Knife Down

"Knife Down" is what a surgeon says in the OR when she puts her scalpel down so no one gets hurt — and it’s the mission here: put the knife down, long before anyone needs to use it. Knife Down is a podcast about how to actually invest in your health so you can live longer, stronger, and with less time in doctors’ offices. The core focus is the world’s leading cause of death—cardiovascular disease—and what to do about it before it shows up as a catastrophe. Hosted by a vascular surgeon on a mission to put herself out of business, the show translates cutting-edge science on prevention, metabolic health, and longevity into real-world strategies you can use in clinic or at your kitchen table. Expect evidence, nuance, and zero wellness hype—plus the occasional dark joke about the state of modern medicine.

Knife Down is a health podcast hosted by Lily Johnston, MD MPH, with 58 episodes on record and a Required Pod Score of 80. PitchCentric scores this show on Booking Probability, Listen Score, and live audience signals refreshed every 24 hours.

Lily Johnston, MD MPH hosts Knife Down, a health show with 58 episodes published.

Our AI reads these to draft pitches. Use them as grounding for a pitch that cites a real guest and a specific topic.

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  Episode #57

  High LDL, Rapid Plaque Progression?! Dave @FeldmanProtocol & I Debate the Data

  Sep 11, 20261h 25mS2026

  Dave Feldman came into my studio and we went through Simon Hill's critique of the KETO-CTA data one clip at a time — high LDL, "rapid plaque progression," the retracted paper, the new preprint. We disagree, and we do it honestly. At the center is the new KETO-CTA preprint: 100 lean mass hyper-responders, two coronary scans a year apart, and a real fight over what the numbers mean. Why the first paper was retracted, the measurement "noise floor" that makes one-year plaque data so slippery, whether 21–29% "rapid progressors" is alarming or expected, and if NATURE-CT is a fair comparison or a borrowed control group. Long and in the weeds on purpose. Watch and decide for yourself. ⏱️ CHAPTERS 0:00 Why I brought Dave Feldman on 3:30 "We only care about LDL because of drugs" 5:28 Why the film resonates: mistrust of medicine 7:19 Biology vs. drugs, HDL, and admitting when medicine is wrong 11:21 What a lean mass hyper-responder actually is 16:00 "Cautiously optimistic": Dave answers for the phrase 19:54 KETO-CTA: 100 people, two scans, one year 21:35 The retraction and the Cleerly anomalies 26:45 The new preprint: same data, Q-angio and HeartFlow 28:02 Reading the abstract: "15% regressed" and the bias question 30:18 The noise floor: what one year of imaging can't tell us 32:56 Which endpoint matters: total vs. non-calcified plaque 40:39 Percent atheroma volume, and defining "rapid" progression 47:11 Where the 1% comes from: PARADIGM and MACE 52:59 NATURE-CT: 3% vs. 21–29%, and my rebuttals 1:01:04 "Integral over time": LDL of 400 and lifetime exposure 1:03:30 Population vs. individual prediction 1:09:25 Gambling on being an outlier, and the comment-section problem 1:12:45 The film clip: Eric's story, and who to treat 1:16:53 The hard question: treat high ApoB with no plaque? 1:20:26 The "business model" question — and Dave's answer 1:23:35 My takehome: debate is healthy, the science isn't settled STUDIES DISCUSSED NATURE-CT (the comparison cohort): Aldana-Bitar J, et al. NATURE-CT. J Cardiovasc Comput Tomogr. 2026. https://www.sciencedirect.com/science/article/pii/S1934592526000973 PARADIGM registry (where the "1%/year = rapid progressor" definition comes from): Lee SE, Chang HJ, et al. Effects of Statins on Coronary Atherosclerotic Plaques: The PARADIGM Study. JACC Cardiovasc Imaging. 2018;11(10):1475-1484. doi:10.1016/j.jcmg.2018.04.015. PMID: 30093065. https://pubmed.ncbi.nlm.nih.gov/30093065/ ▶️ WATCH NEXT: My reaction to the KETO-CTA retraction: https://youtu.be/w8XxoqUoVJc ⚕️ DISCLAIMER This channel is for education, not medical advice. I'm a board-certified vascular surgeon, but I'm not your surgeon, and nothing here replaces a conversation with your own physician. If you have high LDL or ApoB — on a ketogenic diet or otherwise — don't start, stop, or change a medication based on a debate you watched on YouTube. Bring it to your doctor and decide together, with your own numbers and your own history in front of you. If this kind of respectful, in-the-weeds debate is useful to you, subscribe — Dave and I floated doing a round two on the lipid hypothesis itself, and your comments help me decide what's worth the deep dive. Pre-Order my book Disconnected here: https://www.amazon.com/Disconnected-Surgeons-Search-Healing-Broken/dp/B0H86K1T7R Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ About Dr. Lily Johnston Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

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  Episode #56

  What a Vascular Surgeon Eats—and the Artery Test I’m Repeating

  Sep 9, 202615 minS2026

  In this comment-response episode, I break down what I eat in a typical day as a vascular surgeon focused on cardiometabolic prevention. I also discuss the reliability of CIMT testing, why I plan to repeat my own scan, and what first drew me to preventive health. More on CIMT—and a conversation with the CardioRisk CEO—coming soon. For educational purposes only; this is not individualized medical advice. Pre-Order my book Disconnected here: https://www.amazon.com/Disconnected-Surgeons-Search-Healing-Broken/dp/B0H86K1T7R Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ About Dr. Lily Johnston Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease. #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

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  Episode #55

  My Arteries Got Older?! A Vascular Surgeon Explains CIMT Results

  Sep 7, 202622 minS2026

  My CIMT results came back—and one number moved in the wrong direction. In this video, I walk through my own carotid intima-media thickness (CIMT) scan, explain arterial age, plaque burden, IMT progression, and measurement variability, and talk about what a “worse” CIMT result actually means. If you’ve had a CIMT test or are considering one for cardiovascular risk assessment, this is a practical look at how to interpret the report without letting one scary-looking number hijack the whole story. Pre-Order my book Disconnected here: https://www.amazon.com/Disconnected-Surgeons-Search-Healing-Broken/dp/B0H86K1T7R Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ About Dr. Lily Johnston Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

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  Episode #54

  What Really Causes Heart Disease: LDL or Inflammation?

  Aug 29, 202620 minS2026

  In this video, Dr. Lily Johnston addresses viewer questions about lipid panels, heart disease risk, and diagnostic testing. Key topics include: Coronary Calcium Scans vs. CCTA/CIMT: Why calcium scores may not be sufficient for younger patients and the benefits of soft plaque detection. Exercise and Lipids: Clarifying that while exercise is vital for longevity, its impact on LDL-C numbers is often minimal. MRI vs. CT for Plaque: Why MRI is generally not the preferred tool for assessing arterial plaque buildup. Inflammation and Cardiovascular Risk: A discussion on the "Zeus" trial and the ongoing relevance of inflammation in heart disease. LDL-C to ApoB Ratios: Explaining discordance and why both particle count and cargo matter for risk assessment. ApoB Particle Size: Debunking myths about "large fluffy" particles and emphasizing the importance of total particle burden. N=1 Experiment: Dr. Lily reveals she will be testing both Dihydroberberine and Ezetimibe to observe their effects on her own lipid levels, starting with Dihydroberberine. Chpaters 00:00 - Introduction and reaction to lipid panel comments 00:33 - Coronary calcium scans: Scores, age, and soft plaque risk 01:58 - CIMT and CCTA: Better alternatives for soft plaque detection 02:28 - Does exercise move the needle on your lipid numbers? 03:51 - Is MRI better than CIMT for assessing plaque? 05:14 - Why a community poll for a personal medical experiment? 06:05 - The Zeus Trial: Inflammation vs. Lipids debate 08:46 - Understanding the LDL-C to ApoB ratio and discordance 12:24 - Small vs. Large LDL particles: Does size really matter? 15:05 - Dr. Aloe and the "sole predictor" stance on LDL-C 18:14 - The Verdict: Starting the Dihydroberberine experiment Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ About Dr. Lily Johnston Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease. #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

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  Episode #53

  This Changes How I Think About Creatine

  Aug 26, 202634 minS2026

  Can a simple 5g scoop of creatine do more than just build muscle? In today’s video, I’m reacting to Thomas DeLauer’s insights on how creatine might “spare” your body’s methylation cycle—and then diving deep into the actual clinical data to see if it really lowers homocysteine. As a vascular surgeon, I’m always looking for ways to reduce cardiovascular risk. We know that high homocysteine is a major red flag for heart attack and stroke, but the evidence for using creatine to fix it is surprisingly nuanced. In this video, we cover: The "Metabolic Cost" of making your own creatine. How methylation impacts your DNA repair and neurotransmitters. My breakdown of the 2015 Journal of Nutrition study on creatine and homocysteine. Why the "MTHFR mutation" changes the whole conversation. My current stance on methylated B vitamins vs. creatine. Chapters: 0:00 - Reaction to Thomas DeLauer’s Creatine Theory 1:15 - How Creatine Synthesis Drains Your Body 3:02 - The Glycine Connection: Joints, Skin, and Detox 5:42 - Implications for MTHFR and High Homocysteine 8:18 - Does Creatine Lower Homocysteine? (Open Evidence Search) 12:28 - Deep Dive: Bangladesh Randomized Controlled Trial 18:10 - The Verdict: Folic Acid vs. Creatine 21:30 - My Recommendations for Patients Let me know your thoughts on creatine in the comments! Are you taking it for more than just the gym? Do these suggestions align with the direction you want to take for this video? Sign up for more information on my own practice here: https://corsighthealth.com/ High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start Order your own labs here: https://www.ultalabtests.com/partners/lilyjohnstonmd OR www.ownyourlabs.com Other tools for optimal health (note these are affiliate links): Home BP Cuff: https://amzn.to/49Cq7rh Sonicare Toothbrush: https://amzn.to/3KllfMS WaterPik: https://amzn.to/4894Xi8 Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS Intake Breathing Nasal Support: https://amzn.to/48dfQQ1 Personal Blender: https://amzn.to/4pyNGGl True Nutrition Protein: https://oken.do/q2xzqeqw Glass Meal Prep Containers: https://amzn.to/4ocEPJ2 Sleep Mask: https://amzn.to/48fSJV5 Air Purifier: https://amzn.to/4puzTQZ ___________________________ About Dr. Lily Johnston Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease. #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

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