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
3 Myths About Menopause & Heart Health — A Surgeon Explains
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Most women have been taught to fear menopausal hormone therapy.
Blood clots. Heart attacks. Strokes.
A generation of headlines convinced millions that estrogen was dangerous—even when the science didn’t actually say that.
As a vascular surgeon and metabolic health specialist, I spend my days treating the consequences of cardiovascular disease. And I can tell you this: women deserve far better information than they’ve been given.
I break down the three biggest myths about menopausal hormone therapy (MHT) and what the evidence actually shows when you look at timing, dose, delivery route, and individual risk factors—not outdated interpretations of the WHI.
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MYTH #1: “MHT causes blood clots.”
We look at:
• how oral estrogen impacts clot risk and why transdermal estrogen is different
• what matters more than estrogen itself (hint: metabolic health, smoking, and genetics)
• who actually needs to be cautious
Most women have never been told that route of delivery is one of the biggest variables in clot risk. That matters.
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MYTH #2: “MHT causes heart attacks and strokes.”
We walk through:
• how the WHI initially misled the public
• what the re-analyses revealed
• the “timing hypothesis” and why starting therapy early matters
This isn’t about selling hormones.
It’s about recognizing when estrogen is harmful, when it’s neutral, and when it’s deeply protective.
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MYTH #3: “MHT doesn’t impact heart health anyway.”
This one might be the most harmful of all.
We unpack how estrogen affects:
• Vascular aging
• Risk for heart attacks
• All cause mortality
Cardiovascular disease is the #1 killer of women. Pretending estrogen is irrelevant is not neutral—it’s dangerous.
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Who this video is for:
-Women in perimenopause or menopause
-Women deciding whether MHT is right for them
-Clinicians hungry for more nuance
-Anyone overwhelmed by conflicting medical advice
I’m not here to push therapy.
I’m here to clarify risk, translate the data, and help you make decisions based on evidence—not fear.
If you’ve ever felt confused or dismissed when asking about menopause, you’re not alone.
You deserve information that respects your intelligence, your autonomy, and your future health.
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🧬 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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