Cholesterol SOS: What All Statin Users Need To Know About The GG Pathway

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Thanks a lot Joel. Delighted to be here.

Joel Kahn, MD, FACC

And a few people might have already detected you sound like Sean Connery, you are in the great country of Ireland. What city are you in?

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

I’m in Dublin actually. The capital. Yeah, I have been a long time.

Joel Kahn, MD, FACC

All right, excellent. And the shared joy of hearing you talk is half the wonderment we’re gonna have. The other is your amazing young brain and all that you’ve put in it. So tell people, because you are probably, I have another engineer that we’ve interviewed about wearables for the heart. But most people are medically inclined from the beginning. You made this great transition a decade ago. Tell us just a little biography of what that was all about. What were you doing 15 years ago and what do you do now?

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Right Joel. Well basically I did biochemical engineering. So I have a bio background, that was back in 1990 and I worked in medical device, FDA regulated kind of devices and all. But then I moved into high volume manufacture of consumer products and essentially for nearly 30 years I was in a position always of leading teams and complex problem solving. And it culminated as an R&D technical manager for many years, and directly people managing and also the corporation would use me to directly lead as a technical person the biggest, most complex problems that were costing the business money. So that was my whole history. I had a flare for problem solving, logic, and all branches of the science required. That was my corporate career and it was great. However, 2012, I’ll switch quickly. I got some routine blood tests. Three of them were extremely high, cholesterol, our old friend, and serum ferritin, the iron loading in in the blood, and a gamma glutamyl transferase, a liver enzyme. 

So the doctor, I didn’t understand these in depth but they were standards. So I quizzed the doctor, A, what are the implications of readings? I could see I was way outside the normal distributions so I knew it was meaningful. And B, what can I do to attack these? What are the root causes that I can apply? And I got very poor answers. And then I went to a family friend who’s a very experienced doctor, much older in his 50s, and I didn’t get really convincing answers there. And I finally went to a professor of medicine who’s also connected to the family, and the same thing. So I got a test for hemochromatosis, the iron loading disease that’s common in Irish people. It was negative. I was told to eat healthy whole grains, maybe more for the cholesterol, and for gamma glutamyl transferase, maybe I was drinking too much wine, but I wasn’t actually really doing that. So it was very disappointing. 

So a long story short, I had access to PubMed and ResearchGate through my corporation and I started root causing, problem solving. That’s me. And within a few weeks of, to be quite honest, obsessive research, I had eureka moments, I discovered metabolic syndrome, insulin resistance syndrome, IE type two diabetes. I realized I was high insulin with severe metabolic syndrome. That’s why I had bad readings. And I basically just cut out all processed food, breads and sugars and juices. I was drinking lots of juices because they were my five a day. I cut out all the sugary carbs and I went to a more fat-based diet as an emergency measure. And within eight weeks, my bloods were all resolved. And as a side effect, I was not actually striving at all. 

I dropped around 32 or 34 pounds in weight and I went down to a very slim physique, and I just thought, wow. And the reason for that, by the way, in case people are wondering, I began to find that my appetite was under control for the first time in my adult life. And I began to literally skip meals with impunity. I was very high energy in that period. So I was skipping meals and eating non obesogenic food, and together it was a double whammy and that’s why the weight collapsed. So I began to lecture on insulin resistance, metabolic syndrome to all the engineers in my corporate. I got support from the senior leadership for that. Some guys videoed it, got on YouTube and the whole career kind of changed.

Joel Kahn, MD, FACC

Some of your YouTubes have millions of views, don’t they?

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Yeah, I have a million views of my main heart disease one, which is mostly about the calcium scan and the power of that, which of course that’s one of the reasons we met and that one’s hit a million views, yeah, but the others, a few hundred thousand would be the higher ones.

Joel Kahn, MD, FACC

You’re humble, but you have a very big reach. You may shock some people, but tell everybody what your kind of tag name is. I mean, it’s Ivor Cummins is your birth name, but what’s your tag name and your all?

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

It’s The Fat Emperor. And that sounds a little arrogant.

Joel Kahn, MD, FACC

You certainly have reclaimed your health and you look wonderful. We are going to be talking about other approaches to insulin resistance because in my view, you gotta be extreme. You’re on one end of the spectrum and it works and the science is there. But there are people doing more of the 80/10/10 very high complex carbohydrate. Obviously they both share no processed food, no ultra processed food, no added sugars. There are different approaches and it’s interesting to know how adaptable our human biochemistry is to getting junk out of the diet. And then there are two ways to approach it. So it’s good for everybody to hear it. So let’s shift to calcium scoring, although again, it’s a topic that’s gonna come up a few times on this heart disease reversal summit. Where did you first encounter the heart calcium CT scan of which you’re very famous for promoting, get one, early detection, early detection. You can’t reverse heart disease if you don’t detect it. So we have to detect it early. So where did that come in your life? In just a few minutes, riff on that.

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

And actually very clear answer there. David Bobbit is one of Ireland’s wealthiest entrepreneurs. He runs a $600 million turnover business, which he 51% owns. So that’s David Bobbit, remember the name. And he set up a charity, Irish Heart Disease Awareness. And the reason briefly is he got a calcium scan, I think in the Cooper Clinic randomly. He was 52 years old, he was top 10% of fitness for his age. He aced his treadmills. And the doctor said “you’re bulletproof”. And he could wear his kind of prom tux. Slim as a whippet running four times a week, got a calcium scan, 930. And in the following days and weeks he began to research it and realized how extreme his risk really was. 

And he became so passionate about it, he wanted to save the world from heart disease by letting people know there’s a scan. If you’re a middle risk person, it will tell you how big a problem you have and you can take action. And he found me basically in 2015, I was still in my corporates and he said, “look, I can send you around the world to speak, going to your conferences”. And he began to fund all my expenses, no pay, but he would fund me to go all over the world. And that extended my reach. But of course as part of that, I discovered the calcium scan. He told me all about it in our initial phone call, two hours long. And I was skeptical. I thought, how can he have discovered this amazing technology and I didn’t know about it? But I had never looked up diagnostics too much. I was into the metabolism and he sent me a four inch thick folder on calcium scanning, by motor by courier, a folder he’d built. And within an hour I was just thinking, “oh my god, this test is unbelievable”. And that’s how I got into it.

Joel Kahn, MD, FACC

And is he behind the wonderful documentary, “The Widowmaker” movie, which was out of Ireland?

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Yeah, he funded that. It was a couple of million dollars of his own money and he spent a couple of million more on the rest of his mission. But “The Widowmaker” movie was pretty high budget, relatively high budget. And it had Jillian Anderson narrate it and it’s very professionally done by a professional documentary team. And I put a one hour version of it, an abridged version on YouTube. And that one we can put the link in later. You can watch, the one hour is long enough, you don’t need the full two hours.

Joel Kahn, MD, FACC

Yeah, and for anybody listening, although it was funded by this Irish Heart Foundation, most of the interviews are out of the United States where the technology was identified way back in 1990. And then this amazing story, and I won’t blow it for people who haven’t seen it, about this legislator in Texas and how he took on as a mission like you’ve taken on and I’ve taken on, spreading the word about heart calcium CT scanning. What’s the status in Ireland? How likely is it that a primary care team is gonna recommend it? How expensive, how accessible is it to somebody 50 years old with an elevated blood pressure, elevated cholesterol?

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Ireland’s a little better than a few years ago, but it’s still the case that practitioners will not recommend it and they’ll scratch their head if you ask for it because the whole medical industry, as explained in “The Widowmaker” movie, has been steered for 40 years to not like it, without data, of course. But they all feel that way. So you can get it in many independent clinics, it’s around 300 bucks roughly. And some insurance companies, the good news is are beginning to cover it. A few years ago, they really didn’t have the code to cover it. So it’s not bad, but you need to be your own kind of author of your own destiny. You need to push for it and you need to go and get it. The system won’t push it to you.

Joel Kahn, MD, FACC

Not much different here in the states. It’s after literally in many cities, 25 years it’s been available, the price has dropped, but the utilization has not been explosive. Primary care teams are not likely still to recommend it. And sometimes they’re talking patients out of it. What’s it gonna really do to change when we know that, not just you and me, but the American Heart Association, the National Lipid Association, they’ve all put in the power of a zero calcium score into their algorithms. Who needs treatment, statins and everybody needs lifestyle, we know that. But who needs prescription drugs? And obviously it harms the pharmaceutical industry to put in an algorithm that you don’t need pharmaceutical agents. So it just hasn’t been picked up. We did talk to Matthew Budoff, our mutual friend, professor in chief of medicine cardiology at UCLA. He just wrote an editorial making another plea that the insurance companies in the states should now, given it’s about a 75 to $150 test in the states, cover for the test. 

Although it’s within the reach of most people. And of course there was just recently out of, I wanna say Denmark, the DANCAVAS trial, but at least in that one niche, age 65 to 69, it’s now a proven fact that liberal use of the calcium scoring and other screening tests of asymptomatic men has an outcome benefit. That’s always been maybe the weak spot in the argument, prove to us that it makes a difference. It’s now a proven fact. So I hope all your hard work and my championing the hard calcium CT scan. In my own clinic, I mean the majority of the people I see during the week, that’s why, and I cannot guess. Thin body, decent labs, and they have a high score. 

But then when you go deeper you might find, like you said, metabolic syndrome, lipoprotein A, unexplained inflammation, other genetic factors. So we’ve mentioned the pharmaceutical industry a few times. You’re quite an expert on statins, the cholesterol lowering medication, and you have some really interesting understanding of the biochemistry and the liver. Let’s talk a little bit, just off your head, tell us a bit about the mevalonic acid or mevalonate pathway, the production system in the liver for cholesterol. The good, the bad, the side branches. Just share with us what you know, which is a lot.

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

It’s been a while since I’ve done the deep biochem on that, probably six or seven years. But I still remember the key things. So the mevalonate pathway is fascinating because it’s such a fundamental branch of life and biology for humans, mammals in general. But the reason it got really interesting is because it’s where the statin drug class, its action takes place and it basically cuts off the branch. The mevalonate pathway by all means make sure cholesterol, which is vital to life, no one questions that cholesterol is the most important molecule for life. Your brain is 25% cholesterol even though it’s only 4% of your body weight. And every cell can make its own with some exception. So cholesterol is vital and it can become corrupted. But the statins cut off a branch of the mevalonate pathway that fabricates cholesterol, hence they lower and we suspect lower oxidized cholesterol as well and damaged cholesterol particles. So the benefits may come from there. But the sad thing is that in this pathway, there’s many branches and the one that’s hit by the statins, it also is very important to enable K2 metabolism. And we know vitamin K2 is very important for balancing calcium metabolism. And also it is a pathway that unfortunately gets hit that produces polypeptiles for muscle function. And also it’s the pathway that produces COQ10. And many people may be familiar with statins. You may need to supplement COQ10. And there’s one more, it escapes me at the moment c because I know there’s four key ones. K2, muscle peptides–

Joel Kahn, MD, FACC

Protein ventilation and testosterone, testosterone.

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Testosterone and other hormones and the COQ10 that, that’s the basket. So all of these crucial life enabling or health enhancing and longevity producing things sadly get hit by the statin because as Professor Barry Tan said, it’s an indiscriminate blunt instrument. It knocks out the pathway for the cholesterol, which is the target, but it knocks out everything we’ve just discussed. So that’s where you get a lot of muscle aches and pains and some of the neurological problems experienced by people. And COQ10 is lower, there can be links to heart failure type problems over time and et cetera, et cetera. And it’s unfortunate. But as you know now, there is a way of counteracting that problem, at least one that we know of. And it’s quite recent, but based on very old science.

Joel Kahn, MD, FACC

So I like that there still are clearly patients that have a very high cholesterol and a genetic or lifestyle basis and perhaps they’re not willing to change their lifestyle. Cardiologists use statins, widely family practitioners, I use them less than most cardiologists and only in people with established disease. But we’re not getting out of this life by eliminating the statin pharmaceutical industry, which is largely now generic. It’s not an expensive drug class anymore. There are new cholesterol drugs that are extremely expensive, but not the statins. But like you said, it’s a shotgun. When you use a statin to block an enzyme to lower cholesterol production, you’re also lowering good guys. 

We’ve got bad guys and I don’t call cholesterol a bad guy, it’s just excess and oxidized cholesterol may be a bad guy in some people, but we’re knocking down the good guys. So you mentioned a name Dr. Barry Tan, T-A-N. Not everybody’s gonna be familiar with him. You have a wonderful interview on your website that I would recommend people spend the time to see how excited Dr. Tan is about the discovery that something in the Amazon can really make it the best of both worlds. You lower your cholesterol but you don’t lower these four key accessory metabolic products. Testosterone, COQ10, vitamin K2, MK4, and the muscle protein ventilation pathway. So tell us a little about what Dr. Tan discovered in this plant.

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Yeah, so he discovered, oh decades ago this plant, an extraordinary vivid kind of pink seeded plant. And it was on his travels and he thought because he was Chinese background that he would find things of real interests from the natural plant world for health in China. But it ended up, as you say, more Amazonian. And he was there incidentally and he took the seeds of this plant and he brought them back and he realized that there was something in them that stopped them oxidizing, powerfully stopped them oxidizing. And if you remove that component, they would darken in his test tubes. But long story short, he discovered that tocotrienols and very briefly vitamin E, people take vitamin E, but it’s a bit of a double edged swords because there’s tocopheral form of vitamin E and there’s tocotrienol form and taking excess tocopherols may actually be even problematic. And this has been published on vitamin E and most vitamin E is dominated by alpha tocopherols. But he discovered the other part of vitamin E, tocotrienol, I think Gamma and Delta had massive antioxidant properties and really was truly beneficial in studies. 

So he extracted that amazing thing. But to get to the mevalonate pathway, many years later, there was another pale yellow compound he had extracted, which he wasn’t sure what it was. And it’s actually part of the tocotrienol, it’s kind of the tail and it’s called Geranylgeraniol, GG. And after many years of work and research, he discovered that that is the crucial node in the mevalonate pathway that enables all the good things we talked about. And he realized that because the statin knocks the whole pathway and hits GG node also, if you replace the GG, you can counteract all the bad problems with the statin class while leaving it, still, reducing the cholesterol pathway, which is the desired thing for that drug. So that was the kind of amazing road to Damascus. He realized GG would be really helpful and helpful because it declines as we age like many things. So really healthy to take it and supplement it. But most crucially for the countless millions who feel they need to take the statins or they’re the type that can benefit, you could negate the negative effects. You could fix the things that are broken that are just an unfortunate shotgun effect. So that was it. GG PURE is the product from Extend Life. I think you know Warren, my buddy in New Zealand provides Dr. Tan’s top quality raw material. And I’m almost, I’m not sure anyone else is really realizing this. I’m not sure GG’s available generally like other supplements.

Joel Kahn, MD, FACC

I think you just talked about maybe the hottest, promise in the wider use without complications of cholesterol lowering medication. So we’re talking about a plant from the Amazon and I’ve seen pictures of it, it looks a little bit like a pomegranate, like you said, beautiful pink, red kernels or seeds called the annatto plant. And you can extract from it the highest quality form of vitamin E or vitamin E called tocotrienols. But then this discovery that you can extract an entirely different, although biochemically related compound called GG, we’ll call it GG. And you can take your Lipitor, take your Crestor, take your Zocor, obviously the generic form, but you can take GG PURE with it and get your cholesterol lowering and still support the limb of that pathway that seems to be involved with health and wellbeing. I learned in medical school about the biochemistry of taking a cholesterol lowering statin medication and the anticipation you’re gonna block coenzyme Q10 production, it’s just biochemistry, you have to. And who would volunteer to get their COQ10 block? Now we know it’s more than coenzyme Q10, it’s protein, testosterone, vitamin K2, MK4, who would volunteer to have that? It’s bad enough to get old, but you don’t wanna have a pharmaceutical agent accelerate what may be an aging process, probably a vascular aging process. Talk a little bit. We do know that people on statins, we know this frankly from our mutual friend Matthew Budoff’s work and others that statins lower cholesterol and may in some subsets promote avoidance of heart attacks and hospitalizations, but they do increase calcification of arteries. There’s our friend vitamin K2. Do you think it’s that GG pathway blockage that’s resulting in that and now we might actually be able to lower cholesterol without accelerating artery calcification?

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

I think that’s my assumption, and again, the problem with the statins increase calcification is it is associational data and it, it’s quite consistent, but it’s not a proven kind of RCT. And sometimes people say, oh, people who take statins maybe less careful with their diet and that may be the association, it’s confounded. But for me it was always the antagonaztion or antagonizing of the K2 pathway, which I knew about long before GG. I suspected that that was the most likely culprit. And then of course GG’s action de-antagonizes that K2 pathway. And therefore you would expect that you could very well see the excess calcification via statin, whatever the root cause be ameliorated or mitigated. So that would be the expectation. 

But I think we all know that there’s myriad pathways, they all interact, there’s feedback loops. We’re highly complex machines. So the fact that GG enables the key hormones, testosterone, the ventilation, muscle protein synthesis, and the K2, to have all of them being tackled together, there’d kind of be a holistic benefit. And I’m sure that would convert into many forms of better health, including of course vascular deterioration being improved. Oh, and they did do one, at least one. Barry has a load of papers, but one specific human experiment, they gave statin, no statin, GG, no G, and the damage biochemically measured from the statin, which we discussed, where they saw the markers moving in the way you might expect, not a good way, with the GG added into the other group, that was canceled. And in the non-statin group, the GG versus placebo also saw an improvement in these various measures. So it’s not a full RCT with outcomes, but the science is coming in now to actually validate all of the hypotheses.

Joel Kahn, MD, FACC

Well again, we don’t throw the baby out with the bath water, it is a very exciting topic. If you open a package insert of a drug like generic Lipitor, generic Crestor, it’ll say from our FDA, be aware of muscle aching, be aware of blood sugar elevation, be aware of cognitive issues, brain fog, memory because medical science studies have shown these are issues in some people. I doubt we’re gonna get a 10,000 patient trial of statin plus GG PURE versus statin alone because after all these years we hardly have a COQ10 plus statin randomized study to look at. And certainly not a big one. It would have to take quite an enormous amount of money. It won’t happen. But will we be able, just clinicians making observations, a patient that isn’t thriving on a statin that now is put on nutritional support and that’s what I would call the annatto plant, a nutritional biochemical support, GG capsules. Are they gonna resolve some of the detriment and they’ll be able to stay on the medication safer and better? I’ll tell you in my clinic, I see a lot of people on the first visit, Doc, I just got discharged from the hospital six weeks ago. I had three stents, small heart attack. 

I’m on 80 milligram of Atorvastatin, which is a typical discharge protocol by research for 30 days. But nobody ever questions it. So they end up on these massive doses for long term and I’ll draw a blood test and it’s a blood level of COQ10. Now I don’t get that test back for 10 days, but I usually tell the patient, you need to supplement with coenzyme Q10 if you’re gonna stand that kind of dosage. When the blood work comes back, they have nearly undetectable blood COQ10 levels. It’s biochemistry. It’s not a surprise. I didn’t discover this, it’s in the medical literature. I haven’t published the papers, and I’m certainly glad that I put them on supplemental COQ10. What’s really an interesting question is do we now add COQ10 and GG PURE or maybe do we just add GG PURE, Geranylgeraniol, and will that support, and I’m gonna do that on somebody is just put them on GG PURE, recheck the serum level of COQ10 because we do know for certain disease conditions for high blood pressure, a blood level of COQ10 of two and above supports more normal blood pressure. 

So it acts almost like a pharmacologic agent. And in congestive heart failure, a blood level of three or greater ain COQ10 supports a resolution of some of the symptoms and even a rise in ejection fraction. So we don’t wanna walk around with pharmaceutically induced low COQ10, I mean age does that to us. We don’t need to add to age. Age is tough enough on most of us. So this GG pathway that Dr. Tan discovered, and again, I urge people to look up your fairly recent interview with him. So you said the product GG PURE, I think it went quickly, but xtend-life.com if I remember, xtend-life.com, people can read about it. Tell us where people can find more about your YouTubes, your work, your fascinating interviews.

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Right, Thanks Joel. And oh, and just one quick thing I’ll say on GG and in general what you alluded to, people sometimes think, oh, well nutraceuticals are expensive and they kind of trust pharmaceuticals more. But you know an irony for me for many years now? The statin comes from a fungus, it’s taken from plant world, and you get a patent on it and whatever, you might tweak it, but the pharmaceuticals overwhelmingly come from plant world proteins and substances that are tuned or trimmed and patented and they’re huge money. But you can go to nature, like in this case of GG and many other things and extract these fascinatingly beneficial molecules. But because they’re not patented with big trials, they’re not respected as much. So I just thought I’d mention that, it’s all coming from the same place.

Joel Kahn, MD, FACC

Metformin from lilacs, aspirin from willow trees, GG PURE from the annatto plant. I know there’s many, many, many others of course, but you can’t patent a natural product. You can’t patent a lot of the vitamins out there, but of course you can modify them and make them patentable and call them a pharmaceutical agent.

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

And the funny thing is, I used to comment many, many years ago, just make a joke of it. You basically get a natural plant world compound that will do X, but your compound just needs the spin of an electron and one atom in a big molecule changed in order to let you get a patent, give you the exact same thing. But now it’s done a trial and it’s a pharmaceutical. But there you go. But on that question, yeah, I think if you just search my name, Ivor Cummins, very quickly up the top, you’ll hit my Twitter and YouTube and Facebook and they’re the main platforms I go out on, particularly YouTube, all the videos. I haven’t really had time to get into Insta yet. So it’s mainly those three. And my blog, thefatemperor.com, I blog occasionally as well.

Joel Kahn, MD, FACC

Instagram would be for pictures of your five children and if you have any pets. I don’t find scientific posts on Instagram do extremely well, even though I persisted that. And I do post a lot about the calcium scoring. So anyways, I wanna thank you from everybody at this Heart Disease Reversal Summit. You bring a breath of fresh air from across the Atlantic and exciting times. And this GG PURE is really exciting. So we so appreciate you explaining it to us and we’ll catch up soon. Thank you, sir.

Ivor Cummins, BE(Chem), CEng, MIEI, PMP

Excellent. Thanks so much, Joel. Till next time.