Paul Mason MD engagement report
@DrPaulMason - 77K followers on X
Measured over 8 original posts from a 30-day window, last computed on October 18, 2026.
Engagement
A typical post picks up 52 interactions against 77K followers, an engagement rate of 0.069%. Measured over 8 original posts, its engagement rate beats 42% of 20,444 tracked accounts of a similar size, which puts it in the middle of its size range rather than at either end. Posts are seen about 16K times each, and 0.33% of those impressions turn into an interaction. That is about 20.7% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 0.47 posts a day over the last 30 days, though only 10% of days saw any activity at all. Most posts go out around 09:00 UTC, and Thursday is the busiest day of the week. Of the 8 posts sampled, 75% carry an image or video, 75% are part of a thread and 25% link out. The account's strongest tracked post pulled 9.2K interactions, about 176x its own typical post.
Measured over 8 original posts from a 30-day window, last computed on October 18, 2026.
Compared with accounts its own size
Paul Mason MD's engagement rate beats 42% of the tracked X accounts closest to it in follower count (20,444 accounts, accounts of similar size (decile 6 of 10)). A percentile is spread evenly by construction, so 50 really is the middle of that group and 90 really is its top tenth.
On engagement per impression rather than per follower it beats 15% of the same group. When those two numbers disagree, the gap is about how far its posts travel rather than how people react to them.
Where this sits in the catalog
At 0.069%, Paul Mason MD sits above the 25th percentile of the 205,374 accounts in this comparison. That places it in the below the median band, which runs 0.024% to 0.143%.
Show the percentile table
| Percentile | Engagement rate |
|---|---|
| 10th percentile | 0.004% |
| 25th percentile | 0.024% |
| 50th percentile | 0.143% |
| 75th percentile | 0.678% |
| 90th percentile | 2.55% |
| 99th percentile | 82.4% |
This ruler is the whole measured catalog, not a size-matched group: it shows where the raw rate falls across every account we can measure, all of which are large. For a like-for-like comparison, read the size-band percentile above instead. See how the bands are built
Posting timing
This account posts most often around 09:00 UTC, and Thursday is its busiest day of the week. The bars below are the catalog-wide pattern, with this account's own busiest slot marked. They do not show how this account performs at each hour: we keep one aggregate per account, not one per hour, so that measurement does not exist in our data.
Show engagement by hour posted, utc as a table
| Hour (UTC) | Vs author median | Posts |
|---|---|---|
| 00:00 UTC | -1% | 89K |
| 01:00 UTC | -2% | 90K |
| 02:00 UTC | -3% | 88K |
| 03:00 UTC | -4% | 94K |
| 04:00 UTC | -5% | 76K |
| 05:00 UTC | -4% | 75K |
| 06:00 UTC | -5% | 86K |
| 07:00 UTC | -5% | 93K |
| 08:00 UTC | -4% | 108K |
| 09:00 UTC | -4% | 124K |
| 10:00 UTC | -3% | 129K |
| 11:00 UTC | -3% | 141K |
| 12:00 UTC | -3% | 154K |
| 13:00 UTC | -3% | 167K |
| 14:00 UTC | -4% | 173K |
| 15:00 UTC | -2% | 176K |
| 16:00 UTC | -3% | 171K |
| 17:00 UTC | -3% | 159K |
| 18:00 UTC | -2% | 149K |
| 19:00 UTC | -2% | 141K |
| 20:00 UTC | -1% | 131K |
| 21:00 UTC | 0% | 116K |
| 22:00 UTC | -2% | 100K |
| 23:00 UTC | -1% | 90K |
Show engagement by day of week as a table
| Day | Vs author median | Posts |
|---|---|---|
| Sunday | +5% | 393K |
| Monday | +1% | 483K |
| Tuesday | -2% | 520K |
| Wednesday | -3% | 472K |
| Thursday | -2% | 430K |
| Friday | -3% | 447K |
| Saturday | +2% | 393K |
Formats this account uses
Its own posting mix on the left, and what each of those formats does across every account we track on the right. Only formats where the effect clears our publish test appear here, so an empty row is a format we could not measure rather than one that does nothing.
| Format | This account | Catalog effect | 95% interval | Accounts behind it |
|---|---|---|---|---|
| Image or video | 75% of posts | +111% | +108% to +115% | 34K |
| Outbound link | 25% of posts | -41% | -42% to -40% | 32K |
| Typical length | - | no effect | -2% to -1% | 42K |
- 75% of this account's sampled posts carry an image or video. Across the catalog, posts with an image or video run 111% above the same accounts' other posts.
- 25% of its posts carry a link off X. Across the catalog, posts with an outbound link run 41% below the same accounts' other posts.
- Its average post runs 276 characters, which falls in the 180 - 280 characters band. Across the catalog, posts of 180 to 280 characters match the same accounts' other posts almost exactly.
These are catalog-wide differences applied to this account's own posting mix, not a measurement of how each format performs for this account specifically. We keep one median per account, not one per format per account, so the second thing is not something this data can tell you.
Best tweets
- Jan 4, 2026176x their median
Out of the hundreds of papers I read last year, this one could be the most GAME-CHANGING! Demodex mites (cousins to dust mites) likely fuel issues like rosacea, acne, dry eyes, and even chronic nasal congestion. Infestation with these mites, most commonly on the face, is extremely common. But here's the the most important finding - applying plain Vaseline to your eyelids at night could be a SAFE, CHEAP and EFFECTIVE fix, trapping these critters and slashing their numbers. Doctor's, consider a 28-day Vaseline trial for your patients. If effective, this simple hack might save billions on indefinite treatments. https://t.co/q8XZ05EZJt
- Dec 15, 202433x their median
Second study in a week finds seed oils linked to cancer. Men with prostate cancer consuming the most seed oil had more aggressive tumors. With ~40% of cases under surveillance (no active treatment), this could be huge. We need more research on seed oil & cancer links NOW! https://t.co/xYy0GOvwQ4
- Feb 4, 202543x their median
The widespread misuse of Ozempic is leading us headlong into a tsunami of osteoporis and sarcopenia (muscle weakness). In this note for my patients, I detail the evidence that clearly demonstrates this is not a drug to be taken lightly. If you know anyone prescribing Ozempic, they should read this. Ozempic - a disaster waiting to happen Glucagon-like Peptide-1 (GLP-1) is a key hormone regulating energy balance. It's release can be heavily influenced by processing of food, such as grinding, milling, or juicing, which can increase how quickly it is absorbed. One key mechanism of GLP-1 is to suppress secretion of the hunger hormone, ghrelin, thereby suppressing hunger. GLP-1 itself is secreted by L-cells in the lower small intestine in response to the presence of nutrients incluiding carbohydrate, protein, and fat. The location of L-cells far down the small intestine is significant, as rapidly digested processed foods may not reach this far. Consequently processed foods may not stimulate an appropriate increase in GLP-1 levels, leading to persistently high ghrelin levels and hunger. This explains why one can often continue consuming large amounts of processed foods without experiencing true satiety. Ozempic (Semaglutide) mimics the effects of natural GLP-1 but has a longer duration of action, explaining its profound appetite-suppressing effects. However, mucking around with human physiology can often have unintended consequences. One of the trials used for the approval of Ozempic was a a drug company-funded trial known as STEP1. It demonstrated impressive weight loss over 68 weeks of once-weekly injections, the more than 1,300 participants experiencing an average weight loss of 16.86 kg (37lbs). As always however, the devil is in the detail. DEXA body composition scanning was performed on 95 of the STEP1 subjects, and revealed first of all that less than 5% of fat lost was the more problematic visceral fat. Even more concerning, 41% of the total weight lost appeared to come from muscle and bone. You read that correctly. These subjects were on a path both to osteoporosis and sarcopenia (excessive muscle loss). This obvious raises questions about the impact of Ozempic on bone health. A double-blinded, randomised controlled trial was subsequently conducted at two public hospitals in Denmark. This study also found impairment in bone health, weekly semaglutide injections over 52 weeks resulting in bone mass loss in the lumbar spine and hip, as well as thinning of the outer strong cortical bone of the tibia. Perhaps even more concerningly however was that levels of the bone resorption marker C-terminal telopeptide (CTX) continued to rise throughout the study. This suggests that not only is bone loss ongoing while taking semaglutide, but the rate of bone loss may even accelerate with prolonged used. I cannot emphasise this enough. The longer subjects take semaglutide, the closer to osteoporosis they likely get. Which then raises the question of what happens when semaglutide is ceased? Does bone mass return. Unfortunately we don't know the answer to this question, because the drug company funded follow-up to the STEP1 trial, which followed subjects for 12 months after discontinuing semaglutide only reported on weight, not body composition. Still even looking only at weight, the results were not good. Participants regained on average two-thirds of the weight they had lost. Given that 59% of the initial weight loss was fat, it is plausible that the regained weight was primarily composed of fat. It is perhaps unlikely that if indeed these subjects had only regained muscle and bone, that we would not have been told about it. Additionally, the STEP1 trial found treatment with semaglutide to be associated with significant increases in the pancreatic enzyme lipase (rising from 25 U/L to 36 U/L). This is concerning given that Roche withdrew another GLP-1 agonist, Taspoglutide, due to severe side effects, including pancreatitis. Similarly, Exenatide (Byetta), another drug in this class, carries a black box warning for both pancreatitis and kidney dysfunction. There are of course other issues with this class of drug, however I think these alone justify severe caution be used when prescribing it. The fact is, it is very likely that the longer you are on this drug, the weaker your bones get. And with no evidence that this bone mass returns when it is stopped, we may well be facing a future tsunami of premature osteoporosis and sacropenia in coming years. https://t.co/Pzc03dWHU3 https://t.co/O55gB7Fc2I
- Aug 8, 202241x their median
Statins do not offer mortality benefit in those with a good triglyceride to HDL ratio (low trigs, high HDL). This is irrespective of LDL levels. While this paper is sure to spark debate, we (the authors) believe it to be sound. @LDLSkeptic @BenBikmanPhD https://t.co/eKBdBQQKpX
- Jan 3, 202535x their median
I often write short summaries on various topics that I give to my patients. This is what I have just composed for Nattokinase. Nattokinase is a natural enzyme capable of degrading fibrin, a key component of blood clots. It is derived from natto, made from fermented soybeans.
- Jan 27, 202535x their median
Here is a summary on 'Blood Pressure, longevity and drugs' I have composed for my patients. My conclusions might surprise you. 'Blood Pressure, Longevity and Drugs' High blood pressure (hypertension) is a well-known risk factor for early death. The belief that lowering blood pressure can lead to an increase in life expectancy has driven Australians to spend over $1.2 billion annually on blood pressure medications. However, while these drugs lower blood pressure, they don’t address the most common root cause of hypertension, which is insulin resistance. As a result, the expected longevity associated with a particular blood pressure may well be different in unmedicated and medicated individuals. What’s the Ideal Blood Pressure for longevity? Studies assessing the association between blood pressure and mortality often has significant limitations. These studies are often conducted in developed countries on high-risk populations. This means that many study subjects are likely to be taking blood pressure medications, limiting the generalisability of findings to unmedicated populations. Additionally, the number of very elderly participants in these studies is typically limited, restricting the ability of these studies to inform us about blood pressure and optimal longevity. One study, published in BMJ in 2018, addresses these limitations and is the most methodologically sound study I have found on this topic. This was a prospective longitudinal study of 4,658 elderly Chinese individuals with an average age of 92 years (including 825 centenarians). Given the impressive age of the subjects, this study has the potential to inform us of optimal blood pressure for longevity. There are two numbers in a standard blood pressure reading. The top number refers to systolic blood pressure (SBP) and indicates pressure when the heart pumps. The bottom number refers to diastolic blood pressure (DBP), which is the pressure when the heart relaxes between beats. Systolic blood pressure (the top number reflecting peak pressure when the heart pumps) was shown by this study to predict longevity, with an optimal reading being 129 mmHg. Systolic blood pressures both below and above this level were found to represent an increased mortality risk, though this was not significant between about 120 mmHg and 140 mmHg. Importantly, the risk of premature mortality was greater for lower blood pressures than for higher blood pressures. Diastolic blood pressure (bottom number, reflection pressure when the heart is relaxed), was shown to be all but worthless when it comes to predicting longevitiy. All-cause mortality was bascially identical across a wide range of diastolic blood pressure (40 mmHg to 130 mmHg).# In essence, it is reasonable to only consider systolic blood pressure (the top number) when predicting longevity based on blood pressure**. These findings have been replicated in other populations too. A UK-based study of females over the age of 80 had broadly similar findings, identifying the lowest risk of mortality when systolic blood pressure was between 120 to 139 mmHg.## Another study of 68,901 Korean adults over the age of 65 found that the optimal systolic blood pressure in terms of mortality was 130-139 mmHg. In summary, the optimal systolic blood pressure for longevity in an unmedicated population is likely to be around 130 mmHg, with diastolic blood pressure being all but irrelevant.* Does Treating High Blood Pressure with Drugs Increase Life Expectancy? Perhaps the most influential clinical guidelines on the management of blood pressure in Australia were published by the Australian Heart Foundation in 2016. Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers, and thiazide-type diuretics are all recommended as first-line management for hypertension. Despite the strong recommendation to use these drugs for hypertension, on balance, there is no compelling evidence that taking blood pressure medications for hypertension increases life expectancy. This was demonstrated by a 2017 meta-analysis of 74 individual trials involving over 300,000 patients, which found no evidence that treating hypertension, even when systolic pressures were over 160 mmHg, offered any mortality benefit. Of course, it may be argued that some classes of medication may be superior to others, offering benefits through mechanisms independent of their blood-lowering effect. There is little compelling evidence, however, that any of the four classes of medication commonly initiated for hypertension offer mortality benefit. A Closer Look at Specific Drug Classes: ACE Inhibitors A 2014 meta-analysis published in JAMA examined these drug classes in patients with diabetes. Nine out of 11 studies on ACE inhibitors (e.g., Ramipril, Perindopril) found no benefit. The two outliers were industry-funded, with significant methodological limitations. One of these outliers was not in fact a new study, but rather a 're-analysis' of existing trial data from a previous study which just so happened to come to a different conclusion. The other outlier was the ADVANCE trial which also had major methodolgical limitations. One of these was the use of a run in period (commonly seen in statin trials). Before the study officially started, every eligible subject received the active medications for 6 weeks. If they had any side effects to the drugs, they were removed from eligiblity before the study even started (~14% of subjects who registered for the trial ultimately did not take part in the study). Of course, subjects removed during the run-in period were not included in adverse event data. Consequently, practices such as this load the deck in favour of the drug intervention, leading to an overestimation of the net benefits. Further, these studies were on diabetics, and thus not applicable to the general population. Without these two industry funded outlier studies, the marginal benefit found by this meta-analysis for ACE inhibitors in terms of all cause mortality all but evaporates. ARBs A 2014 meta-analysis published in JAMA examined these drug classes in patients with diabetes. Seven individual studies assessed Angiotensin II Receptor Blockers (e.g., Candesartan, Irbesartan, Losartan, Olmesartan, Telmisartan, Valsartan), with none finding a mortality benefit. Calcium Channel Blockers Calcium channel blockers are another class of medication often used for the management of hypertension. One of the earliest drugs in this class was nifedipine, which was introduced into the Australian market in the 1980's. The immediate-release formulation of nifedipine was discontinued in Australia in October 2020 after it was found to significantly increase the risk of death in patients with heart disease by 2-3 times. Slow release nifedipine remains available, and is often prescribed to lower blood pressure. Despite this, I could not locate any research finding nifedipine to offer benefit when compared to 'no treatment at all' in terms of mortality. Most randomised controlled trials compared nifedipine against other blood pressure drugs rather than placebo, meaning can't tell us whether nifedipine is superior to 'no treatment at all'. The only randomised controlled trial that I could find comparing nifedipine against a placebo in the treatment of hypertension, the 'Systolic Hypertension in Europe trial' found there to be no mortality benefit. & Similarly, there is no evidence of mortality benefit compared to placebo for other calcium channel blockers, including amlodipine, felodipine and lercanidpine. Thiazide diuretics As with other blood pressure lowering medications, there is little if any evidence that thiazide type diuretics (eg. hydro-chlorothiazide) and thiazide 'like' diuretics (eg. indapamide) improve longevity when used to treat hypertension. This was demonstrated by a 2015 meta-analysis and systematic review of 21 studies which failed to find any mortality benefit of either thiazide-type or thiazide-like diuretics when compared to placebo. Conclusion In summary, the use of blood pressure medications appears to offer no compelling mortality benefit. Most studies compare drugs against each other rather than placebo, creating an illusion of benefit. Additionally, non-inferiority trials—where a new drug is compared against an older drug—often perpetuate the recommendation of multiple drugs without clear evidence of efficacy. Medications are simply no substitute for addressing the underlying causes of hypertension. Focusing on improving diet, exercise, and overall metabolic health offers a more effective and sustainable path to longevity and well-being. ****************************************************** *It's worth noting that the systolic blood pressure found to be optimal for longevity, 129 mmHg, is a level the American Heart Association considers to represent elevated blood pressure. Indeed, it is just shy of the 130 mmHg threshold which is considered stage 1 hypertension. That the optimal blood pressure for longevity as identified by this study is considered to represent elevated blood pressure ought to have us rethinking our blood pressure goals. **Importantly, this study also looked at whether or not study participants were taking medications for blood pressure and found these findings to be independent of medication status. #There is another measure called 'pulse pressure,' which is the difference between SBP and DBP (SBP - DBP = pulse pressure). Being derived from both systolic blood pressure and diastolic blood pressure, the predictive value of pulse pressure was found to be midway between the two (inferior to the simpler systolic blood pressure). ##This study also found that blood pressures below 120 mmHg were more common in the last three months of life (despite the absence of any medication changes), with blood pressures below 110 mmHg being associated with the highest risk of all. ******************************************************* If you have read this far, thank you. Grok AI suggested some changes which fairly decimated this post. While clearer, it removed a lot of nuance which I feel is important when communicating science. Please feel free to let me know whether you prefer long form summaries as I provide them to my patients, or if I should 'GROKIFY' my posts.
- Nov 18, 202525x their median
1/8 - Just gave a 30-min talk to 100+ conventionally trained doctors. Asked 5 “controversial” nutrition questions BEFORE vs AFTER. The mind-shift was staggering. Doctors aren’t closed minded - they just need to see the actual science. Results below ↓
- Dec 13, 202412x their median
New study links seed oils to colon cancer. Resected tumors showed high levels of pro-inflammatory omega-6 fats and sphingomyelins. The mechanism may be as follows: -beta sitosterol (found in seed oils) boosts sphingomyelin production (a complex lipid), a precursor to ceramides. https://t.co/HbZGibyUQl
- Sep 17, 202617x their median
You’d have to eat 138 kg of bacon a day to match the rat study that started the bacon-cancer scare. Details and more in the latest episode of the Dr Paul Mason Show. https://t.co/ptbJHSC0t1
- Nov 28, 202512x their median
This patient discovered low carb dieting after being diagnosed with diabetes in 2016. If only low carb was sustainable....... https://t.co/PLvLwyYAJM
Ranked by total interactions across everything we have tracked for this account, which is a longer history than the 30-day window the rates above use. The multiple compares each post to this account's own median.
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Reading these numbers
A typical post picks up 52 interactions against 77K followers, an engagement rate of 0.069%. Measured over 8 original posts, its engagement rate beats 42% of 20,444 tracked accounts of a similar size, which puts it in the middle of its size range rather than at either end. Posts are seen about 16K times each, and 0.33% of those impressions turn into an interaction. That is about 20.7% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 0.47 posts a day over the last 30 days, though only 10% of days saw any activity at all. Most posts go out around 09:00 UTC, and Thursday is the busiest day of the week. Of the 8 posts sampled, 75% carry an image or video, 75% are part of a thread and 25% link out. The account's strongest tracked post pulled 9.2K interactions, about 176x its own typical post.
- What is Paul Mason MD's engagement rate on X?
- Paul Mason MD (@DrPaulMason) has an engagement rate of 0.069%, based on the median interactions across 8 original posts from the last 30 days against 76,636 followers. Replies, reposts and quote-posts of other people are excluded from that sample.
- Is that a good engagement rate?
- At 0.069%, Paul Mason MD sits above the 25th percentile of the 205,374 accounts in this comparison. Those comparison accounts are all large ones, because our scanning cadence is weighted towards big accounts, so this is a ranking among peers of similar scale rather than a ranking across X.
- Does @DrPaulMason have real engagement?
- Its engagement rate beats 42% of the tracked X accounts closest to it in follower count (20,444 accounts), which puts it in the middle of its size range group. Ranking inside a size band matters because engagement rate falls as accounts grow, so a raw rate would mostly re-measure the follower count. It is a starting point for a look at follower quality, not a verdict on it.
- When does @DrPaulMason post?
- Most posts go out around 09:00 UTC, and Thursday is its busiest day, at roughly 0.47 posts per day across the measured window.