Saving Tim Russert and George Carlin by Jeffrey Dach MD

Saving Tim Russert and George Carlin by Jeffrey Dach MD

George Carlin Jeffrey Dach MD Tim Russert Jeffrey DACh MD Sadly, two beloved American celebrities have succumbed to heart disease before their time,  George Carlin (left), and Tim Russert (right).  The national response has been dismay, shock and sadness from all segments of society.  On another level, questions have been raised about the apparent inability of our medical system to prevent these two unfortunate deaths.(1)(2)(3)  We expect more from our medical system, touted as the best in the world in the 21st century, and people with heart trouble like Tim and George should have a better outcome.  We are shocked and disappointed that our medical system could let this happen.

Above Images, George Carlin and TIm Russert Courtesy of Wikipedia.

The obvious question to raise is, what medical interventions could have been done differently which might have saved both Tim and George?  What could have been done to prevent this fatal outcome? 

Hypothetical Individuals

First, a disclaimer of sorts: Since their medical records are confidential and closed to the public, the following comments are not directed at any one individual, rather they are directed at hypothetical individuals in the population who share the risk factors for heart disease mentioned in the media for Tim Russert and George Carlin.

Tim Russert

A year before his death, I saw Tim Russert in person June 2007 at Radio City Music Hall in New York.  He was the key note speaker at my son, Benjamin's graduation from Yeshiva University.  Russert spoke about his new book which was a tribute to his dad, and he was a quite charming fellow.  Tim Russert was the TV host for Meet the Press, and asked the tough questions of the Washington elite.  Tim treaded that fine line in journalism, being investigative yet remaining acceptable to the mainstream.(4

How to Save Time Russert, Reversing Heart Disease

Coronary Artery Gif Jeffrey Dach MD The obvious question raised is what could have been done differently to save a person with Tim Russert's risk factors?   For the sake of the discussion we will assume these risk factors include, metabolic syndrome X which includes insulin resistant diabetes and being overweight, elevated calcium score and a normal EKG/treadmill stress test.  Based on a tell-tale characteristic appearance on photographs, I would suspect Tim also had subclinical hypothyroidism.  Current mainstream medical practice which relies solely on the TSH test may miss this diagnosis, which usually goes untreated.

Above Image Courtesy Wikimedia Commons. cardiac catheterization Source cath lab at hospital charite mitte, berlin, germany

Life Saving Preventive Medical Interventions

The life saving medical interventions for such an individual with these risk factors is described in my article on CAT Coronary Calcium Scoring and Reversing Heart Disease,(5) which credits the William Davis MD Track Your Plaque Program.(6)

1) Serial Calcium Scores with CAT Scan which allows you to "track your plaque".

2) Serial Sophisticated Lipoprotein Analysis with the VAP or NMR.  The standard cholesterol panel is now obsolete, and has been replaced by the VAP.

3) Modification of lipoprotein profile with dietary modification, exercise and nutritional supplements including, omega 3 essential FA's, Niacin, L arginine, Dietary Fiber, Vitamin D, antioxidants such as vitamin C and E, etc. Yes, there is something better than the statin drugs, and this is it.

4) Control blood sugar and insulin levels with low glycemic diet, NOT by giving high dose insulin which accelerates heart disease.  Here, I strongly recommend the patient purchase and use a home glucometer along with the instructions in the book by Jenny Ruhl, Blood Sugar 101.(7)

5) Careful control of blood pressure.  Disease arteries are vulnerable to further damage from high blood pressure. 

6) Treatment for subclinical hypothyroidism with natural thyroid medication.  

Was Time Russert Subclinical Hypothyroid?

Below photos (below) show characteristic appearance of low thyroid state.

Left Image: Tim Russert 2007, courtesy of Wikipedia. Notice thinning of outer third of eyebrows, and fullness under chin, and puffiness of eyelids, all signs of subclinical hypothyroidism, a risk factor for heart disease.

Right Image: Typical features of hypothyroidism with loss of outer thirds of eyebrows, fullness under chin and puffiness of eyelids.  Image Courtesy of Mark Starr MD Type Two (8)

Hypothyroidism and Heart Disease

Broda Barnes was the first to point out the connection between subclinical hypothyroidism and accelerated heart disease in his book, "Solved the Riddle of Heart Attacks".(11)  Dr. Barnes spent his summer vacations  in Graz Austria reviewing autopsy studies showing that the low thyroid segment of the population eventually succumbed to heart disease.  The low thyroid condition causes typical changes in the skin and connective tissues called myxedema with infiltration by a gelatinous substance.  This infiltration causes a characteristic puffy look to the eyelids, and fullness to the face, which is called the obese form of hypothyroidism.  Dr. Barnes speculated that this same connective tissue infiltration occurs in the blood vessel walls leading to hypertension and atherosclerotic plaque and heart disease.   Dr. Barnes reviewed his own patient list treated with thyroid medication over many years and found a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study, and he concluded that this was due to treatment of hypothyroidism which largely prevented the development of atherosclerosis.(9)(10)(11)  Recent studies confirm this connection between subclinical hypothyroidism and heart disease originally discovered by Broda Barnes.(12)(13

Before and After Treatment for Hypothyroidism

Left Image shows characteristic hypothyroid appearance (puffy eyes and face, loss of eyebrows). Right Image shows appearance after treatment with thyroid pills. Notice dramatic change with resolution of eyelid and facial puffiness, fullness under chin is gone, and there is regrowth of eyebrows with more youthful appearance.  Courtesy of Mark Starr MD (8)

George Carlin, Sacred Clown (14)
George Carlin at Jeffrey Dach MD
George Carlin was a counter culture sacred clown who rejected his Irish Catholic upbringing.  George Carlin's standup routines often included the topic of religion, death and the after-life.  Ironically, he joked about death and the after-life in this HBO special celebrating this 70th birthday. (links below)

Link to Part One HBO Special George Carlin video. 
Link to Part two HBO Special George Carlin video.

How to Save George Carlin

Of course, George Carlin's medical records are confidential, so instead, we will discuss the case of a hypothetical person suffering from heart failure, which is a decline in pumping ability of the heart.(17)

The program to enhance performance of the pumping ability of the heart has been known for some time now, and is described by Steve Sinatra in his book, Metabolic Cardiology.  Sinatra, a practicing cardiologist in Connecticut, treats his heart failure patients with Coenzyme Q-10, D-Ribose, L-Carnitine and Magnesium, all available at the health food store.  With this regimen, Sinatra has been able to take cardiac cripples off the heart transplant list, and discharge them from the hospital to a functional life at home.(18)(19)(20)

Essential Phospholipid for Reversing Heart Disease

Steve Sinatra teamed up his colleague James Roberts for his latest book, Reverse Heart Disease Now.(21)  Roberts, a practicing cardiologist in Toledo Ohio, has success treating heart disease with phosphatidyl choline, which he feels is the first line effort to reverse heart disease.(21)  Roberts gave a medical seminar reviewing his success reversing heart failure and heart disease with this Phosphatidyl Choline supplement. Forunately, most of this seminar is available on a page at his web site.(22)  Although this is available as a nutritional supplement without a prescription, I recommend you work closely with a knowledgeable physician.  We keep a stock of the same phosphytidyl choline supplement used by Dr. Roberts, and offer it to our office patients.(22)

The Sacred Clown Accepts a New Religion

I spent a few hours laughing myself silly watching Carlin's old stand-up routines on U-tube.  There was a lot of material ridiculing religion, people, government, politics, airport security, etc.  However, it struck me as ironic that, unlike other comedians who lampoon the medical system, Carlin's material was devoid of joking about the medical system.  Apparently he took it seriously.  The sacred clown who rejected organized religion, had apparently accepted the medical system as its replacement.  Perhaps Carlin's life would have been prolonged had he not been so reverent with his new church, and had gone outside his new religion to doctors like James C Roberts, Steven Sinatra or William Davis.

Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021



HEALTH What Happened to Russert The science of sudden cardiac arrest. Newsweek

Western Medicine Fails Tim Russert June 23, 2008 By Byron Richards, CCN a critical look at medical care which failed to prevent for Tim Russert's death. By Byron Richards, CCN Mr. Russert has a negative stress test on April 19th and died suddenly of a heart attack on June 13th.

Western Medicine Fails Tim Russert June 23, 2008 By Byron Richards, CCN a critical look at medical care which failed to prevent for Tim Russert's death. By Byron Richards, CCN Mr. Russert has a negative stress test on April 19th and died suddenly of a heart attack on June 13th.

Tim Russert Wikipedia Timothy John Russert

CAT Coronary Calcium Score Reversing Heart Disease by Jeffrey DACH MD.

William Davis Track Your Plaque Program 

Blood Sugar 101 Jenny Ruhl, How to use home glucometer, to keep sugar and insulin under control through diet.

Mark Starr MD Type Two Hypothyroidsm

Solved: The Riddle of Illness By Stephen E. Langer, James F. Scheer

Hypothyroidism: The Unsuspected Illness By Broda Barnes, Lawrence Galton, Barnes

Solved: The Riddle of Heart Attacks by Broda O. Barnes, M.D., Ph.D. and Charlotte W. Barnes, A.M. Prevention of Heart Attacks: The Key to Progress in Medicine

REVIEW Meta-analysis: Subclinical Thyroid Dysfunction and the Risk for Coronary Heart Disease and Mortality.  Nicolas Ochs, MD; Reto Auer, MD; Douglas C. Bauer, MD; David Nanchen, MD; Jacobijn Gussekloo, MD, MPH; Jacques Cornuz, MD, MPH; and Nicolas Rodondi, MD, MAS. Ann Intern Med. 3 June 2008 | Volume 148 Issue 11 | Pages 832-845
Subclinical hypothyroidism ...may be associated with a modest increased risk for CHD and mortality. (my note: This article is an understatement.  It is not a modest is a greatly increased risk.)

Effects of Subclinical Thyroid Dysfunction on the Heart.  Bernadette Biondi, MD; Emiliano A. Palmieri, MD; Gaetano Lombardi, MD; and Serafino Fazio, MD  AnnIntern Med, 3 December 2002,  Volume 137 Issue 11, Pages 904-914. Subclinical hypothyroidism is associated with impaired left ventricular diastolic function at rest, systolic dysfunction on effort, and enhanced risk for atherosclerosis and myocardial infarction.

Path of the Sacred Clown

George Carlin celebrates his 70th birthday in this HBO Special "It's bad for ya". Part 1 of  7 "Its all bullshit and its bad for ya". Humerous Look at Aging, Jokes about Advantages of being old.  Dont have to carry anything heavy.  People help you.
Leave social event early...Im getting tired. Not responsible for remembering anything anymore. Take advantage of people and you are not responsible for anything.

Dead People: Go through address book and cross out the dead people.  Feeling of power to have outlasted old friends.  Leave the name in for an extra 6 weeks. In the Computer age we delete name from the computer.  Even more Powerful feeling. You can Create a new folder called "purgatory" for your dead friends. Things we say when somebody dies...etc.

Part two: Continuation of Dead People in Heaven or Hell, discussion of afterlife.  Beliefs about death such as "Life after death"., the "afterlife". George is perhaps an atheist who doesn't believe in an afterlife, but he keeps all options open.  Carlin jokes about heaven and hell.

Heart Failure, What klled George Carlin

The Sinatra Solution, Metabolic Cardiology Posted on: Friday, 29 April 2005, 03:00 CDT
When it comes to heart disease, D-ribose, L-carnitine, and Coenzyme QIO have become the triad of nutrients we rely on for healing and prevention. You will soon see that these nutrients can rocket your heart and muscle energy to new heights. They do this by maximizing the amount of oxygen that your heart and skeletal muscle can extract from your blood, by accelerating the rate at which the food you eat is converted to energy in your cells, and by keeping your cellular energy pool healthy.

The Awesome Foursome: Coenzyme Q10, L-Carnitine, D-Ribose, Magnesium
by totalhealth editors The Awesome Foursome Coenzyme Q10, L-Carnitine, D-Ribose, Magnesium

The Sinatra Solution: Metabolic Cardiology by Stephen T., M.D. Sinatra (Author)

Reverse Heart Disease Now by Steven Sinatra MD and James C Roberts MD

PC.htm Phosphatidylcholine Therapy - Phosphatidylcholine (specifically 1,2-dilinolenyphosphatidylcholine) is the most effective therapy in the anti-atherosclerotic armamentarium.  This molecule, which we will refer to as essential phospholipid or PC, improves cell membrane function, increasing absorption of oxygen and nutrition at the cellular level.  PC stimulates the HDL-associated enzymes of reverse cholesterol transport, promoting the removal of excess cholesterol from our cells, including the endothelial cells that line our arteries.  PC has been shown to improve blood flow and reduce symptoms in humans with narrowed arteries, and to anatomically reverse atherosclerotic narrowings in animals and in humans. 

Additional Links

Trusted MD Start Quote: 

WSJ Health Blog: "Russert’s doctor Michael Newman said the tough-questioning but congenial host of NBC’s 'Meet the Press' had been under treatment for asymptomatic coronary disease, but that it was under control with medication. He was carrying excess weight, Newman observed, but he got regular exercise and he performed well on an exercise stress test in April."

GruntDoc: "I therefore propose a new sign in medicine, the Tim Russert sign: death (or MI) shortly after a negative stress test."

I don't have all the medical information, so I'm speculating.

From what I heard last night, Mr. Russert was urged to lose weight and had previously diagnosed coronary artery disease. It would not be unreasonable to assume that he was already on a statin, aspirin, and blood pressure medication (as his enlarged heart can be caused by chronic hypertension).

A point of debate is his negative stress test 2 months ago. It is unclear what type it was - an exercise stress test, stress echocardiogram, or nuclear stress test? This matters, as the sensitivity would vary from 80 to 90 percent.

The gold standard to determine the extent of coronary artery disease is a cardiac catheterization. However, this is not typically done in an asymptomatic patient with a normal stress test. No doubt there will be calls to do so in light of Russert's death.

Did he have any symptoms prior to the MI? Colleagues said he did not "feel well" in the days prior to the event. Was this his anginal equivalent?

Finally, it is likely he collapsed from ventricular fibrillation, which is a shockable rhythm. Did the Washington bureau have an AED? Was it used? Even so, Mr. Russert's chances of survival would still have been slim.

A sad day indeed and a tragic loss in the world of journalism and politics.

Update: Further reading has revealed that Russert had diabetes, and the autopsy revealed significant left anterior descending coronary artery (LAD) atherosclerosis (the so-called "widow maker").

He passed his exercise stress test "at a high level of exercise." Hypertension and cholesterol were reported to be well-controlled.

Still can't find whether the stress test was with imaging or not. It makes a difference in the detection of Russert's plaque:

Imaging tests are more sensitive than the exercise ECG in the detection of severe (three vessel and left main) disease . . . the sensitivity for severe disease was 93 to 98 percent with planar thallium imaging, stress echocardiography, and SPECT perfusion imaging compared with 86 percent for exercise ECG testing.

Given his risk factors, I would not be surprised if Russert's PCP will take heat (or even be vulnerable to a malpractice lawsuit) if the stress test was ordered without some kind of imaging.

End Quote

George Carlin:
George Carlin Home Page. Quote: "Isn’t it a bit unnerving that doctors call what they do “practice”?" An appreciation of comedian George Carlin. On June 22, 2008, George Carlin was admitted to St. John's Hospital in Santa Monica, California complaining of chest pain. He died later that day at 5:55 p.m. PDT of heart failure at the age of 71.  Carlin has irish catholic background. He jokes about religion, death, drug addiction, politics, materialism (your stuff), ten commandments, saving the planet, sacredness of life, government.  George Carlin was a comic genius, and a great person too. Pro-drug and anti-religion. A comedic dynamo and hero! "Endquote
Carlin and Dogma by George Giles on Lew Rockwell
How to stay young Catholic New Times,  Jan 30, 2005  by George Carlin
Wikpedia GEorge Carlin
George Carklin on prescription drugs and birth control pills. 9 minutes audio only.
Jokes about various chemical addictions, alcohol, coffee, diet pills for housewives, atheletes into uppers, amphetamines, birth control pills are a national experiment,
embarassment of needing a "note" for BCP's  to have sex.  New names for BCP's when they are off patent such as Pride-Not, Embry-No, NArry -A-Carry, NAy-Family Way, Mom-Bomb, Junior Miss, Inconceivable, Mommy Not, etc. If only the pills only partially effective....Baby Maybe, Male sexist phone call joke....etc.

Jeffrey Dach MD disclaimer 

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The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician -- patient relationship.  Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur. Finally, the material produced by myself may be reproduced for personal use, provided that appropriate credit is given.

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  • 06-29-2008 Joel M. Kauffman wrote:
    Dear Dr. Dach:

    Superb newsletter.

    Fine discussion on Tim Russert and George Carlin. I thought that fluoridated water was a common cause of hypothyroidism in people who were susceptible, often because they are deficient in iodine.

    Best regards,

    --Joel M. Kauffman
    Reply to this
  • 06-30-2008 Martin wrote:
    Dr. Dach,

    You are absolutely correct about Tim Russert. And the failure of the medical system to recognize his myxedema is scandalous.

    Another recent heart disease death with obvious myxedema is John Ritter. There were even lawsuits, but not a single mention of his unrecognized hypothyroidism.

    Where are the investigative journalists? MSNBC Investigates? 60 Minutes? This is a HUGE story being totally overlooked.

    Dr. Barnes pointed out that the cause and cure of heart attacks was known in 1911! Is this is being ignored or censored on purpose?


    Reply to this
  • 07-01-2008 Mary Shomon wrote:

    Mary Shomon posted this entry on her  Thyroid Web Site:

    Could Thyroid Treatment Have Saved Tim Russert? Tuesday July 1, 2008

    Dr. Jeffrey Dach thinks that based on the health information we have about Meet the Press's Tim Russert, who died earlier this month of a heart attack, that it's possible Russert was subclinically hypothyroid, and that diagnosis and thyroid treatment might have prevented Russert's fatal heart attack.

    by Mary Shomon,  Author of Guide to Thyroid Disease since 1997

    More about Mary Shomon:

    A Patient advocate and writer, Mary Shomon transformed her own 1995 thyroid diagnosis into a mission to educate and empower other patients who struggle with thyroid, autoimmune, and weight loss challenges.

    Mary is author of a number of best-selling books on thyroid disease and weight loss, and a nationally-known patient advocate. In addition to her work with, Mary founded and runs the Thyroid-Info Website, and since 1997 has published Sticking Out Our Necks, the only independent, bimonthly print newsletter on thyroid disease for patients.


    Mary is the author of numerous patient-oriented health books and educational materials. Her 2004 book "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss," was a New York Times best-seller, an Top 10 Health book of 2004, and a semi-finalist for the Quills Awards.

    Mary is also author of Thyroid Hormone Breakthrough: Overcoming Sexual and Hormonal Problems at Every Age, The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss, Living Well With Hypothyroidism: What Your doctor Doesn't Tell you...That You Need to Know, Living Well With Graves' Disease and Hyperthyroidism, Living Well With Chronic Fatigue Syndrome and Fibromyalgia and Living Well With Autoimmune Disease, all published by HarperCollins. She co-authored What Your Dr May Not Tell You About Parkinson's Disease, published by Time Warner.

    Mary also serves on the faculty of the New York Open Center, a leading holistic health educational center located in New York City.


    Mary belongs to the Endocrine Society, the world's largest professional organization of endocrinologists in the world, known as the leading source of research and advancements in endocrinology and metabolism.

    She is also one of the first patient members of the American Academy on Communication in Healthcare, a professional society dedicated to research and education in patient-doctor communications.

    Mary holds a Bachelor of Science degree from Georgetown University in Washington DC.

    Mary Shomon in the Media:

    In her work as a patient advocate, Mary has been featured in the media, including ABC World News Tonight, CBS Radio, The Wall Street Journal, New York Times, Ladies' Home Journal, Woman's World, First for Women, Alternative Medicine Magazine, the CBC, and hundreds of TV, radio, magazine, and news outlets in the U.S. and abroad.

    From Mary Shomon:

    As many as 60 million Americans have thyroid conditions, and the majority aren't even diagnosed. Among those who know they have thyroid problems, the majority don't even feel well. Clearly, something needs to be done to help patients get diagnosed accurately and quickly, and once diagnosed, receive effective treatment.

    Unfortunately, doctors tend to think of thyroid disease as a mundane, easy to diagnose, easy to treat, one-size-fits-all problem. Patients, however, recognize that the truth is far more complex, and that effective treatment requires innovation, and often includes not only conventional approaches, but nutritional and lifestyle changes.

    Information, empowerment, and support is essential. Providing these necessary components is my focus for this site, my site, and my patient-oriented books and resources for patients.

    My motto and battle cry is clear: "We're patients. . . not lab values!" We deserve to feel well!


                                    Jeffrey Dach MD disclaimer

    Reply to this
  • 07-06-2008 Dr Charles Parker wrote:

    Thanks for your comments over at CorePsychBlog... interesting how the polarization between *proven* and *unproven* continues to trouble [read harm] the patients who are seeking basic levels of preventative care. Last time I checked prevention is proven...

    Thanks as well for your lengthy, well referenced and comprehensive notes on all of the work done by others in the field - with a focus more on the details of molecular and cellular physiology, and calcium evidence, - with significant improvement documented in the books we both referenced.

    Some of your readers may be interested a more positive aspect of this discussion: that psychiatric practice is concerned with many of the points you raise so well. The vascular system of the brain is, in many respects, the same vascular system for the heart.

    Another writer I like on this subject is the author of Stop the Thyroid Madness, a blog from UK if I recall correctly. Amazing how many do not understand the relevance of rT3 in functional hypothyroid, how rarely it is measured and how many labs still report the top TSH NORMAL at 5.5!!

    I had to go more deeply into all of this simply because I couldn't find others willing to look more carefully at the subtlety of the numbers. Here is a missive on some of those issues with a link to others interested as you are in thyroid dysfunction:

    Thanks again for stopping by at my site - I look forward to meeting your one day, as I am sure we will cross paths along this road.



    Thanks for your kind words

    warmest regards,

    Jeffrey Dach MD disclaimer

    Reply to this

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