Diet by LDL 7. March 2012 William Davis (0) Conventional notions of heart healthy diets, such as that advocated by the American Heart Association, are largely based on observations of total and LDL cholesterol. So, cut the saturated fat in the diet, cut the overall fat content, and replace them with polyunsaturated oils like safflower, corn, and vegetable oils and increase consumption of whole grains and total and LDL cholesterol show a modest downturn. Thus, diets like the American Heart Association Total Lifestyle Change approach advocate limiting total fat to no more 25 to 35% of calories and saturated fat to no more than 7% of calories.
Orange Cream Cookies 5. March 2012 William Davis (5) If you loved Creamsicles as a kid, you'll love these Orange Cream Cookies. (Sorry, no photo: We ate them up before I realized we hadn't taken the photo. And, worse, we did it twice!) Ingredients:2 cups almond meal2 tablespoons coconut flour1 teaspoon baking soda½ teaspoon sea salt¼ cup golden raisins½ cup chopped pecansSweetener equivalent to 1 cup sugar2 tablespoons finely-grated orange rind 1 large egg2 tablespoons coconut oil, melted½ cup whipping cream (or coconut milk)1 tablespoon vanilla extractPreheat oven to 350º F.Combine almond meal, coconut flour, baking soda, salt, raisins, pecans, sweetener and orange zest in bowl and mix. In separate bowl, whisk egg, then add coconut oil, whipping cream, vanilla extract and mix together. Pour wet mix into dry and blend by hand thoroughly. Spoon onto parchment paper-lined baking pan (or oiled pan) and flatten with spoon to ½-¾ inch thickness. Bake for 20-25 minutes or until toothpick withdraws dry.
Why are heart attacks still happening? 4. March 2012 William Davis (10) I'm a cardiologist. I see patients with heart disease in the form of coronary artery disease every day. These are people who have undergone bypass surgery, received one or more stents or undergone other forms of angioplasty, have survived heart attacks or sudden cardiac death, or have high heart scan scores. In short, I see patients every day who are at high-risk for heart attack and death from heart disease. But I see virtually no heart attacks. And nobody is dying from heart disease. (I'm referring to the people who follow the strategies I advocate, not the guy who thinks that smoking a pack of cigarettes a day is still okay, or the woman who thinks the diet is unnecessary because she's slender.) Two high-profile deaths from heart attacks occurred this week:Davy Jones--The iconic singer from the 1960s pop group, the Monkees, suffered sudden cardiac death after a large heart attack, just hours after experiencing chest pain. Andrew Breitbart--The conservative blogger and controversy-generating media personality suffered what was believed to be sudden cardiac death while walking. It's a darn shame and it shouldn't happen. The tools to identify the potential for heart attack are available, inexpensive, and simple. The strategies to reduce, even eliminate, risk are likewise available, inexpensive, and cultivate overall health. The followers of the Track Your Plaque program who 1) get a heart scan that yields a coronary calcium score (for long-term tracking purposes) 2) identify the causes such as small LDL particles, lipoprotein(a), vitamin D deficiency, and thyroid dysfunction3) correct the causes enjoy virtual elimination of risk.
My letter to the Wall Street Journal: It's NOT just about gluten 8. February 2012 William Davis (7) The Wall Street Journal carried this report of a new proposed classification of the various forms of gluten sensitivity: New Guide to Who Really Shouldn't Eat GlutenThis represents progress. Progress in understanding of wheat-related illnesses, as well as progress in spreading the word that there is a lot more to wheat-intolerance than celiac disease. But, as I mention in the letter, it falls desperately short on several crucial issues.Ms. Beck--Thank you for writing the wonderful article on gluten sensitivity.I'd like to bring several issues to your attention, as they are often neglectedin discussions of "gluten sensitivity":1) The gliadin protein of wheat has been modified by geneticists through theirwork to increase yield. This work, performed mostly in the 1970s, yielded a formof gliadin that is several amino acids different, but increased theappetite-stimulating properties of wheat. Modern wheat, a high-yield, semi-dwarfstrain (not the 4 1/2-foot tall "amber waves of grain" everyone thinks of) isnow, in effect, an appetite-stimulant that increases calorie intake 400 caloriesper day. This form of gliadin is also the likely explanation for the surge inbehavioral struggles in children with autism and ADHD.2) The amylopectin A of wheat is the underlying explanation for why two slicesof whole wheat bread raise blood sugar higher than 6 teaspoons of table sugar ormany candy bars. It is unique and highly digestible by the enzyme amylase.Incredibly, the high glycemic index of whole wheat is simply ignored, despitebeing listed at the top of all tables of glycemic index.3) The lectins of wheat may underlie the increase in multiple autoimmune andinflammatory diseases in Americans, especially rheumatoid arthritis andinflammatory bowel diseases (ulcerative colitis, Crohn's).In other words, if someone is not gluten-sensitive, they may still remainsensitive to the many non-gluten aspects of modern high-yield semi-dwarf wheat,such as appetite-stimulation and mental "fog," joint pains in the hands, legedema, or the many rashes and skin disorders. This represents one of the mostimportant examples of the widespread unintended effects of modern agriculturalgenetics and agribusiness.William Davis, MDAuthor: Wheat Belly: Lose the wheat, lose the weight and find your path back to health
60-year old man dies of high cholesterol 1. February 2012 William Davis (12) Never saw a headline like this? Neither have I. That's because it doesn't happen.Cholesterol doesn't harm, maim, or kill. It is simply used as a crude--very crude--marker. It is, in reality, a component of the body, of the cell wall, of lipoproteins (lipid-carrying proteins) in the bloodstream. It is used a an indirect gauge, a "dipstick," for lipoproteins in the blood to those who don't understand how to identify, characterize, and quantify actual lipoproteins in the blood.Cholesterol itself never killed anybody, any more than a bad paint job on your car could cause a fatal car accident.What kills people is rupture of atherosclerotic plaque in the coronary arteries. For all practical purposes, you must have atherosclerotic plaque in order for it to rupture (much like a volcano erupts and spews lava). It's not about cholesterol; it's about atherosclerotic plaque. Plaque might contain cholesterol, but cholesterol is not the thing itself that causes heart attack and death.So why do most people obsess about cholesterol? Good question. It is, at best, a statistical marker for the possibility of having atherosclerotic plaque that ruptures. High cholesterol = higher risk for heart attack, low cholesterol = lower risk for heart attack. But the association is weak and flawed, such that people with high cholesterol can live a lifetime without heart attack, people with low cholesterol can die at age 43.The same holds true for LDL cholesterol, you know, the calculated value based on flawed assumptions about LDL's relationship to total cholesterol, HDL cholesterol, and VLDL cholesterol.A crucial oversight in the world of cholesterol: There are many other factors that cause atherosclerotic plaque and its rupture, such as inflammatory phenomena, calcium deposition, artery spasm, hemorrhage within the plaque itself, degradative enzymes, etc., none of which are suggested by cholesterol measures.But one observation has held up, time and again, over the past 40 years of observations on coronary disease: The greater the quantity of coronary atherosclerotic plaque, the greater the risk of atherosclerotic plaque rupture. An increasing burden of atherosclerotic plaque along the limited confines of coronary arteries, just a few millimeters in diameter and a few centimeters in length, is like a house of cards: It's bound to topple sooner or later, and the bigger it gets, the less stable it becomes.If you are concerned about future potential for heart disease and heart attack, don't get a cholesterol panel. Get a measure of coronary atherosclerotic plaque.
Back to basics: Coronary calcium 30. January 2012 William Davis (42) After having my attentions pulled a thousand different directions these past 6 months, with the release of Wheat Belly and all the wonderful media attention it has attracted, I've decided to pick up here with a series of discussions about the fundamental issues important to the Track Your Plaque program and prevention and reversal of coronary atherosclerotic plaque.I fear the discussions at times have drifted off into the exotic. This is great because this is how we learn new lessons, but we can never lose sight of the basics, else we risk losing control over this disease.Imagine you've got a beautiful new car. You wax it, gap the spark plugs, rotate the tires, etc. and it looks brand-new, just like it came off the dealer's lot. 50,000 miles pass, however, and you realize you've forgotten to change the oil. Ooops! In other words, no matter how meticulous the attention to transmission, tires, and paint job, neglect of the most basic responsibility can ruin the whole thing. We can't let that happen with heart health.If we propose to reverse coronary atherosclerotic plaque, we've got to have something to measure. First, it tells us whether we have atherosclerotic plaque in the first place, the stuff that accumulates and blocks flow and causes anginal chest pains, and ruptures like a little volcano and causes heart attacks. Second, it gives us something to track over the years to know whether plaque has grown, stopped growing, or been reduced. Without such a measure, you will be driving without a speedometer or odometer, just guessing whether or not you've gotten to your destination.Of course, the conventional approach to heart disease and heart attack is not to track atherosclerotic plaque in your coronary arteries, but to track some distant "risk factor" for atherosclerotic plaque, especially LDL cholesterol. But LDL cholesterol is flawed at several levels. First, it is calculated, not measured. The nearly 50-year old Friedewald equation used to calculate LDL cholesterol is based on several flawed assumptions, yielding a value that can be 20, 30, or 50% inaccurate as a rule, only occasionally generating a value close to the real value. (No point in publicizing this problem, of course: Why compromise a $27 billion annual cash cow?) It also ignores the effect of diet. (No, cutting fat does not reduce LDL for real, only the calculated value. Cutting carbohydrates, especially wheat--"healthy whole grains"--slashes measured LDL values like NMR LDL particle number and apoprotein B.)But all risk factors are, at best, snapshots of the situation at that moment in time. They change from day to day, week to week, month to month, year to year. If you do something dramatic in health, like lose 50 pounds, you can substantially change your risk factors values, like LDL cholesterol and HDL cholesterol. But you may not modify the amount of atherosclerotic plaque in your heart's arteries.Measuring the amount of atherosclerotic plaque in your heart's arteries is, in effect, a cumulative expression of the effects of risk factors up until the moment of measurement.There are several stumbling blocks, however, in the concept of measuring coronary atherosclerotic plaque. We cannot measure all the unique components of plaque, such as fibrous tissue like collagen, or degradative enzymes like collagenases, or inflammatory proteins like matrix metalloproteinase, or the debris of hemorrhage and inflammation. We struggle to contemporaneously mix in measures of bloodborne inflammation, coagulation and viscosity, and physiological phenomena of the artery itself, like endothelial dysfunction, medial (muscle) tone, and adventitial fat.So we are left with semi-static measures of total coronary atherosclerotic plaque like coronary calcium, obtainable via CT heart scans as a calcium "score." No, it is not perfect. It does not reflect that moment's blood viscosity, it does not reflect the inflammatory status of the one nasty plaque in the mid-left anterior descending, nor does it reflect the irritating sheer effects of a blood pressure of 150/95.But it's the best we've got.If anyone has something better, I invite you to speak up. Carotid ultrasound, c-reactive protein, ankle-brachial index, stress nuclear studies, myoglobin, skin cholesterol, KIF6 genotype . . . none of them approach the value, the insight, the trackability of actually measuring coronary atherosclerotic plaque. And the only method we've got to gauge coronary atherosclerotic plaque that is non-invasive and available in 2012? Yup, a good old CT heart scan calcium score.
Myocardial infraction 15. January 2012 Toggle navigation Home Blog Home Archive Join Now Log in Low thyroid: What to do? 8. February 2009 William Davis (25) I've gotten a number of requests for solutions on how to solve the low thyroid issue if either 1) your doctor refuses to discuss the issue or denies it is present, or 2) there are government mandates against thyroid correction unless certain (outdated) targets are met.Oh, boy. While I'm not encouraging anyone to break the laws or regulations of their country (and it's impossible to generalize, with readers of this blog originating from over 30 countries), here are some simple steps to consider that might help you in your quest to correct hypothyroidism:--Measure your body temperature--First thing in the morning either while lying in bed or go to the bathroom and measure your oral temp. Record it and, if it is consistently lower than 97.0 degrees (Fahrenheit), show it to your doctor. This may help persuade him/her.(You can still be hypothyroid with higher temperatures, but if low temperatures are present, it is simply more persuasive evidence in favor of treatment). --Supplement with iodine 150 mcg per day to be sure you are not iodine deficient. This is becoming more common in the U.S. as people avoid iodized salt. It is quite common outside the U.S. An easy, inexpensive preparation is kelp tablets. --Show your doctor a recent crucial study: The HUNT Study that suggests that cardiovascular mortality begins to increase at a TSH of only 1.5 or greater, not the 5.5 mIU usually used by laboratories and doctors. --Ask people around you whether they are aware of a health practitioner who might be willing to work with you, or at least have an open mind (sadly, an uncommon commodity). Also, see thyroid advocate and prolific author, Mary Shomon's advice on how to find a doctor willing to work with you. Yes, they are out there, but you may have to ask a lot of friends and acquaintances, or meet and fire a lot of docs. It shouldn't be this way, but it is. It will change through public pressure and education, but not by next week. Another helpful discussion from Mary Shomon: The TSH Normal Range: Why is there still controversy? You will read that even the endocrinologists (a peculiarly contentious group) seethingly debate what constitutes normal vs. low thyroid function. Also, you might remind a resistant health practitioner that guidelines are guidelines--they are not laws that restrain anyone. They are simply meant to represent broad population guidelines that do not take your personal health situation into consideration. Which statin drug is best? 8. February 2009 William Davis (7) I re-post a Heart Scan Blog post from one year ago, answering the question: Which statin drug is best?I still get this question from patients in the office and online, nearly always prompted by a TV commercial. So let me re-express my thoughts from a year ago, which have not changed on this issue. The statin drugs can indeed play a role in a program of coronary plaque control and regression. However, thanks to the overwhelming marketing (and lobbying and legislative) clout of the drug manufacturing industry, they play an undeserved, oversized role. I get reminded of this whenever I'm pressed to answer the question: "Which statin drug is best?"In trying to answer this question, we encounter several difficulties:1) The data nearly all use statins drugs by themselves, as so-called monotherapy. Other than the standard diet--you know, the American Heart Association diet, the one that causes heart disease--it is a statin drug alone that has been studied in the dozens of major trials "validating" statin drug use. The repeated failure of statin drugs to eliminate heart disease and associated events like heart attack keeps being answered by the "lower is better" argument, i.e., if 70% of heart attacks destined to occur still take place, then reduce LDL even further. This is an absurd argument that inevitably encounters a wall of limited effects. 2) The great bulk of clinical data examining both the incidence of cardiovascular events as well as plaque progression or regression have all been sponsored by the drug's manufacturer. It has been well-documnted that, when a drug manufacturer sponsors a trial, the outcome is highly likely to be in favor of that drug. Imagine Ford sponsors a $30 million study to prove that their cars are more reliable and safer. What is the likelihood that the outcome will be in favor of the competition? Very unlikely. Such is human nature. If we were to accept the clinical trial data at face value and ignore the above issues, then I would come to the conclusion that we should be using Crestor at a dose of 40 mg per day, since that was the regimen used in the ASTEROID Trial that achieved modest reversal of coronary atherosclerotic plaque by intravascular ultrasound. But I do not advocate such an ASTEROID-like approach for several reasons:1) In my experience, nobody can tolerate 40 mg of Crestor for more than few weeks, a few months at most. Show me someone who can survive and tolerate Crestor 40 mg per day and I'll show you somebody who survived a 40 foot fall off his roof--sure, it happens, but it's a fluke. 2) The notion that only one drug is necessary to regress this disease is, in my view, absurd. It ignores issues like hypertension, metabolic syndrome, inflammatory phenomena, lipoprotein(a), post-prandial (after-eating) phenomena, LDL particle size, triglycerides, etc. You mean that Crestor 40 mg per day, or other high-intensity statin monotherapy should be enough to overcome all of these patterns and provide maximal potential for coronary plaque reversal? No way. 3) Plaque reversal can occur without a statin agent. While statin drugs may provide some advantage in the reduction of LDL, much of the benefit ends there. All of the other dozens of causes of coronary atherosclerotic plaque need to be addressed. So which statin is best? This question is evidence of the brainwashing that has seized the public and my colleagues. The question is not which statin is best. The question should be: What steps do I take to maximize my chances of reversing coronary atherosclerotic plaque? The answer may or may not involve a statin drug, regardless of the subtle differences among them. Dr. Nancy Sniderman, heart scans on Today Show 5. February 2009 William Davis (6) While shaving this morning, I caught the report by NBC medical expert, Dr. Nancy Sniderman, about her coronary plaque and CT coronary angiogram. Visit msnbc.com for Breaking News, World News, and News about the EconomyThose of you in the Track Your Plaque program or who follow The Heart Scan Blog know that we should tell Dr. Sniderman and her doctor that:She has done virtually nothing that will stop an increasing heart scan score! In fact, Dr. Sniderman is now following the "prevention program" that is eerily reminiscent of Tim Russert's program! We all know how that turned out.It is pure folly to believe that a combination of Lipitor, exercise, and a "healthy diet" (usually meaning a low-fat diet--yes, the diet that promotes heart disease) will stop the otherwise relentless increase in heart scan score. Dr. Sniderman, please consider:1) Having the real causes of your coronary plaque identified. (It is highly unlikely to be just LDL cholesterol, though the drug industry is thrilled that you believe this.)2) Ask yourself (or, if your doctor knew what she was doing, ask her): Why do I have heart disease? LDL cholesterol is insufficient reason--virtually nobody I know has high LDL cholesterol as the sole cause. LDL cholesterol is, at most, one reason among many others, but is insufficient as a sole cause. 3) What is your vitamin D status? Crucial!4) What is your thyroid status? 5) Fish oil--a must!6) Do you have lipoprotein(a)? Small LDL? Just addressing the items on the above checklist would put you on a far more confident path to stop your heart scan score from increasing. If you were to repeat your heart scan score, my prediction: Your score will be higher by 18-24% per year. My personal experience with low thyroid 3. February 2009 William Davis (31) Something happened to me around October-November of last year.I usually feel great. Ordinarily, my struggles are sleeping and relaxing. As with most people, I have too many projects on my schedule, though I find my activities stimulating and fascinating.I blasted through a very demanding November, trying to meet the needs of a book publisher. This involved sleeping only a few hours a night for several days on end, all after a full day of office practice and hospital duties.But it was getting tougher. My concentration was becoming more fragmented. Getting things done was proving an elusive goal. Exercise became a real chore.Although I usually force myself to go to sleep, I was starting to fall asleep before my usual bedtime, and I was sleeping longer than usual.It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.So I had my thyroid values checked:Free T3: 2.6 pg/ml (Ref 2.3-4.2)Free T4: 1.20 ng/dl (Ref 0.89-1.76)TSH: 1.528 uUI/ml (Ref 0.350-5.500)Normal by virtually all standards. I measured my first morning oral temperature: 96.1, 96.3, 95.9. Hmmmm.My experience coincided with the Track Your Plaque and Heart Scan Blog conversations about low thyroid being enormously underappreciated, with the newest data on thyroid disease suggesting that a TSH for ideal health is probably 1.5 mIU or less. (More about that: Is normal TSH too high? and Thyroid perspective update .Could this simply be a case of medical student-oma in which every beginning medical student believes he has every disease he learns about?Despite the apparently "normal" thyroid blood tests, I took the leap and started taking Armour thyroid, beginning at 1/2 grain (30 mg), increasing to 1 grain (60 mg) after the first week.Within 10 days, I experienced:--Dramatic restoration of the ability to concentrate--A boost in mood. (In fact, the last few blog posts before I replaced thyroid reflect my deepening crabbiness.)--Large increase in energy, now restored to old levels--Need for less sleep--I'm warm again! (It's still <20 degrees, but I get easily stay warm while indoors.)I am absolutely, positively convinced of the power of thyroid. I am further convinced from the clinical data, patient experiences, and now my own personal experience, that low levels of hypothyroidism are being dramatically underappreciated and underdiagnosed.I shudder to think of what my life would have been like 6 months or a year from now without correction of thyroid hormone.Now, the tough question: Why the heck is this happening to so many people? Speaking availability 3. February 2009 William Davis (5) Just a quick announcement:If you would like to hear more about the concepts articulated in The Heart Scan Blog or in the Track Your Plaque program, I am available to speak to your group.Among the possible topics:Return to the Wild: Natural Nutritional Supplements That Supercharge HealthWhy this apparent "need" for fish oil and other heart-healthy supplements? I discuss why some nutritional supplements make perfect sense when we are viewed in the context of primitive humans living modern lives, while other supplements do little.Shrink Your Tummy . . .or, Why Your Dietitian is Fat!Weight loss doesn't have to involve calorie counting, deprivation, or hunger pangs. But the conventional "rules" for weight loss and health have to be broken.The Politically Incorrect Guide to Extraordinary Heart HealthHeart health is something that you can seize control over, something identifiable, correctable, and . . . reversible. Much of this can be achieved with little or no medication, nor procedures. I detail all the enormously empowering lessons learned through the Track Your Plaque program.I can also present in-depth yet entertaining discussions on the power of vitamin D, natural cholesterol control, screening for heart disease, and similar topics covered in the blog.To learn more, just e-mail us at contact@trackyourplaque, or call my office at 414-456-1123. Learn how to eat from Survivorman 31. January 2009 William Davis (22) Look no farther than Discovery Channel to learn how humans were meant to eat. The Survivorman show documents the (self-filmed) 7-day adventures of Les Stroud, who is dropped into various remote corners of the world to survive on little but ingenuity and will to live. Starting without food or water, the Survivorman scrapes and scrambles in the wilderness for essentials to survive in habitats as far ranging as the Ecuadorian rainforest to sub-arctic Labrador.What does Survivorman have to do with your nutrition habits? Everything. The lessons we can learn by watching this TV show are plenty. Survivorman plays out the life we are supposed to be living: slaughtering wild game with simple handmade tools and his bare hands, identifying plants and berries that are safe to eat, trapping fish, scavenging the kill of other predators. He's even resorted to eating bugs and caterpillars, particularly following several days of unsuccessful hunting and scavenging. What is notable from the Survivorman experience is what is absent: In the steppe, desert, tundra, or jungle, you will not find bread, fruit drinks, or Cheerios. You won't find farm-fattened, corn-fed livestock with meat marbled with fat. Imagine the result of such an experience for us, drawn out over 6 months. Even an obese, diabetic, gluttonous, XXX dress size 350-lb woman would return a lean 105 lbs, size 0, non-diabetic, fully able to run miles in the wild tracking game. Survivorman's quiet desperation of living in the wild, preoccupied with worries over where his next meal might be found, is a stark contrast to the bloated, shelves stacked floor-to-ceiling supermarkets, and our modern society's all-you-can-eat several times per day lifestyle. Am I advocating selling the car and house and chucking modern society for the "safety" of the jungles of Borneo? No, of course not. I am advocating taking a lesson from the clever experiment conducted by Mr. Stroud, a return-to-the-wild experience that should teach us something about how perverse our modern nutritional lives have become. CIS: Carbohydrate intolerance syndrome 28. January 2009 William Davis (28) Carbohydrate intolerance comes in many shades and colors, shapes and sizes. I call all of its varieties the Carbohydrate Intolerance Syndrome, or CIS. (Not to be confused with CSI, or Crime Scene Investigation . . . though, come to think of it, perhaps there are some interesting parallels!)At its extreme, it is called type II diabetes, in which any carbohydrate generates an extravant increase in blood sugar, followed by the domino effect of increased triglycerides, reduction in HDL, creation of small LDL, heightened inflammation, etc. and eventually to kidney disease, coronary atherosclerosis, neuropathies, etc. An intermediate form of carbohydrate intolerance is called metabolic syndrome, or pre-diabetes. These people, for the most part, look and act like diabetics, though their reaction to carbohydrate intake is not as bad. Blood sugar, for instance, might be 125 mg/dl fasting, 160 mg/dl after eating. The semi-arbitrary definition of metabolic syndrome includes at least three of the following: HDL <40 mg/dl in men, <50 mg/dl in women; triglycerides 150 mg/dl or greater; BP 135/80 or greater; waist circumference >40 inches in men, >35 inches in women; fasting glucose >100 mg/dl. This is where the conventional definitions stop: Either you are diabetic or have metabolic syndrome, or you have nothing at all. Unfortunately, this means that the millions of people with patterns not severe enough to match the standard definition of metabolic syndrome are often neglected.How about Kevin? Kevin, a 56 year old financial planner, is 5 ft 7 inches, 180 lbs (BMI 28.2). His basic measures:HDL 36 mg/dlTriglycerides 333 mg/dlBP 132/78Waist circumference 34 inchesBlood sugar 98 mg/dlKevin meets the criteria for metabolic syndrome on only two of the five criteria and therefore does not "qualify" for the diagnosis. Kevin's basic lipids showed LDL 170 mg/dl, HDL 36 mg/dl, triglycerides 333 mg/dl.But take a look at his underlying lipoprotein patterns (NMR):LDL particle number 2231 nmol/L (equivalent to a "true" LDL of 223 mg/dl)Small LDL 1811 nmol/l Large HDL 0.0 mg/dlIn other words, small LDL constitutes 81% of all LDL particles (1811/2231), a severe pattern. Large HDL is the healthy, protective fraction and Kevin has none. These are high-risk patterns for heart disease. These, too, are patterns of carbohydrate intolerance.Foods that trigger small LDL and reduction in healthy, large HDL include sugars, wheat, and cornstarch. Kevin is carbohydrate-intolerant, although he lacks the (fasting) blood sugar aspect of carbohydrate intolerance. But he shows all the underlying lipoprotein and other metabolic phenomena associated with carbohydrate intolerance. We could also cast all three conditions under the umbrella of "insulin resistance." But I prefer Carbohydrate Intolerance Syndrome, or CIS, since it immediately suggests the basic underlying cause: eating carbohydrates, especially those that trigger rapid and substantial surges in blood sugar. CIS is the Disease of the Century, judging by the figures (both numbers and humans) we are seeing. It will dominate healthcare in its various forms for many years to come. The first treatment for the Carbohydrate Intolerance Syndrome? Some would say the TZD class of drugs like Avandia. Others would say a DASH or TLC (American Heart Association) diet. How about liposuction, twice-daily Byetta injections, or even the emerging class of drugs to manipulate leptin and adiponectin? How do "heart healthy" foods like Cheerios and Cocoa Puffs fit into this? (Don't believe me? The American Heart Association says they're heart healthy!)The first treatment for the Carbohydrate Intolerance Syndrome is elimination of carbohydrates, except those that come from raw nuts and seeds, vegetables, occasional real fruit (not those green fake grapes), wine, and dark chocolates. Making sense out of lipid changes 27. January 2009 William Davis (9) Maggie had been doing well on her program, enjoying favorable lipids near our 60-60-60 targets (HDL 60 mg/dl or greater, LDL 60 mg/dl or less, triglycerides 60 mg/dl or less). Last fall, her last set of values were:Total cholesterol: 149 mg/dlLDL cholesterol: 67 mg/dlHDL cholesterol: 73 mg/dlTriglycerides: 43 mg/dl The holidays, as with most people, involved a frenzy of indulgent eating: Christmas cookies, cakes, pies, stuffing, potatoes, candies, etc.Maggie returned to the office 6 pounds heavier with these values: Total cholesterol: 210 mg/dlLDL cholesterol: 124 mg/dlHDL cholesterol: 57 mg/dlTriglycerides: 144 mg/dl In other words, holiday indulgences caused an increase in LDL cholesterol, a reduction in HDL, an increase in triglycerides, an increase in total cholesterol. What happened? At first glance, many of my colleagues would interpret this as fat indulgence and/or a "need" for statin drug therapy. Having done thousands of lipoprotein panels, I can tell you that, beneath the surface, the following has occurred:--Overindulgence in carbohydrates from the goodies triggered triglyceride (actually VLDL) formation in the liver, released into the blood. --Increased triglycerides and VLDL triggered a boom in conversion of large LDL to small LDL (since triglycerides are required to form small LDL particles) via cholesteryl-ester transfer protein (CETP) activity.--Increased triglycerides and VLDL interacted with HDL particles, causing "remodeling" of HDL particles to the less desirable, less protective small particles, which do not persist as long in the blood, resulting in a reduction of HDL. The critical factor is carbohydrate intake. This triggered a domino effect that is often misintepreted as excessive fat intake or a genetic predisposition. It is nothing of the kind. I discussed this phenomenon with Maggie. She now knows to not overindulge in the holiday snacks in future and will revert promptly back to her 60-60-60 values. How to Give Yourself Hashimoto's Thyroiditis: 101 25. January 2009 William Davis (18) I borrowed this from the enormously clever Dr. BG at The Animal Pharm Blog. How to Give Yourself Hashimoto's Thyroiditis: 101--lack of sunlight/vitamin D/indoor habitation--mental stress--more mental stress--sleep deprivation... (excessive mochas/lattes at Berkeley cafes)--excessive 'social' calendar--inherent family history of autoimmune disorders (who doesn't??)--wheat, wheat, and more wheat ingestion ('comfort foods' craved in times of high cortisol/stress, right? how did I know the carbs were killing me?)--lack of nutritious food containing EPA DHA, vitamin A, sat fats, minerals, iodine, etc--lack of play, exercise, movement (or ?overtraining perhaps for Oprah's case)--weight gain -- which begins an endless self-perpetuating vicous cycle of all the above (Is it stressful to balloon out for no apparent reason? YES)If you haven't done so already, take a look at Animal Pharm you will get a real kick out of Dr. BG's quick-witted take on things. We are systematically looking for low thyroid (hypothyroidism) in everyone and findings oodles of it, far more than I ever expected. Much of the low thyroid phenomena is due to active or previous Hashimoto's thyroiditis, the inflammatory process that exerts destructive effects on the delicate thyroid gland. It is presently unclear how much is due to iodine deficiency in this area, though iodine supplementation by itself (i.e., without thyroid hormone replacement) has not been yielding improved thyroid measures.I find this bothersome: Is low thyroid function the consequence of direct thyroid toxins (flame retardants like polybrominated diphenyl ethers, pesticide residues in vegetables and fruits, bisphenol A from polycarbonate plastics) or indirect toxins such as wheat via an autoimmune process (similar to that seen in celiac disease)? I don't know, but we've got to deal with the thyroid-destructive aftermath: Look for thyroid dysfunction, even in those without symptoms, and correct it. This has become a basic tenet of the Track Your Plaque approach for intensive reduction of coronary risk. Framing 24. January 2009 William Davis (0) Heart health without a 12" incisionHeart health for less than $44,483 (Cost of a coronary stent according to the American Heart Association 2008 Update)Track Your Plaque: A drug-free zone << Older posts Newer posts >> Newer posts12...474849505152535455...123124Older posts
Low thyroid: What to do? 8. February 2009 William Davis (25) I've gotten a number of requests for solutions on how to solve the low thyroid issue if either 1) your doctor refuses to discuss the issue or denies it is present, or 2) there are government mandates against thyroid correction unless certain (outdated) targets are met.Oh, boy. While I'm not encouraging anyone to break the laws or regulations of their country (and it's impossible to generalize, with readers of this blog originating from over 30 countries), here are some simple steps to consider that might help you in your quest to correct hypothyroidism:--Measure your body temperature--First thing in the morning either while lying in bed or go to the bathroom and measure your oral temp. Record it and, if it is consistently lower than 97.0 degrees (Fahrenheit), show it to your doctor. This may help persuade him/her.(You can still be hypothyroid with higher temperatures, but if low temperatures are present, it is simply more persuasive evidence in favor of treatment). --Supplement with iodine 150 mcg per day to be sure you are not iodine deficient. This is becoming more common in the U.S. as people avoid iodized salt. It is quite common outside the U.S. An easy, inexpensive preparation is kelp tablets. --Show your doctor a recent crucial study: The HUNT Study that suggests that cardiovascular mortality begins to increase at a TSH of only 1.5 or greater, not the 5.5 mIU usually used by laboratories and doctors. --Ask people around you whether they are aware of a health practitioner who might be willing to work with you, or at least have an open mind (sadly, an uncommon commodity). Also, see thyroid advocate and prolific author, Mary Shomon's advice on how to find a doctor willing to work with you. Yes, they are out there, but you may have to ask a lot of friends and acquaintances, or meet and fire a lot of docs. It shouldn't be this way, but it is. It will change through public pressure and education, but not by next week. Another helpful discussion from Mary Shomon: The TSH Normal Range: Why is there still controversy? You will read that even the endocrinologists (a peculiarly contentious group) seethingly debate what constitutes normal vs. low thyroid function. Also, you might remind a resistant health practitioner that guidelines are guidelines--they are not laws that restrain anyone. They are simply meant to represent broad population guidelines that do not take your personal health situation into consideration.
Which statin drug is best? 8. February 2009 William Davis (7) I re-post a Heart Scan Blog post from one year ago, answering the question: Which statin drug is best?I still get this question from patients in the office and online, nearly always prompted by a TV commercial. So let me re-express my thoughts from a year ago, which have not changed on this issue. The statin drugs can indeed play a role in a program of coronary plaque control and regression. However, thanks to the overwhelming marketing (and lobbying and legislative) clout of the drug manufacturing industry, they play an undeserved, oversized role. I get reminded of this whenever I'm pressed to answer the question: "Which statin drug is best?"In trying to answer this question, we encounter several difficulties:1) The data nearly all use statins drugs by themselves, as so-called monotherapy. Other than the standard diet--you know, the American Heart Association diet, the one that causes heart disease--it is a statin drug alone that has been studied in the dozens of major trials "validating" statin drug use. The repeated failure of statin drugs to eliminate heart disease and associated events like heart attack keeps being answered by the "lower is better" argument, i.e., if 70% of heart attacks destined to occur still take place, then reduce LDL even further. This is an absurd argument that inevitably encounters a wall of limited effects. 2) The great bulk of clinical data examining both the incidence of cardiovascular events as well as plaque progression or regression have all been sponsored by the drug's manufacturer. It has been well-documnted that, when a drug manufacturer sponsors a trial, the outcome is highly likely to be in favor of that drug. Imagine Ford sponsors a $30 million study to prove that their cars are more reliable and safer. What is the likelihood that the outcome will be in favor of the competition? Very unlikely. Such is human nature. If we were to accept the clinical trial data at face value and ignore the above issues, then I would come to the conclusion that we should be using Crestor at a dose of 40 mg per day, since that was the regimen used in the ASTEROID Trial that achieved modest reversal of coronary atherosclerotic plaque by intravascular ultrasound. But I do not advocate such an ASTEROID-like approach for several reasons:1) In my experience, nobody can tolerate 40 mg of Crestor for more than few weeks, a few months at most. Show me someone who can survive and tolerate Crestor 40 mg per day and I'll show you somebody who survived a 40 foot fall off his roof--sure, it happens, but it's a fluke. 2) The notion that only one drug is necessary to regress this disease is, in my view, absurd. It ignores issues like hypertension, metabolic syndrome, inflammatory phenomena, lipoprotein(a), post-prandial (after-eating) phenomena, LDL particle size, triglycerides, etc. You mean that Crestor 40 mg per day, or other high-intensity statin monotherapy should be enough to overcome all of these patterns and provide maximal potential for coronary plaque reversal? No way. 3) Plaque reversal can occur without a statin agent. While statin drugs may provide some advantage in the reduction of LDL, much of the benefit ends there. All of the other dozens of causes of coronary atherosclerotic plaque need to be addressed. So which statin is best? This question is evidence of the brainwashing that has seized the public and my colleagues. The question is not which statin is best. The question should be: What steps do I take to maximize my chances of reversing coronary atherosclerotic plaque? The answer may or may not involve a statin drug, regardless of the subtle differences among them.
Dr. Nancy Sniderman, heart scans on Today Show 5. February 2009 William Davis (6) While shaving this morning, I caught the report by NBC medical expert, Dr. Nancy Sniderman, about her coronary plaque and CT coronary angiogram. Visit msnbc.com for Breaking News, World News, and News about the EconomyThose of you in the Track Your Plaque program or who follow The Heart Scan Blog know that we should tell Dr. Sniderman and her doctor that:She has done virtually nothing that will stop an increasing heart scan score! In fact, Dr. Sniderman is now following the "prevention program" that is eerily reminiscent of Tim Russert's program! We all know how that turned out.It is pure folly to believe that a combination of Lipitor, exercise, and a "healthy diet" (usually meaning a low-fat diet--yes, the diet that promotes heart disease) will stop the otherwise relentless increase in heart scan score. Dr. Sniderman, please consider:1) Having the real causes of your coronary plaque identified. (It is highly unlikely to be just LDL cholesterol, though the drug industry is thrilled that you believe this.)2) Ask yourself (or, if your doctor knew what she was doing, ask her): Why do I have heart disease? LDL cholesterol is insufficient reason--virtually nobody I know has high LDL cholesterol as the sole cause. LDL cholesterol is, at most, one reason among many others, but is insufficient as a sole cause. 3) What is your vitamin D status? Crucial!4) What is your thyroid status? 5) Fish oil--a must!6) Do you have lipoprotein(a)? Small LDL? Just addressing the items on the above checklist would put you on a far more confident path to stop your heart scan score from increasing. If you were to repeat your heart scan score, my prediction: Your score will be higher by 18-24% per year.
My personal experience with low thyroid 3. February 2009 William Davis (31) Something happened to me around October-November of last year.I usually feel great. Ordinarily, my struggles are sleeping and relaxing. As with most people, I have too many projects on my schedule, though I find my activities stimulating and fascinating.I blasted through a very demanding November, trying to meet the needs of a book publisher. This involved sleeping only a few hours a night for several days on end, all after a full day of office practice and hospital duties.But it was getting tougher. My concentration was becoming more fragmented. Getting things done was proving an elusive goal. Exercise became a real chore.Although I usually force myself to go to sleep, I was starting to fall asleep before my usual bedtime, and I was sleeping longer than usual.It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.So I had my thyroid values checked:Free T3: 2.6 pg/ml (Ref 2.3-4.2)Free T4: 1.20 ng/dl (Ref 0.89-1.76)TSH: 1.528 uUI/ml (Ref 0.350-5.500)Normal by virtually all standards. I measured my first morning oral temperature: 96.1, 96.3, 95.9. Hmmmm.My experience coincided with the Track Your Plaque and Heart Scan Blog conversations about low thyroid being enormously underappreciated, with the newest data on thyroid disease suggesting that a TSH for ideal health is probably 1.5 mIU or less. (More about that: Is normal TSH too high? and Thyroid perspective update .Could this simply be a case of medical student-oma in which every beginning medical student believes he has every disease he learns about?Despite the apparently "normal" thyroid blood tests, I took the leap and started taking Armour thyroid, beginning at 1/2 grain (30 mg), increasing to 1 grain (60 mg) after the first week.Within 10 days, I experienced:--Dramatic restoration of the ability to concentrate--A boost in mood. (In fact, the last few blog posts before I replaced thyroid reflect my deepening crabbiness.)--Large increase in energy, now restored to old levels--Need for less sleep--I'm warm again! (It's still <20 degrees, but I get easily stay warm while indoors.)I am absolutely, positively convinced of the power of thyroid. I am further convinced from the clinical data, patient experiences, and now my own personal experience, that low levels of hypothyroidism are being dramatically underappreciated and underdiagnosed.I shudder to think of what my life would have been like 6 months or a year from now without correction of thyroid hormone.Now, the tough question: Why the heck is this happening to so many people?
Speaking availability 3. February 2009 William Davis (5) Just a quick announcement:If you would like to hear more about the concepts articulated in The Heart Scan Blog or in the Track Your Plaque program, I am available to speak to your group.Among the possible topics:Return to the Wild: Natural Nutritional Supplements That Supercharge HealthWhy this apparent "need" for fish oil and other heart-healthy supplements? I discuss why some nutritional supplements make perfect sense when we are viewed in the context of primitive humans living modern lives, while other supplements do little.Shrink Your Tummy . . .or, Why Your Dietitian is Fat!Weight loss doesn't have to involve calorie counting, deprivation, or hunger pangs. But the conventional "rules" for weight loss and health have to be broken.The Politically Incorrect Guide to Extraordinary Heart HealthHeart health is something that you can seize control over, something identifiable, correctable, and . . . reversible. Much of this can be achieved with little or no medication, nor procedures. I detail all the enormously empowering lessons learned through the Track Your Plaque program.I can also present in-depth yet entertaining discussions on the power of vitamin D, natural cholesterol control, screening for heart disease, and similar topics covered in the blog.To learn more, just e-mail us at contact@trackyourplaque, or call my office at 414-456-1123.
Learn how to eat from Survivorman 31. January 2009 William Davis (22) Look no farther than Discovery Channel to learn how humans were meant to eat. The Survivorman show documents the (self-filmed) 7-day adventures of Les Stroud, who is dropped into various remote corners of the world to survive on little but ingenuity and will to live. Starting without food or water, the Survivorman scrapes and scrambles in the wilderness for essentials to survive in habitats as far ranging as the Ecuadorian rainforest to sub-arctic Labrador.What does Survivorman have to do with your nutrition habits? Everything. The lessons we can learn by watching this TV show are plenty. Survivorman plays out the life we are supposed to be living: slaughtering wild game with simple handmade tools and his bare hands, identifying plants and berries that are safe to eat, trapping fish, scavenging the kill of other predators. He's even resorted to eating bugs and caterpillars, particularly following several days of unsuccessful hunting and scavenging. What is notable from the Survivorman experience is what is absent: In the steppe, desert, tundra, or jungle, you will not find bread, fruit drinks, or Cheerios. You won't find farm-fattened, corn-fed livestock with meat marbled with fat. Imagine the result of such an experience for us, drawn out over 6 months. Even an obese, diabetic, gluttonous, XXX dress size 350-lb woman would return a lean 105 lbs, size 0, non-diabetic, fully able to run miles in the wild tracking game. Survivorman's quiet desperation of living in the wild, preoccupied with worries over where his next meal might be found, is a stark contrast to the bloated, shelves stacked floor-to-ceiling supermarkets, and our modern society's all-you-can-eat several times per day lifestyle. Am I advocating selling the car and house and chucking modern society for the "safety" of the jungles of Borneo? No, of course not. I am advocating taking a lesson from the clever experiment conducted by Mr. Stroud, a return-to-the-wild experience that should teach us something about how perverse our modern nutritional lives have become.
CIS: Carbohydrate intolerance syndrome 28. January 2009 William Davis (28) Carbohydrate intolerance comes in many shades and colors, shapes and sizes. I call all of its varieties the Carbohydrate Intolerance Syndrome, or CIS. (Not to be confused with CSI, or Crime Scene Investigation . . . though, come to think of it, perhaps there are some interesting parallels!)At its extreme, it is called type II diabetes, in which any carbohydrate generates an extravant increase in blood sugar, followed by the domino effect of increased triglycerides, reduction in HDL, creation of small LDL, heightened inflammation, etc. and eventually to kidney disease, coronary atherosclerosis, neuropathies, etc. An intermediate form of carbohydrate intolerance is called metabolic syndrome, or pre-diabetes. These people, for the most part, look and act like diabetics, though their reaction to carbohydrate intake is not as bad. Blood sugar, for instance, might be 125 mg/dl fasting, 160 mg/dl after eating. The semi-arbitrary definition of metabolic syndrome includes at least three of the following: HDL <40 mg/dl in men, <50 mg/dl in women; triglycerides 150 mg/dl or greater; BP 135/80 or greater; waist circumference >40 inches in men, >35 inches in women; fasting glucose >100 mg/dl. This is where the conventional definitions stop: Either you are diabetic or have metabolic syndrome, or you have nothing at all. Unfortunately, this means that the millions of people with patterns not severe enough to match the standard definition of metabolic syndrome are often neglected.How about Kevin? Kevin, a 56 year old financial planner, is 5 ft 7 inches, 180 lbs (BMI 28.2). His basic measures:HDL 36 mg/dlTriglycerides 333 mg/dlBP 132/78Waist circumference 34 inchesBlood sugar 98 mg/dlKevin meets the criteria for metabolic syndrome on only two of the five criteria and therefore does not "qualify" for the diagnosis. Kevin's basic lipids showed LDL 170 mg/dl, HDL 36 mg/dl, triglycerides 333 mg/dl.But take a look at his underlying lipoprotein patterns (NMR):LDL particle number 2231 nmol/L (equivalent to a "true" LDL of 223 mg/dl)Small LDL 1811 nmol/l Large HDL 0.0 mg/dlIn other words, small LDL constitutes 81% of all LDL particles (1811/2231), a severe pattern. Large HDL is the healthy, protective fraction and Kevin has none. These are high-risk patterns for heart disease. These, too, are patterns of carbohydrate intolerance.Foods that trigger small LDL and reduction in healthy, large HDL include sugars, wheat, and cornstarch. Kevin is carbohydrate-intolerant, although he lacks the (fasting) blood sugar aspect of carbohydrate intolerance. But he shows all the underlying lipoprotein and other metabolic phenomena associated with carbohydrate intolerance. We could also cast all three conditions under the umbrella of "insulin resistance." But I prefer Carbohydrate Intolerance Syndrome, or CIS, since it immediately suggests the basic underlying cause: eating carbohydrates, especially those that trigger rapid and substantial surges in blood sugar. CIS is the Disease of the Century, judging by the figures (both numbers and humans) we are seeing. It will dominate healthcare in its various forms for many years to come. The first treatment for the Carbohydrate Intolerance Syndrome? Some would say the TZD class of drugs like Avandia. Others would say a DASH or TLC (American Heart Association) diet. How about liposuction, twice-daily Byetta injections, or even the emerging class of drugs to manipulate leptin and adiponectin? How do "heart healthy" foods like Cheerios and Cocoa Puffs fit into this? (Don't believe me? The American Heart Association says they're heart healthy!)The first treatment for the Carbohydrate Intolerance Syndrome is elimination of carbohydrates, except those that come from raw nuts and seeds, vegetables, occasional real fruit (not those green fake grapes), wine, and dark chocolates.
Making sense out of lipid changes 27. January 2009 William Davis (9) Maggie had been doing well on her program, enjoying favorable lipids near our 60-60-60 targets (HDL 60 mg/dl or greater, LDL 60 mg/dl or less, triglycerides 60 mg/dl or less). Last fall, her last set of values were:Total cholesterol: 149 mg/dlLDL cholesterol: 67 mg/dlHDL cholesterol: 73 mg/dlTriglycerides: 43 mg/dl The holidays, as with most people, involved a frenzy of indulgent eating: Christmas cookies, cakes, pies, stuffing, potatoes, candies, etc.Maggie returned to the office 6 pounds heavier with these values: Total cholesterol: 210 mg/dlLDL cholesterol: 124 mg/dlHDL cholesterol: 57 mg/dlTriglycerides: 144 mg/dl In other words, holiday indulgences caused an increase in LDL cholesterol, a reduction in HDL, an increase in triglycerides, an increase in total cholesterol. What happened? At first glance, many of my colleagues would interpret this as fat indulgence and/or a "need" for statin drug therapy. Having done thousands of lipoprotein panels, I can tell you that, beneath the surface, the following has occurred:--Overindulgence in carbohydrates from the goodies triggered triglyceride (actually VLDL) formation in the liver, released into the blood. --Increased triglycerides and VLDL triggered a boom in conversion of large LDL to small LDL (since triglycerides are required to form small LDL particles) via cholesteryl-ester transfer protein (CETP) activity.--Increased triglycerides and VLDL interacted with HDL particles, causing "remodeling" of HDL particles to the less desirable, less protective small particles, which do not persist as long in the blood, resulting in a reduction of HDL. The critical factor is carbohydrate intake. This triggered a domino effect that is often misintepreted as excessive fat intake or a genetic predisposition. It is nothing of the kind. I discussed this phenomenon with Maggie. She now knows to not overindulge in the holiday snacks in future and will revert promptly back to her 60-60-60 values.
How to Give Yourself Hashimoto's Thyroiditis: 101 25. January 2009 William Davis (18) I borrowed this from the enormously clever Dr. BG at The Animal Pharm Blog. How to Give Yourself Hashimoto's Thyroiditis: 101--lack of sunlight/vitamin D/indoor habitation--mental stress--more mental stress--sleep deprivation... (excessive mochas/lattes at Berkeley cafes)--excessive 'social' calendar--inherent family history of autoimmune disorders (who doesn't??)--wheat, wheat, and more wheat ingestion ('comfort foods' craved in times of high cortisol/stress, right? how did I know the carbs were killing me?)--lack of nutritious food containing EPA DHA, vitamin A, sat fats, minerals, iodine, etc--lack of play, exercise, movement (or ?overtraining perhaps for Oprah's case)--weight gain -- which begins an endless self-perpetuating vicous cycle of all the above (Is it stressful to balloon out for no apparent reason? YES)If you haven't done so already, take a look at Animal Pharm you will get a real kick out of Dr. BG's quick-witted take on things. We are systematically looking for low thyroid (hypothyroidism) in everyone and findings oodles of it, far more than I ever expected. Much of the low thyroid phenomena is due to active or previous Hashimoto's thyroiditis, the inflammatory process that exerts destructive effects on the delicate thyroid gland. It is presently unclear how much is due to iodine deficiency in this area, though iodine supplementation by itself (i.e., without thyroid hormone replacement) has not been yielding improved thyroid measures.I find this bothersome: Is low thyroid function the consequence of direct thyroid toxins (flame retardants like polybrominated diphenyl ethers, pesticide residues in vegetables and fruits, bisphenol A from polycarbonate plastics) or indirect toxins such as wheat via an autoimmune process (similar to that seen in celiac disease)? I don't know, but we've got to deal with the thyroid-destructive aftermath: Look for thyroid dysfunction, even in those without symptoms, and correct it. This has become a basic tenet of the Track Your Plaque approach for intensive reduction of coronary risk.
Framing 24. January 2009 William Davis (0) Heart health without a 12" incisionHeart health for less than $44,483 (Cost of a coronary stent according to the American Heart Association 2008 Update)Track Your Plaque: A drug-free zone