D2 and D3 are two different things 3. September 2009 William Davis (15) Helena posted this instructive comment in response to the Heart Scan Blog post, Weight loss and vitamin D. It illustrates the confusion common among physicians and pharmacists on the differences between D2 and D3. (Edited slightly for clarity.)Not many weeks ago a colleague of mine (let’s call him Eric) asked me if I knew the difference between D2 and D3 and I told Eric that D2 comes from irradiated mushrooms and D3 comes from wool. In other words, D3 is the same kind of vitamin as humans get from the sun. Humans just don’t get enough and we can’t produce it on our own, like the sheep can. (D3 is natural for humans, D2 is not.)After telling Eric this, he asked me how he would know what he is taking and I gave him the medical definitions of them both (D2 = Ergocalciferol; D3 = Cholecaliciferol). Since I was aware that he had gotten his Vitamin D by prescription, I told him “I am 99.9% sure that you are taking D2, but I would be thrilled to find out I am wrong.” Eric called his pharmacy right away and got the answer I was expecting: ergocalciferol. On confronting the person Eric was talking to, the answer he got back was that Ergocalciferol is the only Vitamin D they are giving out. A week later, Eric had a new appointment with his doctor and decided to ask him about the D2/D3 issue. The doctor said he knew that there was a difference in them both, but could not say what, not even the basic facts I mentioned above. But the doctor stamped a post-it with what he had sent to the pharmacy just to show Eric. “Vitamin D3; 50,000IU tab” is what the stamp said. Eric, off course, got confused and was starting to believe that the pharmacy had made a mistake by giving him Ergocalciferol (D2) since the doctor had given him D3, or at least that is what was stamped on the little note he had. Today, after getting a refill of his Vitamin D he also got and kept all his paperwork that came along with it. Still believing that stamp the doctor had given Eric earlier, he asked me to double and triple check that my definition of D2 and D3 was correct. I did, just for my own sanity, and I was still right. One of the sheets Eric brought me today was the “Patient Education Monograph” sheet stating the drugs and how to use it and so on. The thing that jumped out the most to me was this: Generic Name: Vitamin D – OralCommon Brand name(s): Drisdol, Maximum D3Identification: PA140 Green Oval CapsuleThis is the Drug Eric was given: Vitamin D 1.25 MG softgel; Generic name: ErgocalciferolMy researching mind went into high concentration mood and I started to dig. And this is what I found: The brand name Drisdol is Ergocalciferol (D2), not D3. The Brand name Maximum D3 seems to be hard to find out there in cyber space as a brand name. But the ones I found that were called Maximum D3 seems to be the real stuff, however none of them required a prescription. When trying to find out through the identification number on the pills (PA140) I now know for sure that Eric is taking Vitamin D2 and not the preferred Vitamin D3. The brand name, Drisdol, had the identification W on one side and D92 on the other, but it is still Ergocalciferol. The only conclusion I can draw from all this is that the medical industry does not know or care about the difference in D2 and D3 – it is all same to them. And as long as the pharmacies only give out D2 it does not matter what the doctor prescribe anyway. I know that people are most likely to be prescribed a D2 pill than to be told to buy over-the-counter D3. But it was almost heart breaking to see the letter D and number 3 right next to the drug Drisdol, as we know is a D2 vitamin. It just didn’t make sense to me that they can be labeled as the same type of medication, when we know it is not! Incredible.Why prescribe plant form D2 when you can get perfectly reliable, safe, effective D3--the human form, at the health food store for about $6? Once again, it's the peculiar false bias of physicians and pharmacists: If it's prescription, it must be good; if it comes from a health food store, it must be bogus. Humans need human vitamin D. Plain and simple.For more on the D2 vs. D3 issue, see the Heart Scan Post, The case against vitamin D2.
Weight loss: Different causes, different solutions 1. September 2009 William Davis (8) Heart Scan Blog reader, Kris, related this enlightening story of weight loss (slightly edited for clarity).Kris learned that excess weight is gained through multiple causes. The solutions are therefore multiple, not just one change in diet or two. I started studying about my thyroid issue much earlier and did lose some weight. But ever since I started following Dr. Davis’s blog, it has given me confidence that I was on the right track. I did have my thyroid and iodine figured out from other sources, but Dr. Davis helped me to understand the issues with not only the thyroid but vitamin D3, fructose, fish oil, niacin, wheat etc. I have lost 43lb in last 14 months. It seems to me that there are certain percentages of weight connected with different issues. For example, after I gave up alcohol and sugar, I lost about 14lbs from total weight of 243lbs, weight came down to about 229lb. Then it stopped at 229lb, even though I was in the gym almost 5 to 6 days a week with full workouts. After I changed my thyroid medication to natural thyroid hormones (took synthetic T4 for over 10 years), the weight dropped down further 13lbs or so in matter of few days, shape of the face changed from moon shape/double chin to ordinary long face. Then it kind of stopped at around 213-216 lbs. After giving up wheat, reducing carbs, increasing protein intake (whey protein, chicken etc. no soya, no fructose) the weight came down another 14lbs. Now it is around 200-202lbs and I am over 6.2 tall with heavy set of bones. I feel better than I have ever in my life. More stamina, more clarity/no fog, more confidence and 99% of the time relaxed and being able to see the situation from multiple angles. I use to be able to drink a liter or more jack denial without a problem in one evening but now can’t stand half a can of beer (I miss JD). Drinking alcohol makes me sick. I sleep well and if I wake up in the middle of the night, I have no problem going back to sleep. No more out of breath stair climbing at all. One other thing: I used to be the most attractive meal to the mosquitoes, but not anymore. This year I haven’t been bitten once. I take my dog to the park everyday and I do not use any mosquito repellent, what a relief. I don’t know if it is because of thyroid, iodine, wheat or something else. Skin texture has changed dramatically. I do not use full soap or shampoo, 20% borax, 10 percent of my soap or shampoo for scent and rest water, mixed in a 500ml bottle. No more dandruff, dry skin, pimples for me. Dr. Davis I am thankful to people like you who have the ability to see beyond what you have been taught and have the guts to say the way it is. Most of us work to make living on daily basis but some make their living while spreading their knowledge to save lives. Dr Davis you are one of those few people. Please keep it going.
Calling all losers! 29. August 2009 William Davis (14) I'd like to invite anyone who has followed the Track Your Plaque Break the Weight Barrier program to consider posting their stories and photos on the Heart Scan Blog. Because our focus is prevention and reversal of coronary heart disease, we have not made an effort to catalog the weight loss experience that people have while on the program. For many, weight loss has been substantial. (Several people this week alone have reported weight loss of 9 to 46 lbs in the past 6 months.)It would be helpful to hear and see these results. For those of you who don't mind having a story and photo on this Blog, please come back in future to post your results. You will find this post by entering "weight loss" into the site-specific search bar at the top of the page.
Weight loss and vitamin D 28. August 2009 William Davis (28) At the start of her program, Penny's 25-hydroxy vitamin D blood level showed the usual deficiency at 22 ng/ml. She supplemented with 8000 units of vitamin D. Another 25-hydroxy vitamin D blood level several months later showed a level of 67.8 ng/ml, right on target. But Penny also began our diet, including the elimination of wheat, cornstarch, and sugars, and, over 6 months, lost 34 lbs. Now a much trimmer 146 lbs (still more to go!), another vitamin D blood level: 111 ng/ml. Penny's weight loss means that the vitamin D is distributed in a smaller total volume, particularly a lower volume of fat. This is a common phenomenon with substantial weight loss: lose weight and the need for vitamin D is reduced. The reduction in dose is roughly proportion to the weight lost. Vitamin D should therefore be reassessed with any substantial change in weight of, say, 10 lbs or more, either up or down, because of the influence of fat on vitamin D blood levels. Some references on this effect:Men and women over age 65:Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women.Obese women:Low 25-hydroxyvitamin D concentrations in obese women: their clinical significance and relationship with anthropometric and body composition variablesObese children:Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season.African-Americans:Relationship of vitamin D and parathyroid hormone to obesity and body composition in African Americans.Although the bulk of the effect is most likely due to sequestration by fatty tissue, perhaps less sun exposure in obese people also contributes:Body mass index determines sunbathing habits: implications on vitamin D levels.
Grasscutting, fertilizer, and healthcare 25. August 2009 William Davis (23) A guy named Jeff, a 60-something, taciturn, "How 'bout dem Brewers?" kind of guy, cuts my grass. Once a week, Jeff drives over his rust-rimmed 1994 Chevy pickup and trailer, unloads his ride mower, and cuts the grass. For his 40 minutes of work, I pay him $35. For $35, all he does is cut the grass--no trimming, no picking up debris, no working in the garden, no fertilizing, no weeding. Just cutting the grass. Occasionally, Jeff has proven to be a useful resource for peculiar problems. Last year, I had a drainage problem that he helped solve and two years ago he helped diagnose a tree disease that was killing a tree in the backyard; it's now recovered. To save money, and because I like to work in the yard, I do the rest. I trim the edges, I fertilize the grass, plant new flowers and trees, fix damaged areas, trim wild branches.In my view, my relationship with Jeff, a limited, as-needed relationship, in which I ask him to help with specific issues but I manage the rest myself, is how I believe that healthcare should also be conducted. Your doctor should be like Jeff: Perhaps not taciturn, but an as-needed resource available while you do much of the work. My simple relationship with Jeff is, I believe, the healthcare model of the future. You manage your own cholesterol issues, your own basic thyroid issues, supplement and monitor your vitamin D levels, use diet to suit your needs, order blood tests when necessary, even obtain basic imaging tests like heart scans, carotid ultrasound, bone density testing. Your doctor is a resource, near by when and if you need him or her: guidance when needed, an occasional review of what you are doing, someone to consult when you fracture an ankle. What your doctor is NOT is a paternal, "do what I say, I'm the doctor," or a "You need these tests whether you like it or not" holder of your health fate. It is a model of healthcare that will evolve over the next 20-30 years, only in its infancy now. While we started Track Your Plaque as just a resource for in-depth information on prevention and reversal of coronary heart disease, I now see it as something much greater: a prototype for the emerging concept of self-directed health. Enough for now. I've got some tomatoes to pick.
Iodine deficiency is REAL 21. August 2009 William Davis (30) Like many health-conscious people, Kurt avoids salt. In fact, he has assiduously avoided salt ever since his heart attack back in 1995. Lately, Kurt had become tired, often for little or no reason. His thyroid panel:TSH 4.2 mIU/L (0.27-4.20)Free T3 1.74 pg/ml (2.50-4.30)Free T4 1.05 ng/dl (0.9-1.7)Kurt's TSH of 4.2 mIU/L is sufficient to increase LDL cholesterol by 20-30% and increase the (relative) risk for heart attack 3-fold. Kurt's thyroid was also palpably enlarged. While it was just barely visible--just a minor bulge in the neck (in the shape of a bowtie), it could be clearly felt when I examined him. I asked Kurt to add 500 mcg of iodine every day. Three months later, another thyroid panel showed:TSH 0.14 mIU/L (0.27-4.20)Free T3 2.50 pg/ml (2.50-4.30)Free T4 1.1 ng/dl (0.9-1.7)Kurt's thyroid function normalized to nearly ideal levels just with iodine replacement. (The free T3, while improved, remains low; an issue for another day!) I see this response with some frequency: low-grade goiter and apparent hypothyroidism (low thyroid function) that responds, at least partially, to iodine replacement. In Kurt's case, iodine replacement alone normalized his thyroid measures completely. With improved thyroid measures, Kurt also felt better with renewed energy and a 22 mg/dl reduction in LDL cholesterol. Make no mistake: Iodine deficiency is real. While most of my colleagues have dismissed iodine deficiency as a relic of the early 20th century and third world countries, you can also find it in your neighborhood.
Fish oil for $780 per bottle 19. August 2009 William Davis (16) At prevailing pharmacy prices, one capsule of prescription Lovaza fish oil costs $4.33 each. Yes, you heard right: $4.33 per capsule. What do you get for $4.33 per capsule? By omega-3 fatty acid content, you get 842 mg EPA + DHA per capsule. I can also go to Sam's Club and buy a bottle of their Triple-Strength fish oil with 900 mg omega-3 fatty acids per capsule at $18.99 per bottle of 180 capsules. That comes to 10.5 cents per capsule. That puts the price of fish oil from Sam's Club at 97.6% less cost compared to Lovaza for an equivalent quantity of omega-3 fatty acids. What if we repriced Sam's Club's Triple-Strength and brought it "in line" with what we pay for Lovaza? That would put the value of one bottle of Sam's Club Triple-Strength fish oil at $780 per bottle. I take patients off Lovaza every chance I get.
Organic really IS better 16. August 2009 William Davis (18) If you have any doubts about the value of organic foods vs. conventionally-grown foods, then take a look at the findings from a USDA--Yes, USDA--sponsored study. In this study, the nutritional content of organic vs. conventionally-grown blueberries were compared. Ironically, these observations come from the USDA's Genetic Improvement of Fruits and Vegetables Laboratory of the Produce Quality and Safety Laboratory. Their findings (all values expressed as weight per 100 grams fresh weight blueberries, or a bit less than 1/4 cup):Total phenol content (e.g, flavonoids):Organic: 319.3 mgConventional: 190.3 mgOrganic blueberries had 68% greater phenol content.Total anthocyanins (an important class of flavonoids):Organic: 131.2 mgConventional: 82.4 mgOrganic blueberries had 59% greater anthocyanin content.Antioxidant capacity (ORAC): Organic: 46.14 mgConventional: 30.8Organic blueberries had 50% greater antioxidant capacity. Flavonoids suspected to carry unusually potent health effects--malvidin, delphinidin, myricetin, and quercetin--were all contained in greater proportions in the organically-grown blueberries, also. These flavonoids are demonstrating pharmacologic-level health effects in preliminary studies. Why a genetics laboratory? After all , the study findings came out heavily in favor of non-genetic, organic farming methods of growing produce. It certainly must have at least given pause to the vocal group within agriculture and the USDA that have long argued that organic produce is no different. I suspect that the laboratory will now try to recreate the nutritional value of organic through genetic manipulation of cultivars grown using conventional methods. Regardless of the motivations behind the study, we see that there is no comparison: organic blueberries are superior in nutritional value to those grown with conventional pesticides and herbicides. While the study addressed only blueberries, the dramatic difference makes it likely that similar differences exist in other fruits and vegetables. Coming on the Track Your Plaque website: An in-depth Special Report on the health effects of anthocyanins.
Do you really need calcium? 12. August 2009 William Davis (0) Why are we advised to take calcium supplements?Men and women are advised to take calcium because it has been shown to reduce blood pressure modestly. Women, in particular, can stall the deterioration of bone strength (mineralization) by taking calcium supplements, 1200-1300 mg per day, and eating calcium-rich foods like dairy products. Is that all true?It is true insofar as we remain vitamin D deficient. A funny thing happens when you fully replete vitamin D: Intestinal absorption of calcium as much as quadruples. That means your body will efficiently absorb the calcium in broccoli and spinach. Is it still necessary to force-feed your body megadoses of calcium once vitamin D has been repleted? I don’t think so. While the evidence is indirect, several observations point towards the lack of necessity of calcium once vitamin D is addressed. For instance:Women who take calcium, 1200 mg per day, with vitamin D, 800 units per day, double their five-year risk for heart attack, according to a New Zealand study. Men who take calcium, 1200 mg per day, with vitamin D, 800 units per day, also may substantially increase heart attack risk. Bone density increases more with vitamin D than with calcium. Calcium may not even be necessary to increase bone mineralization, since there are data to suggest that vitamin D can accomplish this by itself. Calcium suppresses parathyroid hormone, PTH. That is, in fact, how calcium stalls (usually does not reverse) bone mineral loss-not by adding calcium to bone, but by suppressing PTH release. (PTH causes bone demineralization.) Vitamin D suppresses PTH to a far greater degree than calcium.What is needed is a broad reconsideration of the advice everyone is getting to take calcium. In an age when more and more people are appreciating the power of vitamin D supplementation to achieve normal blood levels, there may be danger ahead for those who fail to address their calcium overdosing.
The case against vitamin D2 11. August 2009 William Davis (40) Why would vitamin D be prescribed when vitamin D3 is available over-the-counter?Let's review the known differences between vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol):--D3 is the human form; D2 is the non-human form found in plants.--Dose for dose, D3 is more effective at raising blood levels of 25-hydroxy vitamin D than D2. It requires roughly twice to 250% of the dose of D2 to match that of D3 (Trang H et al 1998).--D2 blood levels don't yield long-term sustained levels of 25-hydroxy vitamin D as does D3. When examined as a 28-day area under the curve (AUC--a superior measure of biologic exposure), D3 yields better than a 300% increased potency compared to D2. This means that it requires around 50,000 units D2 to match the effects of 15,000 units D3 (Armas LA et al 2004). --D2 has lower binding affinity for vitamin D-binding protein, compared to D3--Mitochondrial vitamin D 25-hydroxylase converts D3 to the 25-hydroxylated form five times more rapidly than D2. --As we age, the ability to metabolize D2 is dramatically reduced, while D3 is not subject to this phenomenon (Harris SS et al 2002). From Armas LA, Hollis BW, Heaney RP 2004While there are dissenters on this view, the bulk of evidence suggests that D2 is an inferior form of D3. Then why is D2 prescribed by many doctors when the natural, human, and superior D3 is available over-the-counter? You already know the answer: Much of your doctor's education did not come from scientific lectures nor from reading scientific studies. It came from the pretty drug representative in the waiting room who hands the doctor reprints of the "studies" performed by the drug industry to support the use of their drugs. There is no such nutritional supplement representative in the waiting room. This preference for the "drug" D2 over the supplement D3 also stems from the inherent preference of physicians for things they can control, whether or not there is proof of superiority. In my view, there is absolutely no reason to take vitamin D2 over D3 except to enrich the drug industry.
Is Lp(a) part of your legacy to your children? 15. September 2009 William Davis (21) If you have lipoprotein(a), Lp(a)--the most aggressive known cause of heart disease that no one has heard of--then you need to tell your children. Lp(a) is a "cleanly" inherited genetic pattern: If either parent has it, there's a 50% chance that you have it. If you have it, then there's a 50% likelihood that each of your children has it. (Note that each child experiences a likelihood of 50%, not 50% of your children. This is because each child is conceived as an independent statistical event. So much for romance!)The atherogenicity (plaque-causing potential) of Lp(a) also tends to get transmitted. In other words, if your Dad had a heart attack at age 50 due to Lp(a) and you share Lp(a), then you likely share a similar magnitude of risk as your Dad. If your Mom had Lp(a), though passed quietly at age 89 without any overt evidence of heart disease, then you are likely to share the relatively benign form of Lp(a). For most of us with Lp(a), however, it is best to assume that it has at least some potential for causing heart disease, being the most aggressive cause known. (That is, until we have the ability in everyday clinical practice to characterize Lp(a) by assessing such factors as the size of the apoprotein(a) molecule, the number of kringle "repeats" on the tail, etc. Until then, we need to rely on the crude, though helpful, observation of family history.) At what age should you inform your children? There's no hard-and-fast rule. However, I generally suggest to patients that they talk about Lp(a) with their children when they reach their 20s or 30s, old enough to begin to understand the implications and begin to think about adopting healthier lifestyles. Is treatment required at, say, age 35? That depends on the pattern of Lp(a)-related heart disease in the family: With exceptionally aggressive forms, it might be reasonable to begin treatment at this relatively early age.
Do "Heart Healthy" sterols cause heart disease? 9. September 2009 William Davis (19) The sterol question continues to pop up.Sterols are an ingredient widely added by food manufacturers that allows a "heart healthy" claim, since sterols have been shown to reduce LDL cholesterol (at least transiently). HOWEVER, sterols have also been implicated in possibly increasing risk for heart disease. After all, people with the genetic condition called sitosterolemia absorb sterols into the blood and develop coronary heart disease in their teens and twenties. Those of us without sitosterolemia who increase sterol intake with sterol-enriched foods increase blood levels of sterols several-fold. Is this healthy, or does it contribute to coronary plaque as it does in people with sitosterolemia? Below, I've reprinted a previous Heart Scan Blog post on sterols. Sterols should be outlawedWhile sterols occur naturally in small quantities in food (nuts, vegetables, oils), food manufacturers are adding them to processed foods in order to earn a "heart healthy" claim.The FDA approved a cholesterol-reducing indication for sterols , the American Heart Association recommends 200 mg per day as part of its Therapeutic Lifestyle Change diet, and WebMD gushes about the LDL-reducing benefits of sterols added to foods.Sterols--the same substance that, when absorbed to high levels into the blood in a genetic disorder called "sitosterolemia"--causes extravagant atherosclerosis in young people.The case against sterols, studies documenting its coronary disease- and valve disease-promoting effects, is building:Higher blood levels of sterols increase cardiovascular events:Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study.Sterols can be recovered from diseased aortic valves:Accumulation of cholesterol precursors and plant sterols in human stenotic aortic valves.Sterols are incorporated into carotid atherosclerotic plaque:Plant sterols in serum and in atherosclerotic plaques of patients undergoing carotid endarterectomy.Though the data are mixed:Moderately elevated plant sterol levels are associated with reduced cardiovascular risk--the LASA study.No association between plasma levels of plant sterols and atherosclerosis in mice and men.The food industry has vigorously pursued the sterol-as-heart-healthy strategy, based on studies conclusively demonstrating LDL-reducing effects. But do sterols that gain entry into the blood increase atherosclerosis regardless of LDL reduction? That's the huge unanswered question.Despite the uncertainties, the list of sterol-supplemented foods is expanding rapidly:Each Nature Valley Healthy Heart Bar contains 400 mg sterols.HeartWise orange juice contains 1000 mg sterols per 8 oz serving.Promise SuperShots contains 400 mg sterols per container.Corozonas has an entire line of chips that contain added sterols, 400 mg per 1 oz serving.MonaVie Acai juice, "Pulse," contains 400 mg sterols per 2 oz serving.Kardea olive oil has 500 mg sterols per 14 gram serving.WebMD has a table that they say can help you choose "foods" that are sterol-rich.In my view, sterols should not have been approved without more extensive safety data. Just as Vioxx's potential for increasing heart attack did not become apparent until after FDA approval and widespread use, I fear the same may be ahead for sterols: dissemination throughout the processed food supply, people using large, unnatural quantities from multiple products, eventually . . . increased heart attacks, strokes, aortic valve disease.Until there is clarification on this issue, I would urge everyone to avoid sterol-added "heart healthy" products. Some more info on sterols in a previous Heart Scan Blog post: Are sterols the new trans fat? .
Why obese people can't fast 9. September 2009 William Davis (21) Why do obese people claim it is impossible to fast?Most overweight people are terrified at the prospect of facing any period of time without ready access to food. Persuading them to begin a program of intermittent fasting is a hopeless cause. They just refuse. Contrary to popular opinion, this is not just glutonny at work. It is the effect of what I call "the cycle of hunger," the 2-hour up and down cycle of rising sugar and insulin, followed by their inevitable fall. The precipitous fall of sugar and insulin triggers mental fogginess, fatigue, and insatiable hunger. (By the way, this is the same phenomenon underlying the silly notion of "grazing.") According to an LA Times article, fasting may be difficult to impossible for some people: "Ruth Frechman, a registered dietitian in Burbank and spokeswoman for the American Dietetic Assn., says she frequently sees such extreme strategies backfire. 'You're hungry, fatigued, irritable. Fasting is not very comfortable. People try to cut back one day and the next day they're starving and they overeat.'" (Not surprising, coming from the American Diatetic Assn. They, along with such agencies as the American Diabetes Association, are vocal proponents of low-fat, high-carbohydrate, "healthy whole grain" diets--you know, the diets that make us fat and diabetic.)Ms. Frechman is correct: Having someone engage in a period of fasting, no matter how brief, when the diet leading up to the fast is filled with "healthy whole grains" and other carbohydrates will result in painful hunger that eventually overcomes any effort. A period of overeating typically follows the aborted attempt. Fasting cannot work as long as the 2-hour cycle of hunger continues. The first step: Eliminate the 2-hour cycle of hunger by dramatically reducing or eliminating carbohydrates. Our preferred method is to eliminate wheat, cornstarch, and sugars. (Just be aware of wheat withdrawal, the fatigue that develops in the first 5 days after wheat elimination that affects up to 30% of people.)Once wheat, cornstarch, and sugars are eliminated, hunger reverts to that of physiologic need--appetite will be smaller and less intense, since it is driven by your body's needs, not by abnormal stimulation from wheat, cornstarch, and sugar. The fear of not having food dissolves, the 2-hour cycle of mental fogginess, fatigue, and hunger will be gone. Intermittent fasting is a wonderful strategy for reducing weight; gaining control over lipids, lipoproteins, and coronary plaque; regaining appreciation for food; reducing appetite. But it's not even worth trying unless you've already eliminated the unnatural appetite triggers that will booby-trap any fasting effort.
Test your own thyroid 7. September 2009 William Davis (15) 134 people responded to the latest Heart Scan Blog poll:When I ask my doctor to test my thyroid, he/she: Accommodates me without question 45 (33%)Questions why, but orders the tests 49 (36%)Refuses because you seem "healthy" 20 (14%)Refuses without explanation 4 (2%)Ridicules your request 16 (11%)That's better than I anticipated: 69% of physicians complied with this small request. After all, you're not asking for major surgery. You're just asking for a very basic test, as basic as a blood count or electrolytes. 36% of respondents said that their doctor asked why, but still complied; this is simply practicing good medicine--If there is a problem, your doctor would like to know about it.However, the remainder--31%--were refused in one way or another. Incredibly, 11% were ridiculed.Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.Let's say you're tired. Ever since last summer, you've suffered a gradual decline in energy.So you ask your doctor to assess your thyroid. He refuses. "You're just fine! There's nothing wrong with you."You disagree. In fact, you are quite convinced that there is something physically wrong. What do you do?You could:--Drink more coffee--Exercise more in the hopes that it will snap you out of your lethargy--Sleep more--Take stimulants of various sortsOr, you could get your thyroid assessed and settle the issue. But how can you get this done when your doctor won't accommodate you, even though you have perfectly fine health insurance and are simply interested in feeling better and preserving your health?You could test your thyroid yourself. This is why we're making self-testing kits available. Test kits are available here. This is yet another facet of the powerful revolution that is emerging: Self-directed health.
Trains, planes, and heart scans 4. September 2009 William Davis (10) A Heart Scan Blog reader posted the following question:It is not clear to me why getting a cardiac scan is the necessary first step, if in fact the next step would be to bring down small LDL particles which is revealed on a NMR lipoprofile or VAP test. Why isn't the NMR or VAP test the first thing?Good question. Think of it this way:Lipoproteins, as measured via VAP (Vertical Auto Profile) or NMR (Nuclear Magnetic Resonance), provide a snapshot of risk from a metabolic viewpoint at that moment. Lipoproteins shift with the tides of age, menopause, weight changes, even what you ate last evening for dinner (especially small LDL). There are also other factors that cause coronary plaque, as well, not revealed through lipoprotein testing, such as vitamin D deficiency, smoking, high blood pressure, phosopholipase A2, lipoprotein(a), inflammatory factors, thyroid dysfunction, omega-3 fatty acid deficiency, etc. A heart scan, providing a coronary calcium score, provides an indirect measure of coronary plaque that is the sum total of lipoprotein and other plaque-causing factors that have accumulated up to the time of your scan--regardless of the cause.It means that two females, each 60 years old, with 70% small LDL, HDL 42 mg/dl, triglycerides 150 mg/dl, and mild hypertension, have identical markers for potential coronary risk, but can have widely different heart scan scores. One might have a score of zero, while the other might have a score of 300. Why would the same panel of causes measured at one moment yield wildly different quantities of plaque? Several reasons:1) The lifestyles, eating habits, and weight of each woman differed during their earlier years, not currently reflected in this moment's lipid or lipoprotein patterns. Perhpaps one experienced several years of extraordinary stress from a failed marriage, or suffered through two years of depression that caused her to smoke and overeat. 2) There are hidden factors that affect coronary plaque growth that we are presently not able to detect, e.g., vitamin D receptor genotype, cholesteryl-ester transfer protein variants, variation in inflammatory factors. If we can't measure it, we won't know whether it might influence coronary plaque risk. With all the changes that occur over a person's life, with the uncertainties of yet-to-be-identified causes for coronary plaque, how can you possible know what your risk for heart disease truly is? Yup--a heart scan. Do it and you will know.
D2 and D3 are two different things 3. September 2009 William Davis (15) Helena posted this instructive comment in response to the Heart Scan Blog post, Weight loss and vitamin D. It illustrates the confusion common among physicians and pharmacists on the differences between D2 and D3. (Edited slightly for clarity.)Not many weeks ago a colleague of mine (let’s call him Eric) asked me if I knew the difference between D2 and D3 and I told Eric that D2 comes from irradiated mushrooms and D3 comes from wool. In other words, D3 is the same kind of vitamin as humans get from the sun. Humans just don’t get enough and we can’t produce it on our own, like the sheep can. (D3 is natural for humans, D2 is not.)After telling Eric this, he asked me how he would know what he is taking and I gave him the medical definitions of them both (D2 = Ergocalciferol; D3 = Cholecaliciferol). Since I was aware that he had gotten his Vitamin D by prescription, I told him “I am 99.9% sure that you are taking D2, but I would be thrilled to find out I am wrong.” Eric called his pharmacy right away and got the answer I was expecting: ergocalciferol. On confronting the person Eric was talking to, the answer he got back was that Ergocalciferol is the only Vitamin D they are giving out. A week later, Eric had a new appointment with his doctor and decided to ask him about the D2/D3 issue. The doctor said he knew that there was a difference in them both, but could not say what, not even the basic facts I mentioned above. But the doctor stamped a post-it with what he had sent to the pharmacy just to show Eric. “Vitamin D3; 50,000IU tab” is what the stamp said. Eric, off course, got confused and was starting to believe that the pharmacy had made a mistake by giving him Ergocalciferol (D2) since the doctor had given him D3, or at least that is what was stamped on the little note he had. Today, after getting a refill of his Vitamin D he also got and kept all his paperwork that came along with it. Still believing that stamp the doctor had given Eric earlier, he asked me to double and triple check that my definition of D2 and D3 was correct. I did, just for my own sanity, and I was still right. One of the sheets Eric brought me today was the “Patient Education Monograph” sheet stating the drugs and how to use it and so on. The thing that jumped out the most to me was this: Generic Name: Vitamin D – OralCommon Brand name(s): Drisdol, Maximum D3Identification: PA140 Green Oval CapsuleThis is the Drug Eric was given: Vitamin D 1.25 MG softgel; Generic name: ErgocalciferolMy researching mind went into high concentration mood and I started to dig. And this is what I found: The brand name Drisdol is Ergocalciferol (D2), not D3. The Brand name Maximum D3 seems to be hard to find out there in cyber space as a brand name. But the ones I found that were called Maximum D3 seems to be the real stuff, however none of them required a prescription. When trying to find out through the identification number on the pills (PA140) I now know for sure that Eric is taking Vitamin D2 and not the preferred Vitamin D3. The brand name, Drisdol, had the identification W on one side and D92 on the other, but it is still Ergocalciferol. The only conclusion I can draw from all this is that the medical industry does not know or care about the difference in D2 and D3 – it is all same to them. And as long as the pharmacies only give out D2 it does not matter what the doctor prescribe anyway. I know that people are most likely to be prescribed a D2 pill than to be told to buy over-the-counter D3. But it was almost heart breaking to see the letter D and number 3 right next to the drug Drisdol, as we know is a D2 vitamin. It just didn’t make sense to me that they can be labeled as the same type of medication, when we know it is not! Incredible.Why prescribe plant form D2 when you can get perfectly reliable, safe, effective D3--the human form, at the health food store for about $6? Once again, it's the peculiar false bias of physicians and pharmacists: If it's prescription, it must be good; if it comes from a health food store, it must be bogus. Humans need human vitamin D. Plain and simple.For more on the D2 vs. D3 issue, see the Heart Scan Post, The case against vitamin D2.
Weight loss: Different causes, different solutions 1. September 2009 William Davis (8) Heart Scan Blog reader, Kris, related this enlightening story of weight loss (slightly edited for clarity).Kris learned that excess weight is gained through multiple causes. The solutions are therefore multiple, not just one change in diet or two. I started studying about my thyroid issue much earlier and did lose some weight. But ever since I started following Dr. Davis’s blog, it has given me confidence that I was on the right track. I did have my thyroid and iodine figured out from other sources, but Dr. Davis helped me to understand the issues with not only the thyroid but vitamin D3, fructose, fish oil, niacin, wheat etc. I have lost 43lb in last 14 months. It seems to me that there are certain percentages of weight connected with different issues. For example, after I gave up alcohol and sugar, I lost about 14lbs from total weight of 243lbs, weight came down to about 229lb. Then it stopped at 229lb, even though I was in the gym almost 5 to 6 days a week with full workouts. After I changed my thyroid medication to natural thyroid hormones (took synthetic T4 for over 10 years), the weight dropped down further 13lbs or so in matter of few days, shape of the face changed from moon shape/double chin to ordinary long face. Then it kind of stopped at around 213-216 lbs. After giving up wheat, reducing carbs, increasing protein intake (whey protein, chicken etc. no soya, no fructose) the weight came down another 14lbs. Now it is around 200-202lbs and I am over 6.2 tall with heavy set of bones. I feel better than I have ever in my life. More stamina, more clarity/no fog, more confidence and 99% of the time relaxed and being able to see the situation from multiple angles. I use to be able to drink a liter or more jack denial without a problem in one evening but now can’t stand half a can of beer (I miss JD). Drinking alcohol makes me sick. I sleep well and if I wake up in the middle of the night, I have no problem going back to sleep. No more out of breath stair climbing at all. One other thing: I used to be the most attractive meal to the mosquitoes, but not anymore. This year I haven’t been bitten once. I take my dog to the park everyday and I do not use any mosquito repellent, what a relief. I don’t know if it is because of thyroid, iodine, wheat or something else. Skin texture has changed dramatically. I do not use full soap or shampoo, 20% borax, 10 percent of my soap or shampoo for scent and rest water, mixed in a 500ml bottle. No more dandruff, dry skin, pimples for me. Dr. Davis I am thankful to people like you who have the ability to see beyond what you have been taught and have the guts to say the way it is. Most of us work to make living on daily basis but some make their living while spreading their knowledge to save lives. Dr Davis you are one of those few people. Please keep it going.
Calling all losers! 29. August 2009 William Davis (14) I'd like to invite anyone who has followed the Track Your Plaque Break the Weight Barrier program to consider posting their stories and photos on the Heart Scan Blog. Because our focus is prevention and reversal of coronary heart disease, we have not made an effort to catalog the weight loss experience that people have while on the program. For many, weight loss has been substantial. (Several people this week alone have reported weight loss of 9 to 46 lbs in the past 6 months.)It would be helpful to hear and see these results. For those of you who don't mind having a story and photo on this Blog, please come back in future to post your results. You will find this post by entering "weight loss" into the site-specific search bar at the top of the page.
Weight loss and vitamin D 28. August 2009 William Davis (28) At the start of her program, Penny's 25-hydroxy vitamin D blood level showed the usual deficiency at 22 ng/ml. She supplemented with 8000 units of vitamin D. Another 25-hydroxy vitamin D blood level several months later showed a level of 67.8 ng/ml, right on target. But Penny also began our diet, including the elimination of wheat, cornstarch, and sugars, and, over 6 months, lost 34 lbs. Now a much trimmer 146 lbs (still more to go!), another vitamin D blood level: 111 ng/ml. Penny's weight loss means that the vitamin D is distributed in a smaller total volume, particularly a lower volume of fat. This is a common phenomenon with substantial weight loss: lose weight and the need for vitamin D is reduced. The reduction in dose is roughly proportion to the weight lost. Vitamin D should therefore be reassessed with any substantial change in weight of, say, 10 lbs or more, either up or down, because of the influence of fat on vitamin D blood levels. Some references on this effect:Men and women over age 65:Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women.Obese women:Low 25-hydroxyvitamin D concentrations in obese women: their clinical significance and relationship with anthropometric and body composition variablesObese children:Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season.African-Americans:Relationship of vitamin D and parathyroid hormone to obesity and body composition in African Americans.Although the bulk of the effect is most likely due to sequestration by fatty tissue, perhaps less sun exposure in obese people also contributes:Body mass index determines sunbathing habits: implications on vitamin D levels.