Episode 61 – Dr. Craig Backs From The CureCenter

We sit down with Dr. Craig Backs of The CureCenter here in Springfield, IL to go over his approach to cardiovascular health and how his journey helped him change the way he approaches medicine. After practicing mainstream internal medicine for three decades, Dr. Craig discovered the profound reversibility of arterial disease and shifted his focus to prevention and reversal, particularly targeting arterial disease and type 2 diabetes. This is a really fun discussion between the three of us, and we hope to have him back on soon!!

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Dr. Craig Backs From The CureCenter

Introduction

Welcome to the show. I’m Dr. Frederick Schurger. We’ve got Dr. Beth Bagley here and most importantly, we have Dr. Craig Backs with us to share some of his expertise in the medical side of things for heart health and general health. I’m excited to have him on. Doc, I’m going to let you go ahead and tell us a little bit about yourself and what your practice is like, and then we’ll ask any questions.

Thanks. It’s great to be here. I appreciate the opportunity to interact with your audience. I’m a 67-year-old general internist. I’ve been practicing for about 40 years with no plans for retirement. For the first 30 years or so of my career, I practice mainstream general internal medicine dealing with the consequences of chronic disease. At that time, it was a problem but it’s not the same epidemic problem that it is now.

About ten years ago, I discovered that arterial disease is far more reversible and preventable than I ever thought. It blew my mind but it puts me in a position where I either had to change everything or ignore the evidence. I changed everything in my practice and decided to focus on reversing arterial disease as opposed to just managing against decline and watching its consequences. Not going into a lot of the details, I learned that arterial disease is the most common cause of disability, death, stroke, heart attack, type 2 diabetes, or chronic inflammatory conditions that are driven by things that we do to ourselves, the food we eat, the way we live our lives, and the toxins that we encounter more so than anything.

Let me put it this way. It’s not a medication deficiency disease. I learned the science and the medicine of it. I spent the last ten years, hopefully, improving the accessibility to it. The basis of it is called the build-a-name method. If anybody is interested in reading a book about it, you can pick up Healthy Heart, Healthy Brain. I haven’t written a book, but I would cite that as probably the best authority that I can mention.

Much of my website is also based on the principles in that book, TheCureCenter.life, for those who are interested in more background. For the last ten years, I’ve been focusing on reversing arterial disease and type 2 diabetes. I’m happy to report that I had my first patient suffering from an acute coronary syndrome that led to a stent. The first patient that suffered TIA. Other than that, none of our patients have suffered these extremely common events. I’m very proud of them with that track record. Now, I see the need to go over my fear of bragging, tell the truth, and let people know that it is possible.

That has been one of the foundations of health. I believe it goes back to Voltaire who established it for many doctors at least in that day and age fooling the patients until they got well. Now, we have been fooled by our food supplies that it’s hard to get well until we start realizing, “We just need to eat real food.”

You’re right, we’ve been interacting in Springfield on and off for the past decade or so since you opened your practice. One of the things that is common I hear about is how often someone needs to go in for a stent. If you’ve got ten years with your first cases, which invariably you’re going to have some of those from time to time. That’s fantastic. That’s great to hear. Before that, you were at St. John’s in town. Is that correct?

I practiced for about 30 years as a general internist with a group practice. It’s a number of different iterations. Not Springfield Clinic. Not SIU School of Medicine. We were an independent group so to speak. I spent three years as Chief Medical Officer at St. John’s Hospital. It was more of an administrative role trying to herd the doctor cats and keep the troublemakers in line.

What changed your mind from what is unfortunately the traditional medical practice to what you’re doing? What was the mindset that got you there?

My own personal need. I came across an opportunity to get my carotid arteries scanned with ultrasound and it showed that I have the same problem that my father, my uncle, and my grandfather all had, which is atherosclerosis. Unfortunately, I found out before I had an event. I thought, “What else should I be doing?” I was taking medications. I didn’t have high blood pressure. I was beyond overweight. I was obese. I was about 235.

I went investigating. I further asked the company that did the sonogram, “What more should I do?” They said, “You want to go to this preceptorship. They know the need method.” I went thinking I was going to be scammed because the leaders said they offered a money-back guarantee if anybody had a heart attack or a stroke under their care. They would refund their significant annual concierge medicine fee several thousand dollars and they’d only written one check in the last eight years.

When they presented the information, the data, the medical, and the studies that showed how foundational lifestyle is and how effective it is. I don’t want to throw the baby out with the bathwater. I still prescribe medications. I recommend a supplement for targeted or identified deficiencies, but it was convincing. When I returned home, I remember I told my wife, “You have to drive because I have to go through all this information and outline and come up with a plan for implementing it in my practice.”

It has only taken about ten years to get there but I figured out most of it. It’s always wanting to do things every day but the struggle is trying to overcome the mainstream school of thought that this is inevitably a progressive condition. It’s so common, therefore, it’s inevitable. It’s normal but it’s certainly not optimal as it is optional.

Dietary Protocols

I’ve heard it so many times. You said you’ve been helping not only with arterial disease but type 2 diabetes. Many people I hear, “I’ve got type 2 diabetes,” and they’re going to take insulin or something else as opposed to saying, “You can manage it and you can reverse it.” Many doctors are also told, “You can’t do anything about it yet. They can’t change their diet.” I’d like to know a little bit about the dietary protocols that you work with on people to help make those changes.

First of all, the fatalistic nihilistic attitude that patients won’t change, as Henry Ford said, “Whether you think you can or you think you can’t, you’re right.” There are patients. It is difficult mostly because of our culture to overcome the influences that cause people to eat. By the way, I spell it phood for food. You use the word phool for the patient to be followed by Pharma. Phood, phool and into the pharma. It’s a business model. It’s been very successful and it’s getting more successful over time.

I tell patients, “You can choose whether to participate in that or not. It’s your choice.” This is simple but it’s not necessarily easy and needs support. I try to keep it simple. I don’t employ a nutritional counselor. First of all, if they’re certified, they’re doomed or deemed to give the wrong advice. I had a conversation with a certified dietitian in CrossFit gym one Saturday morning 7 or 8 years ago. I asked her how she ate. She said Paleo. I said, “Is that how you teach your patients?” She said, “No, I would lose my license.” They’re held in the food permit.

That was like this is not about the patient as a customer or as a beneficiary of our care. They are the product. If you look at the recommendations from the American Diabetes Association and the food pyramid, you can only conclude that the purpose of the clientele or the constituency of the American Diabetes Association is not people with diabetes but the disease of diabetes. The more diabetes we have, the bigger their influence, the bigger their budgets, and the bigger everything. Everybody loves growth when it comes to their own business.

I tell my patients, I call them the badasses, it comes to the nutritionists, the sweets, the starches, and the snacks. By that, I mean they are processed. Snacks are the processed foods that you’re eating all the time. We try to get our patients to try to eat within, I call it window feeding and intermittent fasting. Try to eat within a 6 to 8-hour window every day. The shorter the better. Some days are easier than others.

You have to get into social situations where you have to make adjustments, but for the most part, don’t eat all the time. We weren’t programmed or evolved to grades. Our hunter-gatherer ancestors gave us their genes that we perfectly adapted to their environment. They stopped eating, fasting for a famine. We had to hack that software back by our behavior. We can’t go with the flow of the three meals a day and free snacking with sugary processed food.

Sugar is enemy number one. Starch turns into sugar. Don’t eat any white foods other than cauliflower, which is a pretty good substitute for potatoes and rice. I have nine S’s, sweet, starches, snack, sitting, seed oils, sleep is important. and salt. I’m a little less striking about salt because salt is going to take the hit while sugar has been doing the damage. Also, smoking.

We can’t simply go with the flow of three meals a day, unrestricted snacking, and sugary processed foods. Sugar is enemy number one.

People seem to be able to remember that, even though it’s not particular. One of the things that I find too often when I’m dealing with my colleagues is that we try to impart information. We say it’s for the patient’s benefit but it’s to prove how smart we are. We talk about data, studies, this, that, and the other. The role of a teacher or a coach, as I see my role is more of, “Here’s where you suck. Here’s where you need to improve.” I shouldn’t say it that way but I’m going back to my high school basketball coach, who used to tell me I stink all the time.

The point is, “Here’s where you can improve. Here’s how you improve. Here’s how we measure your improvement.” Repeat. One of the key things is to be very visual and data-driven in our approach. You’re very familiar with our in-body, which we call the judge, the body composition analysis. We can talk about whether are you too fat or too thin. The machine gives you a number. What do we want to do with that number? Make it better.

One thing on the in-body that is probably, certainly for myself, as someone who’s trying to be strong and trying to get stronger. I could get on a body fat scale to see what the body fat percentage is, but what I didn’t appreciate until I started, and the reason I use the in-body so frequently is that I’m focusing on that muscle mass component. You’ve got seventeen years on me, but that doesn’t mean a whole lot because I’m already past 35 by several. The problem ends up being is it is so hard to build body mass as you get older, as you’re well aware. Are you still at the CrossFit gym?

No, I’m a little embarrassed to say my physical exercise has been a little bit put off. Both of my history play some back surgery and neck surgery in the last three years. It’s a poor excuse. I could do better.

You’re also aware that if you don’t keep that muscle mass as you age, it’s going to deteriorate faster. Ultimately, that’s going to lead to more mortality and morbidity. That number there alone, when I see that number, even if my scale goes up and my fat percentage goes up and the muscle mass goes up. I’m like, “I’m not going to complain about that too much.” When that number goes down and the fat percentage goes up like it did when I stopped by, then I’m just like, “I need to fast.”

I have a question. When you discovered that, I know we already knew you were in an unhealthy state then got that information that made you, “This is the time to change.” How long did it take you to turn that around? Do you use that to help your patients? Do you use that experience?

I’m trying to remember the sequence. My own fitness journey started before I realized the arterial disease and that was Mike Suhadolnik, who was a CrossFit coach. He saw my picture and he said he was offended by my fatness. He came to my office one day and he said, “Why is it you doctors take better care of yourselves?”

Long story short, he had an idea. He was my coach and he taught me. He’s like, “You need to be a better example. You can’t expect people to follow advice from a fat doctor, fat nutritionist, fat nurses, and certified doctors as well.” The point is people spot hypocrisy and they aren’t inspired by it. I lost 70 pounds in probably less than six months but that was rather intense. I do remember the one thing he said. He lied to me the first day. He said, “80% of your weight reduction is not going to be exercised. It’s going to be what you eat.”

The lie was it’s more like 90% or more of what you eat. Not the exercise. That six packs are made in the kitchen. Not in the gym. That’s true, but it’s more true than not, I should say. That’s been born out in my practice as I follow patients. Besides their body composition, we also follow a number of laboratory tests, focusing a lot on chronic inflammation, but more visually, the carotid ultrasound shows what I call the thickness and sickness of the artery wall.

When we follow those things, we can show people their results and the benefits of what they’re doing in a cyclical way. I got a little bit off track there, but one of the key things to behavior modification is to identify the behavior and set a realistic goal. I’m not a believer in saying, “You need to lose 10 pounds.” I believe the only thing that makes any sense to me is a week from now, you need to be less fat than you are today.

For some people, that might be a half or 3 pounds, but it’s just how much less fat, how much exercise more. It’s not about a specific target because eventually and incrementally, you’ll get there. The other thing from a behavior modification point of view, I’ve discovered that very few people are going to do this. I would almost force them to do it, embarrassed and shamed into doing it, frankly, to change things almost like 180 degrees. It’s going to be a series of nudges. Can we make this change? What can you do? You can’t do that. Can you do this? That’s been far more successful for most patients.

This goes back to the situation with people like us. We see the data. We understand the data, and maybe that makes us more highly motivated to make those changes. We’ll do the hard things because we know on the other end of it, it’s going to be there. Whereas, the average patient hasn’t been challenged to do those hard things. The reason that they’re in their situation is because they haven’t been doing the hard things.

They haven’t been making the meal choices that are a little bit harder. Waiting to get home to make dinner as opposed to picking up something along the way, buying fast food, or the fast and processed food at the grocery store as opposed to something that you can cook at home or for that matter, getting out and going to the gym. We have to help. As you said, a lot of it is coaching to help them understand how we are making the change and helping them along the right direction because they’ve never experienced that or it’s been several decades since they’ve experienced that.

One of the things that I try to counter all the time is the bigotry of low expectations and seeing somebody who’s 40 pounds or 50 pounds or maybe 100 pounds and say, “You can’t change.” Maybe we need to give everybody a chance. Some people are better off continuing to disappoint themselves and us. At the same time, the set point should be that this can get better.

People need to be hopeful, but at the same time, be held accountable. That’s why I never let a patient leave my office without having set their next follow-up appointment where we’re going to see what the results of these changes will be made. Sometimes, it’s a one or two-week follow-up appointment. I call it to come to see the judge, get on the in-body, or three months to do their labs. I do operate within an insurance model to make this accessible to more people, but unfortunately, that drives some of the intervals by which we can do laboratory tests.

People need to be hopeful but, at the same time, be held accountable.

It gives them a target to at least know when they need to start cramming for finals, following the nutrition advice and exercising. The other beauty about things like the in-body is that I don’t have to get into debates with patients about what are they doing. I would just show the numbers and say, “Is this what you expected?”

For the audience who aren’t familiar, can you explain the in-body?

The in-body is a body composition analyzer. It uses bioimpedance absorption to do essentially what a CT scanner does with radiation absorption. The in-body measures the absorption of electrical energy in multiple vectors and creates an electrical picture of the body that is correlated with things like DEXA or other measurements of body composition. It gives you a report.

These are newer but the in-body 570 looks something like this. You stand on the platform. These electrodes and these electrodes in the hands transmit the energy and you get a report. I don’t know if they’ll show the report. You get a report that enables us to show the skeletal muscle mass. This is unfortunately a C pattern where there’s more fat and less muscle, where our strife or everything lining up. We can then follow that information over time. I have one in my office. It’s not an expensive investment, but I viewed it as I bought a robot that does what an employee does in terms of nutrition counseling for less than $10,000 seven years ago. I’ve considered it a pretty good ROI.

I like it because it is unlike a DEXA, where it is a radiation dose. Is it every three months or every six months before they want to let you do another DEXA?

I’m not familiar with DEXA. I had one that was my first body composition analysis then I discovered the in-body. A DEXA is $100,000. You use half a ton. In the in-body, it’s not extremely portable but you can move it and take it to other places and do events with it. There’s no harm. There are only two contraindications. One is implanted defibrillators or pacemakers or spine stimulators and pregnancy. Frankly, those are mostly driven by the lawyers wanting to avoid all stress. We may have had an accidental patient or two who get on it without any consequences but we do try to follow those restrictions. It still leaves a lot of people who can benefit from it.

As you were saying, especially with the insurance model. You would like to test more often to see the changes that they made within the month. Often within a month, you can make significant changes in diet to affect those things. With the in-body, you can do that on a regular basis with no impact.

Blood Sugar Management

We’ve had a couple of podcasts where we’ve talked about ways that people can stabilize their blood sugars. I want to know your opinion on people using continuous blood or blood glucose monitors. Do you think it’s a good thing? Do you think it’s too much information? What do you what do you think?

It’s an awesome tool. It’s underutilized. Unfortunately, insurance payment doesn’t kick in until somebody’s type 1 or type 2 diabetic on the insulin. Once the horse is out of the barn but into the next state, now we’ll pay for this. It’s a relatively small investment in patients. You need a prescription for it. It still costs maybe $70 for a month. What better information to find out, “I eat this and my glucose skyrocket. If I fast my sugar, my glucose doesn’t tank out.”

The feedback is valuable. The faster they can get that feedback, the better, and the more repetitive. It’s very helpful. Quite frankly, certainly anybody with arterial disease and you’ve reminded me that I probably need to recommend it more often. It should have that information because long before people have elevated blood glucose, they have insulin resistance. I always tell patients, “There’s very few of us that don’t have insulin resistance. It’s a feature. Not a bug in our software.” Going back to our hunter-gatherer existence, it’s a system that works well to intermittently have energy sources and store that energy for later use and expenditure.

It’s not a good system for constant energy intake, especially in the form of highly processed sugary food. It’s productive to store all that. All of that energy is fat or liver around our internal organs, which we know is inflammatory fat. Forget cholesterol and high blood pressure. The number one cause of chronic inflammation is insulin resistance combined with a culture that tells us to eat all this junk, do it all the time, and indulge your dopamine receptors in the brain and feel good until you don’t feel good.

It is a drug. We need an addiction model to overcome it for the most part. I don’t know if that answers your question going back to the CGM. It’s always instructional. Now, it’s ignored. That’s one thing. Sooner somebody is aware of how this food impacts our blood glucose, but more importantly, how it impacts insulin levels because it’s hyperinsulinemia that is the inflammatory driver and not the elevated glucose.

Glucose happens to be the thing we can measure easily. Insulin is not so easily measured and standardization is not so easy. We need to compare it to how it is relative to the glucose. It’s a little bit more complicated. You have the glaucoma IR testing that can be done as a surrogate for insulin resistance.

Frankly, I look at it this way, the higher your percentage of body fat compared to your muscle mass, the more insulin-resistant you are. What should you want? You should want to be less insulin-resistant. How do you get there? You become leaner, more muscular, more cardiometabolic in balance, and less inflamed. It works pretty much every time it’s successfully tried.

The higher the percentage of body fat you have compared to muscle mass, the more insulin-resistant you become.

How much of that diet ends up being keto-ish or is it keto or carnivore? Where do keto and carnivores fall into the diet stuff that you’re looking at?

Experts do this all day long and talk about it on shows all day long. Haters would say it’s not that simple. In my mind, it’s anything that limits the intake of sugar. By the way, artificial sweeteners don’t have much the same metabolic effect. You wouldn’t say to somebody who had a problem with alcohol, “Drink low-alcohol beer until you’ll be fine.” It’s a gateway drug to the real thing.

It stimulates the sweet tooth. It keeps it strong. It leads to relapse. The key thing, between carnivores, keto is carnivores with plants. Both rely on or shift our metabolism more toward ketosis and away from metabolizing glucose. The problem is we can’t possibly metabolize all the glucose and use it for energy that we ingestive for eating. The standard macadamide has to be stored as that. It becomes a toxin. Nobody has shown that there’s any downside to ketosis or being closer to it in my mind. Tell me if you think there is. If there is harm, the thing that protects us is it’s difficult to stay on it consistently.

Especially in our Western culture. It’s like, “I’ll just have a small piece of cheesecake, a chunk, a quarter. That’s a small piece.”

You can make that somewhat keto, at least, the cheesecake. I agree that then triggers the sweet tooth then someone’s like, “Maybe a bag of chips, but yesterday I did that.” It becomes a downfall.

It’s too easy. It’s everywhere. It’s on our site all the time. It’s on the media all the time. One of the best things, I have a lot less exposure to television and more to your show. That’s had a lot to do with making it. I’m in a friend’s house and I’m seeing cable TV and all the crap. All the memories come flooding back. It’s like taking an alcoholic into a bar or a kegger. It’s dangerous.

The other thing I’ll mention is I always tell patients, “It won’t be your worst enemy that’s going to remind you. It will be your closest friend. Maybe your spouse or your family members. “I made this just for you. This is your favorite.” A purchase of some comfort food. I call it the cram bucket syndrome or the tall poppy syndrome.

One of the things that I try to engage besides the fact that it’s generally a good patient recruiting tool is if I’m taking care of a husband. I want to get their partner too because they’ll either mutually reinforce each other, or they’ll undermine each other. I assume pretty well I end up with which is which. Does that fit with your experience?

For sure. I was going to say, for all three of us if we ever need comfort food, it should be a comfort brisket.

I love some brisket.

No sauce. We can do sauce later. We can figure that out.

You guys live in the same town, correct?

Yes.

Dr. Schurger makes a mean brisket. If he hasn’t brought you any, you should guilt him into bringing you some.

I’ll hold you to that.

I’m bringing you a brisket next time I’m coming in for an in-body.

I love brisket.

Statin Medications

We’ve also done an episode on stat medications. I don’t want to get you in trouble, but we have mixed reviews and thoughts about statins. We’ve talked a lot about how a pro-inflammatory diet causes an increase in cholesterol numbers and that statin medications might not be the good first line of defense to reduce those numbers. What are your thoughts on that?

I don’t want to throw the baby out with the bathwater. I use it as a backstop as a safe precaution. I’m always emphasizing less inflammatory diet exercise. I talked about the nine S’s, but let’s be realistic. Very few people are going to be that compulsive, compliant, and fastidious. The problem with statins as I see it, and as I used to prescribe it, as I used to prescribe them, is too two high doses of the wrong statin for the wrong reason.

If somebody comes to me with an atorvastatin 80 milligrams because their LDL cholesterol was too high. That sums up all three. High-prescribed low doses like 5 milligrams three times a week. A rosuvastatin for the purpose of reducing inflammation and following the markers that we look at for inflammation in the blood like LBPLA2 and C-Rac protein, micro ambient, and creatinine ratio. Also, intima-media thickness on the carotid artery scan. Hopefully, you do have a moment or two to talk about that.

The point is I have seen what happens when people don’t take the statins in terms of those inflammatory markers. I’ve seen what happens when they do. I strongly believe in these multiple end-of-one experiments, which is the one that matters and one that doesn’t in this person. I’ve seen improvement in arterial age and intima-media thickness with the statins. When they stop taking it, I can tell.

I’ve done it myself because one time I was heavily involved in CrossFit, culture, and working out all the time. These muscle aches aren’t CrossFit. They’re suicide. No, it was the CrossFit in my arterial age. It went up by ten years and six months. I went back on and went back down. Now, is that anecdotal? Sort of, but it’s my anecdotes, so it counts.

The key thing though is not to rely on them to say, “This is going to fix all your problems.” For instance, the whole issue with statins causing diet type 2 diabetes. I do believe that high-dose statins prescribed to somebody who doesn’t do anything about their diet and keeps the same starchy sweet diet. They’re going to get type 2 diabetes with the passage of time. Somebody who, at the same time, modifies their diet and sees a reduction in their body fat and their visceral fat, where the judge gives them good reports on the in-body.

I don’t think I’ve seen a single case of progression. In fact, I see regression in hemoglobin A1C as a surrogate marker for insulin resistance, which by the way, one of the things that the in-body also reports is your visceral fat levels. There is a downward trend in visceral fat. It’s this reliable indicator of improving insulin resistance or improved insulin sensitivity.

Anyway, going back. First of all, I ask the patient, “If I say the word statin, what is that? What’s the cause?” In a fairly health-conscious patient population, which tends to be the people who gravitate toward me or more and so on. Probably to you guys as well. There is a lot of statin phobia. Some of it is justified. I always try to classify our US statin intolerant. In other words, you’ve taken them and you don’t tolerate them. You’ve tried several. That’s one thing.

How high was the dose? At a lower dose, we may get the benefit without the downside. There are some people who are convinced and they are not open to it. There are alternatives. One of my favorite supplements is bergamot or berberine. It has favorable effects on inflammation and insulin sensitivity, which is the same thing as inflammation. Some improvement in the LDL, HDL, and triglycerides.

That’s a good alternative, but the reality is that sometimes compliance is an issue because these supplements can become expensive. Maybe especially when the budgets get tighter, inflation, food, and everything else is a problem. It doesn’t do any good if it’s a great program in theory. In practice, they aren’t doing it.

Niacin is underutilized as an anti-inflammatory and a lipid-modifying agent. The flushing is annoying but it’s not dangerous. There are other tricks like radius rise. I’ve seen that it’d be effective in some folks. However, the truth of the matter is that radius rise is molecularly still a statin. If you take a high enough dose, you can still get the statin side effect. Sometimes, what you call it matters. People will get the nocebo effect and the placebo effect. We have to keep those things in mind. I don’t care how long I continue to practice this. It will always be challenging because, at the end of the day, we’re dealing with people.

Carotid Health

Which makes it half the fun because they’re on this journey as much as we are. You mentioned carotid dopplers and carotid health. You had some slides you wanted to share on that as well. We can measure that easily because it’s right here in the neck but how does that relate to the rest of the body?

Our arteries are the blood supply to every one of our organs. If you have a plug artery to an organ, that organ is going to suffer damage. Your heart is going to have a heart attack. Your brain is going to have a stroke, a neurological deficit. You’re going to lose kidney function. You are dialysis ultimately. In my mind, there’s no single place to focus that has more bang for the buck than to improve the health of your arteries.

If you are improving and reducing inflammation in the arterial wall, you’re going to see a reduction in generalized body inflammation. Why? It’s because all the things you’re doing to improve the arteries are going to have a favorable effect on everything else, better diet, more exercise, and avoiding toxins. The beauty of it is so measurable, especially now. This is a tool. I looked it up to a company that was founded in 2017. It’s called Butterfly IQ. For less than $4,000, you can own this. It’s extremely durable. It plugs into a smartphone or other tablet device.

I have adopted the approach to scan first and ask questions later. What I’ll tell you, for those who they’re interested. The images are on my website, TheCureCenter.life/images. Arterial disease is an inflammatory condition inside the artery wall. One of the things we were talking about and this illustrates. I’ve got a bad picture on here. It’s not that bad. This still shows that the endothelium is here. The disease process is inside the wall of the artery. It’s like chewing gum globed inside the artery.

The lumen only becomes compromised in very late-stage disease. Forget about the blood clot for the moment, but that’s where you get to fail a stress test or get chest pain or some similar symptoms. The disease process begins with inflammation and the wall of the artery and forms plaque. I use the analogy of acne. Acne is an inflammatory condition of the skin.

You get pimples. Pimples rupture and they tend to rupture. Plaque is true also when they first form. Plaque goes through a healing process. That’s shown ultrasonographically. This is an atherosclerotic plaque with areas of essentially, it’s like a little abscess. If that abscess breaks through this thin fibrous cap, it triggers a blood clot forming. That’s how you get the inclusion of the lumen of the artery down the stream. In this case, the carotid arteries.

Over time, if we manage the lifestyle, supplements, and medications properly, instead of a fresh pimple. It becomes a scar. People ask me, “Can I get rid of the plaque?” No, but you can heal it. Will my plaque break off? No, but it can break and lead to a blood clot. That’s the problem. With this ultrasound device, we can measure. We can visualize the intermedia layer. This is some very early plaque. I’ll show you an example. I did this scan on a young man age 40 and we were doing a family. It was a father and three brothers. It was like my three sons. You guys may not be old enough to remember my three sons.

I do remember that.

Anyway, the father is in his 70s. It looked pretty good. The oldest son at age 50, a type 1 diabetes, looked pretty good. The youngest son at 40, was very health-conscious and looked pretty good. Here’s a 43-year-old and he’s got this thickening on the artery wall. I’m looking at the artery and cross-section. He’s got this atherosclerotic plaque in his carotid bulb.

What caused that? We went through the process of evaluating it. He’s suffering also from symptoms of COVID. That has something to do with it. By the way, the vaccines and spike protein, whether you got it by infection or injection are pro-inflammatory. There’s a logical mechanism by which this has been happening. We can look at his artery wall. The artery wall thickness is here. This takes about five minutes to do. I can teach it to anybody who has one of these.

I could have somebody doing at least that initial view, the short axis view, within a matter of minutes. After you’ve done about twenty of them, you’d be pretty good at getting this image as well. I’m on a mission to make this scanning, this identification of this disease more ubiquitous, more widespread. It’s like cancer screening, the earlier you find it, the better your chances of avoiding the consequences.

To follow up on this, we can measure the carotid easily. This wasn’t uniformly diseased along the artery. The other thing is the carotid is super important because it goes to your brain. If a clot breaks off, your brain is going to have problems almost immediately. How much does this translate to something in the leg or something viscerally? Is it giving us a picture that says, “If it’s here, it’s a little bit of everywhere?”

What you just said the last. If you see it in the carotid arteries, it’s safe to presume or you should presume it’s also present in the cornea arteries. It continuous everywhere. If you don’t see it in the carotids, you may want to take another look. You can look at the aorta and the femoral arteries. In cornea arteries, we can’t get to with ultrasound, but you can do a cornea artery calcium score.

The point is to find out, do you have this disease. That’s got your attention. Here’s the key, if we can measure the artery wall thickness. For instance, this is an example of a gentleman aged 60, a fit and long-distance bicycle enthusiast. If you looked at him, he looked healthier or healthier than any of us in this room. This is a more complete examination of a very significant plaque in his throat arteries.

We said, “Let’s look at your diet.” One of the things that a lot of long-distance athletes do is carbohydrate load. If you have insulin resistance and he does. We got him to address that, I finally convinced him to try low-dose statin. This was changing his carbohydrate loading, then we added a statin. His arterial wall got thinner. We came up with this construct called the vascular age.

This is at what age would this number be at the 50th percentile? In the population, on average, artery wall thickness increases. That population grows older. Men are thicker than women, but the goal is to see this come down over time. The key concept is that if his artery wall is getting thinner in his blood, what do you think is happening in his other arteries?

There’s going to be problems everywhere.

It’s such an easy, non-invasive, and relatively economical way to monitor arterial disease. It’s very visual and very compelling. It’s great to be able to sit down with a patient and say, “Look what happened. You’re artery age dropped by sixteen years in less than a year.” That’s what we’re doing. He said, “Yes.” It gamifies their care.

Between December and July, his went back up. Now, he can come back and say, “What did I do differently that I need to go back to?”

Going back to our statin story, this is before he accepted taking a low-dose statin and this is after. This is when he thought he didn’t need the statin anymore.

When my dad had his heart attack more than a decade ago now, mild. He lost less than 10% of his heart. They put I’m on a statin. They did a stent. He’s got to take the blood thinner for the stent forever, but the statin was something he would have to take a couple of times a day. Your approach sounds like, “Take it as much as you need it,” and you have data to show why you need it. Whereas, unfortunately, I see too many people come in and they’re like, “My doctor prescribed this to me.” I was like, “What are they measuring to know that it’s helping you?” It’s fantastic there.

I always say when I hear that, they’re like children running around with a hammer. Every problem looks like a nail. That’s the tool that they have. Unfortunately, it’s institutionalized into guidelines. It’s how they’re measured for their effectiveness and their adherence to these guidelines. I’ve been around long enough to know evidence-based medicine. It’s just starting. Like every good thing, it seemed like a good idea, but there were unintended consequences. Now everything has come to the point where it’s like, how did each individual patient do this? How did you manage the population as a whole? It’s a one-size-fits-nobody approach. That’s the mainstream medicine now.

That’s just a pendulum swing as things go back and forth. Especially after everything that we went through in COVID, I feel like that institutional capture was largely responsible for why COVID was so bad as far as taking care of people and making approaches to say, “What established drugs do we have that might be able to treat this like we would treat anything else off label until we have something firm?” We’re seeing the end of that pendulum shift back towards something that makes better sense. At least I hope so.

For those of us, I suspect the three of us, we’re ahead of the curve in terms of our spidey sense or our common sense. Whatever you might want to call it or a BS maybe if you’re saying, “No vaccine is considered safe and effective until it’s been studied for twenties years. All of a sudden, six months out, this is a declaration as opposed to trusting us.” With the truth that says, “If you’re older than life expectancy with morbidity is a high risk of dying. Maybe it’s worth taking the risk of this new and novel agent.”

For everybody else down the road to pregnant women and toddlers, let’s wait and see. That told me volume is like, “You guys are completely full of it. You’re not to be trusted. There’s something else going on here.” The whole vitamin D story was amazing to me. In three months, we knew that very low vitamin D levels were the ultimate comorbidity for death and cold. That’s why our powers have made sure that everybody got a 90-day supply of vitamin D sent to them in the mail. I’m sorry, that didn’t happen.

Vitamin D Testing

Speaking of which, did you see the Medscape article that came up about a couple of days of the endo society? Some endocrine societies said, “Stop testing vitamin D altogether because we don’t know what levels are good. Maybe you’re taking too much.”

They’re trying to scare people.

The Risky Business, the movie. The pimp is played by one of my favorite actors, Joe Pantoliano. Standing next to Joe, he says, “Joe, you’re messing with my business plan.” I’m paraphrasing.

Very much so.

They don’t want anybody messing with the business plan. That sounds crass and accusatory, but if they don’t want us to be accusing them of bad behavior, why do they keep behaving so badly? I’m a walking cliché. Upton Sinclair said, “The surest way to make a man understand something is to make a salary dependent upon understanding it.”

There are many allying forces that establish that if you have a very inexpensive dietary supplement that we all know we should have based on our human history that can eliminate the need for all the pharmaceutical solutions to many of the chronic diseases that were afflicted by, is that good for business? Is reversible arterial disease good for cardiovascular programs, what stands in surgery, cardiac rehab, and stroke rehab? No. It’s terrible.

I’ll also add, by the way, the insurance. The payers are part of the problem too. One of the things that many people don’t realize and maybe you figured this out. With the Affordable Care Act, the mandatory medical loss ratio is the terminology for it. They said, “Ensure you have to pay out at least 85% of what you take in. In medical claims, you can’t take in the dollar. Pay out only $60 and keep $0.40.”

How do you grow that 15% for administration? You become a credit card company, a casino, and a bank. You have to pay more to justify charging more. That’s why you see these double-digit increases in health insurance costs every year and nobody’s talking about the benefit curve because everybody said, “The insurance tended to want to control costs.” No more. Growth is good for everybody.

I know Dr. Bagley and myself are both out of network for everything except Medicare. Getting back to credit card companies is an interesting thought. I don’t know how much Medicare you deal with, but when we get payments, sometimes it’s for $5 or maybe $10. They’ll send a fax with a credit card that could be forgotten.

Ozempic

They could have sent a fax with an eCheck that you could do direct deposit, but they did it with a credit card on purpose so that you might forget about it, and then they’ll keep their $5 or $10. That’ll add up over time. The whole system is broken. As I said, I hope we’re coming around to the end of the pendulum for those things to change. Since we’re talking weight loss and health, I wanted to get your take on Ozempic.

I’m not going to prescribe it. I’m not going to judge anybody who decides to do it, but they need to know this whole story. It’s not magic. In fact, I was watching. It’s interesting how this is getting into my version of popular media. Pierce Morgan did an interview including Dr. Jason Fung in his panel. I was shocked. Jason Fung was well-known for the obesity code. He’s the father of intermittent fasting. He said he’s been prescribing Ozempic for his patients for weight loss for five years as part of the program. His attitude about them is like my attitude about statins. It has a role, but it shouldn’t be the centerpiece.

In reality, it’s dangerous. Not just in terms of side effects. We all talk about gastroparesis, severe constipation, and patients showing up for surgery with a stomach full of food despite the fact they’ve been MPO for 24 hours. That’s how part of how it works is gastroparesis. It does give you a society, but it’s like everything else. It’s a real fad. Any substance can be used or it can be abused. It’s something that’s very prone to abuse.

I don’t think I can be credible with somebody and say, “The linchpin should be eating a healthier and less inflammatory diet.” If your obesity is bad, that’s the thing, then you go see somebody who will offer it to you. If it’s successful, fine. I won’t judge you for it. I haven’t seen a lot of data on this, one thing that people need to be aware of is a significant part of our goal is to lose fat and retain muscle whereas with Ozempic, I would say if you can lose 5 pounds of fat and only lose 1 pound of muscle at the same time, that’s pretty good. With Ozempic, there is a significant amount of muscle and that can’t be good. Again, obesity is not an Ozempic deficiency.

One of the things and this was the one more striking than the muscle loss, which as I’ve stated already, is probably the worst thing you can do after certainly the age of 35 and after the age of 25 because it’s just hard. You don’t have the metabolism. You don’t have the hormone factors running when you’re older as you are when you’re younger to build muscle.

The other thing that is just as staggering is the price alone to do your program and lose probably the same amount of mass as it is on Ozempic. If you compare apples to apples as far as the straight weight loss, they’re basically saying, “In six months, if you change your diet or six months of Ozempic, you lose about the same amount of weight.” Probably more muscle mass on that program. I’ve heard the price tag on that thing and I suspect you are still cheaper than that.

You made me think of a potentially and probably unethical way of going about this. I’ll give you Ozempic but it’ll be a saline injection every week. You have to come in and see the judge to prove that it’s working. By the way, you might want to try eating less sweets and starches. One of the things I’ll mention and keep talking about muscle mass, and you can check me on this, but I believe that two things happen during fasting endocrinologically that are beneficial.

The testosterone levels rise and it’s logarithmic. The longer you fast, the more dramatic it rises. The same thing is true of growth. Both are the opposite of catabolic. They build muscle mass. If nothing else, if I’m a bad boy, otherwise. If I don’t eat until 11:00 in the morning and I stop eating at 6:00. I’d say that’s a significant benefit or I get sick or less fast but everybody can do that.

I agree and that’s the easy one. I’m torn because I’m going back and forth on it, on that same concept but not so much waiting till 11:00, but breaking the fast early in the morning and eating lunch, and then not eating something at dinnertime. Except for we have our Western society. We are socialized to have dinner together. In my brain, I can’t do it. I’ve tried. I’m still trying to make the switch, but there’s something to eating breakfast when you wake up, then lunch, and then skipping dinner.

That’s the hardest one for me. I can skip breakfast all the time but skipping dinner is harder for me but I’m going to get a continuous blood glucose monitor and see which one works better for me. It’s the information.

The number one concept is that our bodies do better when we’re stressed. Physically stressing it. We’re too easy on ourselves and trick the body into adjusting to changes in the environment. That’s the way we were made or evolved. That’s how we do our best. That’s why I think things like cold water or ice plunges or cold showers. It’s like our society has made it so lacking in resiliency because we are no longer seemingly resilient.

The same thing is true. If two days out of the week, you can eat the last meal. If nothing else, eat it early like 3:00 or 4:00 earlier than you normally would. You have that longer period of house cleaning that happens during fasting because of those insulin levels. The key thing is not how low the blood glucose goes. It’s how low the insulin levels stay. That’s the dirty little secret in this. When you put somebody with type 2 diabetes on insulin, it’s just so crazy.

One of the patients I love to show is this is a little different case. This was a 75-year-old type 2 diabetes on three blood pressure medicines, and three diabetes medicines plus insulin. In three years, we dropped his arterial age from 68 to 44. All we have to do is say, “Tom, after all these years, do you think you can cut out sugar?” He did. He was able to get off six medications and insulin.

This is somebody who had had bypass surgery 8 or 9 years earlier. It’s never too late to change and leverage these things. Full disclosure, sad to say about a year later, he was diagnosed with acute leukemia. That’s one of those active God things. I certainly don’t think that his life was worse off for having done these things before he developed leukemia and died. None of us are getting out alive but we can certainly make it more like this as opposed to this steady downhill.

Neurodegenerative Problems

One of the things I wanted to ask because this is something we’re seeing more. I remember one lecture talking about the things that would have got that get us now as medicine becomes more modernized and quicker to take care of some of these acute problems like a heart attack or cancer. We’re living longer and now we’re getting into more neurodegenerative diseases getting us. How do you view the arterial side of things leading to neurodegenerative problems? Your nine S’s are right there and I agree with that. What else do you see along those lines?

A lot of what is diagnosed as Alzheimer’s disease is a vascular dimension. In other words, you don’t get one sizeable blood clot clotting off a branch vessel to your motor cortex and develop paralysis. You might get a tiny little microthrombus that travels downstream from a micro rupture and over a period of time, you get a Swiss cheese effect. There’s that. Let’s put it this way. Every lifestyle modification that improves arterial health certainly doesn’t cause more Parkinson’s disease or more Alzheimer’s disease.

For instance, if you want to do a comparison to Healthy Heart, Healthy Brain, and Dale Bredesen’s book, The End of Alzheimer’s, there’s so much overlap if you do the Venn diagram. The things that are recommended are very similar. What you’re saying is they imply with these things that although they’re more common as we get older, are they part of normal aging? No, they’re just more common because of the cumulative effect of these bad habits, the lifestyle choices that our culture enforces, and the toxins we encounter. We haven’t talked about air pollution. Unfortunately, in Springfield, we have less of a problem with air pollution in the same city as St. Louis or Chicago.

We’ve got all the life phosphate spray and all the stuff coming from the field. I don’t know which one is worse, quite honestly.

One of my moral dilemmas is one of my patients is a crop duster. I don’t even want to ask what he’s spraying but he’s very health conscious for himself. I thought how much of life is safe. One of the most eye-opening lectures I ever listened to was from an emeritus plant botanist, a plant biologist in Purdue, explaining how glyphosate works.

It is the accumulating agent and it depletes the plant of nitrogen and other micronutrients. That’s how it kills the weed. The GMOs that are planted in plants are engineered to where that has less of an impact, but glyphosate is not supposed to accumulate in the plants. It’s not supposed to accumulate in the soil. It’s all BS. It’s all there.

On top of that, along those lines of the chelating agent, it also binds up all the magnesium in the soil. Now we don’t have magnesium with food.

Everyone is magnesium deficient.

That’s probably one that I need to be paying more attention to. Thank you for reminding me of that. Anyway, in my point of view that I try to tell people, you can see the threat but you can, I wouldn’t say eliminate it, but you can largely eliminate the threat. You can see it reverse and it’s not as difficult as one might believe. Make that series of nudged movements to better outcomes.

Supplement Recommendations

My thought on that is what are your top three supplements that you almost always recommend to people?

Vitamin D with K2. I won’t mention the proprietary names but of high quality and reliable manufacturers.

We use Ortho Biotic too. I know you guys like that one.

I can’t always, but I can often tell when they substitute it. Bergamot BPF for the reasons I mentioned earlier. Niacin, particularly for people with elevated lipoprotein A, which by the way, is a genetically determined lipid abnormality affects about 30% of the population. They can have a meaningful impact, especially if you have a family history and folic acid. A chiropractor years ago said, “Are you checking home assisting?” A lot more types of home assisting are a lot more common than you think. I could check the MTHFR gene variant, but my preferences just deal with if their home assisting level is high, the supplement with folic acid.

You do the methylated folic.

My preference is methyl B12. It’s the Ortho Molecular version. I’m sure there are others. I’m not an expert. I go like, “What’s the recommendation?” It’s problem, solution, and measure. It’s amazing how, again, the changes aren’t happening. It’s like, “I don’t understand. Can you help me understand why this isn’t moving?” It’s like, “I ran out of it. I forgot to get it.” I hook everybody up with an account on an online dispensary and it helps us. Sometimes, it doesn’t work with people and what’s the most important one or two because they can’t afford all three or whatever. That’s what keeps it interesting.

It does.

There are so many things that I’ve got a bunch back here. I would do magnesium, fish oils, and D-3 as well with the K subs supplement because those are also driving a lot of that same anti-inflammatory process, especially when we’re deficient in something like magnesium.

Low vitamin D is with insulin resistance and Vitamin K2 also reduces insulin resistance. Since it’s so ubiquitous and almost universal. To me, everybody ought to be doing that.

Especially if you’re up North of a certain parallel. We have to have it in the winter for sure.

Thirty milligrams or micrograms per deciliter is the low end. That’s the definite problem zone. Do you have a higher number that you like to get your patients to or a higher minimum that you like to get your patients to?

I shoot for 60 to 90. A safe range, both from an effectiveness. The whole toxicity with vitamin D is so overblown by the fear of mongers. Stay away from the thing. That might save you. They’re a 1% possibility of making kidney stones if your vitamin D level. We measure vitamin D levels at least once a year or twice a year.

Frankly, most insurance is occurring. One of the things is we look at how things are organized and incentivized. Maybe you know this already but the cost of a vitamin D level in the lab that I use, if you walk in and say, “I want a vitamin D level without insurance paying for over $200.” The same is true for home assisting. What does that tell us about what they want us to know? They don’t want you to know about your home assisting levels or your vitamin D levels because there’s a distant center. Yet, if it’s billed to me, both of them are in the $10 to $15 range.

I got an all-cash rate through Quest as well. It’s like $10 to $15 for both of those. Those are the expensive ones on my list. I can get a whole CBC for $5 and I’m like, “Really?” It comes back to all the way the insurance games are getting played to who is getting their pockets lined and such like that.

It’s like the things that would hurt the business bottle to be known are extremely expensive. This is one of the areas where I am a little bit leery about like testing for early cancers. Total body MRI, blood tests, and 90 cancer markers. That’s good for the oncology treatment business. The hell with the toxicity to the patient and how many of those minimal cancers are self-limited. We can go with that. That could be a whole other discussion.

Honestly, I would love to have you back on and offer another episode if you would be willing because this has been so incredible.

I’m shy and I don’t like to say too much.

Where To Find Dr. Backs

It’s fantastic. For our audience, where can they find you?

I’d say the best thing would be to go to my website, TheCureCenter.life. I’m located in Springfield, Illinois, but for the majority of my encounters now, my consultations are done on telemedicine. Most communities have a Quest lab facility and the number of locations where we can get their credit ultrasound done is growing. Go to TheCureCenter.life. If you go to TheCureCenter.life/discovery-call, they can register for no cost and no obligation discovery call. Regardless of what their interest is, we can figure out, “This is a good fit for you. We can do this or maybe this isn’t the right thing for you.”

When we post the episode, we’ll make sure that those links are available.

Dr. Schurger, where can they find you if they need an upper cervical chiropractor?

I’m at Keystone Chiropractic, KeystoneChiroSPI.com, Springfield, Illinois. Find us on all the socials.

I’m Dr. Beth Bagley. I’m in St. Louis PrecisionChiropracticsSTL.com and socials.

Folks, make sure you like and subscribe to the show. We appreciate you’re joining us for this one. As I said, we’ll see about having Dr. Backs back another time for more fun and discussions on things. Folks, thank you so much for tuning in and we’ll see you next time.

Important Links

About Dr. Craig Backs

Craig Backs, MD, is an experienced specialist in Internal Medicine, caring for adults through diagnostic skills and management of acute and chronic disease. These diseases include diabetes, hypertension, atherosclerosis, and other conditions that respond to better lifestyle choices, supplements and medications. Left to progress, they can dramatically shorten or ruin an individual’s life. He is best described as an “open minded allopath” now focused on root cause elimination, correction of nutrient deficiencies with targeted supplements and medication when the benefit outweighs the risk.

Dr. Backs was educated at Valparaiso University and Southern Illinois University School of Medicine. His Internal Medicine residency was completed at SIU School of Medicine in Springfield, IL. It was there he practiced with a group of other internists and primary care doctors. He served as President of the Illinois State Medical Society among other leadership roles. After three years as Chief Medical Officer at St. John’s Hospital in Springfield, IL, he opened The Center for Prevention Heart Attack and Stroke, which later became The CureCenter for Chronic Disease. Dr. Backs has made it his mission to cure Chronic Disease by digging out its root causes.

His personal journey to cure Chronic Disease began in May of 2012. “My own personal health went through a dramatic makeover,” says Dr. Backs. “I now know better and provide a more credible example for my patients. I understand the challenges they face as they pursue a healthier lifestyle. I know how to motivate and coach success.”

Dr. Backs uses his personal and professional experience to develop and coach your Personalized CurePlan to prevent and reverse chronic disease into remission and live a long optimally healthy life.