Dr. Paul Nystrom: The ER Doctor Who Says Most of What We’ve Been Told About Health Is Wrong

Introduction & Background [0:00]

Charles Eide: [00:00:00] Just to get this right, you’re a medical director, you’re an ER doctor, and you are also on a SWAT team. 

Dr. Paul Nystrom: Yeah, I’m a part-time police officer. 

Charles Eide: And then you were in the Navy. 

Dr. Paul Nystrom: Did four years active duty right out of medical school. Hangry is a carb disease. We can’t eat grass. 

Charles Eide: So you’re not a fan of the vegetarian thing?

Dr. Paul Nystrom: I’m not a fan of the GOP ones. Like this thing called IBS, I’ll tell patients, I said, “I don’t think it’s a real disease.” 

Charles Eide: And, and how do I know if I’m taking enough vitamin D? 

Dr. Paul Nystrom: Um, you’re probably not. 

Charles Eide: This week on Cleared for Takeoff, I have Dr. Paul Nystrom. He talks about how the medical system may be getting it all wrong, and how you can take responsibility for your health starting right now.

Dr. Paul Nystrom: You cut from the sternum, you put in a thing called a rib spreader, which looks like a high lift jack, and you crank this little lever and the ribs spread. So then you deliver the heart. If it’s a little hole in the heart, you literally can put your finger on it or put some staples 

Charles Eide: in it. In their heart?

Yeah. You’re just 

Dr. Paul Nystrom: like… Yeah. Ev- most everything we see, we don’t get an answer a lot of time in the ER. Patients have an expectation that the ER is going to diagnose them with a specific thing, and that doesn’t happen. We rule out things. We rule out the disasters. The obesity, overweight, [00:01:00] like the numbers are through the roof.

Metabolically sick. 

Charles Eide: Why do you think so many people are that way now? 

Dr. Paul Nystrom: It’s food. The fat became demonized. Don’t eat eggs, don’t eat cholesterol. Most of what we’ve been told about health is, is wrong. From big medicine, big insurance, big pharm. 

Charles Eide: How’s that make you feel as a doctor? 

Dr. Paul Nystrom: It’s frustrating. I’m 20 years into doing medicine and I’m more and more convinced

Charles Eide: Dr. Paul Nystrom, welcome to Clear for Takeoff. 

Dr. Paul Nystrom: Morning. It’s 

Charles Eide: good to have you, man. 

Dr. Paul Nystrom: Yeah, I’m looking forward to it. 

Charles Eide: We’ve had some really great conversations in my sauna about everything we’re gonna talk about today, and I just remember sitting there with you going, “People need to hear this stuff. Like, I don’t think this message is out there and clear enough.”

And I think people need to hear this stuff, so I wanna talk about it. So you’re, you’re a, just to get this right, you’re a medical director for a- 

Dr. Paul Nystrom: Yeah, EMS medical director … 

Charles Eide: EM- Yep … yep. You’re an ER doctor. 

Dr. Paul Nystrom: Yep. 

Charles Eide: And you are also [00:02:00] on a SWAT team. 

Dr. Paul Nystrom: Yeah, I’m a part-time police officer. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: And my, my main job is a, at a, as a medical asset on the SWAT team.

Charles Eide: Yeah, cool. Yeah. Now you… And you were in the Navy. 

Dr. Paul Nystrom: Yes. 

Charles Eide: So thank you for your service. Both that- Yeah … and the police job, so thank you. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: But h- you’ve got all these a- accolades. You’re, like, one of the most well-decorated friends I have . And, uh, I, I just wanna understand, how did we get here? Like, how are you…

How did you become all of these things? Where did this all begin? 

Dr. Paul Nystrom: I grew up on a farm in southwest Minnesota. Um, my dad farmed, my mom was a nurse. I got three older siblings. Uh, the other two are, like, seven and 10 years older. So you’re the 

Charles Eide: youngest. 

Dr. Paul Nystrom: I’m the youngest. 

Charles Eide: Oh . Okay. 

Dr. Paul Nystrom: So anyway, this time, they… My brother is two years older.

My dad, uh, so he busted his butt on the farm for years, and then there’s years he’s just hoping to, to break even at the end of the year. Yeah. Just crops, cattle, pigs, usual stuff, and then chickens for Campbell Soup. That was interesting. 

Charles Eide: Like, actually? 

Dr. Paul Nystrom: Yeah, we raised, like, 600,000 chickens a year for Campbell Soup.[00:03:00] 

Charles Eide: Wow. 

Dr. Paul Nystrom: Yeah, when I was in high school. 

Charles Eide: Dang, and then Mom was a nurse. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So long hours. 

Dr. Paul Nystrom: Yeah. Yeah. 

Charles Eide: Yeah. And then Dad’s at the 

Dr. Paul Nystrom: farm. He just farmed. Yeah, he went to college, came back, and just farmed on the family farm. 

Charles Eide: Do you think being raised on a farm gave you an advantage, like, work ethic-wise? 

Dr. Paul Nystrom: Yeah. Yeah.

For sure. Yeah. I mean, everybody in your world works hard, right? Like, that’s… I don’t know that people appreciate that as much, but you have to work hard. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: And then opportunities come, and other things are in place, but you have to work hard. There’s not any way of getting around that. 

Charles Eide: So growing up, did you know you always wanted to be all these things?

Like, how did- 

Dr. Paul Nystrom: I knew a doctor. My dad suggested my brother, who is two years older, he should be a lawyer and I should be a doctor. And I think at the time, the thinking was, my dad was a part of the Silent Generation, I think the thinking was just that do something that makes a good living, and you don’t have to work as har- as hard as I do on the farm.

Charles Eide: Hm. 

Dr. Paul Nystrom: So my brother, both my brothers are engineers. My sister’s a special ed teacher. But doctor stuck for me. So, like, from the time I was probably less than 10 years old, maybe five years old, I was like, “Yeah, I’m gonna be a doctor.” Yeah. That was just the plan. 

Charles Eide: You wanted to be a doctor. Yeah. Did you know what kind of doctor, or you were just like, “Nope.”

Dr. Paul Nystrom: [00:04:00] Not then, no. Yeah. Not then I didn’t know, but then as I got into the process in undergrad, um, emergency medicine came to the front pretty early on in my medical training. 

Charles Eide: Sure. 

Dr. Paul Nystrom: Yeah, 

Charles Eide: so. Emergency medicine. So you went into emergency medicine, did school, residency, the whole thing. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: And then you were in the Navy.

Navy & SEAL Team Experience [4:18]

Dr. Paul Nystrom: Yeah, so I got… I started med school two weeks before 9/11 happened, and I’d already thought about the Navy prior to that. Uh, and then 9/11 happened, so then they paid for, on a scholarship, they paid for three years of med school, and then I did four years active duty right out of medical school. 

Charles Eide: Wow. 

Dr. Paul Nystrom: So. 

Charles Eide: So what did you do when you were active duty?

Dr. Paul Nystrom: Uh, my first year was a, what’s referred to as a transitional internship in Portsmouth, Virginia. So you rotate through, uh, an internship is your first year of residency training, and you rotate through like a transitional internship, you rotate through like all the different departments. So you do internal medicine and surgery and orthopedics and family practice, and you get a taste of everything.

Um, and then I spent two and a half years, um, as a dive medical officer, so got more training in diving. 

Charles Eide: Like underwater diving? 

Dr. Paul Nystrom: Yeah, like- 

Charles Eide: [00:05:00] Like scuba diving. 

Dr. Paul Nystrom: Yes. 

Charles Eide: But medical. 

Dr. Paul Nystrom: Yeah, ’cause you have to learn about the bends and you learn about, also learn about everybody that comes through that training either goes to a diving command or a submarine command, so you learn about the radiation health that goes along with the subs that are nuclear powered, and then you learn diving.

So I was fortunate enough to get stationed with Navy SEALs out on the West Coast. So I’m not a SEAL, I’m very clear about that ’cause sometimes that gets… When people introduce me, they throw that, I’m like, “No Let’s not screw that up 

Charles Eide: That’s a whole nother level 

Dr. Paul Nystrom: of- That’s a whole different thing. I was stationed with the active duty SEAL teams on the West Coast.

Charles Eide: Yeah. 

Dr. Paul Nystrom: Uh, in 2007 to 2009. 

Charles Eide: So what was your role when you were out there? 

Dr. Paul Nystrom: Uh, did primary care for the SEALs. 

Charles Eide: Yes. Sick- So you took care of the SEALs? 

Dr. Paul Nystrom: Yeah. Sick call, and then they’d come see me for the dive physicals. And I joke, the most important thing that I had on my… I had a little stamp with my name on it, you know?

And it said, uh, “Dive medical officer/undersea medical officer,” ’cause they have to, every five years they have to get a new physical so they can keep being a SEAL, which is really kind of silly when you think about it, because they’re doing SEAL stuff. They’re deploying, they’re training, and then they come see me, and I’m like, “Well, I guess you’re doing all that [00:06:00] stuff already.

I guess you’re qualified for another five years to do it some more.” Right? It’s not- You look great. You look great. And, like, what could I possibly do in the office that proves that they can do their job that they’ve been doing? Yeah. So it’s kind of a silly thing, but it’s part of the requirement, so I’d stamp their physical.

“Yep, you’re good. You’re, you’re doing all the SEAL stuff anyway,” so. Did you ever 

Charles Eide: have to tell anybody, “Nope, you’re not good to go”? 

Dr. Paul Nystrom: No. 

Charles Eide: So it was pretty much a- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: rubber stamp job. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: You know who Dave Goggins is? 

Charles Eide: Yeah, of course. 

Dr. Paul Nystrom: I did his physical for him. 

Charles Eide: Did you really? 

Dr. Paul Nystrom: Yes. And I tried to piece together, like I looked him up on Wikipedia to try to see which race, ’cause I, as I recall, it was like he came to me ’cause he needed the form signed so he could do some endurance race.

And I wanna say, I think it was in Europe, and I’ve looked on his Wikipedia. It doesn’t have the time dates of, like, what all the races he’s done. But again, like, he’s gotta do some huge adventure race for hundreds of miles. Like, what could I possibly do in my office to say that you can do that? I’m like, “You’re doing cool stuff.

Like, sure. 

Charles Eide: Go do 

Dr. Paul Nystrom: your thing.” So 

Charles Eide: Goggins owes you his, all of- No, no … his success- … to you giving him that stamp. No. Goggins, if you’re watching- 

Dr. Paul Nystrom: No, no. He was [00:07:00] already… Well, he wasn’t… I mean, he obvi- obviously was still in the Navy then, so he wasn’t as big as he is now, but I mean, he was already doing stuff like that.

But yeah, so I did one of his. Somewhere along the way I signed one of his physicals and- Wow, that’s cool … way back in the early days. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So you do the Navy, you get out- Yeah … of the Navy. Yep. And you’re a doctor now. 

Dr. Paul Nystrom: Yeah, you’re a doctor when you finish med school. 

Charles Eide: Okay. 

Dr. Paul Nystrom: But you’re not specialized in anything, so you have to do- So then what do you-

of course, then I do residency. So then I came back and trained at a level one trauma center for, uh, three years of residency, did the EMS fellowship as part of that, did police training as part of that, uh, and then worked there for a long time. 

Charles Eide: And what is a level one trauma center? You know, I’d imagine there’s a level two and three, and- 

Dr. Paul Nystrom: Yes.

Level one sees the, the, like, can handle any trauma. Level- The 

Charles Eide: worst of the worst. 

Dr. Paul Nystrom: Yeah. Level two and three, like, two is pretty close to a level one in terms of what they can handle, in terms of who your specialists are that are on call, and some other things on the back end, but- So 

Charles Eide: it’s totally based on the people that are working and available to help solve bad things quick.

Dr. Paul Nystrom: Yes. 

Charles Eide: So at a level one trauma center, [00:08:00] what kind of things did you see, especially early on? I mean, I’m sure you see it all the time, but- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: what did you, kind of stuff did you see? 

Dr. Paul Nystrom: I mean, blunt trauma’s the biggest part. Like, when you talk, people talk about trauma, like penetrating trauma, so shootings and stabbings, and blunt trauma, falls and car accidents.

Charles Eide: Mm. 

Dr. Paul Nystrom: So by far every trauma center sees more blunt trauma than penetrating trauma. 

Charles Eide: And is blunt trauma, because there’s more of it- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: probably more d- well, probably not more deadly, probably- 

Dr. Paul Nystrom: Yeah, maybe not more deadly, but there’s just- More of it … a lot more of it. Yeah. Wow. And the y- well, and it’s an interesting thing.

Like I remember talking, this was a long time ago, talking to one of trauma surgeons about trauma that we see in general, and I think the number was roughly 70% of it has alcohol involved between- No kidding … between either victims or perpetrators of violence. But that’s a huge piece. And obviously car accidents, ATVs, snowmobiles.

Charles Eide: Yeah. 

Dr. Paul Nystrom: Drinking is a huge, huge piece of trauma- 

Charles Eide: Yeah … 

Dr. Paul Nystrom: across the board. 

Charles Eide: So you’d get rid of a lot of trauma if people would just stop being drunk. 

Dr. Paul Nystrom: Yeah. A, yeah, significant. It would make- That’s- … a significant dent. 

Charles Eide: So you’ve, obviously you’ve seen all kinds of crazy [00:09:00] stuff. 

Dr. Paul Nystrom: Yeah. I 

Charles Eide: mean- In the ER, there’s only so much you guys can do either, right?

You’re kinda like the don’t die department, right? Like- 

Dr. Paul Nystrom: Yes … 

Charles Eide: you come in, you got this horrible thing. We’re to keep you from dying so that somebody can fix it. 

Dr. Paul Nystrom: Yes. 

Charles Eide: But like we just keep you from dying. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So like what kind of things can you do in an ER that people may think… That like there’s misnomers of what the ER can actually 

Dr. Paul Nystrom: do.

Yeah. People, people ask me if I’m a surgeon. I don’t do surgeries. Like surgery is very specific, in the operating room, sterile conditions, right? So we do procedures. So we were talking about this the other day, that- 

Charles Eide: Yeah … the- You gotta tell us. The- You gotta tell… This is so good and so crazy. 

ER Medicine: Procedures & Trauma [9:42]

Dr. Paul Nystrom: So the pinnacle of like, so ER docs train for like the worst thing, right?

So, and you asked me if I get stressed about it, I think, and like no because like it’s… I don’t, I don’t ever, I tell people this all the time. I don’t wish for bad things to happen, but if they’re going to happen, I hope I’m working when they do. 

Charles Eide: Mm. 

Dr. Paul Nystrom: And they’re gonna happen, so I just hope that [00:10:00] I’m on shift when the bad things happen.

Yeah. It’s like training for the Super Bowl. Like you wouldn’t wanna practice the whole season if you’re an athlete and like not play the big game. Yeah. Like you want, you want the craziest things. 

Charles Eide: Is that also ’cause you trust your abilities over somebody else? 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Like do 

Dr. Paul Nystrom: they have- Like once you’ve done it for a while

Charles Eide: a better chance with you? 

Dr. Paul Nystrom: No. I won’t say I’m like better than my, my colleagues, but like you, we’ve all, we’ve all trained, especially at trauma center. The whole system works. Like everybody’s involved. Like it’s a, it’s a work of art to stand back and watch, and as a senior person there, like you’re watching everything work.

So IVs are getting done. You know, labs are getting sent and airways getting done. Uh, surgeries are usually helping us on the really bad stuff. Like it just, the system works, and it’s amazing to watch. Either like for medical stuff, like a cardiac arrest thing thing, I, I sorta stand back and- Let things be

guide things, but people know what they’re doing. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Right? And the, when the whole thing works, it’s amazing to watch. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: So. 

Charles Eide: You’ve got saving life down to a science. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: There was one we were talking about in the sauna a couple nights ago- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: where our buddy Matt Vincent- Yeah … he was like, “Dude, what is it that like is the pinnacle of your [00:11:00] life-saving craziness?

Tell me about that,” ’cause that was insane. 

Dr. Paul Nystrom: Okay. So it’s called a thoraca- ED thoracotomy, um, or a clamshell. So, um, so shot or stabbed in the chest, we have to try to find the bleeding. So we can look with ultrasound and see if there’s something we can go after, but if like- And the 

Charles Eide: clock is ticking … 

Dr. Paul Nystrom: the clock is ticking.

You’re either dead or like on the verge of being dead, and there’s time. Like if somebody’s long dead when they get to us, like we don’t do this. It’s, there’s very specific criteria, like typically for penetrating trauma, not as much with blunt trauma, ’cause when you get blunt trauma that kills you from something in your chest, you’re just probably dead.

Like you bled out before you even got to us. But if you’re shot or stabbed and like on the verge of dying or dying, we do a thoracotomy. So you cut from the sternum with a scalpel between the ribs down to the bed. 

Charles Eide: Down to the bed. 

Dr. Paul Nystrom: Yep. It’s- So 

Charles Eide: the whole f- 

Dr. Paul Nystrom: Yeah. You put in a thing called a rib spreader, which looks like a high-lift jack, and you crank this little lever, and the ribs spread.

Charles Eide: Does it make a crunchy noise? 

Dr. Paul Nystrom: It does So they’re 

Charles Eide: breaking 

Dr. Paul Nystrom: There’s things pulling, I mean, your ribs [00:12:00] are attached at the front and the back, so you’re- 

Charles Eide: You’re opening 

Dr. Paul Nystrom: them up … you’re opening that up. It crunches. 

Charles Eide: But it’s either this or you’re die- you’re 

Dr. Paul Nystrom: dead. Yeah, either, or you’re already dead. Yeah. So, like, we can’t make you worse.

Yeah. And maybe we have a chance. The success rate on, on thoracotomies is very low, but- 

Charles Eide: Yeah … 

Dr. Paul Nystrom: there’s a chance. 

Charles Eide: Yeah. So- But it’s low because of what has already happened to them. 

Dr. Paul Nystrom: Yes. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Yeah. So we crank that open, and if you can get to- How 

Charles Eide: big a hole are you cranking open? Is it, like- 

Dr. Paul Nystrom: Oh, it’s enough to get-

a hole … it’s enough to get your hands in there. So then you- 

Charles Eide: Between the ribs. 

Dr. Paul Nystrom: Yeah. So then you deliver the heart, and, like, you cut the pericardium, which is the lining around the heart. Yeah. ‘Cause it’s just blood around the heart specifically. Say you got stabbed in the heart. Yeah. You may have just a small hole in your heart, but now you get blood in this sac around the heart.

The heart can’t 

Charles Eide: beat. Is that sac sealed up? 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So it starts to kinda balloon? 

Dr. Paul Nystrom: It, it, yeah, and it puts pressure on the heart, so then the heart stops ’cause it can’t pump over this pressure. So you deliver the heart out of there. You cut a little hole in that and get the blood out of there if you can. If it’s a little hole in the heart, you literally can put your finger on it or put some staples in it.

Charles Eide: In their heart. Yeah. You’re just like… 

Dr. Paul Nystrom: Yeah. And then you [00:13:00] temporize things until, again, a surgeon has to fix this down the road, but to get him out of the ER alive, you stop the bleeding there. If you can’t get to the problem in the left side of the chest, you do a clamshell. So you take a trauma shears and cut across the sternum.

Charles Eide: Which is, like, basically a heavy-duty scissors. 

Dr. Paul Nystrom: Yeah, a raptor, like a Leatherman Raptor. It’s like a trauma shears that EMS carries. Yeah. That’ll, that’ll cut a sternum. 

Charles Eide: So it’ll cut right across. 

Dr. Paul Nystrom: Yeah, it’ll, it’ll cut. And then you do the same thing from the ribs here to the bed. So now you have this whole thing and you just, you lift it up- Yeah

and you can look at everything in there. And then again, you’re trying to, you have lots of people trying to see what’s bleeding, if you can solve a problem, if you can fix something. Sometimes you’re just, there’s nothing to fix, so you can’t do- So how do you 

Charles Eide: open, how do you- 

Dr. Paul Nystrom: Uh, usually you stand at the head of the bed and just pry back on things, and then- Mm

everybody else is in there working, um- 

Charles Eide: Trying to figure it out. 

Dr. Paul Nystrom: Yeah. You can do manual compressions on the heart if you have to. 

Charles Eide: And they’re not conscious. No. They’re like- 

Dr. Paul Nystrom: No … 

Charles Eide: they’re fluttering. 

Dr. Paul Nystrom: They’re either, again, they’re either dead or by this time they would have a, they’d have a breathing tube and they’re on [00:14:00] medications, or they’re already, like, they’re dead anyways by- Do they have 

Charles Eide: a pulse?

Dr. Paul Nystrom: No. 

Charles Eide: Okay. 

Dr. Paul Nystrom: Either they just lost it or they’re gonna lose it, so no, they’re, they’re pretty much dead. And again, if you can stop the bleeding and pump enough blood back in to fill the tank- You have a chance … there’s a chance. It’s small. The percent- the percentage is not high, but yeah, that’s the- Huh … that’s the pinnacle, I would say, of the procedures that we do.

Charles Eide: How many times have you had to do that? 

Dr. Paul Nystrom: Uh, I can think of… I was thinking about this before we talked and, like, I can remember six specifically that I’ve done. Um- 

Charles Eide: The full clamshell deal? 

Dr. Paul Nystrom: No, some were just thoracotomies, but yeah. Jeez. And I’ve, I’ve seen more than that, but I can remember specifically six.

And 

Charles Eide: the reason you go here in between ribs instead of under the ribcage is ’cause it’s just in the way. 

Dr. Paul Nystrom: Yeah, just in terms of access to what you’re trying to stop, you have to go between the ribs here. So- 

Charles Eide: So this is, like, super, super high pressure for you, right? Yeah. Does it get your heart pumping? I mean, are you, like, work- are you, like- 

Dr. Paul Nystrom: I wore a Whoop for a long time when I worked, and I don’t…

it’s not a crazy spike. ‘Cause again, you train for this. Like, this is what I do. Like, you’re just solving the problem, [00:15:00] so. I mean, it, yes, I would imagine it’s up some, but it’s not like a crazy… Like, the residents that, when you’re learning it, yeah, then your heart rate’s up. Like, as you’re going through training in your first years and you’ve never seen this before as a med student or a first-year resident.

How 

Charles Eide: do you train for that if it doesn’t happen that often? Just on cadavers or on- 

Dr. Paul Nystrom: Yeah, you do it, you do it procedure lab. We used to use animals, but PETA wasn’t a fan of that, so that went away, but, uh, on cadavers. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Yeah. And so you get some taste of it, and then you, as you get farther in your training you get to do more of the actual procedure, so.

Charles Eide: Jeez. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: That’s insane. 

Dr. Paul Nystrom: Yeah. If you watch The Pitt, like- 

Charles Eide: The show? 

Dr. Paul Nystrom: Yeah. It- 

Charles Eide: I haven’t watched it. 

Dr. Paul Nystrom: It’s a decent show. And medic- I know they have advisors. There’s medical… Like, medically there’s stuff that’s pretty decent on that show. 

Charles Eide: Really? 

Dr. Paul Nystrom: And they, they pack… Essentially each episode is an, is an hour of the shift, and they pack an entire shift with, like, what would be probably a career for an ER doc.

‘Cause you don’t… This is not every day this is happening, right? This is pretty rare. But that, on that- They’re like, “What 

Charles Eide: hospital is this at?” … 

Dr. Paul Nystrom: on, on that show it’s every hour there’s something dramatic like that going on. Like, all the… They sort of, like, h- check the box on, like, all the, the [00:16:00] pinnacle procedures that we do.

They hit the box on all of those throughout the course of one shift in the ER, which- 

Charles Eide: Jeez … 

Dr. Paul Nystrom: isn’t quite right, but. 

Charles Eide: So what made you wanna do this stuff? 

Dr. Paul Nystrom: I don’t know. Just, I mean, being a doctor w- like I said, that was just way early on, and then the ER was just appealing for the variety and some of that stuff.

Charles Eide: So- So you were telling me there’s stuff the ER can do, which obviously is crazy stuff. 

Dr. Paul Nystrom: Yeah. 

What the ER Can and Can’t Do [16:23]

Charles Eide: What kind of stuff can’t the ER do? 

Dr. Paul Nystrom: Well, most everything else. Well, f- when you talk about, like, chronic disease, we don’t fix chronic disease, so yeah. 

Charles Eide: Maybe, like, the end result of chronic disease- Yes … a heart attack or whatever.

Dr. Paul Nystrom: We can… Yeah. 

Charles Eide: So 

Dr. Paul Nystrom: like, yeah, when you have a heart attack, we’re good at that. Like, and you, you’re really having a heart attack, we’re good at that stuff. But the, everything short of that, we don’t, we don’t solve any chronic disease stuff. Trauma’s the best, the probably the only, like, honest part of medicine left.

So- 

Charles Eide: What do you think the biggest misconceptions about the ER are? 

Dr. Paul Nystrom: Oh, there’s many. Well, let me ask you, like, how many people you think that come to the ER get admitted to the hospital, [00:17:00] if you had to guess a percentage? 

Charles Eide: No idea. Uh, 10%. 

Dr. Paul Nystrom: It’s, like, 20 to 30, depending on where you work. 

Charles Eide: Okay. 

Dr. Paul Nystrom: Only maybe 5% are the, like, criticals, like bad trauma, actual heart attacks.

Follow-up 

Charles Eide: surgeries immediately. 

Dr. Paul Nystrom: Yeah, yeah. So, um, but ev- most everything we see, we don’t get an answer a lot of time in the ER. We’re very good at ruling out what you don’t have, but we don’t always get to what you do have. Like abdominal pain, for example. Um, you come in with abdominal pain, probably 40, 50% of the time we don’t have an answer.

Like, I’ll do all the labs that I can do, do CT scans or ultrasounds, and you go home- 

Charles Eide: You’re like, “Sir, this is gas.” 

Dr. Paul Nystrom: Yeah, but I don’t have a test for that. Like, the CT scan doesn’t show gas or constipation and just your gut’s hurting, right? Like, people eat things all the time that… I mean, we’re, I’m sure we’ll talk about food at some point, but we don’t have an answer.

Like, it’s not diverticulitis, it’s not appendicitis, it’s not a bowel obstruction. It’s not all the things that you need to come in the hospital for, get a procedure. I get that your stomach hurts and you maybe even needed IV opioids because your pain is so bad. Hmm. And at the end of the day I’m like, “I don’t have an [00:18:00] answer.”

Charles Eide: Yeah. 

Dr. Paul Nystrom: So patients are very frustrated, but I think patients have an expectation that the ER is going to diagnose them with a specific thing, and that doesn’t happen. We rule out things. We rule out the disasters. 

Charles Eide: Hmm. 

Dr. Paul Nystrom: Like, you may still go home and like, yeah, your stomach hurt really bad. I’m not saying it didn’t, but it’s not anything that you need to stay in the hospital for ’cause it’s not, you know, X, Y, or Z.

Charles Eide: You need to go see a specialist or something. 

Dr. Paul Nystrom: Yeah. And they may or may not have any answers. 

Charles Eide: So leading up, uh, uh, assuming something isn’t, like, a, an accident, a trauma, a, you know, a wound- It seems like a lot of the things that people are dealing with are chronic issues, issues 

Dr. Paul Nystrom: that- Yeah, we see more for chron- we see far more chronic stuff in the ER.

Charles Eide: So the chronic stuff that I think is probably pretty common that we’ve talked about is blood sugar issues, diabetes- Yeah … heart issues, cholesterol, all these things. 

Dr. Paul Nystrom: Yes. 

Charles Eide: So where are you seeing that we’re going wrong? Because I, it [00:19:00] seems like in the United States you see a, a new statistic every, you know, every week that’s, like, telling us how sick and- 

Dr. Paul Nystrom: Yeah, the obesity, overweight- Yeah

like the numbers are through the roof. Metabolically sick. And you know what I 

Charles Eide: see- 

Diet, Carbs & Metabolic Health [19:16]

Charles Eide: Why do you think so many people are that way now? Like, what is, what is your opinion on why we are- It’s food. It’s 

Dr. Paul Nystrom: food. Yeah, by far. So way back in the 1950s and ’60s there was a push, ’cause heart disease was on the rise after World War II.

Ancel Keys was from the University of Minnesota, one of the biggest names in cholesterol and fat, and he had this idea that, like, eating saturated fat and cholesterol caused heart disease. So he published a lot of data that was cherry-picked data. So he, he had his preconceived ideas about what the problem was.

There was other people at the time that thought sugar was the problem, but that got… So he wasn’t, like, there was no internet trolling, but he had a big personality, and these other folks got downplayed that sugar was the issue. So there was a big- So 

Charles Eide: sugar, the… His, his thing was no, it’s not sugar, it’s fat, it’s cholesterol.

Dr. Paul Nystrom: Yes. 

Charles Eide: It’s these things you’ve [00:20:00] been told by all of the big, uh, associations and fundraising groups that are trying to s- you know, save the world. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: That’s all- 

Dr. Paul Nystrom: Well, well he was part of that as it grew, the American Heart Association, so there became a big push to not eat fat. That was the biggest switch.

Charles Eide: Yeah, ’cause in the ’90s and 2000s it was everything was fat-free. 

Dr. Paul Nystrom: Yes. And this goes back even decades before that. Uh, so, um, yeah, the, the fat became demonized. The first dietary guidelines came out in 1980, um, and then there’s been a push. And if you… The standard diet, like, if, if you eat the standard diet, you have protein, carbs, and fat are your three big macronutrients.

Charles Eide: Mm-hmm. 

Dr. Paul Nystrom: Fat us- or protein, excuse me, usually falls out about 15%, unless you’re really hardcore trying to eat more protein, and then it’s your fat and your carbs that you’re trading. So if you take fat out of everything, which we were told to do, you can’t eat saturated fat, don’t eat eggs, don’t eat cholesterol.

I grew up eating Crisco, right? Like, like processed m- machine oil that they figured out they could make it into Crisco that we can eat, right? 

Charles Eide: So it’s bad for you. 

Dr. Paul Nystrom: Oh, yeah. It’s ter- Margarine, [00:21:00] Crisco, that stuff is terrible, right? But the push was to take the fat out or eat that kind of fat, which is not healthier.

And then- 

Charles Eide: To eat the fake fats that are made by the industrial complex ’cause it’s safer and healthier than the real fats? 

Dr. Paul Nystrom: Yes, which is… Yes, which is not true at all. Like the seed oils, the vegetable oils or seed oils as they’re referred to, corn oil, soybean oil, canola oil, those things, they cause more heart disease.

Uh, but that’s what we were told to eat. So, and if- But you 

Charles Eide: see the canola oil at the store and it says, uh, you know, heart healthy. 

Dr. Paul Nystrom: That’s ’cause they pay American Heart so they can put that on the label Yeah, so there’s money changing hands. Your, your Cheerios probably have American Heart Association on the label because they pay American Heart Association to be able to put that on the label.

And there’s some criteria for what that has to be. Like, it has to be low in, in fat and, uh, low in sodium, and there’s some, there’s some rules around it, but it doesn’t mean it’s actually healthy. 

Charles Eide: Okay, so a couple things have come up now, fat and sodium. 

Dr. Paul Nystrom: Yep. 

Fats, Cholesterol & Heart Disease [21:48]

Charles Eide: So tell me the misnomers around fat. So you’re saying What fats are healthy to eat then?

And is fat bad for you if you eat too much of it? 

Dr. Paul Nystrom: No. And so- 

Charles Eide: So you can eat all the fat you [00:22:00] want? 

Dr. Paul Nystrom: Yeah. And fat that God made, not in a machine, not by man. So butter, been around forever. Tallow, pork fat, lard. The things that your grandparents- So 

Charles Eide: animal proteins. 

Dr. Paul Nystrom: Animal, yeah. 

Charles Eide: So you’re a fan of animal proteins?

Dr. Paul Nystrom: Yeah, for sure. So- Animal products are far more nutrient dense than plant-based products. 

Charles Eide: So is it healthier? 

Dr. Paul Nystrom: Yes, by far. 

Charles Eide: So why is eating butter healthier than eating margarine? What does it… Well, how is it different to my body? I don’t wanna sound like a moron ’cause I know these things, but I, I want you to tell me again.

I mean, 

Dr. Paul Nystrom: well, there was trans fats, which were like a… has to do with, um, how saturated the, the fat mo- So there’s m- saturated fat, monounsaturated, polyunsaturated. Uh, and it has to do with the, the bonds and how stable they are. So the unsaturated fat that we’ve been told to eat is actually more unstable. So- 

Charles Eide: The unsaturated fat is more unstable.

Yeah. So like canola oil. 

Dr. Paul Nystrom: Yes. All the seed oils. Ca- canola, corn, soybean are sort of the big ones. 

Charles Eide: Palm oil. 

Dr. Paul Nystrom: Palm oil is more saturated [00:23:00] fat. 

Charles Eide: Okay. 

Dr. Paul Nystrom: Um- 

Charles Eide: What about coconut oil? 

Dr. Paul Nystrom: Coconut oil is more saturated fat, but all the fats have all three of those fats in ’em. But the ones that are more… Like butter’s more saturated fat.

Um, tallow is mostly saturated and mono, has some polyunsaturated. So 

Charles Eide: you’re saying saturated fat is better for you? 

Dr. Paul Nystrom: Yes. 

Charles Eide: So the misnomer about, oh, that’s gonna go clog up your arteries, that’s not true? 

Dr. Paul Nystrom: Oh, the thing where you just eat it and it clogs your, like your sink? 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Like everybody’s heard that, right?

Charles Eide: Yeah, they’re like, “Oh, well, if it’s in a solid form and I eat it, I mean, obviously it’s heated up by cooking or whatever- Yeah … and I eat it, but it’s gonna clog up my arteries.” That’s not true? 

Dr. Paul Nystrom: No, not at all. You, you’ve used beef tallow lotion, right? 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Yeah. Does it… Well, as soon as it warms to your body temperature, what does it do?

Charles Eide: It’s soft. 

Dr. Paul Nystrom: Yeah. It’s, 

Charles Eide: yeah. 

Dr. Paul Nystrom: Like, so room temperature and your body temperature are not the same thing, right? So that, I mean, that’s not the main point of it, but- 

Charles Eide: So the temperature really doesn’t have much to do with it. 

Dr. Paul Nystrom: No, it just made a nice analogy to scare people to- 

Charles Eide: So they were like, “Oh, it’s solid on the outside, so it be-” So it 

Dr. Paul Nystrom: must be solid in your pipes.

Like n- it doesn’t work like that. It just, just eating saturated fat doesn’t go right into your arteries and clog them up. 

Charles Eide: Well, so [00:24:00] when people say, “Oh, my arteries are getting all clogged up,” what’s causing it? Uh- Why is it, why 

Dr. Paul Nystrom: are people- … oxidative damage. So there is, there is LDL cholesterol in the plaques in your arteries, but that’s not the thing that- 

Charles Eide: Causes 

Dr. Paul Nystrom: it

that’s not the most dangerous thing. Oxidized LDL, and oxidized has to do with like damaged LDL particles and damaged vessels, and that has to do with insulin resistance. So- 

Charles Eide: Okay. So you’re saying oxidized particles are what are causing these plaques? Yeah, 

Dr. Paul Nystrom: that’s a much bigger deal than just your LDL number.

So 

Charles Eide: what causes oxidation on the particles? 

Dr. Paul Nystrom: Uh, inflammation Carbs 

Charles Eide: Carbs 

Dr. Paul Nystrom: Insulin resistance 

Charles Eide: Carbs and sugar. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So sugar and carbs are… It’s not just a joke. They are really the culprit. 

Dr. Paul Nystrom: Yes. What am I- Yeah, my, and my thinking on this has changed, ’cause it, through medical school, I had one nutrition lecture in med school.

That was it. That’s all I remember about anything nutrition-related. 

Charles Eide: Really? 

Dr. Paul Nystrom: Yeah, and it was, it was the heart-healthy, low-fat. That was what I grew up with, uh- 

Charles Eide: And you probably believed, ’cause that’s how 

Dr. Paul Nystrom: you were trained. Yeah, that’s what I was eating. Like, yeah, before, like, I stumbled into this [00:25:00] and, like, digging into nutrition as a hobby, I was pizza and Mountain Dew.

Mm-hmm. Right? Like, that was my college days and even med school, and then it wasn’t till after that when I was in the Navy and actually found CrossFit, and that’s what turned my eyes on to, like, working out different and then also eating different, and then it’s been an evolution since then for 20 years now.

Charles Eide: So carbs and su- Now are all carbs and sugar considered the same? Like, if I eat an orange, right? Yeah. Or a, a, a Snickers bar. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: They’re both carbs. They’re 

Dr. Paul Nystrom: both carbs. 

Charles Eide: They’re both sugar. 

Dr. Paul Nystrom: It’s a… There’s a glucose molecule that’s getting across. Like, it has to be dissolved. Even, like, starches, people are like, “Well, I eat potatoes or rice, and that’s not sugar.”

Um, so the storage form in, is glycogen. When that gets broken down in your gut, it has to be absorbed as a single molecule, so it’s still gonna raise your blood sugar. Arguably, it’s not as bad as sugar, 

Charles Eide: but- So a potato’s gonna raise your blood sugar. 

Dr. Paul Nystrom: Yes. 

Charles Eide: Rice. 

Dr. Paul Nystrom: Yes. 

Charles Eide: Basically any of these carbs. 

Dr. Paul Nystrom: Everything made with flour.

Charles Eide: What about asparagus? 

Dr. Paul Nystrom: Not as much. 

Charles Eide: But it’s a carb. 

Dr. Paul Nystrom: It’s a carb, but there’s, there’s far less in, in asparagus compared [00:26:00] to an orange. 

Charles Eide: So the number of carbohydrates is a factor as well. 

Dr. Paul Nystrom: It’s a big deal, yeah. And it, it’s not all cut and dry, because, like, if you eat carbs with fat and protein, your blood sugar won’t spike as fast.

Charles Eide: Why? 

Dr. Paul Nystrom: Because the, as it, it gets absorbed differently. So if it’s just straight sugar, it’s gonna get absorbed in a hurry. But you 

Charles Eide: eat yourself an orange with nothing else, you’re gonna have a spike in blood sugar. 

Dr. Paul Nystrom: Yes. But- 

Blood Sugar, Insulin & Ketosis [26:21]

Charles Eide: So what are these spikes in blood sugar doing to us? ‘Cause it all related back to clogging up our arteries, or at least that’s where I’m- 

Dr. Paul Nystrom: Yeah.

When you eat carbs, you get insulin re- uh, release from your pancreas to help bring your blood sugar down. 

Charles Eide: So you’re eating this sugar, whatever form it is. 

Dr. Paul Nystrom: Yep. 

Charles Eide: Your blood sugar rises. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: You get that little zip. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Then your pancreas puts out insulin to lower it. 

Dr. Paul Nystrom: Yes. 

Charles Eide: And where is it going? 

Dr. Paul Nystrom: You have to either burn it or it gets stored in your muscles and your liver, or it gets stored as fat 

Charles Eide: W- how does it determine which one?

Dr. Paul Nystrom: If your muscles and liver are empty ’cause you’ve burned down your glycogen supply, then it’ll go 

Charles Eide: to- So glycogen [00:27:00] is like a fuel tank … 

Dr. Paul Nystrom: is a, is a storage form of carbs 

Charles Eide: Okay, so your liver and your muscles hold carbs- 

Dr. Paul Nystrom: Yeah, they have some … 

Charles Eide: called glycogen. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Okay, and so what empties the tank of those so that you can put the carbs there instead of, you said fat?

Dr. Paul Nystrom: Yeah. Exercising. So but they… If you have a huge bolus of carbs, like say you eat a huge bowl of pasta, you go, you know, pasta and garlic bread- 

Charles Eide: Mm-hmm … 

Dr. Paul Nystrom: that’s a huge spike in your, in your glucose, so it’s gotta go somewhere. So either you have to burn it- 

Charles Eide: Mm-hmm … 

Dr. Paul Nystrom: so you can only burn so much. Uh, it’s gonna f- go to your muscles and your, your liver, but if they’re already full, it’s gonna get stored as fat.

Charles Eide: So how do you empty your liver and your muscles so that you can put the carbs there? 

Dr. Paul Nystrom: Exercise. Yeah. 

Charles Eide: Exercise. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So, like any exercise? 

Dr. Paul Nystrom: Uh, high intensity exercise more so to burn down the glycogen stores. 

Charles Eide: Like cardio. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: What about lifting heavy? 

Dr. Paul Nystrom: Yeah. But I mean, like, high intensity interval training I think is one of the best ways to get your muscles empty so it can take up- So 

Charles Eide: sweating your face [00:28:00] off.

Dr. Paul Nystrom: Yeah. That’s good. 

Charles Eide: That empties them. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Now if you, let’s say you’re only, uh, l- you know, doing legs or something. Does it only empty the glycogen in the leg muscles, or is it systemic throughout your whole body? 

Dr. Paul Nystrom: I would say probably mostly in the legs, yeah. 

Charles Eide: So it’s r- it doesn’t, it does redistribute, but it’s burning from where you’re using it- 

Dr. Paul Nystrom: Yes

Charles Eide: locally. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: And is that the energy source for the muscle then? 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So if your muscle doesn’t have glycogen, where is it pulling its energy from? 

Dr. Paul Nystrom: It can pull from other parts of the body, ’cause your, your liver’ll make glucose from its glycogen stores. 

Charles Eide: Your liver will make it- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: and put glucose- Yeah

back in. 

Dr. Paul Nystrom: Yeah. You don’t have to actually eat any glucose. So your liver makes glucose from glycogen stores in the liver. 

Charles Eide: Hmm. So- 

Dr. Paul Nystrom: So 

Charles Eide: you’re saying that you store gl- gl- basically you store blood sugar using insulin, and insulin puts it into your muscles, your liver or fat cells? 

Dr. Paul Nystrom: Yes. 

Charles Eide: So is that why we’re getting so fat is because we’re eating too many carbs and we’re not [00:29:00] emptying the tanks?

Dr. Paul Nystrom: Yeah, that’s part of it. And just generally, like eating too much is the biggest thing. 

Charles Eide: So too many calories. 

Dr. Paul Nystrom: Too many carbs. 

Charles Eide: Too many carbs. 

Dr. Paul Nystrom: Yeah. The calorie thing is not as cut and dried as we’ve been told. Like, you burn more calories, like burn more, eat less. That, that’s been a push for decades as well, right?

Like, you just have to balance your in and out. The hormone effects of what you eat are way more important than just your total calorie intake. ‘

Charles Eide: Cause I heard one time- that if there was no insulin going into the blood because there’s no blood sugar to need that, that your body can’t really store excess calories anywhere because there’s no insulin telling it to go somewhere ’cause there’s nothing, there’s no blood sugar.

Is that right? 

Dr. Paul Nystrom: No. I think that doesn’t make sense to me. Like y- 

Charles Eide: Well, like, you know, like let’s say you only ate rib eye steaks and there’s not a single carb in sight. 

Dr. Paul Nystrom: Well, then you can burn ketones. Your body goes into ketosis and you burn fat for energy, which your body can use just fine. And if you do need glucose, uh, like at any given time you only have [00:30:00] about a teaspoon of blood- of sugar in your bloodstream at any given time.

Charles Eide: Okay. 

Dr. Paul Nystrom: So, and if you need more, your liver makes more. 

Charles Eide: Your liver makes more. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So, now you mentioned ketones and ketosis. There’s so much hype and buzz around keto diet and ketosis and ketones. What the heck is that? And you had said it’s a fuel source. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Help me understand that. 

Dr. Paul Nystrom: Um, again, I’m not an expert on the, the biochemistry off the top of my head, but, uh, if you’re not eating carbs your body makes ketones, so it breaks down fat to burn that for energy.

Charles Eide: So- So ketones are a form of energy. A f- 

Dr. Paul Nystrom: yeah, they’re a form of fuel for the body. 

Charles Eide: And does your body prefer one over the other? 

Dr. Paul Nystrom: It can switch. Um, 

Charles Eide: it- Does it prefer ketones over carbs in the blood or glucose? It 

Dr. Paul Nystrom: depends on what your ch- Does it prefer it? Uh 

Charles Eide: Well, does, does one work better than the other?

Like for mental- I think 

Dr. Paul Nystrom: ketones work better, for mental stuff for sure. Like hang- like pivoting a little bit, like hangry is a carb disease. 

Charles Eide: Hangry is a carb disease. 

Dr. Paul Nystrom: Yeah. Like [00:31:00] if you don’t eat carbs and cycle from this high blood sugar to low blood sugar, so you eat a bunch of sugar or carbs, your blood sugar goes up, your insulin brings that back down, and you get the high of when you ate, just ate the carbs, and that also hits your, affects your dopamine and your opioid pathways.

We could talk more about that. It’s not, they don’t, not in the same way that drugs do, but there’s a similar increase in your dopamine and there’s some effect on the opioid 

Charles Eide: system. So that’s why we love donuts and we love sweets- Yes … is ’cause it gives you- You get 

Dr. Paul Nystrom: a hit … 

Charles Eide: a hit. 

Dr. Paul Nystrom: Yes. And again, it’s not the exact same as like meth and cocaine and, but there’s some, there’s some overlap of the pathways, both dopamine and opioids when you eat carbs.

So you feel good- That’s why we 

Charles Eide: like them. 

Dr. Paul Nystrom: Yes. And that’s why you eat more of them. Uh, and then when you drop, then you feel crummy, so then you gotta eat again, and you crave the same things that you just ate. 

Charles Eide: Mm. 

Dr. Paul Nystrom: So. 

Food Addiction & Behavioral Change [31:45]

Charles Eide: It’s funny you say that. I feel like I’m so sensitive to carbs now. Last night I made steak and then, and then I made some mac and cheese for the kids.

Dr. Paul Nystrom: Okay. 

Charles Eide: Of course, I had some mac and cheese too. I tried to eat the steak first, which I did, but afterwards I felt so crummy for like [00:32:00] an hour ’cause I had that mac and cheese. Yeah. I, I laid down and I was like groggy and tired. I’m like, “It’s 7:00 at night. Why do I wanna go to bed right now?” 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Why is that?

Dr. Paul Nystrom: Uh, just- 

Charles Eide: What’s causing that feeling? 

Dr. Paul Nystrom: The feeling of being tired? 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Uh, probably like a relative low. Like you’re not getting dangerously low. Like you don’t need, you don’t need like an IV with glucose in it, like someone, like a diabetic who takes too much insulin. But yeah, that, those swings contribute to that.

Charles Eide: So it makes you feel tired and sluggish. 

Dr. Paul Nystrom: Yeah. Yeah. 

Charles Eide: So is that what’s contributing to us getting fatter and sicker? 

Dr. Paul Nystrom: Yeah, for sure. The more I’ve done this, the, the- so we’re, I’m 20 years into doing medicine, and I’m more and more convinced that carbs and refined carbs, processed food are the biggest thing that contributes to everything else.

So insulin resistance is the biggest piece of it. So, like metabolic syndrome was defined by a doc named Gerald Reaven way back in 1988. He had like a landmark presentation, uh, gave a lecture. And, um, insulin re- or metabolic syndrome is high blood sugar, high blood pressure. [00:33:00] So high blood sugar being pre-diabetes or diabetes, high blood pressure, high triglycerides, uh, low HDL, uh, and ab- abdominal obesity.

So those five pieces put you at high risk for cardiac disease. Like having one of them is risky. Having two or more, or having all of them is risky. 

Charles Eide: So the, the, to get this straight, if we eat a ton of sugar and… Like, like a donut is pretty much the worst possible thing you could eat ’cause it’s full of oil that it was cooked in.

Dr. Paul Nystrom: Yep. 

Charles Eide: That’s like the bad oil. 

Dr. Paul Nystrom: Yep. Right? For sure. Everything processed. Like at every, every fast food restaurant, besides Buffalo Wild Wings, uses vegetable oils of some kind ’cause the supply chain is there and they’re far cheaper. Buffalo Wild Wings uses beef tallow. Uh, the original McDonald’s fries were beef tallow way back in the day 

Charles Eide: before- So the body likes tallow better, but we can’t tell the difference.

We can’t feel the difference, can we? 

Dr. Paul Nystrom: Not necessarily, no. 

Charles Eide: So you can eat french fries that have been cooked in this bad oil- 

Dr. Paul Nystrom: Yep … 

Charles Eide: and french fries that are cooked in tallow, and you can’t necessarily feel the difference. 

Dr. Paul Nystrom: Probably not, 

Charles Eide: no. [00:34:00] But it’s affecting you differently. 

Dr. Paul Nystrom: Yes. Yeah, the vegetable oils, the, the seed oils as they’re referred to are, are much worse.

Why? And then they’re cooked at high temperatures, so they’re, that oil is getting oxidized just because of the bonds. They’re less stable, so they go rancid. Uh, when they’re cooked at high temperatures, they oxidize. In the body, they get oxidized. 

Charles Eide: So- And that’s what’s causing plaquing. 

Dr. Paul Nystrom: Yes, that’s the, the other piece of the, the heart disease argument, right?

It’s not just LDL. It’s not your total number LDL. It’s- 

Charles Eide: Now what is LDL versus HDL? You hear these numbers. You hear triglycerides. Yeah. What… Explain those to me. 

Dr. Paul Nystrom: There are different things that you get. Like when you check a lipid panel, you have LDL and HDL, and they’re not actually cholesterol. Those are like the lipoproteins that carry cholesterol.

Charles Eide: Okay. 

Dr. Paul Nystrom: They’ve, they’ve been… It’s been dumbed down to just say a- HDL is good and LDL is bad, and that’s an oversimplification of it. So they’re both proteins that carry the, the fats in your blood because the fats can’t float around in the water ’cause, uh, your blood is more water, so they’re, they’re lipophilic.

Excuse me, they’re lipo… They’re not lipophilic. 

Charles Eide: [00:35:00] They’re hydrophilic? Hydrophilic. 

Dr. Paul Nystrom: Hydrophobic. Yeah. 

Charles Eide: Going back to biology in my head here. 

Dr. Paul Nystrom: Yes. Yeah, me too. Probably misspeaking on this, but the point is like the LDL and HDL are carriers for the cholesterol. 

Charles Eide: So I was, ’cause I was listening to Diary of a CEO and he had a heart doctor on.

Yep. He was saying that, um, they’re now finding some, there’s some scary new studies showing that people that have high LDL, the bad one- are living into their 90s. Like cholesterol isn’t the whole- 

Dr. Paul Nystrom: No. And, and going back to, to Reaven’s stuff with, uh, the metabolic syndrome, um, your triglyceride to HDL ratio is a much better predictor of heart disease risk than LDL ever was.

So if you have high triglycerides, which comes from eating too many carbs- 

Charles Eide: So triglycerides is eat too many carbs, you get high triglycerides. Yes. 

Dr. Paul Nystrom: Okay. And, and again, going back to, like, if we’ve been eating a low-fat diet for 40, 50 years- Mm-hmm … your HDL’s gonna be low, your triglycerides are gonna be high, and that ratio is the best predictor of cardiovascular risk.

LDL is not the best predictor of [00:36:00] cardiovascular risk. But we make meds that lower LDL. 

Charles Eide: I was gonna say, traditionally they go, “Well, you should get on a statin- Yeah … to lower your cholesterol.” Yeah. ‘Cause I, I have friends that are like, “Yeah, I’m on a statin.” 

Dr. Paul Nystrom: Yeah. It will lower your cholesterol, or will lower your LDL.

Charles Eide: But that’s not fixing the issue. 

Dr. Paul Nystrom: No. 

Charles Eide: So what fixes it? 

Dr. Paul Nystrom: Less carbs. If you eat more fat and less carbs, you move that ratio of triglycerides. Your triglycerides go down, your HDL goes up. 

Charles Eide: But, uh, the, the misnomer I, I mean, like, I’m not a doctor or scientist, obviously, okay? But you think to yourself, “Oh, LDL, HDL, these, the- these are fats.”

Yeah. “So I just eat less fat and my-” 

Dr. Paul Nystrom: Yes, and that makes a convenient story, but yeah, it’s not that simple. It’s not that simple. The whole thing… It’s the same thing with the pipe analogy. Like, you eat fat, it goes in your arteries. It’s not that simple. No. 

Charles Eide: So no. What’s causing it to stick inside, especially the heart, right?

We have tiny vessels everywhere in our body. Why does it stack up in the heart [00:37:00] muscle and cause a heart attack? Or not the muscle, 

Dr. Paul Nystrom: the vessels. I don’t know if I, I don’t have a, I don’t know if I have a good answer on that one, why is there more… I mean, it’s the same process that affects, it, um, like strokes are the same thing.

Like, you get a clot and you get plaques in your carotid arteries or get plaques in your head. So those, the vessels are getting damaged everywhere. 

Charles Eide: Hmm. 

Dr. Paul Nystrom: Um, at a microvascular level, your kidneys are getting damaged. Uh, people have peripheral arterial disease where they have, like, clots in their legs, and then they get leg pain when they walk.

Like the sort of, you get a, it’s called claudication. You get leg pain when you walk because you have the same process going on in your legs that you do in your heart. It’s like angina is like heart pain, like when your heart works too hard and people have chest pain because they have clogged arteries.

Like, not acutely having a heart attack, but they’re narrowed, and then your heart works too hard, you have chest pain. The same thing happens in your legs. So the, the same process is happening in legs, in your brain, in your heart. 

Charles Eide: So if someone’s having angina or these issues, obviously that’s, like, a big warning sign.

Like, warning, stuff’s getting [00:38:00] clogged up. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: How do I reverse that? What can I do to, to make- To 

Dr. Paul Nystrom: reverse plaque once you have it? 

Charles Eide: Yeah. Can I? 

Dr. Paul Nystrom: Uh, I’ve read differing opinions on that. Some people think yes, you can actually reverse plaque. I don’t know. I don’t… I’m not sure you can 

Charles Eide: Well, what can I do to, to stop- 

Dr. Paul Nystrom: Prevent it?

it 

Charles Eide: from- 

Dr. Paul Nystrom: Getting worse? … 

Charles Eide: getting worse? 

Dr. Paul Nystrom: Less carbs. 

Charles Eide: In general? 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Stop 

Dr. Paul Nystrom: eating oranges. And I sound like a broken record. The people that I talk to that hear, that hear me talk about this all the time, like I, I sound like a broken record. But I’m convinced that sugar, uh, processed food, sugar, flour, and seed oils.

Like if I talk to patients, and sometimes I’m able to have a really detailed conversation with patients. Sometimes they wanna hear what I have to say, sometimes they just want a pill. And so I, I tease out in the conversation like, “Do you wanna hear my other contrary opinion to this?” And if we do, I get like, “If you just want big picture,” like you leave the ER, um, like sugar, flour, seed oils are the biggest three things that you could cut out.

Which 

Charles Eide: is all lifestyle. 

Dr. Paul Nystrom: Yeah. And it’s all processed food Right? But again, people will crave that stuff. So like y- we talked about, a little bit about the food addiction and the [00:39:00] opioid and the, the dopamine pathways. So I think food addiction is a much bigger deal that I, I read about it some now. People are starting to talk about it, but that’s why it’s so hard to make, uh, habit changes, right?

‘Cause you crave the sugary stuff, and it’s hitting your… It’s affecting your dopamine and your opioid pathways. You 

Charles Eide: truly are feeling happier. 

Dr. Paul Nystrom: Yes. Yes. I had a conversation with a, uh, recently- You’re feeling happy 

Charles Eide: while getting sick … 

Dr. Paul Nystrom: a 17-year-old girl came in with terrible stomach pain, and we, she got a big workup.

We didn’t figure out why. It’s probably bad acid reflux from what she was eating ’cause she had Alfredo, and then felt a little bit better, then had Taco Bell. So, uh, it didn’t go so well for her, but we ended up having a, a conversation. She’s 17 and 250 pounds at 17 years old, and we were able to have a decent conversation with her and her mother.

I’m like, “This, like you…” She was open to the idea that this is gonna be problematic for her. Like, 250 pounds at 17 year old, 17 years old is gonna be a problem, right? She’s gonna have all kinds of things down the road, and she described herself as a bit of a foodie, and her boyfriend’s a foodie, and their family eats a lot of food.

And she, I think she even mentioned dopamine. Like, [00:40:00] she, she could make the connection that she craves food, right? And w- it, and food addiction, I think, is a much harder thing to solve ’cause, like, if you cut out alcohol, you cut out meth, cocaine, like, those things are hard to quit. Nicotine, those things are hard to quit.

Smoking, whatever it is. But you don’t have to navigate those every day. If you just cut out alcohol, right? Like- 

Charles Eide: You can still live … 

Dr. Paul Nystrom: you can still live. The food environment is around you all day, every day, so you have to navigate food all the time, right? And so people that have that, that it hits their… For whatever reason, it probably hits her pathways different.

Like, I can have something really sweet, and I don’t, I’m not spun up for days. People that have, like, food addiction, um, like, you have like a… Like, cheat days don’t work for them, right? Like, you could eat really clean for six days, and that’s, some people do that. Like, they have their cheat day. Like, they just sort of save up.

They eat really good, and then they have a cheat day. If you’re, have more, if you’re, have a tendency to have more food addiction where your pathways are getting hit more than the average person, you’re not gonna… Cheat days don’t work because you’re gonna be derailed. Like, you eat your mac and [00:41:00] cheese.

Like, this morning, what’d you have? You probably didn’t have cereal for breakfast. I 

Charles Eide: had… No, I had, uh, I had some eggs, and I had some cheese curds. 

Dr. Paul Nystrom: Yeah. Okay. 

Charles Eide: Not fried. 

Dr. Paul Nystrom: Yeah, just plain cheese curds, right? Plain 

Charles Eide: cheese curds. 

Dr. Paul Nystrom: Yes. So if you had food addiction, like this morning you probably would have had donuts and cereal, and you’d be craving that more.

So getting out of that cycle of, “I’m just always craving, I’m craving the carbs.” 

Charles Eide: How, how long does it take to break that if you’re really strict? 

Dr. Paul Nystrom: It depends on the person. Hmm. There’s not a, there’s not a- 

Charles Eide: Is it like a two weeks? Is it like three days? Is it like a month? 

Dr. Paul Nystrom: I’d say into weeks to months. 

Charles Eide: Hmm.

Dr. Paul Nystrom: Yeah, but it’s still something that’s gonna haunt them. Just like an alcoholic who goes back to the bar, you know, they’ve been sober for three months and they go back to the bar, they might- that might be the thing that now they’re derailed again, right? So y- again, the, the food thing is like, it’s just a constant battle.

It’s a hard one to overcome. You have to have some awareness of it. And we eat for all kinds of reasons. You’re stressed. ‘Cause again, it’s messing with your other pathways in your brain, so you may not even be hungry, but you’re just craving carbs, or you feel… You’re anxious, or you have pain, or you’re stressed.[00:42:00] 

You go to food ’cause you know it makes you feel better. So even from the time we’re little, like we give treats for, like cake and cookies and everything has just become part of, from the time you’re little, you’re just trained that that makes you feel better. You know it makes you feel better, right? 

Charles Eide: It’s a birthday party.

We gotta have some cake. 

Dr. Paul Nystrom: Yes. All the time. But 

Charles Eide: just everything- I have a friend who, uh, they, they’re very conscious of these things, and they had their first child, and they did a watermelon cake for the first- Okay. Yeah … birthday, and this kid never sees any of that. I mean, it’s a carnivore diet on this kid.

Dr. Paul Nystrom: Yeah. 

Charles Eide: And they swear by it. They’re like, “Our kid’s pretty well-behaved all the time.” Like- 

Dr. Paul Nystrom: Yeah, there’s 

Charles Eide: something to that … do you think a lot of children’s behavior issues are related to the food we’re giving them? 

Dr. Paul Nystrom: Oh, yeah. 

Charles Eide: Tell me more about that. 

Dr. Paul Nystrom: Yeah. I mean, the, again, the same, the same way that hangry is for adults, kids are the same way.

Like the highs and lows, like yeah, it’s messing with them. And then the processed food, and this I don’t, I don’t know where the It probably [00:43:00] varies for the person, but like the, the pro- the dyes and, you know, RFK is going after dyes and all these things. I think the chemicals and stuff I think is bad, but I don’t know exactly how much that’s contributing.

But your kid may have a reaction to that stuff, and you just don’t think of it, ’cause this is just what all kids eat, so you just assume everything is fine. And adults do this too. They just eat stuff and they assume it’s fine ’cause it’s what everybody eats. They don’t know how bad it’s affecting them until you cut it out, and then you’re like, “Oh, wow, I actually feel better.”

So, and that can be, uh, chronic abdominal pain, like this thing called IBS, irritable bowel syndrome. I’ll tell patients, I said, “I don’t think it’s a real disease. I believe you’re having symptoms and your guts hurt, and you’re diarrhea part of the time, and you’re constipated part of the time, and you’re bloating, and you feel terrible, and you have abdominal pain.

Those are all real things, but IBS is just a made-up name so we can give you a drug for it.” Like, you need to figure out what you’re eating. 

Charles Eide: Like- So like what are we putting in there that’s making- Yeah … you do this? 

Dr. Paul Nystrom: Yeah. Yeah, like, uh, up to about 10% of ER visits for, are for abdominal pain. Like across the board, that’s one of the most common ER visits is for abdominal pain.

And the younger you are, the [00:44:00] more likely we’re not gonna find anything. As you get older, you have more risk of sort, pretty much all diseases, right? So the chance that if I do a CT scan on an old person to find like a bowel obstruction or diverticulitis, that’s gonna be higher than if you’re 20 years old.

But it’s what you’re eating, and it doesn’t get… Like, how could it not be what you’re eating? Like, it’s your guts. Well, yeah. Your guts hurt. It’s gotta be what you’re eating. But- You look 

Charles Eide: at like the, the an- like having a, a dog or something. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: And you, you know, you’re like, you’re like, “Oh, we can’t feed him that.

It’ll make him diarrhea on the carpet.” But then we don’t think about our 

Dr. Paul Nystrom: own. Well, and people don’t… No, not at all. It’s just- Why 

Charles Eide: don’t we put that together? 

Dr. Paul Nystrom: Because it’s just, it’s just acceptable to just eat what we eat. Like the standard American diet, or SAD as people refer it, like it’s just what we eat.

And like nobody connects the dots that, yeah, y- what you’re eating is not agreeing with you. And once you cut it out, and that’s why, I mean, carnivore sounds crazy to some people, but it, ’cause it’s a very restrictive diet. But at the same time, like it, it’s a way to… Like when people have abdominal pain and they, and they go see somebody and talk about like cutting things out, they’ll maybe start by like weeding out something.

There’s like a paleo autoimmune [00:45:00] protocol where you cut out certain things, uh, or like a FODMAPs diet. Like carnivore sort of strips all that away because like particularly ruminant meat is like the healthiest thing you can eat. 

Charles Eide: What is that? 

Dr. Paul Nystrom: So ruminants have a four-chambered stomach. So that’s cows, bison, elk, deer.

Like- 

Charles Eide: Sheep. 

Dr. Paul Nystrom: The… Yep. Sheep, goats. They have a four-chambered stomach, right? So what they eat gets processed and bio-hydrogenated in their guts, so their final, the meat there is different than like chicken, turkey, and pork. 

Charles Eide: Mm. 

Dr. Paul Nystrom: And chicken, turkey, and pork gets fed a lot of grains, which is high in linoleic acid.

That’s one of the, like the seed oils have a lot of lino- linoleic acid. So if cows, whether they’re grass-fed or grain-fed, they process all that out, so their final percentage of linoleic acid in the fat of, of ruminant is far lower than chicken, turkey, and pork. So yeah, that’s the healthiest thing you can eat.

And it gets processed in your small, or your, it gets digested in your stomach, absorbed in your small intestine. Meat doesn’t rot in your colon. It’s g- again, like these things that we’ve been told, like you have to eat fiber, fiber, fiber, and don’t eat meat ’cause it’s gonna rot in your colon and

[00:46:00] ferments. There’s not much by the time it gets to your colon because it’s been digested and absorbed in your stomach and small intestine. We actually don’t have the enzymes to digest fiber So that’s what sits in your colon and makes you feel terrible. 

Charles Eide: The fiber. So, 

Dr. Paul Nystrom: yes, for some people that’s a much bigger issue.

I, I- Like, that gets pushed for constipation all the time. I see patients for constipation. Every shift I probably see somebody with constipation, and they’ve been told fiber, fiber, fiber. Like yeah, you’re just clogging up the system. It bulks up your stool, it’s clogging up the system. It’s not the end all, like everybody, like we’ve been told.

Charles Eide: Back to cows, I think it’s interesting. I, so I have a ranch. I have- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: cows. And the… I heard one time, and maybe it’s true, is you know, you have people that say, “Well, if animals can get their protein from eating grass, so can people.” 

Dr. Paul Nystrom: No. 

Charles Eide: But then at, yeah, at one point I heard someone say, and I can’t remember now, the, the protein that the cows are actually consuming is the bacteria from the [00:47:00] fermentation of the, or the, you know, the de- decomposition of the grass.

So th- they’re getting tons and tons of protein because of the process of the grass creating all of this bacteria. Yeah. That bacteria is their protein. So they’re- 

Dr. Paul Nystrom: Yeah, they, yeah, ruminants upcycle protein, so they can eat like 60 grams of protein and they can make 100 grams out of 60 because of this whole process.

We can’t do that. We can’t eat grass. You could try. Like, you c- you know, 

Charles Eide: we- There’s people that do. 

Dr. Paul Nystrom: Yeah, we can’t eat grass. 

Charles Eide: So you’re not a fan of the vegetarian thing or the vegan thing? 

Dr. Paul Nystrom: No. And the, my, my beef with that is sort of there’s, I, I feel like there’s like four pieces to, when we talk about, and this talks about, like, how polarized it is about eating, right?

So, like, cows are destroying the planet and whatever. There’s like four pieces of the, the animal versus the plant stuff that I think come into play. So one, uh, like the PETA folks, somebody who’s like, “You can’t kill anything,” like, “I don’t want anything to die.” I think it’s a very naive opinion, frankly, because if you, if you eat, something had to die, right?

‘Cause, like, if you’re gonna eat all plant-based stuff, [00:48:00] you have monocrop agriculture of whatever that looks like, whether it’s your lettuce field, your corn field, your soybeans. There’s no monocrop agriculture naturally, right? Like, we made monocrop agriculture. Like, think Kansas wheat fields, right? How many things are dying so that you can have a Kansas wheat field?

Those combines, the machines, the pesticides, the herbicides. There’s lots of things dying so you can have your corn or your soybeans or your lettuce, right? 

Charles Eide: Your kale. 

Dr. Paul Nystrom: Yes. Something is dying so you can eat. Like, that’s across the board. There’s no way around that. So I think that argument doesn’t hold water.

Uh, the climate thing. There’s a narrative about climate change and how cows are destroying the planet. If you dig into the details of that, like how much rain water they use versus, like, almonds, like those two, like almond milk is better. Like, almonds are draining the aquifers of California so we can have almonds, right?

Cows are just drinking rain water. The grass is there because of rain water, right? So there’s a big, there’s a disconnect there, but that gets pushed as a reason why we shouldn’t eat beef. And then the third piece of it that gets lumped into this is a religious thing [00:49:00] actually, because the, the underpinnings of like the American, uh, nutrition and dietetics came from Seventh Day Adventists.

And again, r- not… If you, whatever your religion is, sure, have your… That’s, that’s fine. But that doesn’t, that doesn’t mean that you eating for religious reasons is the same as health reasons. So these three things get accepted or get pushed out as this is the best way to eat because you’re not killing things, and for the climate and for religious reasons, and that makes them healthy.

Those are all very different things, but they get lumped together and there’s a huge narrative around those three things, then by de facto cars are, or cows are bad and they’re destroying the planet and they’re not healthy. And that’s not the case at all. 

Charles Eide: It’s so interesting to hear you talk about this again when you and I have been…

I mean, you’ve been telling me this for a long time. I remember when we were hanging out last July, so whatever that is, 10 months ago, nine months ago. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: And I was complaining about my blood pressure [00:50:00] and my excess weight and my skin. It was m- a lot of it was my skin. Yeah. Big, big s- big s- Well, basically zits.

Zoi- boils. Like you’re a 

Dr. Paul Nystrom: teenager. 

Charles Eide: Yeah. And, you know, I’m like, “I just don’t know what to do about it,” and I remember you, you said, “Why don’t you just try eating only meat, and maybe a little bit of fruit if you can’t handle it?” Yeah. “But just that.” And I was like, “Well, I can do anything for 30 days.” You said, “Do it for 30 days,” and I did, and it was crazy ’cause a lot of things cleared up in that 30 days.

Dr. Paul Nystrom: And, and things that people don’t expect clear up. Like gut issues clear up for people. Yeah. And there’s no, and again, there’s no guarantees with this, but there’s no guar- the only guarantee in medicine is that all bleeding stops eventually. That’s- That’s the only one. Okay, so but yeah, gut issues clear for people.

Skin things that they didn’t even know were related. Yeah, my 

Charles Eide: skin cleared up. Yeah. It was crazy. In a month. 

Dr. Paul Nystrom: Yeah, you wouldn’t even know that that should be a thing. I used to 

Charles Eide: get these big zits all the time. 

Dr. Paul Nystrom: Yeah. Uh, people have like [00:51:00] psoriasis, eczema. Um, asthma can get better when you cut out carbs.

Asthma’s an inflammatory disease of the lungs. Some people, their asthma gets better when they cut out all the inflammatory things they’re eating. Again, sugar, flour, seed oil, and they didn’t expect that to be the case. And again, there’s no guarantees, but 

Charles Eide: yeah. And I lost 15 pounds. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: 15 pounds in like, in like 45, 60 days.

Dr. Paul Nystrom: ‘Cause you’re bringing insulin down. Yeah. Like insulin’s a fat storage hormone. It takes the glucose out of your blood and it puts it in the, again, it goes to your… You burn it, it goes to muscle or liver or it goes to fat cells. So when your insulin is high constantly from, from eating carbs, you can’t burn your internal fat stores.

So eating a diet, either low carb, keto, carnivore, something in that realm, drops your insulin so now you can burn your internal fat stores, which leads to more energy. So when I talk to patients about weight loss, they’re like, “Oh, I gotta go to the gym more.” I’m like, “Skip the gym.” Like not for weight loss anyway.

Like exercise is a huge thing, uh, and there’s, there’s more and more evidence that exercise is one of the biggest things for longevity. Maintaining muscle mass as you get older keeps you from being frail, so when you don’t break a hip or you recover if you fall, or you don’t fall because [00:52:00] you have better muscles.

But, um, all of those things aside, like you have to have low insulin to be able to burn your internal fat stores, and then you have more energy. So like as you start to eat better, if you focused all your energy on eating better, you’re like, “Wow, after dinner I don’t feel like a slug.” Like if you don’t eat the macaroni and cheese- Yeah

last night, you probably would’ve gone out for a walk. 

Charles Eide: Well, and 

Dr. Paul Nystrom: I- It was a beautiful night, 

Charles Eide: right? I can speak to that because I was so disciplined for like six months, so disciplined. Yeah. I mean, you remember, we went out to dinner one night and I was like- Yeah … “I ain’t touching any of that.” No. “I’m having my ribeye.”

And but it’s so true, we’re surrounded by all these food opportunities and situations that make your brain crave that. Yeah. And it’s easy to slowly reintroduce the crap- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: back in. 

Dr. Paul Nystrom: And the pressure is there, right? Like- 

Charles Eide: Tons of 

Dr. Paul Nystrom: pressure … like if you cut out meth, none of your friends are gonna tell you you should start eating meth a- taking meth again, right?

Like, that’s a pretty… Like, the drugs are, people are, they’re, people are fully supportive and on board when you cut drugs out of your life, drugs and alcohol. Like, nobody’s gonna give you a hard time about stopping smoking, right? But go back to food. You say like, “I’m, [00:53:00] I’m low carb, I’m, I’m keto, I’m carnivore, I’m not eating that.”

“Oh, come on.” 

Charles Eide: Oh, 

Dr. Paul Nystrom: it’s- “Oh, it’s just, it’s just whatever.” … so true. Right? So you’re, again, you have to navigate that every day. So the, the food is actually addictive because of how it hits your, the pathways in your brain. The social pressure is huge. It’s everywhere. It’s cheap. Yeah, it’s a constant monster to have to battle that, right?

But if you can get… Like, I’ve gone more, I w- like I’ve had, my diet’s evolved over like 20 years. Um, and it’s now, it probably 90% of the time I eat ground beef with kaas cheese. Like, I enjoy the taste of it. I could eat it every day. 

Charles Eide: I mean, it sounds pretty yummy. 

Dr. Paul Nystrom: It’s, it’s boring, but… And it’s the fatty, don’t buy the lean stuff, right?

Charles Eide: You want the fat. 

Dr. Paul Nystrom: Yeah, the fat’s good for you. So eat the fats, like the 80/20. Don’t go to the grocery store and buy the 93/7, like the lean stuff. It’s more expensive and it doesn’t taste as good. It’s not as good for you. So there’s no point in eating the lean stuff. So 

Charles Eide: the fat is good for you- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: as long as it’s a whole animal-based fat.

Yeah, 

Dr. Paul Nystrom: a God-made fat versus a machine chemical plant [00:54:00] processed fat. Yeah. 

Charles Eide: So a lot of this is, I mean, almost all of the issues we’re facing today, you believe a lot of them, most of them stem from a bad diet. 

Dr. Paul Nystrom: Yes, absolutely. Yeah. ‘Cause a- again, insulin resistance, like going back to that metabolic syndrome, it’s all from insulin resistance and hyperinsulinemia.

So you have high insulin in your blood, the cells don’t respond to it, how your body… Like, the different cells of your brain, what they do, how, how insulin resistant they become. And resistant just means they don’t respond to the signals of insulin, right? So it happens different in your muscles and your liver, but you get fatty liver disease.

So, uh, fatty liver disease is vast. Over 90, 95% of the time it’s either too much alcohol or too many carbs. And I see fatty liver disease on lots of patients. So I’m CT-ing everybody with abdominal pain regularly in the ER. Maybe they don’t have an acute problem like appendicitis or a bowel obstruction that needs a specific treatment, but the, the CT comes back with hepatic steatosis.

That means fatty liver. That’s a precursor to all these other downstream things. And people don’t get all those things of metabolic syndrome. You don’t [00:55:00] get them all at once. Like for, like take my, my family for example. My dad had… He always had high triglycerides, low HDL, a little bit of abdominal obesity, but he never got diabetes or hypertension.

My mom on the other hand, she’s got hypertension. She doesn’t have high blood sugar. She’s not fat. Uh, her lipid panel’s okay. So she’s got a couple of them. He had a couple. They don’t hit everybody at the same time, and you don’t get all of them. Eventually some people get all of them, but you get a few of them.

But precursors to that are insulin resistance, and, like, fatty liver is a precursor to that. So if you have fatty liver, when I see you I’m like, “If you don’t do anything, this is gonna get worse.” Like, other things are coming your way, and you can reverse it in as little as, like, three months. There was a study done in 2009 with…

They, um, they took Richfield firefighters, uh, and they put them all… They measured their abdominal fat and their… So their visceral fat, ’cause the fat around your middle is much different than the fat that you carry on the rest of your body. It’s metabolically more unhealthy. 

Charles Eide: This is the stuff that’s behind your muscle wall, inside- 

Dr. Paul Nystrom: Yes, around your-

your body cavity Yes. Yep. So it’s very different than just the fat on your butt or your legs or [00:56:00] anywhere else. So they measured, um, their liver fat and their abdominal fat with MRIs and put them on a low-carb diet. A bunch of them lost a ton of weight. I think one… It’s ma- This was a news article many years ago, and one of the guys lost, like, 60 pounds, which is, like, the equivalent of the gear that he carries when he goes into a fire, right?

And then they measured them again after three months, and they all had improvements in their liver fat and their abdominal fat in as little as three months just going on a low-carb diet. So you can reverse fatty liver, but you gotta make some changes there. And I see plenty of patients when I talk to them about they either have fatty liver or they’ve had labs and, like, their blood sugar’s a little bit high in the ER.

I’m like, “Okay, so are you diabetic or pre-diabetic?” They’re like, “Oh, I’m pre-diabetic.” And I say, “Well, what are you doing about that?” Nothing. It’s just accepted like, “Oh- I’m 

Charles Eide: stopping at the fast food joint 

Dr. Paul Nystrom: on the way 

Charles Eide: home, 

Dr. Paul Nystrom: man. Yeah. They don’t- I’m hungry … and, and I don’t know that if they… And I don’t know where the disconnect is, ’cause I don’t, I don’t think primary care providers are bad, but I don’t know, the, the patients I talk to often don’t have an appreciation for pre-diabetes.

Like, if you have pre-diabetes and you don’t change anything, it will become diabetes. Like, you can’t… [00:57:00] It’s not like it’s just gonna stall out. What 

Charles Eide: tells you you have pre-diabetes? Is that in 

Dr. Paul Nystrom: a blood panel? It has to do with… Yeah, the… Typically, it’s tested with an A1C, which measures your, like, it roughly an average of, like, your last three months of blood sugar, and the cutoff, I believe, is, like, 5.7, so less than 5.7 is normal, 5.7 to 

Charles Eide: hopefully is- How can they see your trailing three months of it with one blood test?

Dr. Paul Nystrom: Uh, it has to do with, um, the glycation on the red blood cells, and I, uh- So they 

Charles Eide: can tell the last three months this is what stuff’s been like- 

Dr. Paul Nystrom: Yes … 

Charles Eide: on 

Dr. Paul Nystrom: the A1C. It’s not, it’s not perfect, and there’s debate about how useful it is, but generally speaking, it, it’s a decent enough test. And that one commonly gets checked.

Like, say you go to your physical once a year. You’ll probably get a lipid panel, and you get an A1C. Those are pretty typical. 

Charles Eide: Blood tests. 

Dr. Paul Nystrom: Blood tests, yep, and you get those because that’s what insurance pays for, and that’s what the standard of care is. What they don’t often check, and I’ve read more and more lately from the people that I follow about fasting insulin, ’cause your fasting insulin can be up five, maybe 10 years, so, like, there’s a warning sign that this was going awry.

Charles Eide: You’re [00:58:00] saying fasting glucose? 

Dr. Paul Nystrom: No, fasting insulin. 

Charles Eide: Insulin. 

Dr. Paul Nystrom: Yeah, ’cause your insulin can be super high. You d- you, your glucose stays under control because your insulin is so high. 

Charles Eide: Mm. 

Dr. Paul Nystrom: Right? And that can go on for five, 10 years, and eventually, then the insulin, like, craps out, like can’t keep up, and now your blood sugar starts to rise, and now we pick it up with an A1C or, like, a fasting blood sugar.

But we knew this was coming. We could have known this was coming, but fasting insulin is not regularly checked by primary care. Insurance doesn’t pay for it. It’s not standard of care. It’s not part of the deal. So we could be checking this, we- years. ‘Cause like when, when I di- diagnose somebody with diabetes, like for the first time, and I had a guy just, uh, in my last couple of weeks I had a guy, um, blood sugar of like 360.

Charles Eide: Oof. 

Dr. Paul Nystrom: And he’d had a 380-something in clinic a week before. 

Charles Eide: And for context, normal’s like 90 to 100? 

Dr. Paul Nystrom: Yeah, like to, like 100 to 120 maybe. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Yeah. And it’ll spike at, depending on what you eat, but yeah. Much- But if 

Charles Eide: it’s fasted… 

Dr. Paul Nystrom: Yeah, like you shouldn’t be in the 300s. So this guy’s in the 300s, and he didn’t [00:59:00] have other electrolyte abnormalities, which is called DKA, when your like diabetes gets really out of control and you need to come in the hospital, you need IV fluids, insulin.

There’s a whole, whole thing with that. So he just has sort of isolated high blood sugar. Um, and he had had a lab a week before, and the doc hadn’t really told him about it. So, and then I, and I ordered an A1C, which doesn’t come back in the ER, but I do it. When patients like that, I’m like, “Okay, so your doc, when they follow up, this will be available.”

His A1C was 13. 

Charles Eide: What 

Dr. Paul Nystrom: is normal? And like, again, like 5.7- 

Charles Eide: Oh, 

Dr. Paul Nystrom: fuck … or less would be normal. So he runs around, he’s been running around with a high blood sugar for a long time. 

Charles Eide: And- Is he a heavy guy? 

Dr. Paul Nystrom: He’s a bigger guy, yeah. Uh, but again, like had somebody checked a fasting insulin on him two years ago, three years ago?

‘Cause your body’s already getting wrecked. When that process is going on, the hyperinsulinemia and insulin resistance, if you’ve had a high fasting insulin for decades, that’s already causing damage to your blood vessels, putting you at higher risk for cardiovascular disease. But we didn’t check that, right?

So we’re way be- Like, okay, you have diabetes now. It’s not like you just started damaging your body now. [01:00:00] This has been smoldering for at least months, probably years, maybe a decade. 

Charles Eide: And is this something you can feel? Like you can tell, like can I look at symptoms? 

Dr. Paul Nystrom: No. 

Charles Eide: No, that guy, um, I mean, like when- Or is it like, no, you have to have a blood test to tell you that

Dr. Paul Nystrom: when your blood sugar gets really high, yes, you can. Like you’re like super thirsty and you’re peeing a lot, because your kidneys can only process so much glucose that you eat. And so if you start spilling glucose into your urine, then it makes you pee more, it makes you more thirsty. So like when that happens, uh, you can, you can tease that out.

Um, this guy was probably just, like he didn’t feel well. And I had another, a similar guy who had very high blood sugar who’d had all kinds of weird symptoms, just like not feeling good, dizzy, lightheaded. And he got a big workup and didn’t find anything else. Like yeah, it’s probably been, you’ve probably been cycling really high between your blood sugars being really high, coming down with the insulin, and that’s probably contributing to why you’re feeling so crummy.

Charles Eide: So you’re a fan of getting blood tests freq- like regularly? Like is it, is it a good idea to go d- I know I do it twice a year, but- 

Dr. Paul Nystrom: Yeah. Great … 

Charles Eide: you know, do you think, do you think [01:01:00] everybody could 

Dr. Paul Nystrom: It depe- yes, no- Like, don’t- Like, I don’t know if you get them every year, but, like, the fasting insulin I think is one that people should get.

If you have, um, obesity or you’ve been told you had high triglycerides or any of those things or high blood pressure, like a fasting insulin would tell you… That’s a, that would be a good screening tool even if you’re asymptomatic, probably more so for those people because they think they’re fine, but you don’t know.

So checking that one is very reassuring, like, okay, you’re still doing all right. But if that one’s high way before we see the other ones, you could start doing something about it way back then, right? Before all the stuff accumulates. 

Hormones, Blood Tests & Preventive Health [1:01:34]

Charles Eide: If I wanted to have a blood test done and just get a general baseline understanding of how I’m doing, what things should I ask for in a blood test?

Dr. Paul Nystrom: Uh, I would- 

Charles Eide: You, you mentioned lipids. 

Dr. Paul Nystrom: Yep. I would do an ad- like if I had my way, I would do an advanced cardiometabolic panel, ’cause a- again, the LDL doesn’t tell the whole story. So there’s other things like LP little A or ApoB. They’re like some other markers that go along with LDL [01:02:00] cholesterol, so those are good to check.

The fasting insulin, a hemoglobin A1C, those would all be good to check. 

Charles Eide: What about hormones? There’s a lot of talk about hormones. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Checking hormones? 

Dr. Paul Nystrom: Yes, that’s a good idea as you get older. Uh, there’s been a big push for a long time that we shouldn’t, nobody should be on hormones, and I think that’s, it’s changing, but very slowly, and it’s not standard of care with big medicine.

And the change is that even when research comes out with just anything, not related to hormones, but just anything, there’s like a 5 to 15-year lag with some data that actually should change practice before it actually becomes like a change in the guidelines, a change in the standard of care. There’s a huge lag.

So, um, that- 

Charles Eide: The standard of care is 15 years behind what the science is saying. Yeah, 10 

Dr. Paul Nystrom: to 15 I think is what I’ve, I’ve read. 

Charles Eide: So, so I wanna talk more about hormones really quick because I wanna understand, there’s all this talk about, uh, HRT, right? Yep. Guys getting on testosterone and- Yep … gals getting on estrogen.

And I’ve heard recently that [01:03:00] the estrogen myth is that estrogen does not cause an increase- No … in breast cancer. 

Dr. Paul Nystrom: No. 

Charles Eide: But that’s what people have been told for a long time? 

Dr. Paul Nystrom: Yes, and it, it just the, the data was very skewed, and I don’t, I’m not an expert on the, the details of it. But the, the long story short is that, yes, like the data wasn’t great.

It got pushed out that, yes, you shouldn’t be on hormones at all ’cause it’s gonna increase your risk of cancer. Um, but that’s not the case. So if you’re on hormones- And so it actually protected, like for women in like perimenopause, being on hormones, if they’re getting them dialed in, protects you from osteoporosis, protects you from Alzheimer’s, protects you from heart disease.

So there’s been generations now of women who have never had this stuff because we told, “Oh, cancer, just shut it down. Nobody’s doing this at all.” But now we see all the downstream effects of that and women that are dealing with all these other issues that potentially could have been prevented had they been on appropriate hormones.

And for guys, there was a push like, “You can’t be on hormones ’cause you’re gonna get prostate cancer.” The studies on that are also, were not that good. So 

Charles Eide: yeah. So if someone needs their [01:04:00] hormones tweaked or looked at or whatever- Yeah … is there an i- indicator in my life that would tell me Whether or not I should look into that.

Like, would I feel a certain way as a guy? 

Dr. Paul Nystrom: Sluggish, brain fog, putting on more fat. 

Charles Eide: Bad sleep. 

Dr. Paul Nystrom: Yeah, bad sleep. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: But it… And, like, it’s a mix, right? Because a lot of these things could be, could be made better without tweaking your hormones, actually going on, like, TRT. 

Charles Eide: Hmm. 

Dr. Paul Nystrom: Right? So, like, I’ve been… I teach public safety about health, and I’ve been doing this since 2009, and my big buckets are nutrition, sleep, exercise, and community, right?

So if you’re sleeping terrible, going on hormones, like, right, like, it’s sort of the, it’s the end option. But if your sleep is terrible and you’re eating a processed food diet, uh, you don’t get any exercise at all, you don’t have any community in your life, you don’t have any purpose, you’re not doing other healthy behaviors, getting sunshine, getting vitamin D, and then you’re just gonna throw hormones at it, like, that’s not gonna fix the problem.

Like, you… There’s plenty of things you [01:05:00] could do, uh, to, like, make your life better and make your health better before you have to actually go on hormones. 

Charles Eide: No, there’s a 

Dr. Paul Nystrom: lot 

Charles Eide: of- And then- Go ahead. 

Dr. Paul Nystrom: And then there’s, there’s folks that, like, do actually have that dialed in, and maybe they’re still having issues, right?

So they are actually sleeping good. They eat a pr- a whole food sort of diet, whether you like, again, plants or animals. I think the animals are better, but at least you’re not eating processed food, right? You’re getting exercise. You’re getting vitamin D, sunshine. You have community. You have purpose. Like, you have relationships, like, all of that, and you’re still maybe need some tweaking with hormones.

That’s an option, too. But jumping to hormones, which are happening with, like, all the… There’s clinics popping up all the time. People are just, “Oh, we’ll check your hormones and give you this.” Yeah, but you still have to deal with the behavior stuff underlying that. So, and then 

GLP-1s, Ozempic & Weight Loss Drugs [1:05:41]

Dr. Paul Nystrom: same with- 

Charles Eide: Fix the diet, too.

Dr. Paul Nystrom: Yeah, for sure. You have to fix that stuff first, and maybe you still need hormones. Maybe you check them and your hormones are low, and you do need some tweaking there, but you still gotta get the other stuff done first. And they’re, they’re, like, much easier th- not… They’re simpler things. Maybe not easier.

Simple and easy are not the same, right? Like, they’re a simple thing. You need to eat better, [01:06:00] sleep, exercise. Those things are not easy as, as we’ve talked about with eating in particular, but you gotta get those things dialed in first. So in the same way, like the GLP-1s, I’m not a fan of the GLP-1s. Hmm. I see, and I have a bias and I tell patients this, like I’ll come in and talk to patients, they cause abdominal pain, they can cause bowel obstructions, gastroparesis where your stomach doesn’t empty, pancreatitis.

Uh, they cause all kinds of issues, and I see the population that they’re not working for. Do they work for some people? Are they standard of care? Yes. Will they help control your glucose if you have diabetes? Yes. Will they help you lose weight? Yes. But 40% of that weight loss is thought to be lean muscle mass, and about 60% of patients get off them in two years, right?

So if you don’t stay on them, you will gain weight back. And everybody knows as you get older, what, what’s easier to build, muscle or fat? 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Nobody’s putting on muscle when you’re 60 years old, 70 years old, right? ‘Cause you have to eat a lot of protein and you have to have actual resistance training to build muscle.

So, and when you’re on those, you’re, you have like low-level nausea. People are like, “Oh, I don’t have an appetite.” That’s [01:07:00] ’cause you’re kind of nauseated. Like it’s on a spectrum, right? You’re not puking, but you’re like, “I don’t wanna eat.” So to use them at lower doses, which some like high-end clinics do, like you put on a low dose of that, but you also…

I think the, the best use for that stuff is at lower doses and you have to have habit forma- or habit changes to go with that. So I mean, if you’re 600 pounds and like you, you’re just stuck, going on that to like start to get some wins and like actually… ‘Cause mentally then you feel better like, “Okay, I’m actually losing some weight,” right?

You start to build this pathway of like some wins which helps you. Um, but the average person who’s on them, like the Ozempics and the Wegovys that I see, they’re on like their standard dose Uh, and then they’re, they’re gonna be losing muscle, and they’re not hungry. So even though maybe- 

Charles Eide: Why are they losing muscle?

Is it ’cause they’re just not eating enough protein? 

Dr. Paul Nystrom: Yeah. You have to eat… You have to have resistance training. You need enough protein to do that. But when you’re on those- Yep … nobody’s reaching for a rib eye when you, when you’re hu- you’re not hungry. And if you are hungry, you’re gonna have a snack. And what are snacks?

Charles Eide: Carbs. 

Dr. Paul Nystrom: Processed food and carbs, right? So it’s very difficult to eat enough [01:08:00] protein and work out enough to maintain your muscle mass on the standard doses of those medications. 

Charles Eide: So if someone’s 600 pounds or 400 pounds- 

Dr. Paul Nystrom: Yep … 

Charles Eide: and they need to get some quick wins, it’s far better to see them start using a GLP- 

Dr. Paul Nystrom: Potentially, yeah

Charles Eide: to help them get it going. Yes. But they need to fix the underlying issue- Yeah, 

Dr. Paul Nystrom: for sure … 

Charles Eide: of w- their habits. 

Dr. Paul Nystrom: Yeah. ‘Cause often, again, people don’t stay on ’em. Either they can’t tolerate the side effects ’cause they’re always feeling nauseated or they have stomach pain, or they can’t afford ’em. Their insurance switches.

They get a different job, and now it’s not covered. So they’re gonna end up off ’em, and when you’re off ’em, you’re gonna gain back fat. ‘Cause 

Charles Eide: you didn’t fix the habits. 

Dr. Paul Nystrom: Yeah. So now you’re weaker and fatter than you were before, and muscle mass into old age is a huge piece of longevity, right? Again, trying to pr- so if you have better muscle mass, less likely to fall, likely to recover better if you do fall and break something.

So there’s layers of, of that, so. Yeah. But now you’re just… You’re bigger than you were, and you’re weaker than you were before. Hmm. That’s just a set… That’s just a recipe for going into a nursing home much younger. 

Charles Eide: It’s a setback. 

Dr. Paul Nystrom: Yeah, 

Charles Eide: for sure. Big setback. So back to the hormone [01:09:00] conversation. You’d mentioned vitamin D, which I think we’ve all heard over and over again, especially in climates like Minnesota.

Dr. Paul Nystrom: Yeah. 

Charles Eide: You need vitamin D. You need vitamin D ’cause it’s a precursor to making the right hormones. 

Dr. Paul Nystrom: Hormones. Yeah, for sure. 

Charles Eide: Is that true? 

Dr. Paul Nystrom: Yeah. And- 

Charles Eide: And, and how do 

Dr. Paul Nystrom: I 

Charles Eide: know if I’m taking enough vitamin D? 

Dr. Paul Nystrom: Um, you’re probably not. Like, you gotta get sunshine, right? Sun- sun is not killing us. You gotta get sunshine.

Um, you need to get your labs checked, but the range is very wide, and there, there’s argument that even the what’s considered the normal range should be set higher. So even if you check ’em and you’re on the low end or low end of normal, like you should be pushing for the higher end of whatever lab you’re using.

And I don’t remember the numbers off the top of my head, but we should be 

Charles Eide: higher. So taking enough vitamin D, maybe take a little more than they suggest. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: And then what about magnesium? ‘Cause I added that in, and that’s been huge for me. Yeah. But what are your thoughts on taking magnesium? 

Dr. Paul Nystrom: It’s good for…

It can help with sleep. So yeah, in general it’s, it’s good. 

Sleep, Sunlight & Small Wins [1:09:55]

Charles Eide: And bringing up sleep, how important is sleep? 

Dr. Paul Nystrom: It’s huge. So one of my [01:10:00] friend, uh, Kirk Parsley’s a good buddy of mine. He was a, a doc. He was a SEAL, then became a doctor and took my job, uh, when I got out of the Navy. And he worked with the SEALs changing…

getting those guys off Ambien. Uh, again, fixing their, their baseline metabolic things with, like, basic stuff. Sleep is his biggest piece. Um, and we’ve had this conversation ’cause I’ve talked about nutrition for a lot of years when I’d do education for public safety. And many years ago we had a conversation, and he would argue, I think probably still, that, like, sleep is more important than nutrition even.

So it’s huge. Uh, and all the ways that we, like, the Ambiens, the Lunesta, all the medicines we put people on to sleep, they’re not… You’re not actually getting good sleep. It messes with your sleep cycles. Alcohol messes with your sleep cycles. Like, have you ever… I know you gave up drinking a while ago, but if you ever measured your sleep and your HRV- It’s horrible

your REM sleep. Yeah, guaranteed. Everybody that I read… I d- I wore a Whoop for a long time. Uh, yeah, like you get objective data, like you drank yesterday, you said you drank yesterday, and now your HRV sucks, your REM sleep is 20% less, your deep sleep is this much [01:11:00] less. So yeah, n- anything that we take to help sleep, uh, messes with your sleep cycles.

Charles Eide: How much sleep do I need? 

Dr. Paul Nystrom: Eight is a good standard, more or less. Some people do a little more or less, but eight’s a good goal to shoot for. Yeah. 

Charles Eide: And if someone has trouble falling asleep, I know there’s been a lot of controversy around using melatonin. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Is that… Is melatonin bad? 

Dr. Paul Nystrom: I think it’s a reasonable choice.

I haven’t, I haven’t dug into, like, lately the, whatever’s the latest on it, but, um, it can help if you’re having trouble falling asleep, but assuming you don’t have enough melatonin. I’ve tried it ’cause I work, I only work night shifts in the ER, so I have a week where I’m on nights, and then I have a week where I’m on daytime hours, and I’ve tried to use it, but it doesn’t seem to be, consistently help my sleep, and I don’t know if my melatonin is already okay, so, like, adding more is not changing anything.

So- All of this- … it’s a reasonable, it’s a reasonable thing. Certainly before you would go to the Ambiens and all the, the other stuff. And I see people all the time that come to the ER with insomnia, and they’re on, they’ve been on this and that and [01:12:00] Seroquel and just endless lists of meds, and all that stuff is messing with your sleep cycles, so.

Charles Eide: It seems like all of this is pointing to one thing, and that’s personal responsibility for your own health, and then eating better. 

Dr. Paul Nystrom: Yeah, absolutely. 

Charles Eide: And eating better means eat less sugar, less carbs, less refined everything. 

Dr. Paul Nystrom: Less processed 

Charles Eide: food. So really what they’ve been saying this whole time. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: E- eat healthy and exercise.

Dr. Paul Nystrom: Yeah. But healthy, when I talk to patients about the word healthy, what do they… I have to pin them down because- Yeah, let’s do it … that’s not a sp- that’s not a specific term. ‘Cause I’ll ask patients, and often they say, “Oh, I cut out red meat.” Like, w- that’s the exact opposite of healthy in my mind, right? But that’s what we’ve been told.

There, there’s still- Why do you think they tell us to stop eating 

Charles Eide: red meat? There’s still- Oh, it’s, uh, meat is bad for your heart. 

Dr. Paul Nystrom: Yeah. They were going back to the cholesterol, the saturated fat, bad for the planet. Like, the e- it’s just endless attack on beef when it’s, it’s one of the healthiest things we can eat for sure.

Charles Eide: Yeah. I mean, it’s pretty much all you eat. 

Dr. Paul Nystrom: Yeah, 90% of the time. I mean, I, I enjoy special occasions. I’ll have… Key lime pie is my [01:13:00] favorite if I go out to a fancy restaurant. You know, I’ll have key lime pie or cheesecake, but that’s not my norm. My norm is meat and dairy. 

Charles Eide: So what’s something I can do today That may not be a big step to fix all these things, ’cause most of us are probably doing a lot of things wrong.

Dr. Paul Nystrom: Yeah. 

Charles Eide: But what is, like, one simple thing? I know you gave me the carnivore thing, and that was a… That’s really hard to do. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Right? That’s, that was not easy to do, and after this conversation, I’m going back on it hard. I’m so excited. Uh, but what is something easy that I can do today, starting today, on a regular basis that will make…

That’s not, not a lot of work, but will change my outlook? Give me something little. 

Dr. Paul Nystrom: Some little. To change your outlook? 

Charles Eide: Yeah, no, to make me healthier. To get me to stop eating crap. 

Dr. Paul Nystrom: Don’t buy it. Like, changing your environment is one of the biggest things. Like, you’ve read James Clear’s Atomic Habits. You’ve probably heard of it.

Charles Eide: Such a good 

Dr. Paul Nystrom: [01:14:00] book. Right? Like, the environment matters. So if it’s in your house… Like, I don’t have any- I don’t buy anything in the grocery store. I have, I have the willpower in the grocery store to not buy anything that I, that’s not good for me, so it’s just not in my house. So even if I have a craving now and then, like I like salt and vinegar chips, I could eat a whole bag of those.

I don’t buy them ’cause if they’re in my house, I’ll eat them. So changing your environment, and that has to do with your sleep. Like, you need to have a good sleep environment. I’m sure you’ve had people talk about, like, dark, cold, and quiet, uh, winding down before you go to bed, not too much alcohol or no alcohol, cutting off caffeine midday, right?

So, like, all those things are little tweaks so that you’re gonna sleep better tonight. Um, the environment that you- whatever you eat, again, not, not having it in your house is a big step. Planning to get some exercise, getting sunlight first thing in the morning, that’s huge with sleep. Like, if you get some sunshine in your eyes early in the day, even when it’s cloudy, um, getting outside, going for a walk in the morning, that’s huge ’cause it sets you up, the, the way your hormones and the melatonin sets you up to sleep better later.

So again, they’re just small things, but they, they stack on each other. Like, you start doing some [01:15:00] small ones and you get some wins and you feel better and it, and it builds, so. 

Charles Eide: Yeah, for the sunlight thing, ’cause we live in Minnesota and it’s so dark in the winters- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: I started using a red light therapy panel- Okay

as my, like, you know, fake sunlight- Yeah … in the morning, and it, it does make a big difference. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: I mean, it wakes you up. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: It’s pretty crazy. So the, the little things that we can do add up to the big things. 

Dr. Paul Nystrom: Yeah, for sure. You gotta stack the little wins. Yeah, and it’s gotta be consistent. Like, and it doesn’t…

I think people also get, um… Like, guy- people that know me, when they see me eat something that’s not good for me, they give me a hard time. Like, I’m not a purist. Like, I don’t, I don’t claim to have a perfect diet. I don’t have perfect sleep. I don’t have perfect exercise, but, right, the, the majority of the time, I’m doing good, healthy things, right?

And that’s… People can tell. You can do that for a long time, right? Like, if I, if I see somebody in the ER and, like, we’re talking about eating, and they’re like, “Oh, I drink a, you know, a lot of Pepsi. That means I can never have a Pepsi?” I’m like, “No. [01:16:00] Like, that’s not realistic.” If Pepsi’s your thing, like, it’s probably not gonna be a thing that you…

Don’t leave here saying you’re never gonna have a Pepsi, ’cause then you do, and then you just throw in the towel, and then you chase the Pepsi with a donut and a cake and pizza and… Right? But, so, like, move in that direction with things that you can actually change, and then as you do it more, like, it, it feels better.

And then you start realizing, like, with my eating, like, I don’t do vegetables. Like, every now and then if they’re really tasty, but I’m just not a fan, right? And I feel good when I don’t, so. 

Charles Eide: You don’t do vegetables? 

Dr. Paul Nystrom: No. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: I think they’re overrated. The whole, like, the five a day for better health, you’ve heard that, right?

Charles Eide: Yeah. 

Dr. Paul Nystrom: It w- that goes back into, I believe it’s the ’90s, and it was more or less a marketing campaign in California by a bunch of, like, produce growers and food people that wanted people to eat more. There’s no science at all behind the five a day for better health. Nothing. But everybody’s heard that, like, “Oh, you gotta get five fruits.”

There’s no science whatsoever to say that that’s healthy. But it’s been so pushed on us that you have to get your fruits and vegetables, and fruits and vegetables are just not as nutrient dense as animal products are. So [01:17:00] 

Charles Eide: You said the environment. I think a lot of, a lot of normal humans live with other people.

And so what do you say to someone who wants to maybe get their act together here? 

Dr. Paul Nystrom: Yep. 

Charles Eide: But they, you know, they, they give you- they’re given a grocery list of like, “Hey, I need you to pick up Cheerios and donuts, and grab those croissants and the jelly,” and- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: you know, I, I mean, is this, how, how do you get around that when you live in an environment where, you know, other people…

Maybe you’re married to someone who’s seemingly looks healthy, maybe they’re skinny fat or whatever. Yeah. Right? And they’re like, “No, I like my croissants,” and you do too, but you wanna change. Yeah. Are there things you can do to help get on course for yourself? 

Dr. Paul Nystrom: Yeah. That- that’s much harder. 

Charles Eide: I buy the chicken nuggets for the kids, not for me.

Dr. Paul Nystrom: Yeah. 

Charles Eide: At 11 o’clock at night pounding chicken nuggets. 

Dr. Paul Nystrom: Yeah. I would say with kids, like lean towards the [01:18:00] whole foods. So give them… You can give them choices. Like, my kids are older now, but y- like you give them choices, but either choice, like you’re fine with either one, right? 

Charles Eide: Do you want chicken or you want beef?

Dr. Paul Nystrom: Yes. And you want some veggies. How about lamb or beef? And, like, kids are gonna wanna eat the starches, the macaroni and cheese or the pasta, but if you, if you’re serving for a family like that, like tend for- tend towards smaller servings of the stuff that’s bad. They still get some, but push the stuff that’s, that you’re fine with them eating.

So you can, you can still steer that as opposed to having like, we’re gonna make a little bit of meat, everybody gets a little bite, and we have a huge pot of mashed potatoes. 

Charles Eide: Mm. 

Dr. Paul Nystrom: Right? Like, okay, well, let’s make a small helping of this, so when that’s gone everybody gets some, and it’s gone, okay, we still got lots of roast left.

So those are your choices. Like, right? So you can steer it, or the vegetables. 

Charles Eide: Oh, you’re still hungry? Here’s some more roast. 

Dr. Paul Nystrom: Yeah. Yeah. So yes, it’s, it’s much harder with- I think a lot 

Charles Eide: of times 

Dr. Paul Nystrom: we use- … with the 

Charles Eide: environment … our kids as an excuse, you know? 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Oh, no, they’re never gonna eat that. 

Dr. Paul Nystrom: But yeah, but kids are gonna take donuts over a roast most of the time, but if donuts aren’t an option, which goes back [01:19:00] to the environment, like depending on what you buy, you don’t have to have all that in the house.

You can, you can make some shifts like, okay, we’re just not buying that thing ever. Like Pop-Tarts, like you don’t need Pop-Tarts in your house, right? Like, your kids might like them, but if they’re just never there, you’re steering to, okay, well, it’s gonna be you want breakfast, bacon and eggs is gonna be better than your Froot Loops.

So you can, you can- I guess I’ll 

Charles Eide: take more bacon, Dad. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: Most kids like bacon. Bacon and eggs- Oh, 

Charles Eide: yeah … 

Dr. Paul Nystrom: yeah. Yeah. So you gotta steer the, get the small wins and steer them to something that’s a better choice. So- 

Charles Eide: Yeah. We, we have chickens at the ranch, you know. Yeah. And I’ve given you eggs- Yeah … many times, but the eggs are like a big staple for us.

Yeah. ‘Cause it’s like, do you want eggs for breakfast or eggs with butter for breakfast? 

Dr. Paul Nystrom: Yeah, those are your choices. Yes. With a side of bacon or a side of leftover steak from last night? 

Charles Eide: What about, like, shredded cheese? 

Dr. Paul Nystrom: Not as good as regular stuff. Yeah 

Charles Eide: If you’re gonna shred it, shred it yourself off a block?

Dr. Paul Nystrom: Yeah. Yeah. It’s pretty processed to get so that it doesn’t stick and everything that goes into that. Like, I haven’t dug into the weeds of it, but [01:20:00] I would go the more whole, the less processed, right? It’s not like I don’t eat processed food. Like, cheese is processed, right? Like, everything is processed to some extent, but the less processed it is, the better off for you.

And like, even if… Like, I talk to patients, like they don’t… Maybe they’re like, “I just don’t like red meat.” Like, okay, well, still steering anywhere away from processed food is a step in the right direction. So whether it’s chicken, turkey, pork, seafood, whatever your… Whatever it is. Even… And if you like the vegetables and that’s your thing, but less processed is better.

The Broken Medical System [1:20:29]

Charles Eide: So from a guy that’s in the ER talking to somebody who hasn’t yet visited the ER for a, a chronic issue that’s been there, and they all of a sudden have an emergency like a heart attack- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: people who think it’s, it’s, you know, “It’s too late. I’m too far gone. I’m just gonna keep my habits,” what do you say to somebody who, who says, “I’m just too far gone”?

Dr. Paul Nystrom: And if you’re 80 years old, you’re probably right. Like, making huge changes at 80 years old is probably not gonna s- if you already [01:21:00] have a stacked up medical problems of all of these things, you’re probably not gonna make a huge change. And I have this conversation with my own mother, and I have it with patients because we’ll have some conversation.

Maybe their blood sugars are still running high, their, their blood pressure runs high, which again is all insulin resistance. And so I give them a bit of a spiel that I’m like, “You’re 85 years old. You’ve earned the right to do what you want,” right? So like I, I acknowledge that, like, no- somebody who’s 85 is not gonna make a huge switch to this.

Like, they’ve done this for that long in their life, they’re gonna die of something. It’s probably gonna be heart disease, Alzheimer’s, cancer, like a neur- neurodegenerative disease of some kind, so… But people that are younger, especially in their 30s, 40s, I think a lot of people in that age have already resigned themselves that they’re gonna be like, “I can’t do anything about this,” which is not true.

Like, when you’re young, you can still make some big changes, and I think the bar gets lower and lower that people just accept… Everybody throws out, “Oh, it’s genetic.” Okay, well, there’s genes for all these sorts of things, but there’s very few genes that make you have a thing for sure. Like, you may be more predisposed to have something, but like, Huntington’s disease, an example.

Like, if you [01:22:00] have that gene, you get Huntington’s disease. That’s a devastating disease. You don’t really have any way around that one. But there’s very few diseases that are like that. Like hypertension, diabetes, heart disease, AFib, all these other things, obesity, they’re all modifiable. You ha- probably have some genes that make you more or less susceptible to them, but they are modifiable.

So just throwing in the towel at 35 years old and saying, “Oh, everybody in my family’s big. I’m 250 pounds at 5’7″, it’s genetic.” No. Like, you can make some changes. Like, you can, you can still change the trajectory of this thing. If you just throw in the towel and accept it and just figure, “Well, I’m not 300 pounds like my neighbor, so I’m good,” well, 250 at 5’7″ is not good, right?

So yes, you can still make a big dent, but yeah. Early on- So it’s never 

Charles Eide: too late, 

Dr. Paul Nystrom: really. No. 

Charles Eide: No. I mean, I’ve seen people in their 60s, 70s that change their lifestyle, and they lose a ton of weight, and they look great. 

Dr. Paul Nystrom: And they feel better, and mentally they’re better. 

Charles Eide: Yeah. 

Dr. Paul Nystrom: They’re functioning higher. Yeah.

Charles Eide: Gives them more time with the grandkids. 

Dr. Paul Nystrom: Yeah, for sure. Yeah, at some point, there’s probably a it’s not gonna matter. Your 80s, you’re probably [01:23:00] not gonna make a difference, but short of that, like yeah, making some changes can be helpful. 

Charles Eide: You know what I have noticed? My dad, he’s 88, gonna be 89 next week, this week, and lived a long, great life.

Now, he’s had health challenges, but what I have noticed, and he’s got a little bit of dementia starting. Yeah. He is far more clear mentally Then he, if he’s eating clean- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: but if you give him a cookie after dinner, I’m not kidding, that sug- something, that sugar does something, and it tips him into this other world.

There’s something about when he has a little bit of sugar, or let’s call it a lot of sugar- 

Dr. Paul Nystrom: Yeah … 

Charles Eide: it changes him dramatically, like, for the rest of the day. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: He’s not diabetic. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: Isn’t that crazy? 

Dr. Paul Nystrom: Yeah. 

Charles Eide: I don’t 

Dr. Paul Nystrom: know. And it has to do with how the glucose and the insulin resistance in the brain. Uh, some people call Alzheimer’s Type III diabetes.

So there’s… And there’s growing evidence of, like, a keto diet for all kinds of [01:24:00] brain issues from, uh, Georgia Ede and Chris Palmer, both out of, I think both out of Harvard, have written books on it, have talked about it. It’s been on social media. But things like schizophrenia, bipolar, anxiety, depression, uh, Parkinson’s, Alzheimer’s.

There’s growing evidence, and the, the ketones, as we talked about earlier, like a, a different fuel source, they’re a much more stable fuel source. So the sugar going up and down, getting into your cells can be quite variable. But if you’re in ketosis and just burning fuel, it’s a much more steady fuel source.

Yeah. In the same way, like, hangry. Again, like, if you’re in ketosis, you don’t get hangry ’cause you have a steady fuel source, so you feel fine. You just, you’re fine. So yeah, there’s growing evidence for, for people with neurocognitive stuff like that, that ketosis would not be a bad idea. Again, hard to do.

At 88 years old, he’s probably not gonna go into ketosis. He’s probably not gonna eat a ketogenic diet. But yeah, there’s something about what you’re, what you’re seeing- Just like 

Charles Eide: a kid, maybe if that’s all there is. 

Dr. Paul Nystrom: Yeah. But what you’re seeing doesn’t surprise me that, 

Charles Eide: yeah. That’s interesting. 

Dr. Paul Nystrom: Is he on a statin?

Charles Eide: No. 

Dr. Paul Nystrom: Those cause neurocognitive decline. Yeah, 

Charles Eide: we got him off 

Dr. Paul Nystrom: those. There’s people that- He was 

Charles Eide: for a while … 

Dr. Paul Nystrom: there’s people that, [01:25:00] I think that gets- 

Charles Eide: Well, that’s like Bruce Willis was on statins, I think, and his, he’s got full-on dementia now. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: I, I mean- 

Dr. Paul Nystrom: Yeah, there’s, I think there’s growing evidence of like the, the, the potential higher risk for diabetes with the statins and higher risk for neurocognitive decline.

Charles Eide: Hmm. 

Dr. Paul Nystrom: And I think big pharma downplays that as, “Oh, it’s, it’s not that big a deal,” and I think it’s a bigger deal than, than we’re told that it is. 

Charles Eide: Hmm. 

Dr. Paul Nystrom: Yeah. 

Charles Eide: So much more at play than we all know. 

Dr. Paul Nystrom: Yeah, most of what we’ve been told about health is, is wrong for decades now, from big medicine, big insurance, big pharm, big food.

Yeah. 

Charles Eide: How’s that make you feel as a doctor? 

Dr. Paul Nystrom: It’s frustrating. Yeah. Like, I enjoy taking care of, making people better. Um, but yeah, it’s frustrating. And when I can have… I guess my- when I leave my best shifts, it’s either I got to do something cool or, like, I feel like I had a connection with patients, like maybe I actually sowed some good here.

Like, they were actually receptive to the idea. ‘Cause, like, people with high blood sugar, like, if [01:26:00] they go to clinic, they’re gonna get started on at least a couple medications for their high blood sugar. Like, I’ve seen… I saw a 400-pound dude, um, he came in, he had a bowel obstruction because he’d been started on…

He had, like, new diabetes and 400 pounds, and he got started right away, like, on a GLP-1. And then I saw him within, I don’t know, a month or a couple weeks with a bowel obstruction. I’m like, “Dude, didn’t anybody talk to you about the fact that you could eat better?” And I gave him my spiel as best I can in my limited window of time.

He’s like, “Yeah, I just bought a bunch of steaks from Costco.” I’m like, “There you go, man. Like, eat your steaks.” Like, you could- 

Charles Eide: But steaks aren’t gonna bowel obstruct you. 

Dr. Paul Nystrom: No, not at all. Like, wait till your bowel obstruction gets better. Like, now is not the time to start your steaks. But, but, like, the, a conversation about low carb or lifestyle changes, any of that was not had at all.

It was just, “Here’s a couple of medications.” Like, that out of the gate you get medications, right? And it, I don’t know if we just assume that patients aren’t able to do it. You assume they’re too dumb to do it. Like, I think there’s plenty that would make some changes if you, if they were presented as an option.

But it gets back into, like, the primary care system, which we didn’t go [01:27:00] into so much, but there’s good people there, but the primary care system is a feeder system for hospital systems, right? There’s no money in primary care. It’s like, uh, at Thanksgiving when you go to the grocery store, right, the turkeys are super cheap.

Why does the grocery store do that? 

Charles Eide: All the other groceries. 

Dr. Paul Nystrom: Yes, exactly. So you’re getting a deal on your turkey, but you gotta buy the cranberry sauce and the pie and the sweet potato. Like, everything else, right? Primary care is the same way. Like, they’re a loss leader. The, uh, you’re burning out primary care providers ’cause they have to see more patients ’cause it doesn’t reimburse well, but when that patient, uh, needs their colonoscopy, they’re gonna go to that health system where their primary care is.

When they need their knee replacement from their obesity and arthritis, uh, that’s gonna get reimbursed well. So procedures and surgeries get reimbursed really well. So the primary care system drives business to the hospital system, which makes money on the other things, right? So those poor primary care providers are getting burned out.

They’re forced to see more patients in less time, so they get 15-minute appointments or 20-minute appointments. Uh, and [01:28:00] so if you come into the, the primary care and say you’re depressed and have high blood pressure, are you gonna dig into why you’re depressed? Are you gonna have time to talk about like, “Okay, I have stress- There’s no 

Charles Eide: time

Dr. Paul Nystrom: I have stress with my kids. I have stress at work. This thing’s not going so well. I’m not sleeping well. Maybe I need to talk about it ’cause I’m perimenopausal,” if you’re a woman, “and my hormones are off.” No, you probably get an SSRI. “Here’s a, here’s a prescription for your depression and your high blood pressure.

Why do you have high blood pressure? Well, you’re insulin resistance or insulin resistant, so you probably have all these other things going on, but here’s a medication. Let’s lower your blood pressure. I’ll see you in three months 

Charles Eide: No time to 

Dr. Paul Nystrom: actually do the work Primary care 

Charles Eide: provider, 

Dr. Paul Nystrom: no. And that’s standard of care.

If you have high blood pressure, you get a medication. And the primary care providers are doing the best they can. They’re not bad people, but they have a limited amount of time. They have metrics and standards that, like, if your patients have high blood pressure or if they have diabetes, they need to be on this med.

That’s what the guidelines call for. So which is driven by big medicine, big pharma saying, “Oh, yeah, th- here’s the guidelines. This is what… Your LDL is too high. You need a statin.” And again, [01:29:00] it’s not that simple. Like- 

Charles Eide: Sounds kind of corrupt. 

Dr. Paul Nystrom: Yeah. And I think big pharma’s corrupt. I think that, that, that one’s a hard one to argue with ’cause, like, they’ve paid fines for bribery and, like, going back, you can look up case law and all the things that they’ve been charged with or convicted of.

So yeah, there’s certainly corruption there. As far as the individual level, like, again, I don’t think people are bad. I don’t think primary care providers, I don’t think specialists are bad. Everybody has their window. The primary care doesn’t have time to deal with all the things. Things that become abnormal get kicked to a specialist.

The specialist knows their area of expertise. This other specialist knows their thing. And then, like, it’s just patients get lost in the system because they’re like, they’re seeing this person who said they should do this, but it doesn’t quite jive with this person, but then that information’s gotta get back to primary care, and they have to sort out, well, what’s the best guess here?

Like, I’m, “Well, you should be on this, but it’s gonna cause a problem here,” right? And the limited time that they have with patients, so patients just get lost. And they’re just, “I don’t know what to do. I’m hearing conflicting information.” They do their own Googling, and they [01:30:00] hear that eating a plant-based diet and more fiber is gonna save them.

Like, yeah, okay, maybe. I… So. 

Charles Eide: So really the, the responsibility is in our own hands- 

Dr. Paul Nystrom: Yeah, for sure … 

Charles Eide: to not eat a plant-based diet. 

Dr. Paul Nystrom: Yes. 

Charles Eide: This has been so helpful. This has been amazing. You are w- you’re such a wealth of information. I’m so grateful for it. You have, you’ve helped me tremendously in my journey already.

Good. I can’t… I’m gonna kick in that carnivore mode hard now. I’m excited. I’m gonna go get some steaks this afternoon. 

Dr. Paul Nystrom: Perfect. 

Charles Eide: This is, this is really great, Paul. 

Legacy & Closing [1:30:34]

Charles Eide: I want to ask you one last thing. Okay. And that is your legacy, what do you want to be remembered for? 

Dr. Paul Nystrom: Uh, I thought about this for a long time, not just when you, I knew I was g- you were gonna ask me this, but, uh, making people better.

Like, in all the different people that I interact with through my different jobs, patients, the people I work with, I hope on shift people are happy when they work with me, the law enforcement, the EMS that I get to work with, sharing knowledge, the education that I [01:31:00] get to do. I hope I make people better.

Charles Eide: You totally make people better. Okay. You’ve already done that for me. 

Dr. Paul Nystrom: Well, there’s one, there’s one for me then. 

Charles Eide: Thank you for coming on and sharing. Yeah. I really appreciate it, and I can’t wait to, uh, see where, what the future holds for you. 

Dr. Paul Nystrom: Yeah. We should do this again sometime. I’d love it. So thank you so much.

Charles Eide: Thanks for watching this episode. I hope you loved it. If you did, make sure you subscribe, turn your notifications on, and share it with somebody. If you wanna learn more about me or my company, EideCom, I set out years and years ago to start a production company that did things differently. And today, 23 years later, we produce corporate events that are really impactful for our clients all over the country, and you can find out more at EideCom.com.