Who lost weight?

1. August 2009 William Davis (30)
The results of the latest Heart Scan Blog poll are in.


I went wheat-free and I . . .


Gained weight 6 (3%)

Lost no weight 41 (21%)

Lost less than 10 lbs 28 (14%)

Lost more than 10 lbs 34 (17%)

Lost more than 20 lbs 22 (11%)

Lost more than 30 lbs 28 (14%)

I'm still losing weight! 30 (15%)

(189 respondents)


This means that, by eliminating wheat:

24% had no success

31% had moderate success (less than 10 lbs or more than 10 lbs)

25% had extravagant results with 20 lbs or more lost

It would be interesting to know where along the weight-loss spectrum the last category, "I'm still losing weight," group falls. (Anyone with a good story please speak up!)

I believe we can conclude from this casual exercise that, as a simple strategy, wheat elimination is surprisingly effective.

Why would 3% gain weight? Well, without knowing the details, there are several possible explanations:

1) Weight gain developed through other foods. For instance, I've had people eliminate wheat only to replace it with fattening gluten-free alternatives. Remember: wheat-free is not gluten-free. Others load up on the wrong foods, e.g., Craisins and other dried fruit; overdo dairy; or snack on wheat-free but unhealthy foods like ice cream and chips.

2) Too much alcohol

3) Hypothyroidism--A lot more common than you'd think. In fact, this has been the case with a majority of people who have done everything right, yet either failed to lose weight or gained weight.

Those are the biggies.

I'd like to hear your personal stories of wheat elimination--the ups and downs, your success or failure, how you felt during the process, how easy or difficult, your eventual results. Just post them as a response to this blog post.

A niacin primer

29. July 2009 William Davis (19)
A reader of Life Extension reminded me of a piece I wrote about niacin a couple of years back.

Anyone desiring a primer on how and why to use niacin to correct lipid and lipoprotein patterns might find this useful.

While some people, no matter what they do, cannot tolerate niacin (about 10% of people), many others enjoy spectacular benefits.


Q: I recently had a cholesterol profile blood test and learned that I may be at risk of heart disease because my levels of beneficial HDL (high-density lipoprotein) are too low. I read that niacin could help increase my HDL, but my doctor said niacin is dangerous. Whom should I believe?

A: Your doctor would be right—if we were still living in 1985. Since then, however, we have learned how to use niacin (vitamin B3) safely and effectively. Unfortunately, many physicians have not yet caught up, or are still trapped by the idea that cholesterol-lowering statin drugs are the only way to decrease cardiovascular disease risk. I have personally prescribed niacin for thousands of patients as part of our program to reverse coronary disease. In fact, niacin is the closest thing we have available to a perfect treatment that corrects most of the causes of coronary heart disease.

Continued here.

What would life be like . . . ?

29. July 2009 William Davis (16)
What if coronary heart disease could be prevented--no eliminated--applying methods that were accessible, easy, and cheap?

What if coronary heart disease and, thereby, angina, heart attack, sudden cardiac death, ventricular tachycardia, heart failure, and the cerebrovascular equivalent, stroke, could be eliminated using readily available tools available to virtually everyone in the U.S.? And, over a year, it cost less than a once-a-week latte at Starbucks?

How would the healthcare landscape change? What would become of hospitals, manufacturers of the billions of dollars of hospital equipment necessary to supply the cardiovascular hospital industry (e.g., stent manufacturers, catheter manufacturers, defibrillator and pacemaker manufacturers, pharmaceutical manufacturers who no longer have to produce the volume of antiplatelet agents, inotropic drugs, antiarrhythmic agents, etc.)?

How would our lives change? What would the end of life look like if people stopped dying of heart attack, sudden cardiac death, congestive heart failure at age 55, 65, or 75, but lived out their lives to die of something unrelated?

What if the solution had little or nothing to do with drugs but evolved from simple nutritional strategies, supplements meant to correct the deficiencies that accompany modern lifestyles, and a few unique strategies targeted towards the genetic predispositions that lead to heart disease?

What if all this were possible at a cost of a few hundred dollars per year?

It would certainly be a cataclysmic change. Hospitals would shrink to a small remnant of their current gargantuan, dozens-per-city presence. The need for hospital staff would be slashed by over half. The rare cardiologist would tend to congenital heart disease sufferers and other unusual forms of heart disease and he or she might have a colleague or two in all of a major city.

Healthcare costs would plummet, no longer having to sustain the enormous cardiovascular healthcare machine of hospitals, staff, industry, and long-term care. Health insurance, private or public, would drop by 50%.

It would free up nearly a trillion dollars that could be redirected towards other pursuits, like schools and research. Extraordinary leaps forward in quality of life and science would emerge, given that magnitude of funding.

It's not as grand a thought experiment as Alan Weisman's The World Without Us, in which he imagines what the world would be like without humans altogether.

How long would it take to recover lost ground and restore Eden to the way it must have gleamed and smelled the day before Adam, or Homo habilis, appeared? Could nature ever obliterate all our traces? How would it undo our monumental cities and public works, and reduce our myriad plastics and toxic synthetics back to benign, basic elements?

But I believe this thought experiment--what would life be like without heart disease because it was eliminated using inexpensive tools-- is more plausible, more likely to occur. In fact, it has already begun to occur.

See those vines growing up the side of the hospital?

Are jelly beans heart healthy?

27. July 2009 William Davis (0)
Total Fat

3 g or less

Less than 6.5 g





Saturated Fat



1 g or less

1 g or less





Cholesterol

20 mg or less

20 mg or less





Sodium

480 mg or less per RACC* & labeled serving

480 mg or less per RACC* & labeled serving





Nutrients

Contain 10 percent or more of the daily value of 1 of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber



Contain 10 percent or more of the daily value of 1of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber





Trans fat

Less than 0.5 g per RACC* and labeled serving



Less than 0.5 g per RACC* and labeled serving





Whole Grain

N/A



51 percent by weight/RACC*







Minimum Dietary Fiber



N/A

1.7 g/RACC of 30 g

2.5 g/RACC of 45 g

2.8 g/RACC of 50 g

3.0 g/RACC of 55 g





(RACC=Reference Amount Customarily Consumed)

Thyroid correction: The woeful prevailing standard

27. July 2009 William Davis (16)
Rich has been taking Synthroid or levothyroxine for many years.

When Rich came to my office for continuing management 10 years after his bypass surgery, I checked his thyroid panel:

TSH 7.44 uIU/L

Free T4 1.88 ng/dl (Ref range 0.80-1.90 ng/dl)

Free T3 2.0 pg/ml (Ref range 2.3-4.2 pg/ml)


Rich's thyroid hormone distortions--high TSH, low T3--are sufficient to account for a tripling of heart attack risk long-term.

As Richs' thyroid was being managed by his primary care physician, I notified this doctor of Rich's panel. He therefore increased Rich's levothyroxine from 75 mcg per day to 100 mcg per day. Another thyroid panel several months later showed:

TSH 0.98 uIU/L

Free T4 2.38 ng/dl

Free T3 2.0 pg/ml


As you would expect, increasing the intake of the T4 hormone (levothyroxine) increased free T4 and suppressed TSH.

But what about T3? It's unchanged.

Indeed, Rich says that he feels no better and, in fact, wakes up in the morning foggy and requires a nap in the afternoon.

In my experience, the majority (approximately 70%, but not 100%) experience subjective improvement when T3 is added in some form and the free T3 level is increased. While the data (summarized here) are conflicted on whether there is objective benefit to T3 management and supplementation, there seems to be a poorly-quantified subjective improvement.

Rich's increased levothyroxine dose decreased (calculated) LDL cholesterol by 10 mg/dl. Based on my experience, I'll bet that his lipid panel would likely be further improved with T3 correction.

What I find incredible is the absolutely rabid resistance waged by primary care physicians and endocrinologists against this notion of T3, mostly due to fears of the remote likelihood of inducing atrial fibrillation and osteoporosis, while they are ready to prescribe lifelong statin drugs without a moment's hesitation.

Launch of new Track Your Plaque newsletter: Cardiac Confidential

27. July 2009 William Davis (3)
Track Your Plaque has just launched a new version of our newsletter. We call it Cardiac Confidential.

Cardiac Confidential is meant to be a no-holds-barred, go-for-the-throat exposé of the world of heart disease. We will expose the dishonest, reveal what we view as the underlying truth. We'll even have an occasional "undercover" report of what goes on in hospitals and the go-for-the-money world of heart procedures.

Read the first issue here (open to everyone) in which "Laurie" describes her encounter with a sleazy, profiteering cardiologist. She survives, but not without paying a dear price.

Thyroid: Be a perfectionist

27. July 2009 William Davis (18)
If you'd like to reduce LDL cholesterol with nearly as much power as a statin drug, think thyroid.

When thyroid is corrected to ideal levels, LDL cholesterol drops 20, 30, 40 mg/dl or more, depending on how poor thyroid function and how high LDL are at the start. The poorer the thyroid function (the higher the TSH or the lower the T3 and T4) and the higher the LDL cholesterol, the more LDL drops with thyroid correction.

(For those of you minding LDL particle size, such as Track Your Plaque Members, the "dominant" LDL species will drop: If you are genetic small LDL, small LDL will drop. If you have mostly large LDL because of being wheat-free and sugar-free, then large LDL will drop.)

One of the problems is that many healthcare providers blindly follow what the laboratory says is "normal" or the "reference range," which is usually nothing more than a population average (actually the mean +/- 2 standard deviations, a common method of developing references ranges). In other words, a substantial degree of low thyroid function, or hypothyroidism, can be present when your doctor adheres to the reference range provided by the laboratory.

What does it mean to achieve ideal thyroid status? My list includes:

--Normal oral temperature of 97.3 F first upon arising. (The thyroid is the body's thermoregulatory organ.)
--TSH 1.0 mIU/L or less
--Free T3 upper half "normal" range
--Free T4 upper half "normal" range
--You feel good: mental clarity, energy, upbeat mood. You lose weight when you try.

Iodine replacement should be part of any thyroid health effort. Iodine is not an optional trace mineral, no more than vitamin C is optional (else your teeth fall out). The only dangers to iodine replacement are to those who have been starved of iodine for many years; increase iodine and the thyroid can over-respond. I've seen this happen in 2 of the last 300 people who have supplemented iodine.

In my view, neglecting T3 replacement is absurd. While it is not clear to me why many otherwise healthy people have low T3 at the low range of "normal" or even in the below-normal range, people feel better and have better health--faster weight loss, reduced LDL, reduced triglycerides, they are happier and enjoy more energy--when T3 is increased to the upper half of the reference range. (Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)

It pays to be a perfectionist when it comes to thyroid. Not only do you feel better, but LDL cholesterol can drop with a statin-like magnitude, but with none of the adverse effects.

If interested, Track Your Plaque offers fingerstick blood spot testing that you can perform in your own home. Each test kit will test for: TSH, free T3, free T4, along with a thyroid peroxidase antibody (a marker for Hashimoto's thyroiditis, an autoimmune inflammatory condition of the thyroid).

Nutrition Syllogism

21. July 2009 William Davis (21)
What do you think of these chains of logic?

Cyanide is a potent lethal poison; carbon monoxide is a less lethal poison.
Therefore: plenty of carbon monoxide is good.



Having uterine cancer is a bad thing. Having uterine fibroids is a less bad thing.
Therefore: plenty of uterine fibroids are good.


These are obvious examples of seriously flawed logic. Students of logic and philosophy will recognize the above erroneous sequences as examples of the twisted arguments often used to persuade an argumentative opponent of the logic of a premise. As long ago as 335 B.C., Greek philosopher, Aristotle, recognized the pitfalls of thinking in such arguments. You think we’d know better by now.

Try this one:

White enriched flour is a bad for health; whole grains are less bad for health.
Therefore: plenty of whole grains are good for health.


Ouch!

In the 1960s, we all ate hot dogs on white buns, white flour Wonder Bread® sandwiches, Mom made cookies and cupcakes with white flour. Then, during the 1970s and 1980s, clinical studies were performed demonstrating that whole wheat and whole grains reduced colon cancer, high blood pressure, diabetes, and heart disease compared to white flour. In other words, add back fiber and B vitamins and health benefits develop: No argument here.

Therefore: whole grains must be good for health. Further, lots of whole grains?unlimited quantities of whole grains many times per day, every day?must be even better. Even the USDA says so on their nutrition pyramid, with 8-11 servings of grains per day, 4 of which should be whole grains, at the widest portion of the pyramid.

But what happens when you follow this logic through and fill your diet with whole grains?

Look around you and it’s easy to see: Appetite increases, people become obese, blood sugar increases, diabetes develops, HDL cholesterol plummets, triglycerides skyrocket, inflammatory patterns (e.g., c-reactive protein, or CRP) increase, small LDL (the number one cause for heart disease in the obese U.S.!) shoots through the roof.

I would no more fill my diet with “healthy whole grains” than I would close my garage door with the car running.

Is pomegranate juice healthy?

19. July 2009 William Davis (20)

Pomegranate juice, 8 oz:

Sugars, total 31.50 g

Sucrose 0.00 g

Glucose (dextrose) 15.64 g

Fructose 15.86 g




In your quest to increase the flavonoids in your diet, do you overexpose yourself to fructose?

Remember: Fructose increases LDL cholesterol, apoprotein B, small LDL, triglycerides, and substantially increases deposition of visceral fat (fructose belly?). How about a slice of whole grain bread with that glass of pomegranate juice? The Heart Association says it's all low-fat!


(Coming on the Track Your Plaque website: A full in-depth Special Report on fructose in all its glorious forms and whether this is truly an issue for your health. Fructose tables and the scientific data to establish a safe "threshold" value will be included.)

Image courtesy Wikipedia

Honeydew melon

18. July 2009 William Davis (4)

Honeydew melon:

Sugars, total 51.97 g

Sucrose 15.87 g

Glucose 17.15 g

Fructose 18.94 g

Because sucrose is half fructose (the other half is glucose), there are approximately 26 grams of fructose per one-half honeydew melon.



Image courtesy Wikipedia

Does staying up late make you fat?

3. March 2009 William Davis (5)
Lack of sleep makes you crabby.

But can staying up late make you fat? Or diabetic? Or increase heart disease risk?

Can forcing your body to ignore its evolutionarily-programmed day-night/sleep-wakefulness cycle also distort health, even when sleep is adequate?

Yet another study adds to the growing clinical literature documenting the lack of sleep, or, in this case, the "violation" of circadian rhythms that occurs with unpredictable or shifting sleep patterns.

In this small study of 10 men and women, forcing them to sleep on an unnatural 28-hour per "day" schedule, causing a dyssynchrony with natural day-night cycles, yielded increased glucose (blood sugar) levels, poor response to insulin, increased blood pressure. It also led to a decrease in leptin levels, a phenomenon that can trigger increased appetite.

Such circadian misalignment was meant to recreate the distorted day-night cycles of shift workers, a group that is unusually prone to diabetes and heart disease. This study further confirms that there are indeed unhealthy physiologic consequences of defying normal day-night sleep cycles.

This study suggests that, not only is sufficient sleep important for health, but the predictability and concordance with normal circadian cycles is also important.

Add to this previous studies demonstrating an association with sleep deprivation and low HDL/high triglycerides (Kaneita Y, et al 2008) and increased likelihood of having a positive heart scan (coronary calcium) score (King CR et al 2008), and it is increasingly clear that sleep is a crucial factor for overall health. It may even be a helpful strategy to control weight.

A full report on the importance of sleep is planned for the Track Your Plaque website.

Vitamin D Project: Grassroots Health

3. March 2009 William Davis (24)
Here's an interesting project a Track Your Plaque Member brought to my attention: Grassroots Health.

Carole Baggerly, Director of GrassrootsHealth, is a breast cancer survivor who has engineered an impressive project to collect and tabulate vitamin D blood levels in thousands, perhaps millions of people, over the next 5 years. Anyone can participate at a cost of $30 twice a year to get a vitamin D home test kit. (A fingerprick is required. I've tried the test kit--it's easy and painless to use.) They simply ask you to provide some basic health information that will be accumulated and analyzed.

Here's a graph they feature on their website showing the vitamin D blood levels distributed among the first 300 participants:











(Click to enlarge.)

Ms. Baggerly is apparently working with vitamin D pioneer, Dr. Reinhold Vieth, of the University of Toronto.

This sounds like a really great idea. Should you enroll, please come back here and let us know about your experience.

Statin Diary

1. March 2009 William Davis (17)
Here are a sampling of some of the comments I've received from people taking statin drugs:


Barkeater said:

On Lipitor since 1997, and pretty sure I had no side effects. Hey, I am a man, I don't complain.

Work has gotten real challenging (but they pay me well). At age 52, 2 years ago, I was fed up with working hard, cranky, and wanted to quit. Very low tolerance for frustration. A year ago, I hit a low spot again, but knowing that quitting was not an option, I started pestering my wife about things married people quarrel about other than money. No matter how great she was, every month or so I would get in a complete funk about it. Meanwhile, my brother had an MI, freaking me out, so at my doctor's suggestion I doubled the Lipitor dose (to 40 mg a day), bringing LDL below 100 and total chol. to 162 (40% below what God's original design of me produced). Plus, I ached a lot after exercise with severe "arthritis" in my hip, and these pains took days to go away, and still I got mad every few weeks at my wife and otherwise into a depressed funk (one morning I wrote an essay about suicide, which was much on my mind). Mood swings could be sudden.

She finally asked whether it might be the Lipitor, which I dismissed as very unlikely because I wanted to believe I was controlling my anger and depression better at that point (not really so) and besides everyone knows that statins have very few side effects. But, I did poke around a bit, and saw that kooky internet people seemed to have a lot of statin side effects, including depression. So, I thought I would quit, as an experiment. Like the JUPITER study, the results were so stunning I had to end the experiment in just 48 hours, except unlike JUPTIER, the clear result was that statins are nasty poisins that were ruining my life. I quickly concluded that no statin would again pass my lips. Depression, gone immediately (I am now 45 days off Lipitor). Relationship with wife, great (maybe "saved" is the word). Athletic performance, vastly better (adjusted for my modest natural abilities), with aches reduced vastly. Ability to withstand frustration, zoomed way way up. I feel totally different, and better; I think of my high cholesterol as my friend, protecting my from the abyss.

The other exciting thing is that I was depending on Lipitor to prevent heart disease, but I see now that it was only a raffle in which I had one ticket, with 75 or 100 other ticket holders in the NNT raffle (to prevent a survivable coronary in the next ten years, but not to prevent death -- that is not a prize in this raffle). There are obviously way better things I can do for prevention, at low cost and no negative side effects (plenty of positive ones, though).

I feel ten years younger. I refer to quitting Lipitor as my "miracle cure." I feel a moral obligation to warn others.



Anonymous said:

It was the craziest thing, my elbows felt like they needed to pop but couldn't. I was taking 20mgs of Zocor, and the first couple of months the elbows were fine, but one day I realized they hurt and wouldn't pop. I enjoy tennis and will occasionally shoot baskets with the boys - working elbows are a requirement for both sports. I told my doctor the problem and he said to stop taking Zocor, and after two weeks he will have me try a different statin. Avoiding Zocor brought relief. After a week of being statin free the elbows stopped aching.

I havn't gone back to my doctor to receive a prescription for that new statin. After learning more about heart disease prevention from this site and others, my starting LDL was low to begin with right around 80, and so decided to take a different natural approach to lower my LDL and more importantly for me raise HDL. I cleaned up my diet and began taking nutritional supplements. It worked, today cholesterol levels are great, and I have working elbows.



Tom said:

Two weeks after I started 10mg/day of Lipitor I developed tinnitus. I had never noticed a ringing in my ears before and now all of a sudden it was LOUD. After three months I saw my doctor for a cholesterol retest (it went way down) and complained of the tinnitus. He said he hadn't heard of this side effect, but I told him the web said 2% complain of it. He suggested I go to 5mg/day to see if it helped. I tried this for a few months, then went totally off for a few weeks, and the tinnitus got better, but never went away. I'm still on a 5mg dose after 9 months and I still have tinnitus. My fear is that the damage is done and the tinnitus will never go away.



Veedubmom said:

I got sun sensitivity from taking Simvastatin. Wherever my skin is exposed to the sun, it turns red and starts itching intensely and my skin looks like giant hives. I have to wear long sleeves, gloves, turtlenecks, etc.



Jegan said:

I was on Lipitor, but as a result of a recent study, asked to go on Simvastatin. I too have never suffered tinnitus until taking statins. I perceive it most at night. It sounds either like a pure high pitched white noise, or often like being stuck in an aviary with a million high pitched birds. I did not suffer any pains, but I clearly am more forgetful. I also feel depressed, and really don;t care about anything... Paying bills, family, cleaning, you name it. Also, my rosacea seems to act up a lot more.



Terri SL said:

Statin side effects are, in my personal experience, vastly under-reported. What Dr. in practice takes the time to fill out FDA complaint forms or contacts independent researchers about a pts. side effects? What pt. even knows that they can do so, whether their Dr. wants them to or not? No surprise about that 80% if you've taken statins!

I've personally taken two different statins (Pravachol, Zocor/Vytorin) and developed horrendous muscle aches even while taking CoQ-10 200 mgs. daily in divided dose. I also experienced mental fuzziness, gait instability and near complete GI shutdown, when Dr. doubled statin dosage against my protests. Stop the drug = complete reversal within ~three days!

What seems to be consistent is the dosage of the statin... the higher the dose, or the more potent the statin (Lipitor, Crestor), the greater the chance of adverse side effects. The other consistency is that Drs. out there in practice are not recommending CoQ-10 to their patients on statins, or at least that has been my experience.


Am I advocating that everyone stop their statin drug? No, I am not.

What I am advocating is that statins be used carefully, after all efforts at correction of lipid/lipoprotein patterns have been made, with an assessment of true coronary risk (not such nonsense as the Framingham score). A more reasonable application of statin drug prescription would shrink the market from its current $27 billion to a tiny fraction of that.

These drugs can be useful but are miserably and tragically overused.
For a discussion of an alternative to statins for LDL cholesterol reduction, see my post, Which is better?

How apathy saved a life

28. February 2009 William Davis (7)
John from California left this comment recently on my Wacky statin effects post. He tells such a vivid, compelling story that I had to pass it on.



I started taking statins a couple of years ago. A friend told me that he heard that they caused Alzheimers-like symptoms. I didn't think that I exhibited any effects like that, so I pretty much ignored it, except to raise the issue with my doctor.

During the last two years, I gradually lost interest in pretty much everything. It wasn't that I was forgetful, I just didn't much care about anything. Didn't care about my hobbies, quit my job, only paid bills when I felt like it, left a rental property vacant for 1 1/2 years and other similar issues.

I am normally a pretty active person with lots of pursuits. When I spoke to my doctor about my 'lack of interest and motivation', she suggested putting me on testosterone and later a mood enhancer. (I'm 60 and I lost my wife to breast cancer about 3 years ago, so I guess the thinking was either that I was going through male menopause or just depressed over her passing.)

Although I never had the muscle aches or liver problems that are considered the side effects of statins, gradually I began to feel weaker (not uncommon at 60) and more lackadaisical in my approach to bills and responsibilities. I also began suffering continual intense tinnitus and insomnia. I became crankier and more vehement in my dealings with other people and dangerously aggressive while driving.

Oddly enough, my lack of concern with paying bills led to the pharmacist telling me that Blue Shield had canceled me. Although I could easily have called the doctor for a prescription for $5 statins through KMart, I just couldn't be bothered, so I discontinued my medication.

It's been about 2 1/2 weeks since my prescription ran out. Within 4 days I began feeling better and my thinking became clearer. I no longer have tinnitus, my good mood has returned and I actually accept life's small annoyances again. Finally, I feel better physically and am more motivated. (Unfortunately, now I have to clean up all the financial garbage I've accumulated in the last year or so.)

If you take statins and begin to suffer any of the symptoms that I've noted above. Tell your doctor to take you off for a month. If your symptoms improve, you'll know why.

Although I no longer have medical insurance, one requirement of the coverage was that my cholesterol be controllable with statins. I'd rather have a heart attack or stroke and die than to go back to being the useless walking zombie that I was.

Imagine the consequences of of everyone take a statin drug, even "putting it in the water," advocated by some of my colleagues.

Make no mistake about it: The widespread, indiscriminate use of statin drugs is not without profound implications for many people. The popular notion of "the more statin agent, the better" that has propagated, thanks to the billions of dollars spent on marketing and "research," will lead to more unfortunate experiences like John.

Statins are drugs with real effects and very real side-effects.

Wheat hell

27. February 2009 William Davis (17)


Can including wheat in your diet create hell on earth?

Was The Inferno nothing more than Danté’s prediction for the state of the U.S. diet circa 2009?

I’m kidding on The Inferno allusion, but the American diet nonetheless sure does create an inferno of unhealthy phenomena.

If we define hell on earth as constant, nagging pain and discomfort; energy depleted sufficient to impair daily function; chronic bloating and diarrhea; leg swelling, peculiar rashes; progression of a multitude of diseases ranging from annoying all the way to fatal . . . well, that’s a pretty bleak picture.

I have indeed witnessed it all. Inclusion of wheat products in the human diet in many (not all--I'd estimate 70% of people) yields devastating health effects. In a few, it shortens life. In the majority, it leads to a slow, miserable hell of inflammatory diseases like arthritis, coronary disease, and cancer.

I have also witnessed dramatic reversal of these phenomena with complete removal of wheat from the diet.

(For clarity, I am not only referring to gluten sensitivity, the immune reaction gone haywire that plagues people with celiac disease. Celiac disease is indeed another variety of wheat-induced hell on earth, but there’s far more to it than that.)

Among the effects I’ve seen with wheat removal:

--Increased clarity of thought—I can vouch for this effect personally. Focus, concentration, the capacity for prolonged application of effort is restored with elimination of wheat.

--ADHD—Marked improvement in attention deficit disorder can occur in children and adults with this focus-depriving condition. Elimination of sugars and cornstarch may be necessary for full effect. While it doesn’t seem to work in everybody, the effect is powerful enough?and the implications so profound?that it is worthy of consideration in any child with this condition.

--Improved bowel health?Many people plagued by chronic bloating, diarrhea, and urgency experience complete relief. In its most extreme form, it is expressed as celiac disease. But there are a larger number of people who do not have celiac who are plagued by this lesser form of intestinal intolerance.

--Weight loss?Patients have told me that they were actually frightened when they eliminated wheat, meaning weight dropped so rapidly that they thought something was wrong. Nothing is wrong. The weight loss simply represents the removal of this bizarre, unphysiologic trigger of appetite, blood sugar, insulin, and weight gain.


Relevant to heart health, wheat elimination effects include:

--LDL cholesterol reduction?Yes, I know that it’s not what the “official” agencies say. “Reduce fat, reduce saturated fat and cholesterol will drop.” That’s barely true; reductions of saturated fat reduce LDL cholesterol, but rarely more than 20 mg/dl. In contrast, elimination of wheat yields LDL reductions of 40, 50, even 100 mg/dl. And the type of LDL reduced is the small particle variety, the kind mostly likely to lead to heart disease. (Cutting fat generally reduces large LDL, the more benign form.)

--Triglyceride reduction?Triglyceride reductions of 50, 100, even 1000 mg/dl can be achieved with elimination of wheat (though elimination of cornstarch, sugars, and other processed carbohydrates may be necessary for full benefit).

--HDL increase?A variable response, but increase of 5-10 mg/dl are common.

--Reduced inflammation?This phenomenon expresses itself in a number of ways, including dramatic reductions of the common inflammatory marker, c-reactive protein. While the media focuses on the JUPITER trial of rosuvastatin’s (Crestor) ability to reduce CRP 50-60%, wheat elimination can easily match this?without drugs.


What's more, you just feel better. Less commonly, I've seen arthritis (both common osteoarthritis and rheumatoid arthritis), skin rashes, and sleep disorders improve. I've had pre-diabetics become non-pre-diabetics, diabetics become non-diabetics.

It's not so much whether that food is carbohydrate-rich or protein-rich. It really comes down to calories, a very simple message.'
— Dr. Frank Sacks

While some advocate the notion that only calories count and diet composition makes no difference, I offer this possibility: Whether or not weight is lost by diet, there can be enormous health effects independent of weight based on the composition of diet. Inclusion or exclusion of wheat is one such crucial factor.


Image courtesy Wikipedia, The Eighth Circle of Hell.

Unique vitamin D observations

21. February 2009 William Davis (47)
It seems not a single day passes that I don’t learn something new about this unique hormone (mis)named “vitamin D.”

From its humble beginnings recognized only as the factor responsible for bone maturation (with deficiency leading to childhood rickets), vitamin D now commands a recognized role in almost every conceivable aspect of health and disease.

Among the unique observations I’ve made over the past several years, having corrected vitamin D in well over 1000 people:

--Ankylosing spondylitis—This fairly rare genetic disease programs a peculiar solidification of the spinal column that leads to disabling restriction of spinal mobility, accompanied by incapacitating pain. A physician came to my office after reading my Life Extension summary of vitamin D’s cardiovascular benefits, After reading it, he put himself on vitamin D 10,000 units per day and verified “therapeutic” levels with a blood test. He came to my office (he requested a consultation) and proudly showed me his near-normal spine flexibility that, until approximately 2 months earlier, had left him rigid and unable to even tie his shoes. He also reported that the chronic pain that had left him completely dependent on anti-inflammatory agents and narcotics was nearly entirely gone.

--Aortic valve disease—The list of people with either aortic valve stenosis (stiffness) or insufficiency (leakiness) that develops later in life (not congenitally deformed or bicuspid aortic valves) continues to grow. Not everyone responds, but some of the cases I’ve seen have been nothing short of miraculous. One man had severe aortic valve insufficiency (severe leakiness). After one year of vitamin D, 8000 units per day that yielded a blood level of 67 ng/ml, the insufficiency was down to a minimal level. Before vitamin D, I had never witnessed “spontaneous” reversal of aortic valve disease before.

--Chest pain—Not the chest pain of heart disease, but a chronic gnawing, toothache-like pain in the sternum that is relieved within days of initiating vitamin D. I don’t know precisely why this happens, but I speculate that, with vitamin D deficiency, there is disordered calcium metabolism, and perhaps the sternal pain represents cellular (osteoclastic) activity that is eroding sternal calcium for the purpose of maintaining blood calcium, since intestinal absorption of calcium is poor. Replace vitamin D and the abnormal calcium uptake ceases. Just my guess.

--Relief from claustrophobia—This one has me stumped. But one man’s vivid description of his previously terrifying experiences in elevators and other enclosed spaces, now entirely gone raises some fascinating questions. For instance, how much psychological disease is nothing more than the expression of disordered metabolism from vitamin D deficiency?

--Immunity from viral infections--I first learned of this association from Dr. John Cannell of the Vitamin D Council (www.vitamindcouncil.com). Dr. Cannell recounts his experience with the 2006 flu epidemic in the hospital in northern California, where he is a psychiatrist charged with the health of 200 inpatients held in closed wards. While the flu spread like wildfire to the patients in all the other wards, the 200 patients in Dr. Cannell’s ward failed to contract a single episode of flu while taking 2000 units of vitamin D per day.

I was a little skeptical at first, having been disappointed by the failure of several nutritional agents like zinc, vitamin C (perhaps, at best, a minimal effect). Now, three years into my vitamin D experience, I am absolutely convinced that Dr. Cannells’ early observation was correct: Vitamin D enhances immunity enormously. Not only have I personally not had a virus in several years, the majority of my staff and patients have been happily free of viral infections. There have been a few, to be sure. But the usual winters of hacking, coughing, and sneezing in the office have become largely a memory. It is a rare person who comes to the office with viral symptoms.


With new lessons being learned every day, it is inevitable that other fascinating new vitamin D observations have yet to be made.

Dr. Michael Eades on the Paleolithic diet

18. February 2009 William Davis (16)
Dr. Michael Eades has posted an absolutely spectacular commentary on the Paleolithic diet concept:

Rapid health improvements with a Paleolithic diet

The post was prompted by publication of a study that tried to recreate a Paleolithic-like diet experience over a brief study period:

Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet.

Dr. Eades discussion is wonderfully insightful and comprehensive and there's little to say to improve on his discussion.

I'd make one small point: From what I see in my experience, the improvements in lipid patterns seen in the brief period of this study are very likely to have been primarily due to the removal of wheat. Followers of this blog know that wheat elimination is among the most powerful cholesterol-reducing strategies available.

What vitamin D form?

15. February 2009 William Davis (36)
In response to questions regarding why don't vitamin D tablets work, here are my observations.

When I first started correcting vitamin D levels around 3 1/2 years ago, people would begin with starting 25-hydroxy vitamin D blood levels of around 20 ng/ml.

Taking, say, 6000 units vitamin D as tablets over 3 months yielded blood levels of 24-30 ng/ml. Taking 6000 units in an oil-based form, and blood levels would commonly be 60-70 ng/ml.

In other words, tablets are very poorly absorbed. I also saw very erratic absorption with tablets, with tremendous variation in blood levels.

I witnessed this effect many times. I finally began telling patients to avoid the tablets altogether. It's simply not worth it. Taking dose X of tablets, you cannot predict what the blood level of vitamin D will be.

Now, you can sometimes make the tablets get absorbed by either taking with a teaspoon of oil (e.g., olive, flaxseed) or taking with an oil-rich meal. However, I am uncertain just how consistent the absorption is under these circumstances, not having done this enough times to know.

Oil-filled gelcaps are no more expensive than tablets (or perhaps a dollar more). Health food store employees and pharmacists don't know this. I have had many patients come to the office claiming they changed to tablets because that's all their health food store or pharmacy carried and the person behind the counter assured them it was the same. Blood level of vitamin D to confirm: right back down to the starting level or near it--little or no absorption.

The only way to know whether a preparation is absorbed is to check a blood level. But, in my experience, having checked vitamin D blood levels thousands of times, gelcaps never fail; tablets fail over 80% of the time.

Vitamin D for the pharmaceutically challenged

14. February 2009 William Davis (20)
Most Heart Scan Blog readers already know:

Your doctor has been brainwashed by the pharmaceutical industry.

Your doctor more than likely has spent the better part of his or her career in the Guantanamo Bay of healthcare, water-boarded by seductive sales representatives, enticed with promises of fame and riches, threatened with ostracism from the clubby internal halls of healthcare if--gasp!--he or she didn't subscribe to the "rule" that only drugs are good, anything else is bad.

The same FDA-approval-is-necessary-to-be-good brand of nonsense is gaining popularity among my colleagues who, having caught some mention (on the Today Show, Oprah, or similar source of medical information), hope to join the vitamin D hoopla.

People will proudly declare that they are taking a high dose of vitamin D: 50,000 units once per week.

No. They are taking a barely useful form: D2, ergocalciferol.

Studies examining the reliability of the D2 form differ:

There's the Heaney study suggesting that D2 is less effective than D3:
Vitamin D2 is much less effective than vitamin D3 in humans

Then there's the Holick study showing they are equivalent:
Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D.

My experience is more in line with the Heaney study: Little or no real effect with D2.

One particularly illustrative case I witnessed was a woman who was mistakenly prescribed D2 at 50,000 units per day. She told me that she'd been taking it for a year. I fully expected to see clear-cut signs of toxicity (e.g., high blood calcium levels). Curiously, she showed no signs of toxicity. Nor did she show any vitamin D at all in her blood: 25-hydroxy D level of zero--literally zero.

I've witnessed similar phenomena several times: plenty of vitamin D2 . . . very little vitamin D in the blood.

All in all, I suppose that D2 is better than No-D at all. But you are far better off joining the ranks of the pharmaceutically challenged and go with the stuff that really works: D3.

D3, or cholecalciferol, yields confident increases in blood levels. It is inexpensive, safe, and an exact copy of the human form of vitamin D. (Of course, gelcap or drops only, NEVER tablets.)

There is absolute NO reason to take vitamin D2, the form that sometimes works, sometimes doesn't, the facsimile plant form issued by the drug industry.

Why don't stents prevent heart attack?

12. February 2009 William Davis (11)


No study has ever documented that stents prevent future heart attack. But, in day-to-day practice, stents are frequently implanted for just this reason.

A little clarification. Stents do prevent heart attack--if the heart attack is already underway, either as an "acute myocardial infarction" or "unstable angina."

In other words, a plaque in a coronary artery can rupture just like a little volcano. Rather than spewing lava, the underlying plaque contents--fibrous tissue, inflammatory cells, cholesterol crystals, fatty material, debris--are exposed to flowing blood and trigger spasm of the artery and blood clot formation. A ruptured plaque is typically found in people who go to the emergency room with severe chest pain or have difficulty breathing.

A heart catheterization is performed, a severe (e.g., 90-100%--completely closed) is found. A stent in this situation is of clear-cut benefit.

What is not clearly beneficial is someone with no symptoms, symptoms only with physical activity that has been present for at least several months, or someone with a high heart scan score and no symptoms. In these circumstances, stent implantation does not reduce risk for future heart attack.

Why?



Take a look at this angiogram of a right coronary artery. You can seen plaque all along the artery (represented by areas that appear pinched off. There are at least 4 visible.)

Putting one 15 millimeter stent in the artery will only affect the area of artery stented. (Stents vary in length, but typically are 12-18 millimeters in length.) The right coronary artery is about 10 times or more this length. There are also two other arteries of similar length. A stent at one location will do nothing to affect the potential for rupture in any of the other plaque-laden areas.

Say a stent is implanted in the "worst" blockage in this right coronary artery, the plaque located at around 9 o'clock. What about all the other plaques? They can still rupture.

Why not put in many stents, say, 4 or 5, and stent all the visible plaques?

Two reasons: 1) Plaque you can't even see on an angiogram can still rupture, and 2) it is very costly (easily $30,000 at the very least), 3) incurs greater procedural risk, and 4) messes up the artery for future procedures, since a steel-lined artery that develops more disease in future will be more difficult to re-implant stents, bypass, or perform other procedural manipulations.

The point: Putting in stents does not reduce potential for plaque rupture in the entire artery.

What can prevent plaque rupture? That's the whole point of following an effective prevention program: prevent plaque rupture.

(Of course, this discussion cannot encompass the wide variety of potential situations that may cause your doctor to individualize your approach. Nonetheless, when advised to have an elective heart procedure, a healthy dose of skepticism and is clearly a good practice.)

Top image courtesy National Heart, Lung, and Blood Institute.

No BS weight loss

13. April 2009 William Davis (18)
If there's something out there on the market for weight loss, we've tried it. By we, I mean myself along with many people and patients around me willing to try various new strategies.

Maybe you say: "Well that's not a clinical trial. How can we know that there aren't small effects?"

Who cares about small effects? If a weight loss strategy causes you to lose 1.2 lbs over 3 months--who cares? Sure, it may count towards a slight measure of health in a 230 lb 5 ft 3 inch woman. But it is insufficient to engage that person's interest and keep them on track. That little result, in fact, will discourage interest in weight loss and cause someone to return to previous behaviors.

What I'm talking about is BIG weight loss--20 lbs the first month, 40 lbs over 4 months, 50-60 lbs over 6 months.

Right now, there are only three things that I know of that yield such enormous effects:

1) Elimination of wheat, cornstarch, and sugars

2) Thyroid normalization (I don't mean following what the laboratory says is "normal")

3) Intermittent fasting


Combine all three in various ways and the results are accelerated even more.

Self-directed health is ALREADY here

12. April 2009 William Davis (12)
It can't happen.

People are too stupid/ignorant/lazy or simply don't care.

It is irresponsible. People will misuse, abuse, misdiagnose, fail to recognize all manner of medical conditions.


It's all true. Most of the medical establishment believes it. And it is self-fulfulling: If you believe it, it will happen.

Diabetes: Better than hedge funds

7. March 2011 William Davis (23)
Diabetes is where the action is.

While, for virtually all of history, type 2 diabetes was an uncommon condition of adults, the disease has spread so much to all levels of American society that even kids are now developing the adult form. Researchers from the Center for Disease Control and Prevention predict that, by 2050, one in three adults will be diabetic.

The diabetes market is booming, handily surpassing growth of the oil industry, the housing market, even technology. It makes Bernie Madoff’s billions look like small potatoes. In health, few markets are growing as fast as diabetes—-not osteoporosis, not heart disease, not cancer.

Americans are getting fat from carbohydrate consumption, becoming diabetic along with it. While kids hanging around the convenience store gulp down 26 teaspoons of sugar in 32-ounce sodas and 56-grams-of-sugar in 16-ounce frozen ices, health-minded adults are more likely eating two slices of 6-teaspoons sugar-equivalent “healthy whole grain” bread, wondering why last year’s jeans are too tight.

The U.S. is not the only nation affected. Globally, 2.8% of the world’s population are diabetic, a number expected to double over the next 20 years.

Pharmaceutical companies boast double-digit growth for diabetes drugs, growth rates that keep profit-hungry investors happy. Merck’s Januvia, for instance, introduced in 2006, recently catalogued 30% growth in sales, with annual sales approaching $1 billion. Recently FDA-approved Victoza, requiring once-a-day injection, is expected to reap $4 billion in sales per year for manufacturer Novo Nordisk. Such numbers can only warm a drug company CEO’s heart.

Most diabetics don’t just take one medication, but several. A typical regimen for an adult diabetic after a couple of years of treatment and following the dietary advice of the American Diabetes Association includes metformin, Januvia, and Actos, a triple-drug treatment that costs around $420 per month. Two forms of insulin (slow- and fast-acting), along with two or three oral medications, is not at all uncommon.

“Collateral” revenues from the other health conditions that develop from a diet rich in “healthy whole grains,” such as drugs for hypertension, drugs to slow the progression of kidney disease in diabetes, drugs for “high cholesterol,” and drugs for high triglycerides, and you have a pharmaceutical drug bonanza. You, too, would throw all- body orifice without disturbing you. A practical solution is to measure temperature first upon arising in the morning, before drinking water, coffee, making the bed, etc.--immediately.

While traditionalists (followers of Dr. Broda Barnes, who first suggested that temperature reflects thyroid function) still advocate axillary (armpit) temperatures, in 2009 it is clear that axillary temperatures are unreliable. Axillary temperatures are inconsistent, vary substantially with the clothing you wear, vary from right to left armpit, ambient temperature, sweat or lack of sweat, and other factors. It also can commonly be 2-3 degrees Fahrenheit below internal ("core") temperature and does not track with internal temperatures through the circadian rhythms of the day (high temperature early evening, lowest temperature 3-6 am).

Rectal, urine, esophageal, tympanic membrane (ear), and forehead are other means to measure body temperature, but are either inconvenient (rectal) or require correction factors to track internal temperature (e.g., forehead and ear). For these reasons, we use oral temperatures. Oral temperatures (on either side of the underside of the tongue) are convenient, track reasonably well with internal temperatures, and are familiar to most people.

Though there are scant data on the distribution of oral temperatures correlated to thyroid function, we find that the often-suggested cutoff of 97.6 degrees Fahrenheit, or 36.4 C, seems to track well with symptoms and thyroid laboratory evaluation (TSH, free T3, and free T4). In other words, oral temp <97.6 F correlates well with symptoms of fatigue, cold hands and feet, mental fogginess, along with high LDL cholesterol, all corrected or improved with thyroid replacement and return of temperature to 97.6 F.

But be careful: There are many factors that can influence oral temperature, including clothing, season, level of fitness, "morningness" (morning people) vs. "nightness" (night owls), relation to menstrual cycle, concurrent medical conditions.

Also, be sure that your thermometer can detect low temperatures. Just because it shows low temperatures of, say 94.0 degrees F, doesn't mean that it can really measure that low. If in doubt, dip your thermometer in cold water for one minute. If an improbable temperature is registered, say, 97.0 F, then you know that your device is incapable of detecting low temps.

A full in-depth Special Report on thermoregulation will be coming soon on the Track Your Plaque website.

Self-directed health: At-home lab testing

29. March 2009 William Davis (20)
I have a prediction.

I predict that more and more healthcare can and will be obtained directly by the individual--without doctors, without hospitals, without the corrupt profit-at-any-costs modus operandi of the pharmaceutical industry. I predict that, given the right tools, Joe or Jane Q. Public will have the choice to manage his or her own health using tools that are directly accessible, tools that include direct-to-consumer medical imaging (CT scans, ultrasound, MRI, etc.), nutritional supplements (a loosely-defined term, to our advantage), and direct-to-consumer laboratory testing.

Done responsibly, self-directed healthcare is superior to healthcare from your doctor. While no one expects you to remove your own gallbladder, you can manage cholesterol, blood sugar issues, vitamin D, low thyroid, and others--better than your doctor.

As everyone becomes more comfortable with the notion of self-directed health, you will see new services appear that help individuals manage their health. You will see prices for direct-to-consumer medical imaging and lab testing drop due to competition, something that doesn't happen in current insurance-based healthcare delivery. People are being exposed to larger deductibles and/or draw money from a medical savings account and will seek more cost advantages. Such direct-to-consumer competitive pricing will meet those needs. Overall, the presently unsustainable cost of healthcare will decline.

To help accelerate the shift of human healthcare away from conventional paths and divert it towards the individual, we have launched a panel of direct-to-consumer at-home laboratory tests that we are making available on the Track Your Plaque website.

On your own (except in California, which requires a doctor's order or prescription; and NY, the only state in the nation that prohibits entirely), you can now test, in the comfort of your own home with no laboratory blood draw required, parameters including:

--Thyroid tests--Free T3, free T4, TSH
--Lipids
--C-reactive protein
--Vitamin D
--Testosterone
--Progesterone

and others.

As the technology improves, more tests will become available for testing at home. (Lipoproteins are not yet available, but will probably be available within the next few years. That would be an enormous boon to those of us interested in supercharged heart disease prevention and reversal.)

Anyone interested in our at-home testing can just go to the Track Your Plaque lab test Marketplace.

When I first began the Track Your Plaque program around 8 years ago, I saw it as a way for people to learn how to control or reverse coronary atherosclerotic plaque, and I'd hoped that physicians would begin to see the light and become patient advocates in this process. But I have lost hope that most of my colleagues are interested in becoming your advocate in health. They are too locked into the "call me when you hurt" mentality. I now see Track Your Plaque as a way for people to seize control over coronary plaque with minimal assistance from their doctors. Indeed, some of our Members have achieved reduction of their plaque in spite of their doctors.

This is just the tip of the iceberg of what's to come. Brace yourself for a cataclysmic shift in returning health to you and away from those who would profit from your misfortune.

Vitamin D for Peter, Paul, and Mary

27. March 2009 William Davis (15)
Why is it that vitamin D deficiency can manifest in so many different ways in different people? One big reason is something called vitamin D receptor (VDR) genotypes, the variation in the receptor for vitamin D.

It means that vitamin D deficiency sustained over many years in:

Peter yields prostate cancer

Paul yields coronary heart disease and diabetes

Mary yields osteoporosis and knee arthritis.


Same deficiency, different diseases.

VDR genotype-determined susceptibility to numerous conditions have been identified, including Graves' thyroiditis, osteoporosis and related bone demineralization diseases, prostate cancer (Fok1 ffI genotype), ovarian cancer, rheumatoid arthritis, breast cancer (Fok1 ff), birth weight of newborns, melanoma and non-melanoma skin cancers, insulin resistance and metabolic syndrome, susceptibility to type I diabetes, Crohn's disease, and neurological or musculoskeletal deterioration with aging that leads to falls, respiratory infections, kidney cancer, even periodontal disease.


Why is it that the dose of vitamin D necessary to reach a specific level differs so widely from one person to the next? VDR genotype, again. Variation in blood levels of 25-hydroxy vitamin D from a specific dose of vitamin D can vary three-fold, as shown by a University of Toronto study. In other words, a dose of 4000 units per day may yield a 25-hydroxy vitamin D blood level of 30 ng/ml in Mary, 60 ng/ml in Paul, and 90 ng/ml in Pete--same dose, different blood levels.

Should we all run out and get our VDR genotypes assessed? So far the data have not progressed far enough to tell us. If, for instance, you prove to have the high-risk Fok1 ff genotype, would you do anything different? Would vitamin D supplementation be conducted any differently? I don't believe so.

Virtually all of us should be supplementing vitamin D at a dose that generates healthy blood levels, regardless of VDR genotype. For those of us following the Track Your Plaque program for coronary plaque control and reversal, that means maintaining serum 25-hydroxy vitamin D levels between 60-70 ng/ml.

As the fascinating research behind VDR genotype susceptibility to disease unfolds, perhaps it will suggest that specific genotypes be somehow managed differently. Until then, take your vitamin D.

Blowup at Milwaukee Heart Scan

26. March 2009 William Davis (20)
A local TV investigative news report just ran a critical report of the goings-on at Milwaukee Heart Scan:

Andy Smith went to Milwaukee Heart Scan. "It passed the smell test like a road kill skunk. I mean it was bad," Smith explained.

Our hidden cameras went inside the high pressure sales pitch. "On a good day I sell eight, nine, 10 people. On a bad day probably three," sales manager Angelo Callegari told us.


What the heck happened?

Let me tell you a story.

Back in 1996, I learned of a new technology called UltraFast CT scanning, or electron-beam tomography (EBT), a variation on the standard CT technology that permitted very rapid scanning, sufficiently rapid to allow visualization of the coronary arteries. Back then, only a few dozen devices had been established nationwide.

But the technology was so promising and the initial data so powerful that I lobbied several hospital systems in town to consider purchasing one of the $1.8 million devices. I was interested in applying this exciting technology for early detection of coronary heart disease in Milwaukee. While administrators from several hospitals listened, they quickly lost interest when they figured out that the scanner was primarily a tool for prevention, and would not be directly useful to increase revenue-generating hospital procedures.

I floundered about for a year, trying to drum up support for obtaining a scanner. The manufacturer of the device, Imatron, put me in touch with a couple from Indiana who were also interested in setting up a scanner and had actually obtained the investment capital to do it. We met and, over the next year, got Milwaukee Heart Scan up and running. I served as Medical Director (but never an investor or owner).

Milwaukee Heart Scan was busy from day one, performing EBT heart scans, as well as CT coronary angiograms as long ago as the late 1990s, virtual colonoscopies, and other imaging tests. We all spent a great deal of time educating the public and physicians on what this technology meant for detection and prevention of disease.

Despite the public's perception that the owners, Nancy and Steve Burlingame, were making a bundle of money, in reality they could barely pay their expenses. As price competition heated up in Milwaukee with the lower-cost competing multidetector scanners cropping up, the Burlingames often did not pay themselves.

My interest was to keep this device afloat. I therefore told the Burlingames that they should pay their bills first--their staff, overhead, the scanner costs, and pay themselves--and not worry about reimbursing me for the (very modest) heart scan interpretation fees. For several years, I read thousands of scans without any compensation. But that was okay with me--I just wanted to be sure this device remained available.

But in 2008, some business people from Chicago contacted Steve Burlingame with prospects of applying a contract model of long-term scanning to patients,i.e.,getting people to sign a several-year contract for discounted imaging. They proposed that Milwaukee Heart Scan offer heart scans for free to get people in the door.

What was peculiar about all this is that none of the four physicians on staff at Milwaukee Heart Scan had any knowledge of these discussions at all, including myself. Personally, I figured something was afoot when I came in to read scans in the summer of 2008. While, ordinarily, there is a single stack of scans to read from the preceding few days, this time there were numerous stacks of scans, hundreds of scans in all. Not a word had been said to me or my colleagues. I quickly figured out (thanks to the staff filling me in) that they had been offering scans for free. Not surprisingly, many people took them up on the offer.

Up until then, I had been readily willing to read heart scans without compensation, provided I could perform scan readings in a modest time commitment every week on the weeks it was my responsibility. But work several hours every day for free? Impossible.

My colleagues and I were deeply upset and concerned and insisted on a meeting with all the people involved, including the Burlingames, who had engineered this new sales program. We expressed serious reservations about what they were doing and insisted that they dramatically scale back the promises being made to people. I personally asked that they fire several of the people they had hired as sales people, given what we thought was unprofessional appearance and behavior.

The Burlingames and their new business partners essentially thumbed their noses at the physicians and ignored our advice. So, of the four physicians (one radiologist, three cardiologists), three of us resigned. (The one remaining cardiologist, I believe, didn't really understand what was going on.)

Apparently, after we left, the hard sales tactics continued. The news media got hold of the story through some understandably disgruntled people, and you know the rest.

The tragedy in all this is that, as wonderful as heart scans are, they don't make money for the people who invest in the technology. In the sad case of Milwaukee Heart Scan, it meant that my former friends, the Burlingames, turned to questionable tactics to make this technology pay.

Make no mistake: Heart scans remain a wonderful medical imaging modality. EBT, in particular, remains a fabulous technology that would--even today--remain the pre-eminent means to image coronary arteries, except that GE (who acquired Imatron some years ago) decided that a more direct path to bigger revenues was to purchase Imatron, then promptly scrap the entire operation, choosing to focus on multidetector technology exclusively.

Don't let the spotty past and petty ambitions cloud the fact that heart scans remain the best way to identify and track coronary plaque. Just don't get tempted by the offer of any free scans "without obligation."

Do you work for the pharmaceutical industry?

24. March 2009 William Davis (30)
In response to my post, Lovaza Rip-off, I received this angry comment:


Very high triglycerides, as you all know, is a very serious and life-threatening condition. Therefore, it is very important that any medication you take for treatment must be FDA proven and scientifically backed. This is true for a few reasons. First, there have been zero studies done to show the effects of Costco brand fish oil pills on patients with high triglycerides. So, you cannot assume, simply because the pills you are taking "claim" to have a certain amount of Omega 3 in the them, that they actually do (supplement labeling is self-submitted by the company, and not regulated by any external or 3rd party agency).

Secondly, the other components in fish oil, and maybe in Costco brand (no one knows because it isn't on the label) can actually inhibit the bioavailablity of Omega 3, most notably, Omega 6. And, nowhere on the Costco label does it tell you how much Omega 6 is in it. We also cannot underestimate the importance of purity with these compounds: a top selling brand of fish oil found stores like CVS was recently recalled because it was found to have large amounts of fire retardant in it! These supplements are NOT regulated by the FDA.

Thirdly, be careful when you compare costs. The cost of hospitalization due to acute pancreatitis (a risk of very high triglycerides) far outweighs the cost of taking Lovaza for even several years. If you have a real disease, you need a real drug. And, until Costco does a prospective long-term clinical trial to show that it lowers triglycerides, it should not be used in place of Lovaza.

Finally, I am a living example of how taking a high-potency supplement form of Omega 3 barely lowered my triglycerides, yet within 2 weeks of being on Lovaza there was a significant difference. I am now at my goal. So, before you knock a company, that, in my opinion, has saved my life, please do your research and do not mislead people into thinking that an Omega 3 is an Omega 3 is an Omega 3. If your insurance covers the most potent, the most pure, and the ONLY proven Omega 3 pill on the market, you should be thankful.


The comment was posted anonymously, so I don't know who it came from. But I can tell who I think it is: Someone who works for the drug industry.

This is a common phenomenon: Large corporations are fearful of the comments that are generated on internet conversations and other media. On the internet, there are actually people whose job it is to do "damage control." I suspect this came from one of them.

Why bother? Surely there are better things to do? Well, that's easy. There are billions of dollars at stake. Lovaza, in particular, is sold on the perception that it is somehow superior. If word gets out that maybe you can achieve the same results at a fraction of the cost . . .

Perhaps the "commenter" should also question whether omega-3 fatty acids can come from eating fish.

As part of my cardiology practice, I provide consultation on complex hyperlipidemias, or unusual lipid abnormalities. I have many patients with something called familial hypertriglyceridemia, a genetic condition that permits triglyceride levels of 500, 1000, even many thousands of mg/dl, levels that, as the anonymous commenter points out, can be dangerous.

I virtually never prescribe Lovaza for these people. In their treatment program, I use simple fish oil supplements, such as that from Costco, Sam's Club, or other retailers. I have not witnessed a single failure in treating these people and reducing triglycerides. People with lesser triglyceride abnormalities likewise respond very nicely to inexpensive fish oil that we can buy at the health food store. (I do rely on useful services like Consumer Reports and www.consumerlab.com to reassure us that no pesticide residues, mercury, or other contaminants are in the brands we use.) Excellent, high-quality fish oil supplements are sold by Carlson, Life Extension, Barlean's, even the Members' Mark brand from Sam's Club.

So, the notion that only prescription fish oil is capable of reducing triglycerides is, in a word, nonsense.

Take that back to your CEO.

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