No flush = No effect

13. November 2006 William Davis (3)


"Inositol Hexanicotinate is the true 'flushless niacin.' Unlike 'sustained-release' niacin, which is just regular niacin in a pill which dissolves more slowly, Inositol Hexanicotinate is a niacin complex, formed with the B-vitamin-like inositol. When you take an IHN supplement, the central inositol ring gradually releases niacin molecules, one at a time delivering true niacin. This, like “sustained-release” niacin, allows you to take niacin at clinically-proven doses without going crazy with the itch."


That above bit of nonsense adorns one manufacturers sales pitch for its no-flush niacin. No-flush niacin is one of the biggest scams in the health food store.

Ordinarily, I love health food stores. There's lots of fun and interesting things available that pack real power for your health program. Unfortunately, there's also outright nonsense. No-flush niacin is absolute nonsennse.

No-flush niacin is inositol hexaniacinate, or an inositol molecule complexed with 6 niacin molecules. So it really does contain niacin. However, although it works in rats, it exerts no known effect in humans.

Just Friday, a 41-year old woman came to my office for consultation because her doctor didn't know what to do with lipoprotein(a). She had seen a cardiologist who told her to take no-flush niacin. Both the cardiologist and the patient were therefore puzzled when lipoprotein(a) showed no drop and, in fact, was slightly higher on the no-flush preparation.

The lack of any observable effect and no studies whatsoever showing a positive effect (there is one study demonstrating no effect), manufacturers continue to manufacture it and health food stores continue to push it as an alternative to niacin that causes the flush. It's quite expensive, commonly costing $30-$50 for 100 tablets.

Don't fall for this gimmick. Niacin is among the most helpful of treatments for gaining control over coronary plaque. It raises HDL, corrects small LDL, reduces triglycerides (along with its friend, fish oil, of course), reduces lipoprotein(a), and dramatically contributes to reduced heart attack risk. No-flush niacin does none of this. Track Your Plaque Members: For a thorough discussion of niacin--how to use it, what preparations work and which do not, read Niacin: Ins and outs, ups and downs on the www.cureality.com website.
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Comments (3) -

  • Hoop

    7/4/2007 8:38:00 AM |

    Then again it maybe this patient was using too low a dose?
    And what else was the patient ingesting? And there is the issue of which class lipid abnormality this patient had.

    In my comments below I've included some abstracts of some human based studies that suggest inositol hexanicotinate isn't useless for altering serum lipid levels.


    If we assume for a moment the validity of your anecdote,
    I won't call inositol hexanicotinate worthless rather I would suggest it might have has narrower scope of uses not including the altering
    blood lipids.  Not everyone (me) takes large doses niacin for it lipid altering properties. Consider Kaufman's work with niacinamide in patients
    with degenerative arthritis. He used doses of 1.5 to 4 grams and
    claimed increased joint mobility after a couple of months.
    In my experience, niacin also works as well as niacinamide
    against my pains in and around my joints. Its benefits against the pain come about gradually but
    nonetheless are quite effective for me.

    The flush can be pretty nasty if one isn't careful about the dose.
    I know when I mixed niacinamide and niacin in the past I seemed
    to have somewhat more flushing. I took niacin for several years
    until it started to be trigger atrial premature beats.
    I'll comment further in this posting on a way around these adverse effects of niacin.


    Inositol hexanicotinate maybe superior provided one chooses
    the right patients? Please see the second abstract below.
    ----------------------------------------------------


    1: Eur. J. Clin. Pharmacol. 1979 Aug;16(1):11-5.


    Nocturnal inhibition of lipolysis in man by nicotinic acid and derivatives.


    Kruse W, Kruse W, Raetzer H, Heuck CC,
    Oster P, Schellenberg B, Schlierf G.


    The effect of nicotinic acid and several derivatives
    on the nocturnal level of free fatty acids was studied
    in 12 healthy young women and men. Free fatty acids
    are an important precursor of plasma triglycerides
    and their concentration is highest at night.
    The drugs used were nictinic acid, beta-pyridyl-carbinol,
    mesoinositol hexanicotinate and xantinol nicotinate.
    The highest plasma nicotinic acid level was observed
    with beta-pyridyl-carbinol, but significant reduction in
    free fatty acids during the entire night was only
    achieved with inositolhexanicotinate and
    xantinol nicotinate. There was no correlation between
    the plasm levels of free fatty acids and nicotinic
    acid at any sampling time. If prolonged reduction
    in free fatty acid concentration is desired in the therapy of
    hyperlipidemias, the inositol and xantinol esters of
    nicotinic acid appear to be superior to the other preparations.


    PMID: 499296 [PubMed - indexed for MEDLINE]
    ========================================


    Inositol hexanicotinate seems to work to lower some
    blood lipids in this next human study and granted
    another drug is also involved.
    -------------------------------------------------------------
    1: Arzneimittelforschung. 1979;29(10):1621-4.


    [Treatment of various types of hyperlipoproteinaemia with
    a combination of Mg-chlorophenoxy-isobutyrate and
    mesoinositol-hexanicotinate (author's transl)]


    [Article in German]


    Bolzano K, Krempler F, Haslauer F.


    50 patients with different types of hyperlipoproteinaemia
    were treated with a combination of Mg-chlorophenoxyisobutyrate
    (700 mg) and mesoinositol-hexanicotinate (500 mg) (Atroplex)
    twice daily. 7 patients had type IIa, 39 patients type IIb
    or IV and 4 patients type V. After a period of one
    month without any treatment the patients were treated
    during two months. While the effects of this combination
    on cholesterol of type IIa patients was poor, the
    drug had an excellent lipid-lowering effect in the patients
    with type IIb, IV and V. After 14 days' treatment the
    plasma cholesterol and triglyceride levels in
    patients of type IIb or IV were significantly lowered.
    This effect became even more pronounced after
    one-month treatment. There was no significant difference
    between the effect of one-month treatment and
    that of two-month treatment. About two-thirds of the
    patients of type IIb or IV were responders. No serious side
    effects could be observed during our study.


    Publication Types:
        English Abstract


    PMID: 583231 [PubMed - indexed for MEDLINE]
    --------------------------------------------------
    So could it have been that this patient had one of the classes
    of hyperlipidemic disorders such as type 1, type
    2-a or type 3 for which inositol hexanicotinate
    maybe ineffective?


    =====================================================
    It may have other uses see next paper.
    -------------------------------------


    1: Clin. Rheumatol. 1988 Mar;7(1):46-9.


    A double blind randomised placebo controlled trial
    of hexopal in primary Raynaud's disease.


    Sunderland GT, Belch JJ, Sturrock RD,
    Forbes CD, McKay AJ.


    University Department of Surgery,
    Glasgow Royal Infirmary, Scotland.


    The peripheral vasospastic symptoms associated
    with Raynaud's disease continue to
    be an unsolved clinical problem. Hexopal
    (Hexanicotinate inositol) has shown
    promise in uncontrolled studies and its use in
    patients with Raynaud's disease may reduce such
    vasospasm. This study examines the effects of
    4 g/day of Hexopal or placebo, during cold weather,
    in 23 patients with primary Raynaud's disease.
    The Hexopal group felt subjectively better and
    had demonstrably shorter and fewer attacks of
    vasospasm during the trial period.
    Serum biochemistry and rheology was
    not significantly different between the
    two groups. Although the mechanism of
    action remains unclear Hexopal is safe
    and is effective in reducing the vasospasm
    of primary Raynaud's disease during the winter months.


    Publication Types:
        Clinical Trial
        Randomized Controlled Trial
        Research Support, Non-U.S. Gov't


    PMID: 3044673 [PubMed - indexed for MEDLINE]
    ====================================================
    : J. Int. Med. Res. 1979;7(6):473-83.


    An experimentally controlled evaluation of the effect
    of inositol nicotinate upon the digital blood flow
    in patients with Raynaud's phenomenon.


    Holti G.


    The vaso-active effects of inositol nicotinate (Hexopal)
    were investigated in thirty patients with primary and
    secondary Raynaud's phenomenon using several
    non-invasive experimental techniques under
    controlled conditions. The earlier formed impression
    that this drug requires a prolonged 'build-up' period was
    confirmed. Recording the time required to induce
    Raynaud's phenomenon as well as assessments of total
    and nutrient digital blood flow showed significant
    beneficial therapeutic effects upon the skin's
    microcirculation by inositol nicotinate. This study
    suggests that the therapeutic effect of this drug is not
    merely due to vasodilation but that other mechanisms
    such as enhanced fibrinolysis and lowering of
    serum lipids may play a significant part in its
    overall effect. Smokers responded slower than non-smokers,
    but even elderly patients with longstanding vasospastic
    disease showed measurably improved digital circulation.
    Unlike some other drugs in this field inositol nicotinate was found
    to be effective orally and to be devoid of unwanted side-effects.
    However, in the majority of patients it failed to
    abolish their increased vascular spasm although
    it diminished it significantly in most. It appears
    to be a safe and well tolerated drug, which,
    together with other symptomatic measures, merits
    to be used in the management of vasospastic
    disease of the extremities even in the
    presence of partial obliteration of the microcirculation.


    Publication Types:
        Clinical Trial
        Randomized Controlled Trial


    PMID: 391622 [PubMed - indexed for MEDLINE]
    =======================================


    Perhaps what is needed is a larger dose in comparison
    to other forms of niacin?

    ---------------------------------------------
    Now to expand the topic to plain old TR niacin and betaine.
    ---------------------------------------------

    Timed release niacin as I recall is twice a effective
    as simple niacin in lowering lipids and twice as toxic.
    So it seems come out about even if one takes a half
    the dose of TR niacin.

    Of course, what I'd love to test is niacin in its various forms
    along with trimethylglycine (TMG) aka betaine. And I won't  
    just consider lipid level effects but also the effects on
    osteoarthritis and other joint pains.

    Why do I mention betaine? I know from personal experience
    high doses of betaine along with niacin pretty well blocks
    the flushing effect as well as completely
    blocking the atrial premature beats (AVB) that I would get
    when taking either high dose niacin or niacinamide.
    I had taken niacin at a rather high doses for about 5 or 6 years
    back a couple of decades ago and then I started
    to get the AVBs when I tried to
    resume the use of doses above 100 milligrams.
    Now of course provided I take the betaine I don't have
    this problem. However, I do get AVBs if I don't use the
    betaine and only take the niacin.
    Granted some suggest niacin lowers the lipid levels
    by "stressing" the liver so if betaine blocks
    this effect it maybe contraindicated for the purpose
    of changing lipid levels.
    Here are Pubmed ID numbers, for some papers that
    reflect similar thinking using betaine to reduce
    the toxicity of high dose B-3.
    PMID: 10985907
    PMID: 17156888

    --------------------------------------------

    I'd be interested in your comments on the points of
    theory and science. I am not looking for personal
    advice. A number of people including myself
    are discussing the niacin topic on the
    Usenet forum....sci.life-extension (which
    is also available by way of the Google Group
    Archive for free provided you have a throw away email address).
    Someone else referred to your blog comments and yet
    another person proposed contacting you for a comment.
    I was elected Wink to contact you.
    The group/forum members were interested as to whether there is
    more to your anecdote concerning the possible ineffectiveness
    of inositol hexanicotinate as a lipid lower agent.

    Thank You.

  • Dr. Davis

    7/4/2007 1:36:00 PM |

    Thanks for your insightful comments.

    My experience is based on the experiences of about 10 patients on the no-flush preparation in doses of 1000-4000 mg per day.

    If the rationale for the no-flush preparation is that it provides niacin in such a way as to avoid the flush, we should see rises in HDL, reductions in triglycerides, small LDL, and lipoprotein(a), regardless of the type of hyperlipidemia present (IIa, IIb, III, etc.).

    After using no-flush for up to one year, I have seen absolutely no effect, accepting my relatively small experience.

    Please also understand that my focus is prevention and reversal of coronary heart disease, something that the Track Your Plaque approach does exceptionally well, so I try not to stray off too far from our focus. But why would no-flush have any beneficial effects on arthritis, etc.,as an alternative method of delivering niacin when niacin itself does not possess these effects? I'm not sure I follow the rationale. To be included in a program of coronary atherosclerotic regression, we would have to see substantial effects, as we do with plain old niacin.

    Nonetheless, I encourage your continuing interesting thoughts.

  • buy jeans

    11/3/2010 12:29:51 PM |

    Just Friday, a 41-year old woman came to my office for consultation because her doctor didn't know what to do with lipoprotein(a). She had seen a cardiologist who told her to take no-flush niacin. Both the cardiologist and the patient were therefore puzzled when lipoprotein(a) showed no drop and, in fact, was slightly higher on the no-flush preparation.

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Wheat-free 2007

1. January 2007 William Davis (4)

Long ago, most of us made the change of reducing saturated fat in our diet. Few people now rely on butter (despite the idiotic butter vs. margarine controversy), full-fat dairy products, fried foods, and greasy meats. That's a healthy change, since saturated fat has conclusively been tied to various cancers, high blood pressure, rise in LDL, and is calorie-dense.

But if there were just one change you were to make beyond a reduction in saturated fat, a change that would translate into dramatic health benefits, it would be a drastic reduction, even elimination, of wheat products.

People do indeed eat enormous quantities of wheat flour-containing products. U.S. per capita consumption of wheat flour was 110 pounds in the early 1970s, and rose to 141 pounds in 1991. It's even higher now. 20% or more of most people's caloric intake every day is provided by wheat flour products.

Wheat containing foods are tasty and convenient. Witness the popularity of bagel shops, the goodie counter at Starbuck's, the proliferation of crackers, breads, and breakfast cereals at the grocery store. Patients are horrified when I suggest that they find a substitute for the sandwiches they eat every day. Even Mom said they were okay!

You're unlikely to hear much about this from the popular press. The wheat industry is enormous and exerts extraordinary clout, just like the drug industry. Texas alone farms 6 million acres of wheat, yielding over $2 billion for the state's economy. The "wheat chain" is complex and far-reaching: growers, processors, food manufacturers, the transportation industry, retailers, chemical producers, and on and on. Wheat futures are traded on the Chicago Board of Trade. Wheat is a major export industry for the U.S.

Of course, these are not evil people, intent on corrupting your health. In fact, most of them are probably working under the perception that they are raising a healthy product. The point is that the notion that wheat is healthy is deeply entrenched in the minds and economy of the U.S. Don't expect to hear unbiased commentary on the health effects of wheat products from most media sources.

What can you expect if you sharply reduce or eliminate wheat? The majority of people:

--Feel like a cloud has been lifted from their thinking.
--Don't experience the afternoon blah or tired feeling after lunch.
--Lose weight, sometimes substantial quantities.
--Raise HDL.
--Reduce small LDL.
--Reduce triglycerides, particularly if they start >100 mg/dl.
--Reduce blood sugar.

The reduction in small LDL can be especially impressive.

For most people, reducing or eliminating wheat is a sacrifice, a major change in food choices and even a loss of convenience. But the health benefits for most people can be dramatic.

Is vitamin D a "vitamin"?

29. December 2006 William Davis (5)
Vitamins are crucial participants in the body's reactions and are obtainable from food. Vitamin C, for example, comes from citrus fruits and vegetables. Vitamin K comes from green vegetables. The B vitamins are found in meats, soy, dairy products, and grains. Vitamin A comes from carrots, squash, and other orange and green colored vegetables.

How about vitamin D? What foods contain vitamin D? The list includes:


Food International Units(IU) vitamin D per serving

Cod liver oil, 1 Tablespoon 1,360
Salmon, cooked, 3½ ounces 360
Mackerel, cooked, 3½ ounces 345
Tuna fish, canned in oil, 3 ounces 200
Sardines, canned in oil, drained, 1¾ ounces 250

Milk, nonfat, reduced fat, and whole, vitamin D fortified, 1 cup 98
Margarine, fortified, 1 Tablespoon 60
Pudding, prepared from mix and made with vitamin D fortified milk, ½ cup 50
Cheese, Swiss, 1 ounce 12

Ready-to-eat cereals fortified with 10% of the DV for vitamin D, ¾ cup to 1 cup servings (servings vary according to the brand) 40

Egg, 1 whole (vitamin D is found in egg yolk) 20
Liver, beef, cooked, 3½ ounces 15

(Modified from the Office of Dietary Supplements, National Institutes of Health)


You'll note that the only naturally-occurring food sources of vitamin D are the modest quantities in fish, egg yolks, and liver. All the other vitamin D-containing foods like cereal, milk, and other dairy products have vitamin D only because humans add it.

It takes me (personally) 6000 units of vitamin D per day to bring my blood level to an acceptable 50 ng/ml. To obtain this from eating salmon, I would have to eat 58 ounces, or 3 1/2 pounds of salmon--every day. Or, I could eat 30 cans of tuna fish.

If I didn't want to eat loads of fish every day, I could drink 60 glasses of milk every day. After I recovered from the diarrhea, my vitamin D might be adequate, provided the milk indeed contained the amount stated on the label (which it often does not when scrutinized by the USDA).

If vitamin D is a vitamin, how are humans supposed to get sufficient quantities? I don't know anybody who can eat 3 1/2 lbs of salmon per day, nor drink 60 glasses of milk per day. But aren't vitamins supposed to come from food?




The problem is that vitamin D is not really a vitamin, it's a hormone. If your thyroid hormone level was low, you'd gain 20, 30, or more pounds in weight, your blood pressure would skyrocket, you'd lose your hair, become constipated, develop blood clots, be terribly fatigued. In other words, you'd suffer profound changes. Likewise, if thyroid hormone levels are corrected by giving you thyroid hormone, you'd experience profound correction of these phenomena.

That's what I'm seeing with vitamin D: restoration of this hormone to normal blood levels (25-OH-vitamin D3 50 ng/ml) yields profound changes in the body.

If there's one thing that I've come across lately that packs extraordinary potential to help us in reducing heart scan scores, it's the vitamin--sorry, the hormone--cholecalciferol, or D3.

Heart scan curiosities 3

28. December 2006 William Davis (0)

Note the shape of the chest in this 64-year old man. The front of his chest (upper portion of scan) is concave. In other words, if you were looking at this man (shirtless, of course) face to face, his chest would bow inward, rather than the usual outward configuration. The official name for this is "pectus excavatum".





Compare this to the normal chest in the second image, in which the chest is convex. Face to face, the chest would bow slightly outward.















What does it matter? The pectus excavatum in and of itself has no importance, just a curiousity. (I personally find this surprising, given the fact that the heart actually appears squashed by the sternum, or chest wall.) However, it is commonly associated with a "floppy" mitral valve (also called mitral valve prolapse), a common congenital disorder of the mitral valve often accompanied by a slender build, loose joints, and even a nervous disposition. Occasionally, in its more severe forms, the aorta is also enlarged. (This man's aorta is not enlarged.)

So, while we can't actually visualize the mitral valve by a CT heart scan, we can surmise that he likely has a floppy mitral valve, is slender, is probably a nervous sort, and has long limbs with loose joints. He probably required braces as a child, since many people have a phenemenon of "crowded teeth". The roof of his mouth, or hard palate, probably unusually high up in the mouth. He probably has a "weak chin", meaning a less prominent protuberance of his chin. His fingers and toes are likely unusually long and slender.

It could mean that some attention and exploration of how floppy his mitral valve might be could be useful, e.g., an ultrasound or echocardiogram. He might even require oral antibiotics at the time of any oral or some gastrointestinal procedures, since floppy valve are more susceptible to blood infections when potentially "dirty" orifices are instrumented.

All that from a heart scan!

Gratitude

24. December 2006 William Davis (2)
The holidays and the end of the year may be a good time to reflect on how grateful we should be for having the freedom to discuss the ideas we share on this Blog, the Track Your Plaque website, online and offline.

Although I rant and rave against the status quo in heart disease, the shameful profiteering of my colleagues and hospitals, the cut-throat marketing practices of drug and device manufacturers, I am truly grateful that, in the U.S., I have the extraordinary freedom to say these things. You have the freedom to agree or disagree and none of us pays a price for truth.

I've been reflecting myself a great deal on this idea of happiness and gratitude being a critical component of coronary plaque regression and dropping your heart scan score. (See The Heart Scan Blog from earlier this week.) The more I think about this, the more I think that it is indeed true: Harboring anger and resentment, regrets, irritability, all those petty emotions that most of us know are not good for us, erode our chances for success in dropping your heart scan score.

We could rationalize it this way: Anger and other negative emotions are adrenaline-driven states, also characterized by activation of the "sympathetic" nervous system. (Despite its name, the sympathetic system is not sympathetic, as in compassionate; its the "fight-or-flight" activator that accelerates heart rate and blood pressure.)

Happiness, contentment, and gratitude are "parasympathetic" states characterized by slower heart rates, deeper respiration, greater variation in beat-to-beat heart rates (a powerful predictor for health and the basis for the HeartMath program of Lew Childre), lower blood pressure, and even a subtle change in brain waves. In other words, happiness is not just a mental and emotional state, it is a constellation of physical phenomena.

Even though I pick on Dr. Dean Ornish for his stubborn adherence to the outdated low-fat mantra, I do agree with him on the value of happiness. His book, Love and Survival, articulates this concept. Ornish has even said on several occasions that it wasn't the diet that was most important but the connection and warmth that was created by the comraderie created by participation in the Ornish Program group sessions.

I am personally grateful that the concepts I promote are gaining a following and that I can say so without fear of prosecution. I am grateful that Track Your Plaque followers are not just sharing our concepts, but obtaining genuine and powerful health advice that will help keep them home and healthy, away from hospitals, procedures, and the dangers of heart disease.

I hope you share in my gratitude and are thankful for all the truly wonderful things that surround us. I wish you all a wonderful holiday and long, healthy life filled with gratitude.

A Track Your Plaque failure

23. December 2006 William Davis (0)
We recently had a man suffer a heart attack after beginning the program. Let me tell you the details.

Jerry's heart scan score 781, age 53. Multiple lipoprotein abnormalities: HDL 32 mg/dl, triglycerides 279 mg/dl, nearly all of his LDL was in small particles with an "effective" LDL (LDL particle number), and very high IDL. So Jerry added fish oil 6000 mg per day, niacin, and vitamin D to the statin drug prescribed by his primary physician. Jerry added oat bran, ground flaxseed, and tried to eat fish at least once per week.

However, Jerry continued to smoke. He'd smoked for 40 years (!), up to 2 packs per day, and just reasoned that it was too late to quit. He also continued to indulge in the packaged, processed foods that were part of his convenience story business.

Jerry's stress test was normal--no chest pain, normal EKG, normal images of blood flow, though he was somewhat breathless, likely from his lung disease from smoking.

Two months into his program, he abruptly experienced severe crushing pain in his chest. Because he was traveling, he ended up in a small local hospital. A failed angioplasty led to urgent coronary bypass surgery.

Jerry's alive. Now he's a non-smoker. He's got the pursed lips and peculiar breathing pattern that smokers get, but he's breathing.

Lesson: In the face of the most powerful program for heart disease known, it can still be overpowered by Twinkies, Hoho's, pretzels, chips--and cigarettes.

The new year is approaching. Be grateful for another year of healthy life and commit to a new year of even greater health. If you're a smoker, there's no choice: you've got to quit.

Are you more like a dog or a rabbit?

20. December 2006 William Davis (11)
Dr. William Roberts, editor of the American Journal of Cardiology and cardiovascular pathologist, is a perennial source of clever ideas on heart disease.
In a recent editorial, Dr. Roberts comments:








"Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivorers, humans also must be herbivores. Most humans, of course, eat flesh, but that act does not make us carnivores. Carnivores and herbivores have different characteristics. (1) The teeth of carnivores are sharp; those of herbivores, flat (humans have some sharp teeth but most are flat for grinding the fruits, vegetables, and grains we are built to eat). (2) The intestinal tract of carnivores is short (about 3 times body length); that of herbivores, long (about 12 times body length). (Since I am 6 feet tall my intestinal tract should be about 60 feet long. As a consequence, if I eat bovine muscle [steak], it could take 5 days to course through those 20 yards.) (3) Body cooling for carnivores is done by panting because they have no ability to seat; although herbivores also can pant, they cool their bodies mainly by sweating. (4) Drinking fluids is by lapping them for the carnivore; it is by sipping them for the herbivore. (5) Vitamin C is made by the carnivore's own body; herbivores obtain their ascorbic acid only from their diet. Thus, although most human beings think we are carnivores or at least conduct their lives as if we were, basically humans are herbivores. If we could decrease our flesh intake to as few as 5 to 7 meals a week our health would improve substantially."



You can always count on Dr. Bill Roberts to come up with some clever observations.

I think he's right. Some of the most unhealthy people I've known have been serious meat eaters. Most of the vegetarians have been among the healthiest. (I say most because if a vegetarian still indulges in plenty of junk foods like chips, crackers, breakfast cereals, breads, etc., then they can be every bit as unhealthy as a meat eater.)

Should you become a vegetarian to gain control over coronary plaque and other aspects of health? I don't believe you have to. However, modern livestock raising practices have substantially modified the composition of meats. A steak in 2006, for instance, is not the same thing as a steak in 1896. The saturated and monounsaturated fat content are different, the pattern of fat "marbling" is different, the lean protein content is different. Meat is less healthy today than 100 years ago.

Take a lesson from Dr. Roberts' tongue-in-cheek but nonetheless provocative thoughts. Pardon me while I chew on some carrots.

Are happy people more likely to reduce heart scan scores?

18. December 2006 William Davis (0)
I was talking to Darryl, a patient today: 71 years old with a heart scan score of 378, as well as an enlarged aorta (4.5 cm).

We had identified numerous lipoprotein abnormalities 12 months ago and advised him on a program for correction. His patterns included small LDL, high triglycerides, sky-high IDL (VERY important when you have an enlarged aorta), and lipoprotein(a). Blood pressure was also high, another crucial fact to correct when the aorta is enlarged.

Anyway, Darryl corrected lipoproteins to perfection: basic lipids were substantially better than 60-60-60; lipoprotein(a) was reduced well into the desirable range; IDL was eliminated; blood pressure was 108/64. Repeat heart scan score: 354.

There's nothing spectacular about Darryl's story, except that, despite these issues, Darryl was a happy man. He smiled throughout our conversation. He has told me on several occasions how grateful he is for the life he has.

Darryl is not wealthy. He retired around 4 years ago and fills his day with helping his wife, walking outdoors, helping out at his church, and contributing to the care of his grandchildren. Through all this Darryl is incurably, unfailingly, and irrepressibly happy.

It made me think back through all the other people who've also had great succes in their Track Your Plaque program. It struck me that, for the most part, they too were a happy bunch: generally optimistic, happy, not overly stressed nor prone to extremely stressful responses to stressful situations. All seem to also be grateful for the good in their lives, though most had no more money than the average person and had their share of difficulties in life. In fact, I can only recall one person who reversed coronary plaque who was an angry, pessimistic personality. Just one.

Could it be that happy, optimistic people are more likely to reverse coronary plaque? It would, after all, be consistent with all the other observations that type A personalities have more heart attack, etc.

Anyway, this is just an informal observation but one that seems very consistent. Track your plaque--and be happy!

Don't overdo the vitamin D

17. December 2006 William Davis (1)
As time passes and I advise more and more people to supplement vitamin D, I gain increasing respect for this powerful "vitamin". I am convinced that vitamin D replacement is the reason for a recent surge in our success rates in dropping CT heart scan scores. I believe it is also explains the larger drops we've been witnessing lately--20-30%.

But vitamin D can be overdone, too. Too much of a good thing . . .

Despite being labeled a "vitamin", cholecalciferol is actually a hormone. Vitamins are obtained from food and you can thereby develop deficiencies because of poor intake. Deficiency of vitamin C, for instance, arises from a lack of vegetables and fruits.

Vitamin D, on the other hand, is nearly absent from food. The only naturally-occuring source is oily fish like salmon and sardines. Milk usually has a little (100 units per 8 oz) because milk producers have been required by law to put it there to reduce the incidence of childhood rickets.

A woman came to me with a heart scan score of nearly 3800, the highest score I've every seen in a woman. (Record for a male >8,000!) She was taking vitamin D by prescription from her family doctor but at a dose of 150,000 units per week, or approximately 21,000 units per day. This had gone on for about 3-4 years. This may explain her excessive coronary calcium score. Interestingly, she had virtually no lipoprotein abnormalities identified, which by itself is curious, since most people have some degree of abnormality like small LDL. Obviously, I asked her to stop the vitamin D.

Should you be afraid of vitamin D? Of course not. If your neighbor is an alcoholic and has advanced cirrhosis, does that mean you shouldn't have a glass or two of Merlot for health and enjoyment? It's a matter of quantity. Too little vitamin D and you encourage coronary plaque growth. Too much vitamin D and you trigger "pathologic calcification", or the deposition of calcium in inappropriate places and sometimes to extreme degrees, as in this unfortunate woman.

Ideally, you should have your doctor check your 25-OH-vitamin D3 blood levels twice a year in summar and in winter. We aim for a level of 50 ng/ml, the level at which the phenemena of deficiency dissipate.

"It must have been the statin"

13. December 2006 William Davis (0)
After four years of trying, Randy finally reduced her heart scan score. It not only dropped, it plummeted. After four previous scans that showed 25% or more increases, she'd finally dropped her score 23%. (I Blogged about Randy's case a few weeks ago.)

Randy also works for a cardiologist. When she told him that she had reversed her coronary plaque and reduced her heart scan score by 23%, he said, "It must have been the statin agent."

Randy was indeed on a statin drug at a low dose. But she also had taken great efforts in exercise, food choices, fish oil, and vitamin D. In fact, her score had progressed dramatically while she was taking the drug. Put simply, it was not the statin.

But that is the mindset of the conventionally thinking cardiologist. Stent, bypass, or statin drug--what else is there? Even with crystal clear evidence for coronary plaque regression, they refuse to acknowledge that tools that are not in their everyday consciousness could have achieved so spectacular a result.

Given a choice, 9 out of 10 cardiologists would rather put a stent in and walk away $2000 richer for an hour of work. Don't allow them to have this choice. Take control now.

12. December 2006 William Davis (0)
Statin Drugs May Help the Healthy:
Cholesterol-Lowering Statin Drugs May Benefit People Without Heart Disease

That's the headline on WebMD, reporting the findings of a recent study published in the Archives of Internal Medicine. In reality, it wasn't really a study at all, but a re-analysis of previously published data, a so-called meta-analysis.

Nonetheless, the University of Toronto group re-analyzed the results of several studies, pooling data on 28,000 people, none of whom had known coronary disease. The results were similar to the results of the studies that were reported individually: a 29% reduction in heart attack and other "events" in people taking statin drugs.

What's surprising to me is this notion that statins, or any other treatment for that matter, prevent heart attack in people without heart disease. This is idiotic. Of course they had coronary heart disease. You can't have a heart attack in the absence of coronary disease. (There are very rare exceptions, like cocaine users, who experience coronary spasm from the drug).

What the study shows is that people with unrecognized heart disease experienced a reduction in heart attack. What it also means is that many, many people truly without heart disease were unnecessarily treated. As you'd predict, the drug manufacturers love this sort of broad, untargeted use of their drugs. It's an approach that brings in billions of dollars of revenues. The article on WebMD, in fact, was accompanied by three ads for various cholesterol drugs on this single page story.

What if only people with heart disease, as identified by CT heart scan scores, were treated? You would indeed witness an even larger reduction in heart attack risk, because the group receiving treatment both has the disease and is thereby at greater risk. Treatment should yield even greater risk reduction than treating broad groups who superficially appear to not have heart disease.

Ignore this nonsense about statin drugs reducing heart attack risk in people without heart disease. If you don't look for it, you won't know you have it. Once again, you can be lots smarter than the media. Get a heart scan and find out if your risk is worth reducing.