ▶ 12:20

Sponsor read

Sponsor read for DMN, a gut health supplement with fiber, polyphenols, and resistant starch shown to increase short-chain fatty acids.

“
Daily Microbiome Nutrition, or DMN

Dosage
Daily scoop in water or smoothie
Certainty
explicit
strong endorsement

Gut HealthMicrobiomeFiber
Endorses Whoop device · Simon Hill ▶ 14:10

Sponsor read

Sponsor read for WHOOP wearable tracking sleep, recovery, HRV, exercise, and biological age.

“
I've been using WHOOP for over six years

Dosage
Daily wear
Certainty
explicit
strong endorsement

WearableTrackingSleepRecovery
Avoids Carnivore diet practice · Terry Simpson ▶ 15:20

Strong warning against carnivore diet; claims like curing psoriasis are false and it can worsen conditions.

“
Carnivore will cure your psoriasis, it won't. It will actually make it worse

Certainty
explicit
strong warning

CarnivoreDietMisinformation
Endorses Tirzepatide supplement · Terry Simpson ▶ 22:10

In a protocol

Terry personally uses Zepbound (tirzepatide), lost 50 lbs and kept it off, with improvements in sleep apnea, stress, libido, and food noise.

“
I am now on it and it's done remarkable. I've lost 50 pounds

Dosage
Weekly injection; half-life ~5 days
Caveats
GI side effects (constipation, nausea); food poisoning lasts longer; need to maintain hydration and fiber
Certainty
personal only
personal use

GLP-1Weight LossObesityTirzepatide
Endorses Culinary medicine training practice · Terry Simpson ▶ 28:20

Terry recommends learning cooking and culinary medicine; his patients who cooked did better post-bariatric surgery than those who didn't.

“
my patients who cooked did better than my patients who didn't

Certainty
explicit
recommendation

CookingCulinary MedicineNutrition
Endorses Mediterranean diet practice · Terry Simpson ▶ 35:40

In a protocol

Strong endorsement of Mediterranean diet pattern (high vegetables, fruits, whole grains, olive oil, low red meat) for cardiovascular health, weight loss maintenance, cancer reduction, and longevity.

“
The Mediterranean diet's about 50 to 55% plant forward

Dosage
250g+ vegetables/day, 250g+ fruit/day, 250g+ whole grains, <4oz red meat, <5oz wine for women/10oz men
Certainty
explicit
strong endorsement

Mediterranean DietCardiovascular HealthLongevityWeight Loss
Endorses Truemed service · Simon Hill ▶ 36:20

Sponsor read

Sponsor read for Truemed service that lets qualified customers use HSA/FSA pre-tax dollars on health products.

“
truemed.com

Caveats
Qualification varies; tax savings vary
Certainty
explicit
recommendation

HSAFSAHealth Spending
Endorses LMNT supplement · Simon Hill ▶ 39:10

Sponsor read

Sponsor read for LMNT electrolytes used 60-90 min before exercise; new 12oz sparkling format with 500mg sodium, 100mg potassium, 30mg magnesium per serving.

“
a serve of element 60 to 90 minutes before I play Padel

Dosage
500mg sodium, 100mg potassium, 30mg magnesium per can; pre-exercise
Certainty
personal only
strong endorsement

ElectrolytesHydrationExercise
Endorses Fiber supplement · Terry Simpson ▶ 46:50

Recommends increasing fiber from variety of plant sources, particularly for GLP-1 users to prevent constipation and augment native GLP-1.

“
more fiber, have more fiber sources, have more of a variety of plants

Certainty
explicit
recommendation

FiberPlant-Forward DietGLP-1
Avoids Low-carb/Atkins diet practice · Terry Simpson ▶ 47:00

Caution against low-carb diets long-term; correlation with obesity rise, doesn't work for many, lacks evidence for sustained benefit.

“
low carb people really didn't do well, by the way, long term

Certainty
explicit
mild caution

Low CarbAtkinsDiet
Nuanced Retatrutide supplement · Terry Simpson ▶ 55:20

Organic (prompted)

Neutral discussion of retatrutide - shows weight loss and decreases osteoarthritic pain, but heart rate/arrhythmia concerns being monitored.

“
retatutide decreases osteoarthritic pain

Caveats
Heart rate increase and arrhythmias noted; phase 3 trials pending
Certainty
hedged
offhand mention

GLP-1RetatrutideWeight Loss
Avoids Compounded GLP-1 medications supplement · Terry Simpson ▶ 58:10

Strong warning against compounded GLP-1s sourced outside FDA channels; ~80% of ER complications from GLP-1s come from compounded versions.

“
about 80% of the complications...come from compounded GLP1s

Certainty
explicit
strong warning

GLP-1CompoundingDrug Safety
Endorses Function Health service · Simon Hill ▶ 58:55

Sponsor read

Sponsor read for Function Health lab testing service offering 160+ biomarkers per year for $365 with AI integration.

“
I use Function

Dosage
160+ biomarkers per year
Certainty
personal only
strong endorsement

Lab TestingBiomarkersHealth Tracking
Endorses Oral semaglutide (Wegovy pill) supplement · Terry Simpson ▶ 1:05:20

Alternative

Oral Wegovy is nearly as effective as injectable (within 0.6%) and offers advantage of shorter clearance time during illness.

“
oral version of Wegovy is just as effective within like 0.6%

Certainty
explicit
recommendation

GLP-1Oral MedicationSemaglutide
Avoids BPC-157 supplement · Terry Simpson ▶ 1:07:00

Organic (prompted)

Warning against BPC-157 due to minimal human clinical studies and lack of efficacy/toxicity data.

“
has pretty minimal clinical studies in human beings

Caveats
Could cause unknown long-term harms like cancer
Certainty
explicit
mild caution

PeptidesBPC-157Supplements
Endorses Rosuvastatin supplement · Terry Simpson ▶ 1:13:55

In a protocol

Terry personally takes Crestor for familial hypercholesterolemia and recommends statins broadly; says he wishes he'd started decades earlier.

“
I started with the Crestor

Caveats
Some people have side effects (he had none)
Certainty
explicit
personal use

StatinsCholesterolCardiovascular DiseaseApoB
Endorses Ezetimibe supplement · Terry Simpson ▶ 1:14:40

In a protocol

Terry takes ezetimibe alongside Crestor to further lower LDL/APOB into the 40s.

“
my physician also said, take ezetimide also

Dosage
Combined with statin
Certainty
explicit
personal use

CholesterolApoBLipid Lowering
Endorses Coronary artery calcium score service · Terry Simpson ▶ 1:15:00

In a protocol

Terry obtained a calcium scan to assess coronary artery disease and recommends it implicitly as part of cardiovascular risk assessment.

“
I have a positive calcium scan

Caveats
Doesn't replace need for treatment if APOB is elevated
Certainty
explicit
recommendation

Cardiovascular ScreeningCalcium Score
Nuanced Bempedoic acid supplement · Terry Simpson ▶ 1:16:55

Alternative

Mentioned as an alternative lipid-lowering option for people scared of statins.

“
there's bempeditic acid

Certainty
hedged
offhand mention

Lipid LoweringStatin Alternatives
Endorses PCSK9 inhibitors supplement · Terry Simpson ▶ 1:17:55

Alternative

Terry says he would choose a PCSK9 inhibitor for Simon given evidence of plaque regression at lower APOB levels.

“
if it were up to me, I would go on a PCSK9 inhibitor

Certainty
hedged
recommendation

Lipid LoweringPlaque RegressionApoB
Endorses Intravascular ultrasound (IVUS) practice · Terry Simpson ▶ 1:18:50

Best imaging method for evaluating coronary plaque, better than coronary CT scans.

“
intravascular ultrasound, not coronary CT scans

Caveats
Invasive; may not be needed if addressing causal agent (APOB)
Certainty
explicit
recommendation

Cardiac ImagingPlaque Assessment
Endorses Exercise practice · Terry Simpson ▶ 1:30:00

Organic (prompted)

Vigorous exercise enlarges coronary arteries and helps accommodate atherosclerotic burden, though doesn't eliminate risk.

“
their coronary arteries are larger than normal because they're accommodating that exercise

Caveats
Doesn't eliminate plaque or risk of rupture
Certainty
explicit
recommendation

ExerciseCardiovascular
Avoids Nattokinase supplement · Terry Simpson ▶ 1:31:10

Strong warning against taking nattokinase for cardiovascular protection; data is weak and it raises bleeding risk.

“
why would you take something to cause bleeding?

Caveats
Increases bleeding risk in trauma
Certainty
explicit
strong warning

SupplementsCardiovascularBleeding Risk
Avoids Fish oil supplements supplement · Terry Simpson ▶ 1:31:50

Organic (prompted)

Fish oil supplements don't reduce heart disease, heart attacks, strokes or CHF risk in literature, though eating fish does.

“
fish oil...doesn't decrease your risk of heart disease

Caveats
Pregnancy DHA may have weak benefits
Certainty
explicit
mild caution

Fish OilOmega-3Cardiovascular
Endorses Fatty fish (eating whole fish) food · Terry Simpson ▶ 1:32:00

Organic (prompted) Alternative

Eating fish reduces cardiovascular risk in ways fish oil supplements do not.

“
eating fish does

Certainty
explicit
recommendation

FishOmega-3Cardiovascular
Avoids Alcohol avoidance practice · Terry Simpson ▶ 1:34:00

Organic (prompted)

Stop drinking alcohol if you have fatty liver disease.

“
Drink alcohol. I mean, so if you have fatty Liver

Certainty
explicit
recommendation

AlcoholFatty Liver
Avoids Refined grains avoidance practice · Terry Simpson ▶ 1:34:10

Organic (prompted)

Stop eating refined grains if you have fatty liver disease.

“
stop having refined grains

Certainty
explicit
recommendation

Refined GrainsFatty LiverDiet
Endorses Saturated fat reduction practice · Terry Simpson ▶ 1:34:20

Avoid saturated fat in fatty liver disease; isocaloric studies show saturated fat is the worst dietary factor for fatty liver.

“
the worst part was saturated fat for fatty liver

Certainty
explicit
recommendation

Fatty LiverSaturated FatDiet
Endorses Whole food plant-based diet practice · Simon Hill ▶ 1:34:45

Simon describes his own diet since 2015: whole food plant-based, which dramatically improved his biomarkers.

“
My diet is whole food plant based

Certainty
personal only
personal use

Plant-BasedDietCardiovascular
Endorses Olive oil (California extra virgin) food · Terry Simpson ▶ 1:37:50

Terry uses California extra virgin olive oil for most cooking; California has highest standards in world for EVOO purity.

“
I use olive oil for almost everything

Certainty
explicit
personal use

Olive OilCooking OilsMediterranean
Endorses Canola oil food · Terry Simpson ▶ 1:38:15

Alternative

Canola oil is fine for cooking/frying; concerns about seed oils are unfounded and not supported by data.

“
I have no problem with canola oil

Certainty
explicit
recommendation

Seed OilsCanolaCooking