Yes, We Prescribe GLP-1 “weight loss” Medications at Iron Direct Primary Care GLP-1s aren’t just for weight loss — they’re powerful tools that can truly transform health. • GLP-1s slash heart attack & stroke risk • They slow or prevent kidney disease • They put type 2 diabetes into remission for many • They help reverse obesity-related damage • Emerging data shows they may protect the brain & lower addiction risk At Iron Direct Primary Care, we prescribe GLP-1s (like sem

📉 ApoB: The Stronger Evidence Wins The data for lowering ApoB (via statins, ezetimibe, PCSK9i, etc.) is rock-solid and backed by decades of high-quality research. The idea that high ApoB is “fine if you’re lean and fit” (e.g. LMHR/keto crowd) is still just a hypothesis with weak, conflicting support. ✅ Evidence for Lowering ApoB -Plaque regression trials (GLAGOV, ASTEROID, SATURN, HUYGENS): Intensive lowering (ApoB often <65 mg/dL) consistently shows plaque regression, stab

Low-dose naltrexone (LDN) has been gaining attention in recent years for its potential to improve health in various ways. Originally developed to treat opioid addiction, naltrexone at low doses is now being explored for its broader therapeutic effects. This article delves into the naltrexone health benefits, explaining how LDN works, its applications, and what makes it a promising option for many people. Understanding Naltrexone and Its Health Benefits Naltrexone is a medicat

Iron DPC is opening our office to the wonderful Anna Martin LMT for massage bookings starting in July. Hi, I’m Anna Martin, your licensed Massage Therapist! My practice is founded on a deep understanding of human anatomy and kinesiology with an undertone of intentional energetic balancing. My sessions consist of focusing on targeted issues, tailoring our time to your unique needs through a thorough physical assessment and an understanding of your medical history, daily activi

A lot has changed just this year in medicine and my own practice. Part 2 of The 2026 ACC/AHA Multisociety Guideline on Dyslipidemia This lecture continues my review of the latest guideline update from the American College of Cardiology. It’s ok but they are a bit too far behind what I am now recommending. They are not using Apo B yet. Still using LDL. It’s ok. I like apo B for many of the reasons discussed in the Iron DPC blog. Namely: it isn’t affected by nonfasting so lo

Ezetimibe is a lipid-lowering medication that works differently from statins. Instead of blocking cholesterol production in the liver, it blocks cholesterol absorption in the small intestine through inhibition of the NPC1L1 transporter (Niemann-Pick C1-Like 1) located on intestinal enterocytes. Mechanism of Action At the intestinal brush border, NPC1L1 normally transports dietary and biliary cholesterol into enterocytes. Ezetimibe selectively inhibits this transporter, result

Most people know about cholesterol, blood pressure, and blood sugar. Far fewer know about homocysteine — an amino acid produced during normal metabolism that, when elevated, may quietly damage arteries and the brain. High homocysteine levels (called hyperhomocysteinemia) have been linked to cardiovascular disease, stroke, cognitive decline, and Alzheimer’s disease. What Is Homocysteine? Homocysteine is formed when the body breaks down methionine, an amino acid found in dietar

Yes — you can reverse arterial plaque. Dr. Alo’s blog post explains how modern cardiology has overturned the old idea that plaque buildup is a one-way street. Nine key clinical trials using tiny cameras inside the arteries (IVUS, OCT, NIRS) prove that aggressive LDL cholesterol lowering can stop plaque growth and, in many cases, actually shrink it. Full article on https://www.dralo.net/blog/reverse The Big Takeaway Lower LDL = less plaque. Getting LDL below 70 mg/dL (ideally

This is the most straightforward course to learn hormone replacement therapy for the primary care clinician. Formatted and taught the same way you learned in didactic year of your MD, DO, NP or PA training. It doesn't matter what specialty you are in from cards to ortho or primary care it is every single MD, DO, NP or PA needs to be applying HRT into practice be it insurance based or not. Every woman peri and post menopause is a candidate and an ever increasing number of men

Ezetimibe has long been viewed as a straightforward adjunct to statin therapy—an inhibitor of intestinal cholesterol absorption via NPC1L1, useful for lowering LDL-C with minimal systemic effects. But recent data suggest a more complex story may be unfolding, with potential implications for brain health and neurodegenerative disease. From Lipids to the Brain: Why This Matters Cholesterol metabolism is tightly intertwined with neurobiology. Dysregulated lipid homeostasis has b

Keto/Carnivore vs. Vegan/Vegetarian both ends of the spectrum promise quick wins… but what happens long-term? Left Side: Keto/Carnivore ✅ Short-term: Ketosis, rapid weight loss, reduced inflammation ❌ Long-term risks: - Elevated LDL cholesterol - Higher triglycerides - Kidney stones - Gout Right Side: Vegan/Vegetarian ✅ Short-term: Antioxidants, fiber for gut health, weight control ❌ Long-term risks: - Declining bone mineral density - B12 & ferritin deficiency - Omega-3 defic

Falls are catastrophic for elderly and the warning signs start in the 30s at the desk job, giving up exercise due to excuses ad infinitum in adulthood. 30 years later that 30-something adult who made an excuse every day to not train ends up as an elderly fall in the ER. Falls are serious and costly. One out of 10 falls results in an injury that causes the older adult to restrict their activities for a day or more or to seek attention from the healthcare system. Each year, the

The AMORIS Study: Following 175,000+ people, researchers found ApoB was a stronger predictor of fatal heart attacks than standard LDL. UK Biobank & Clinical Trials: Large-scale data (FOURIER, IMPROVE-IT) confirm ApoB outperforms LDL-C and non-HDL-C, especially in cases where these metrics provide conflicting results. Medical Consensus: The 2024 National Lipid Association highlights ApoB as a critical tool for accurate risk assessment and treatment. Target Levels When it com

Many believe cardiovascular disease (CVD) only develops when someone has both insulin resistance and high lipids (like elevated LDL). A common illusion—especially among athletic, lean people with excellent insulin sensitivity—is that “good” metabolic health makes lipids less important. This is no longer accurate. Risk arises along two independent axis, with cumulative effects over decades: 1. Accumulated LDL Exposure High LDL cholesterol (dyslipidemia) independently drives at

Statins like Rosuvastatin are primary tools for reducing high cholesterol. Emerging evidence shows it possesses beneficial effects far beyond its intended purpose. In a functional medicine context, we are shifting from a single-focus approach to one that utilizes this medication as a potent modulator of systemic inflammation, oxidative stress, and immune dysregulation — known root causes of chronic illness. Beyond the Lipid Panel The traditional approach to healthcare often z

We didn't change our minds because it was popular—we changed them because the data gave us no choice. Most people treat their diet like a religion, but in functional medicine, staying stagnant is a disservice to the patient. Join Sarah Zaldivar, PhD (Ex-Carnivore) and Stefan Hartmann, PA-C (Reformed Lipid Denialist) for a raw look at what happens when your clinical results and the latest research force you to dismantle your own dogma. We’ve taken the heat from our followers a

In this episode of the Iron Direct Primary Care podcast, Stefan and Nurse Practitioner Ashley Curtis are joined by midlife health coach Maria to pull back the curtain on menopause, perimenopause, and the massive gaps in standard medical care. We dive deep into why "normal" lab results aren't "optimal," the hidden cardiovascular benefits of high-dose estradiol, and the real reason many women are misdiagnosed with UTIs and anxiety when they actually need hormone replenishment.

Making the case for using apoB in primary prevention (people without known ASCVD, like heart attack, stroke, or prior events) is strong and growing, based on expert opinion, observational data, Mendelian randomization (genetic evidence showing causality), and discordance analyses. While major U.S. guidelines (like the 2026 ACC/AHA) still center on LDL-C for broad primary prevention, many lipid specialists argue apoB should be the preferred or routine marker—here's why: ApoB d

Lp(a) elevation massively increases risk of heart attack and stroke Lp(a) concentrations are mostly genetically determined by the LPA gene, and population distributions vary by ancestry (highest levels in individuals of African ancestry). Prospective studies have found robust associations for Lp(a) with ASCVD outcomes and calcific aortic valve disease, and genetic studies support causal associations. ASCVD risk increases in a continuous manner with higher Lp(a) concentrations