The formula for aortic valve disease?

28. February 2011 William Davis (60)
I've discussed this question before:

Can aortic valve stenosis be stopped or reversed using a regimen of nutritional supplements?

I had a striking experience this past week. Don has coronary plaque and began the Track Your Plaque program. However, discovery of a murmur led to an echocardiogram that measured his effective aortic valve area at 1.5 cm2. (Normal is between 2.5-3.0 cm2.)

Because of his aortic valve issue, I suggested that, in addition to the 10,000 units of vitamin D required to increase his 25-hydroxy vitamin D level to 70 ng/ml, he also add vitamin K2, 1000 mcg per day, along with elimination of all calcium supplements. (I asked Don to use a K2 supplement that contained both forms, short-acting MK-4 and long-acting MK-7.)

One year later, another echocardiogram: aortic valve area 2.6 cm2--an incredible increase.

This is not supposed to happen. By conventional thinking, aortic valve stenosis can only get worse, never get better. But I've now witnessed this in approximately 10% of the people with aortic valve stenosis. The majority just stop getting worse, an occasional person gets worse, while a few, like Don, get better.

Aortic valve stenosis is to the aortic valve as degenerative arthritis is to your knees: A form of wear-and-tear that leads to progressive dysfunction. When the aortic valve becomes stiff enough (i.e., "stenotic"), then it leads to chest pains, lightheadedness or losing consciousness, heart failure, and, eventually, death. Bad problem.

Aortic stenosis typically starts in your 50s with calcification of the valve, getting worse and worse until the calcium makes the valve "leaflets" unable to move. The treatment: a new valve, a major undertaking involving an open heart procedure.

What if taking vitamins D and K2 and avoiding calcium do not just reverse or stop aortic valve stenosis once established, but prevents it in the first place? Tantalizing possibility.

Pressures on my time being what they are, I've not had the freedom to put together a prospective study to further examine this fascinating question. But it is definitely worth pursuing.
Tags :

Comments (60) -

  • Might-o'chondri-AL

    2/28/2011 1:03:38 AM |

    Aortic stenosis is +/- 2% once age 65 and +/-4% for those over
    85; but that's still
    +/-300,000 valve replacements done yearly for it. I'm not passing myself as the doctor here, so following is what I think is relevant science.

    The cytokine TGF-B1 (transforming growth factor beta)is seen in the blood progressively more as the aortic stenosis pathology worsens. Other elevated indicators
    are fibronectin, collagen I & II, plus sarcomeric protein myosin light-chain 2.

    All of the preceeding seem to be driven by TGF-B1 kinase-1 (TAK1) pathway, &/or TGF/SMAD transcription factors. The obstructive build up involves TGF-B1 inducing a pheno-type alteration of the local fibroblasts into more of a matix.

    It's altered the valvular cells' environment, so to speak, and so extra cellular matrix (ECM) components acrue. Calcium in circulation is capable of depositing in the aged valve matrix; which, scaffolding matrix, youth don't have to "trap" the calcium.

    The treatment of very high
    vitamin D would down-regulate the cytokine TGF-B1, high vitamin K2 encourage matrix solubility and restricted calcium mineral with it's ion dynamics take the load off valve.

  • Jim

    2/28/2011 1:16:04 AM |

    Doc, this is a phenomenal result!!  Thanks should be given to your keen medical insight and willingness to try alternative medicine in helping your patients!  You have what I consider to be probably the best website of its kind on the internet.  
         I live in a Chicago S/W suburb, which is really not that far, from your Milwaukee Office.  I have gone to your city a few times on business over the past couple of years and I regret not making an appointment in getting an exam.  One of these days I will make the trip to see you with or without an accompanying business trip.  Maybe this will spur more folks from the Chicago area to make the trip up North.

  • Ken

    2/28/2011 3:39:12 AM |

    Excellent work Dr.Davis.Vitamin K2 ensures that calcium ends up where we want it.The combination of vitamins D3
    and K2 has many benefits.

  • Anonymous

    2/28/2011 4:06:40 AM |

    I am thrilled to read this thread. I am a 64 y/o woman diagnosed w/"mild to moderate" aortic stenosis with some regurgitation as well as some mitral valve regurg. As a child I had several severe strep throats, had a total hysterectomy at 42, and subsequently have been diagnosed with hypothyroidism, all of which I have read might be causative.  My MGH cardiologist says I'm not "bad enough" for surgery,and of course I don't want it, but I feel really awful--very tired, some chest pain at times, and occasional feelings that I can't get my breath.
    I need a plan--and would appreciate any help.
    Laura

  • Anne

    2/28/2011 7:33:02 AM |

    Ever since I came across Dr Davis's heart scan blog four years ago I have been waiting for more more info on this. I have aortic valve stenosis - not due to degenerative changes but due to congenital aortic valve defect - a bicuspid aortic valve - and I have been supplementing with high dose vitamin D ever since.

  • Anonymous

    2/28/2011 9:52:57 AM |

    Maybe for those who have severe calcification, they should avoid calcium. However, for the rest of the population, ensuring enough K2+D3+retinol(natural form)+magnesium and other nutrients is probably a better approach. Calcium itself protects against the heavy metal burden the body has been shown to accumulate with age. Calcium has also been proven to result in lessened inflammation (CRP), less genomic damage, longer telomeres, and lessened mortality. In the end, I would say, don't avoid calcium. Just make sure you don't get too much ***in relation*** to the other nutrients you are getting.

  • Anonymous

    2/28/2011 11:17:02 AM |

    Echocardiograms can have substantial variability, certain assumptions are built into the mathematical formulas used to evaluate aortic valve stenosis. Was there any differences noted in the doppler velocity (Lvot, cw)or outflow tract dimension? Small differences in these measurements can yield large variability in aortic valve area. Just playing devils advocate here.......

  • Ken

    2/28/2011 2:01:33 PM |

    I read some comments by a doctor on a website.He said,"Vitamin K2 decreased calcium deposits in aortic valves.Some of my patients' stenotic aortic valve systolic gradients decreased by about 20mm mercury."

    Intestinal absorption of calcium can double or even quadruple when vitamin D levels approach desirable levels.Therefore, calcium supplements are not required.Hypercalcemia can lead to heart attacks, kidney stones , atherosclerosis and arthritis over long periods of time.There is plenty of calcium in food.

  • Anonymous

    2/28/2011 3:28:34 PM |

    So you're saying my knees won't get better?!

  • Anonymous

    2/28/2011 3:34:11 PM |

    1000 mcg per day!  Is that 1000 of MK-4 or MK-7.
    For about 6 months a while backmI ws taking 1000 of MK-7
    the-kid

  • PeterVermont

    2/28/2011 6:19:42 PM |

    I found out about K2 when my Dad was diagnosed with aortic stenosis. I tried to convince him to try Vitamin D and K2 but he went the conventional route and now has a cow's aortic valve.

    I have been taking 200mcg K2 every day along with my ~4000 IU/day Vitamin D. I have never had a scan and always wonder how blocked my arteries are and whether the vitamin k2 is regressing any blockage.

    A nice blog post from Nephropal on Vitamin K2

  • Anonymous

    2/28/2011 6:26:26 PM |

    Thanks again Dr. Davis, your dedication to your job is incredible!
    I have looked for K2 supplements containing both MK-4 and MK-7 but can't find them anywhere? They are not to be found in your own online shop at https://shop.trackyourplaque.com/ - where can I buy them in this proposed heavy duty dose (is's like 20 x 50mcg pills a day, quite a lot)? And what is the right balance between MK-4 and MK-7? Anyone?
    Thanks - The Viking.

  • Paul

    2/28/2011 9:45:42 PM |

    Viking,

    I have searched long and hard for such a supplement with no success.  My guess is it doesn't exist because these two forms of K2 come from two completely different sources.

    K2-MK4 (menatetrenone) is the animal form. The richest natural food source is found in green grass-fed cow's butter.  Supplements made from the natural source of menatetrenone are hard to find. The only one I'm aware of is a product called X-Factor Butter Oil made by Radiant Life.  There are less expensive synthetic forms of menatetrenone sold by Carlson Labs and Thorne Research.

    K2-MK7 (menaquinone-7) is the plant form. Its richest food source is fermented soy beans, also called "natto".  Supplements made from a natural source of menaquinone-7 are widely available.

  • Anonymous

    2/28/2011 10:37:38 PM |

    Life Extension's 'Super K' formula contains MK4 & MK7 and is available everywhere - try iherb.com

  • Might-o'chondri-AL

    2/28/2011 11:11:51 PM |

    Natto is fermenting here at home; it's remarkably easy and cheap. Doc's posted data is for each 100 grams Natto (3.5 oz., +/- 2 shot glasses volume) Mk-7 = 1,000 mcg, plus Mk-8 = 84 mcg.

    Home preparations won't exactly match commercial products analysis. Previously Doc stated that Natto raises serum Mk-4 & is active inside us for up to 4 hours; Mk-7 potent longer.

    G.E.M. Cultures (now in Washington state) sell pure Japanese Natto spores by mail order. I've no financial interest here, just their long term customer. (Natto's poly-glutamic acid was a melting stabilizer in a tropical dairy development project's ice cream manufacturing.)

    Buying the "commercial" size spore vial will let your learning curve be cheap. Online are plenty of variations on how to make Natto; G.E.M. ships with instructions in English and Japanese original.

    To make 1 pound soy bean batch you just need to incubate a dish +/- 10 inches by 10 inches and less than 2 inches deep. It'll last a person weeks refrigerated.

  • Ken

    2/28/2011 11:37:32 PM |

    I take one Life Extension Super K with Advanced K2 Complex softgel capsule per day.
    Each capsule contains 1000 micrograms Vitamin K2 as menaquinone-4, 100 micrograms
    Vitamin K2 as menaquinone-7 and 1000 micrograms of vitamin K1. I buy the capsules
    at iHerb.com but other places sell them including Life Extension.
    Invite K2 capsules contain 500mcg of MK-4,500mcg of MK7 and 1000mcg of vitamin K1.

  • Dr. William Davis

    2/28/2011 11:58:58 PM |

    Hi, Might'--

    Thanks, as always, for your incredibly insightful comments. I, too, suspect that there are discrete, identifiable pathways that would provide a plausible basis for a D3/K2 effect on aortic valve pathology.


    Anonymous with questions about the echo Doppler data--

    The aortic valve areas were obtained with 3 views on the maximal aortic supravalvular velocity, using both the standard transducer as well as the Pedoff. On both studies, the LV outflow tract diameter was 2.1 cm. The second aortic valve diameter was also confirmed with planimetry.

    Notably, peak aortic valve velocity dropped from 20 mmHg to 9 mmHg. I watched the echo tech (a very capable one, by the way) while he interrogated the valve. I am confident that we obtained the maximal peak velocity.

    All in all, I believe it is a real effect.

  • Dr. William Davis

    3/1/2011 12:00:15 AM |

    Anonymous and Paul--

    I have been advising the Life Extension "Super K."

    Super K contains 900 mcg MK-4, 100 mcg MK-7, as well as 1000 mcg vitamin K1.

  • Anonymous

    3/1/2011 12:34:09 AM |

    Have you seen any results like this on any of the other heart valves?
    My Dad has severe mitral valve stenosis. I am taking D and K2 and trying to convince him to do the same.

  • Paul

    3/1/2011 1:27:34 AM |

    Thank you, Dr. Davis.

    Looks like I'm in need of sharpening my search skills.

    Super K looks like a good deal.  I'll have to check it out when my supply of K2 runs low.

  • Anonymous

    3/1/2011 1:44:15 AM |

    In the Life Extension Super K, is the 1000 mcg of K1 a problem as far as causing clotting?

    I always understood that K2 (both MK-4 & MK-7) do not cause clotting like K1 does.

    Would love to see some calcium scoring results (and/or angiogram) before and after K2 administration, as well as carotid ultrasound results.

    Thanks for this blog, I visit it often.

  • Davide

    3/1/2011 2:19:58 AM |

    I'm curious if the addition of large doses of fish oil to the formula would also help decrease stenosis.

  • AllanF

    3/1/2011 3:59:15 AM |

    FWIW, another source of K2: http://www.vitacost.com/NSI-Ultra-Vitamin-K-with-Advanced-K2-Complex/?ntt=844197013470

    I don't have the links at hand, but I remember reading second-hand a study that showed excess K1 does NOT up-regulate clotting. Unless you are on Warfarin, K1 is completely safe, even for stroke patients.

    Good luck.

  • Anonymous

    3/1/2011 5:28:12 AM |

    Off topic but amusing considering...

    http://www.sciencedaily.com/releases/2011/02/110223122425.htm

    High Vitamin-D Bread Could Help Solve Widespread Insufficiency Problem

    ScienceDaily (Feb. 24, 2011) — With most people unable to get enough vitamin D from sunlight or foods, scientists are suggesting that a new vitamin D-fortified food -- bread made with high-vitamin D yeast -- could fill that gap. Their study, confirming that the approach works in laboratory tests, appears in ACS' Journal of Agricultural and Food Chemistry.

  • Anonymous

    3/1/2011 5:40:59 AM |

    Wow, to any regular reader of this (wonderful) blog that (i.e., the vitamin D bread) is hilarious!!!

  • Might-o'chondri-AL

    3/1/2011 6:47:14 AM |

    Measured my just finished Natto yield from 1 pound dry soy beans. Digital scale here is down, so spring scale reading is ~ 875 grams Natto made.

    Spores cost $14 (plus shipping) and are enough to make +/- 86 pounds of finished Natto. That's 39,000 grams of Natto.

    If 100 grams Natto offering 1,000mcg Mk-7 is fine, then that's 390days worth. Dry soybean substrate for 390 days Natto is 45 pounds of soy (using my spring scale yield data).

    Elsewhere in this blog, Doc I think, stated 32.7 mcg K2 decreased aorta calcification. Maybe the decimal got misplaced in my notes. Or reversal, verses prevention, demands mega-dose vitamin K.

    I fork mash +/- 50 gr. Natto and blend it in with  +/- 50 gr. Hummus. That amount of Natto will fit on 2 rice cakes as well.

  • Anonymous

    3/1/2011 2:31:54 PM |

    Dr. Davis, my greatest respect for your work. Two questions to your groundbreaking observations on D3/K2:
    1) Did the patient in question have a biscupid or triscupid valve?
    2) Was the patient exposed to any other lifestyle changes apart from D3/K2 that could explain the remarkable change?
    3) I have seen some sites selling K2 warning against taking them together with high fibre meals. Why is that, and what is the best time/frequency to take D3/K2?
    Regards, Louis

  • Anonymous

    3/1/2011 6:05:12 PM |

    I'm curious if Dr. Davis has seen any improvements in his patients using vit D3 alone.

    I expect K2 (MK-7 to be exact) helped, but was just wondering how he knows what helps or doesn't, when his patients are doing several protocols at one time (D3, fish oil, no-wheat/low carbs, perhaps niacin)...

  • Paul

    3/1/2011 7:35:41 PM |

    Might-o'chondri-AL,

    Your notes are correct.  The 32.7 mcg K2 data point comes from the Rotterdam Heart Study.  It was the minimum dose in participants showing a lower risk of both heart attack and aortic calcification.

  • Diana

    3/1/2011 8:23:43 PM |

    I use Life Extension Super K with Advanced K2 Complex that I buy from iherb. You can also get K-2 (MK-4)from High vitamin butter oil from green pastures. (You can buy it alone or with Fermented Cod Liver Oil)
    Use this code to save $5.00 off your 1st order with iherb: ROV990

  • Dr. William Davis

    3/4/2011 3:01:31 PM |

    Hi, Louis--

    The fundamental problem with retrospective observations is that you never know with absolute certainty what was done to achieve the observed effect.

    However, everybody in the Track Your Plaque program and coming through my office do nearly the same thing, i.e., fish oil, vit D, diet, etc. I NEVER witnessed regression of aortic stenosis until we added vitamin D. I am speculating whether K2 adds yet another level of control over aortic valve disease.

    This is still in the world of anecdotal observation. This is, of course, nothing even close to a clinical trial. But this can be how new ideas get their start.

  • C.J. Bahnsen

    3/4/2011 10:25:31 PM |

    Hi Doctor Davis,

    I am new to your HS blog and, after reading a few, I'm glad I signed on. Great info. Quick question regarding this idea of "cleaning" or adding flexibility to the arteries: Do you put any value in Chelation therapy? I took oral chelation supplements for a time and it seemed to lower my triglyceride and cholesterol levels. Any thoughts on this, especially as it pertains to the oral version versus the IV method?

    Thanks,  Chris

  • bodylift

    3/5/2011 9:43:55 AM |

    This is been amazing. I am take it seriously. Thanks for this information.

  • Jack

    3/9/2011 6:55:39 PM |

    Chances are the calcium supplement you are taking now is a rock source of calcium. The label will say "calcium carbonate", which is nothing more than limestone. AlgaeCal Plus contains an organic, plant-sourced calcium form derived from a unique South American marine algae called Algas Calcareasâ„¢.

  • Karen

    6/5/2011 8:18:39 PM |

    Dear Dr. Davis,

    Thank you for your website.  I am a 68-yr female with AS.  My aortic valve area is 0.69.  I weigh 118, and fast-walk/jog for an hour 4 days/wk.  I am asymptomatic, and my cardiologist advises watchful waiting.  

    How much Vit.D would you advise.  Is the amount weight related?

    Thanks again.  

    Karen

  • nose surgery

    7/6/2011 5:33:09 PM |

    Intestinal absorption of calcium can double or even quadruple, when vitamin D levels levels.Therefore desirable approach, calcium can not required.Hypercalcemia to heart attacks, kidney stones, atherosclerosis and arthritis over a long period have lead tours is a lot of calcium in food.

  • varicose veins

    7/6/2011 6:06:28 PM |

    Dr. Davis's heart scan blog ever since I met four years ago, I have been waiting for more information on this. I have aortic stenosis - not because of degenerative changes, but because of congenital aortic valve defect - bicuspid aortic valve - I have been using high doses of vitamin D supplements since.

  • Eric

    8/16/2011 6:49:42 PM |

    Dr. Davis,

    Do you mean to say that you put him on 1,000mcg of K2 MK-7 per day? (or was the 1,000mcg a combined total of all forms?)

  • Adam

    10/8/2011 4:28:38 PM |

    Dear Dr. Davis, a Final Guidance question.....

    I know Life extensions Super K is a good supplement, but the question that seems to have been asked a few times on this blog is..."what is a good & ideal target daily does combination of both MK-4 and MK-7" ?

    We have heard you say that 1000 mg a day of mk4 & mk7 is a good target...but in what ratio?  Just like Omega3 has good target ratio of EPA/DHA....can you suggest some guidance as to what a good target ratio
    of mk4 & mk7 would be ?

    Thank you!

    Adam

  • Dr. William Davis

    10/9/2011 11:00:50 PM |

    HI, Adam--

    I wish I knew! This is the difficulty with K2: too little known.

    Sure, there are plenty of opinions, but little fact. You and I can only continue to follow the emerging evidence and make our decisions as the evidence unfolds. Right now, it is simply not clear what the ideal regimen is.

  • Tom

    12/8/2011 4:33:42 PM |

    Dear Dr,

    I just came across your blog. Mind-blowing stuff. Especially because I have mild-moderate stenosis. Moderately calcified and bi-cusped. I wanted to know if any of your patients had bicusped aortic stenosis and your treatment with D3 and K2 might have seen reversals?

    also, do you suggest K2 with Mk-4 and Mk-7 or is just MK-7 sufficient?
    I am taking just about 2000 IU D3 and 100 MK-7 K2, fish oil and veggies, fruits, walking.

    Hope you can respond.

    As always, thank you for all the good work you do.

    Tom.

  • Sandra Broussard

    12/20/2011 9:00:24 PM |

    life extention vitmin k2 is from GMO soy.  Shame on them for trying to poison us.

  • Rita

    1/25/2012 5:08:47 PM |

    Can you tell me how you found out that Super K contain GMO soy?

  • jane cook atkins

    3/5/2012 4:06:52 AM |

    My father was just diagnosed with aortic stenosis and I had to go to a friend who is a biochemist to discuss some nutritional options for an 83 year old man.  I have used Isotonix supplements or the Nutrametrix line of same product since 1995.  Personally I wanted to go in that direction with a scientific mind to talk with. My Dad''s doctor told me he personally uses supplements but was not allowed to direct my father on them.  He is basically following a check list.  My Dad is a player and I have him on a great regimen.  After finding your blog, I am looking to add d with k2 in Isotonix.  I have him on an Isotonix Calcium supplement that has d3 in it.   Not junk calcium or tums.  
    http://dwithk2.blogspot.com/
    this is my blog and you can go to the bottom of it to see label on the product.
    Our next stop is the cardio doc who we were advised would want to replace his aortic valve.  I really think that should be a very last resort.  
    Really, I believe some lifestyle changes and bumping some Isotonix supplements to heavy dosing is a better option.

  • Dr. William Davis

    3/6/2012 3:52:23 AM |

    The key, in my view, for control over aortic stenosis (thought I have not YET published the observations) is:

    1) Supplement vitamin D to achieve a 25-hydroxy vitamin D level of 60-70 ng/ml, and
    2) Vitamin K2 supplementation to provide 1000 mcg MK-4 or at least 100 mcg MK-7, and
    3) Take NO supplemental calcium, as calcium is passive "mortar" that will calcify the aortic valve.

  • Dr. J. Edwards

    3/16/2012 6:18:32 PM |

    Pertaining to myself (aortic valve stenosis and stenosis of the spine) and my wine (parathyroid adenoma (non malignant) on Sinsipar to control without surgery.

    If we eliminate calcium  supplements (which this  makes me consider), can I forget about getting too much in food (I also take buffered Vitamin C, which will be a problem, since I have gastritis).

    Also wonder if magnesium, boron & strontium are good or bad to take??????

    Last, can you give me a link for natural treatment of parathyroid adenoma. My wife also refuses to take Boniva and her bone density is bad.

    Thanks in advance.

  • Dr. Davis

    3/26/2012 4:52:09 PM |

    Dr. Edwards--

    Unfortunately, no data.

    You are venturing further into the world of "normalizing" calcium metabolism. I'd like to believe that all this makes sense, as they tend to benefit osteoporosis/osteopenia, and removal of calcium as a supplement is likely a good thing, given its contribution to cardiovascular risk.

    But we lack real data on the effects. I will tell you that the vitamin D, however, is very real, having now done this in around 60+ patients.

  • Rita C.

    5/3/2012 7:38:41 PM |

    Dr. Davis,
         I'm 67, female with CAVD.  Heart murmur, dizziness, exhaustion since holidays led to apt with cardiologist resulting in mild aortic stenosis diagnosis in early April.
         I have taken Vitamin D3 over last two years after Welcome to Medicare physical showed low levels.  I have now added CoQ10.  After stumbling upon your blog, I'm now adding 135 mcg K-2 Mk7.  
         Despite the fact that I'm symptomatic, I'm hoping to avoid heart surgery until the new trans-vascular technique is approved for a wider range of patients.  I return to my cardiologist in early August and I will be most interested in comparing new test results against my April numbers--call it a personal clinical trial of one.
         A few years ago I observed open heart surgery at a major surgical center in Houston.  I vowed I would never have it myself, but here I am now, staring it squarely in the face.  I can't thank you enough for your website. It's given me a small measure of hope.

  • John Wilsonf

    5/25/2012 9:22:58 PM |

    Dr Davis:
    I am a 70 year old slim athletic male with a bicuspid aortic valve that has been stable for about 6 years with echo area measurements showing 1.2 to 1.3 sq cm.  When I got my first echo 6 yrs ago I searched published literature and decided to start 200mg MK-7 daily and I take quite a few supplements, including vit D, niacin, and about 3 gms fish oil (EPA+DHA).  My cardiologist is surprised to not see a reduction in area, and valve replacement seems to have been put off successfully.  This year, however, my ascending aorta was measured at  48 mm by echo, up from 44 (MRI measurement) a year ago.  Surgery was recommended, based on the aneurysm, not the valve, but of course both would be done at the same time.  A cardiac CT scan was ordered by the potential surgeon and the radiologist report indicated a maximum ascending aortic diameter of 45mm, but the surgeon said he looked at the 3-D CT images and it looked more like 47-48 mm to him.  Search for coronary artery plaque indicated all arteries "normal" except for the "1st Obtuse marginal: Tiny focal calcified plaque causing no luminal narrowing" .Beginning January, 2012, I have eliminated wheat and calcium supplements and have actually gone low-carb, high fat, adequate protein to the extent to be in "nutritional ketosis".  Ketones range from 0.5 to 1.9, depending on time of day and whether it is before or after exercize, etc.  I feel great!  Given that I am "on the boarder line" where surgery is recommended, I have thought about giving this more stringent diet a year to see if the aneurysm shrinks.

    My question is this:  Some time ago you posted your experience of seeing patients ("Jake") where diet/supplements contributed to reducing the size of an aneurysm, but I cannot find any follow-up information in your excellent blog (or publications).  What is the best diet/supplement regime that would optimize reduction of an aneurysm?  If the mechanism for the aortic wall degredation is the same as for artery plaque, then I know your answer because of your writings on this subject.  My interest in writing is to determine if there are other dietary or supplement changes I should make that would optimize my chances of improvement in my one-year trial, should I decide to do it.  Also, do you agree that nutritional ketosis (which I have no problem staying on) should be advantageous?

  • Gaurav

    8/17/2012 11:23:56 PM |

    Dr. Davis,
    I chanced upon your blog while searching for content of MK7 in natto! What a fortuitous discovery for me.

    I started taking a Vitamin D3 supplement last year when my level was diagnosed at 20 ng/ml. I took about 3000 IU per day for 9 months and my level rose to 27 ng/ml. I did so using a D3 spray in coconut oil sprayed under my tongue.

    Recently, I came across research that D3 supplementation, even in the 2000-3000 IUs a day dosage, without K2 supplementation will cause calcification of arteries and soft-tissues.

    Wanted to ask for your input on this:
    - How much K2 should I take, especially to reverse calcification? Seems like 100 mcg of MK7 and 1000 mcg of MK4 are common doses.
    - Can I take K2 just 2-3 times a week, just to be conservative. How about if I just eat Natto for MK7 and stay away from the supplements?
    - Would you still recommend D3 along with K2? If so, what is a safe D3 dose to go with 100 mcg of MK7?
    - Is calcification observed in those who were taking Calcium with D3 or it can be seen even without Calcium supplementation? I eat a pretty low-carb, high-fat, decent amount of proteins, less red meat diet. Also, I take no dairy, calcium supplement or calcium fortified foods.

    Thanks so much for your time.

  • Rita C..

    9/16/2012 4:35:50 PM |

    Update to my first comment after six months.  

    After six months of K2/D3, CoQ10, and Niacin supplements, I had my first nuclear stress test at my cardiologist's office.  Photos were picture perfect--strong, well functioning heart.  Efficiency percentage was mid 60s in March, but went to 87% in late August.  Primary Care physician had difficulty locating murmur that was pronounced in March.  I'm now scheduled for a second echocardiogram in early February.  That will be the acid test.  

    Despite excellent test results, I'm still experiencing some fatigue and dizziness, but not nearly so much as when first diagnosed.  I remain hopeful that with continued supplement therapy and good eating habits, I'll be one of the lucky ten percent who experience remission from AS with K2/D3 therapy.

  • Mel

    10/12/2012 9:29:25 AM |

    Hi Rita I thought to mention that I've been going through the comments here and really appreciate that you are giving us updates of your progress. Hoping for good results for you next round!

  • Holly

    12/18/2012 4:39:24 PM |

    Dear Dr.Davis,
    I came across your blog by chance and very interested in your opinion regarding valve problems. I would be most grateful if you can advice me on my situation:
    I always believed that I have a strong heart as I excercised a lot--swimming and hiking, never expected that the first thing knocked me down is my heart. Starting this year from January, I went to Hospital Emergency 8 times, 4 in Jan, 2 in Feb and 1 in April and anthor 1 in Nov, all because of very fast heartbeat. The first 4 made me hard to breath and thought I was dying. All the blood tests at the hopsital came out normal. However, the ecogram showed that I had moderate aortic valve regurgitation. As meantime I was suffering from gastric problems of not being able to eat much, my heart condition gave me scaring experience of being extreme fatigue, dizzy, chest pain, neck and should pain.  Doctors said I do not need to do anything.
    Even the fast beat of my heart is getting better recently, constant fatigue and dizziness and neck pain prevents from living a normal life.

    I am also scared to see my 4 year ecogram with only "traces of aortic valve regurgitation," now changed to moderate.

    I would likfe to know why my valve degenerate so fast? what can I do to stop the process. After seeing your blog, I bought vitamin D (my level is 43) and K2 (both mk4 and 7), how much dose should I take, will these vitamins alone help stop the degeneration process?

    I also considering coming down to see you if you give appointments for consultation.

    Thanks for your help!

    Holly

  • Holly

    12/18/2012 4:43:39 PM |

    by the way, I am 50 years old and have a stressful job.
    HOlly

  • Karen

    2/10/2013 9:47:04 PM |

    Dr Davis,

    Any research on a wheat less diet and lipoproteins and their affects on Aeortic stenosis? If elemenating them will prevent or reverse this condition?

    Thank you,

    Karen

  • John Wagner

    5/11/2013 6:16:00 PM |

    There are several different causes of aortic stenosis. Congenital (ie bicuspid aortic valve) and rheumatic fever start at younger ages. ASc or sclerosis is a disease of older people, same age risk as ASHD or coronary disease (atherosclerosis) and is nothing more than a variant manisfectation of the same risk factors that causes myocardial infractions., high blood pressure, smoking, obesity, diabetes and lipid disorders from high carb diets or a combination commonly called Metabolic syndrome. All of these risk factors cause coronary artery disease and/or ASc, it is just a crap shoot as to which one may show up first...but, treat both the same. Does that mean Vit D doesn't work? Of course not, newer studies beginning to show high Vit D levels are Importent in atherosclerosis Ann cancer prevention.

  • Courtney Janak

    7/31/2013 3:08:56 PM |

    My husband has a coronary calcium score of over 900. His cholesterol levels were: total:217, HDL:44, LDL:147, trigyclerides:167. His cardiologist wanted to put him on Provastatin and scheduled him for an echo-cardiogram stress test. He has chosen to put off taking the statins and has started taking K2 and magnesium supplements. Is this ok? Should statins be recommended for his score?

    Is there a cardiologist in or near Santa Fe, NM, who has an understanding of nutrient issues similar to yours?

  • Lisa D

    7/31/2013 5:15:57 PM |

    I stumbled upon your blog a year ago when researching how to reverse aortic valve calcification.  At the time I was 49 and had just gotten my echo results.  I was told that I had abnormal relaxation of my left ventricle consistent with diastolic dysfunction, a trileaflet aortic valve with a trace of regurgitation and mild calcification.  My aortic root is borderline in size.  Well that was a heck of a blow because my echo the previous year was normal.  (I have echos done because I had chest pain several years ago that turned out to be esophageal spasm.  However, everyone in my family died from heart disease and my father had his major MI at age 47.  My grandmother died from aortic stenosis... so they do yearly echos on me.  I also have hypothyroidism, polycystic ovary syndrome and my ApoE genotype is 3/4)

    After I read your blog, I went out and bought Life Extension Super K.  I have been taking it for over one year--since last July.  I found in my research that people with the ApoE4 allele don't hold on to vitamin K2 as well as those who do not have this genotype, so I didn't know if one pill a day was enough.  After a gigantic hassle trying to find a lab that runs the undercarboxylated osteocalcin test, I finally had my level drawn.  It came back at 3.8.  (Normal was anything below 12.1).  The results provided a graph which showed I am in the low normal end of the spectrum.  It showed that 80% of the population is lower than me--which surprises me because I bet most of the population doesn't take vitamin K2.  Maybe the only people having this test done are those who do supplement with vitamin K...   In any case, that lab was drawn in mid May, and since that time I doubled my dose to 2 capsules per day.  What should my undercarboxylated osteocalcin level be?  I can't find any data about what level is acceptable to reverse calcification.  I have also been taking vitamin D for several years--my level was originally 9.  I take 50,000 units once a week.  My last D level was 87.4, so I'm pretty close to the 70 that you suggest.  I also throw in about 8,000 u of vitamin A twice a month because I read that it's necessary to downregulate the D.  My D had gotten as high as 115 last year but has been in the mid 60s-80s since.  I also take CoQ10 200mg per day and fish oil. (I was taking it daily, but what do you think about the new study out saying it increases the incidence of prostate cancer?  I didn't want to increase my possibility of any kind of cancer, so I'm only taking it twice a week now... thoughts?)

    I had an echo and a Lexiscan (because I couldn't walk on the treadmill due to foot problems and foot surgery 1.5 yrs ago) done last week.  I get my results tomorrow and am hoping that the calcification is gone... When I had my echo done last year I was overweight (BMI 38.8) with some sleep apnea.  After that appointment, I walked out of that office and changed my life.  I have been on basically a "no white" diet--no sugar, flour, pasta, rice, bread, sweets, etc.  Because of my PCOS, I can't even eat complex carbs without gaining weight.  (I have done strict Atkins before but couldn't sustain it because it was so strict.  This is working for me.  My carbs come from low glycemic fruits and vegetables primarily.  I do eat meat, dairy and nuts).  I went back to the gym and go every other day.  I lift weights (my son is a personal trainer), climb the stair master for 20 minutes and then go home to ride my exercise bike for 45 minutes every day.  I ride my exercise bike every day for at least 45 minutes and sometimes do double cardio days on weekends.  I have lost 63 pounds in the last year.  I would like to lose another 20 pounds.  I have an oral appliance for the sleep apnea and will have another sleep study done after I lose the last 20 lbs.  I know that I didn't used to snore when I was thin (pre-pregnancy).  I'm only 11 lbs above my pre-pregnant weight now.  I know that the sleep apnea can lead to diastolic dysfunction.  I'm hoping I'm reversing that!

    Any other suggestions for me?  I'm especially interested to know how much vitamin K2 I need to take to potentially reverse this darn calcification.  I've mentioned the K2 to my other doctors and so far they're all in the dark and don't even seem to care about it... I'm shocked, because there are big studies out there that back it up.  I don't know about my cardiologist because I don't see him until tomorrow.  I'm shocked that my endocrinologist didn't seem to care because he does bone density scans in his office.  I'm getting one done in a couple months.  In my past 2 scans, I was dropping towards osteopenia.  I'm hoping with the vitamin K2 that I show dramatic improvement so that I can show him I was right about the K.

    Thank you for any help,
    Lisa D. RN

  • Marsha

    8/25/2013 12:40:59 AM |

    Oh come on Jim, try google every once in awhile.  This isn't Dr. Davis' discovery...it's been studied and written about for at least 8 years now.

  • Michael

    8/25/2013 12:51:35 AM |

    Isn't that the brand that everyone over on the Inspire.com site is having problems with?  Seriously, there's been quite a discussion about it.  Many found that once they switched to Carlson's K2 only, that their palpitations, etc., went away.

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Synthroid, Armour Thyroid, and the battle for T3

6. July 2008 William Davis (2)
In the last Heart Scan Blog post on thyroid issues, Is normal TSH too high?, the provocative findings of the the HUNT Study were discussed. The text of the study can be found at:

The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study

Hypothyroidism, or low thyroid that is signaled by high thyroid-stimulating hormone, TSH, is proving far more prevalent an issue than previously thought. While previous estimates put hypothyroidism as affecting only about 3% of younger populations, 10-20% of older populations (women more so), data like the HUNT Study suggest that, if lower and lower TSH levels (higher thyroid) are necessary for perfect heart health, then many more people stand to benefit than we used to think.

But another crucial issue in the world of hypothyroidism: Is T4 (thyroxine) enough? Or should we be supplementing T3 (triiodothyronine) along with T4?

Your friendly neighborhood primary care doctor or endocrinologist would likely argue vehemently that T4 (as Synthroid, Levoxyl, levothyroxine, and others) is adequate and not subject to the impurities and contaminants of natural thyroid extracts. They would also argue that T4 is effectively converted to T3 at the tissue level, and exogenous supplementation is unnecessary.

Others--most of all thyroid patients themselves, along with thyroid advocates like Mary Shomon and Janie Bowthorpe, along with some physicians--argue that supplementing T3 along with T4 can be very important. They argue that people feel better, have more physical energy, lose weight more effectively, and more completely resolve many of the phenomena of hypothryoidism with T3 added. There are also some data that argue the same.

Adding T3 to the mix may address the presumed poor conversion of T4 to T3 that is peculiar to some people. It may overcome the "reverse T3" phenomenon, the production of a useless look-alike T3 that occurs in some people. It may also (anecdotally) exert greater effects on some lipid/lipoprotein parameters, such as Lp(a).

My experiences adding T3 to T4 have been mixed: Some feel better, others do not. Some show objective improvements, others do not.

Nonetheless, hypothyroidism, or incompletely corrected hypothryoidism by way of inadequate T3, is an issue to consider in your plaque-control program.

More on this somewhat complex issue, along with practical solutions to consider, can be found on the Special Report to be released this week on the Track Your Plaque website.

Letter to New York Times

3. July 2008 William Davis (9)
All right. I sent a Letter to the Editor to the New York Times. No word from them; it's no longer news.

So here is what I tried to convey.

While the authors overall did a credible job of talking to my colleagues and laying out the issues, they made the crucial and boneheaded mistake of confusing CT heart scans with CT coronary angiograms. Sadly, many people who may have been considering having a simple screening heart scan may be scared away by the confused authors, Alexn Berenson and Reed Abelson.

They do correctly point out that, while CT coronary angiograms are fascinating examples of technology and a way of visualizing coronary arteries, this test all too often is being subverted into the "let's make money from high-tech testing" medical model. It's also a test that frequently leads to the "real" test, heart catheterization, since the "time bomb" you have in your arteries might "need" a stent.

CT coronary angiograms are also virtually useless for purposes of tracking disease, since they are not longitudinally (along the length of the artery) quantitative, nor should anyone be exposed to this much radiation repeatedly.

A simple heart scan, on the hand, provides a longitudinal summation of coronary plaque volume. Radiation exposure is sufficiently low that repeated scanning can be performed for purposes of tracking . . .yes, track your plaque.

Poorly-informed reporters can do a lot of damage. As always, you and I must dig a little deeper for the truth.




Dear Editor,

Re: Weighing the Costs of a CT Scan’s Look Inside the Heart

The Times featured an article on June 29th that discussed rapidly expanding use of CT scans for the heart:
Weighing the Costs of a CT Scan’s Look Inside the Heart.

The authors, Alex Berenson and Reed Abelson, stated that CT heart scans “expose patients to large doses of radiation, equivalent to at least several hundred X-rays, creating a small but real cancer risk.”

I’d like to offer a clarification.

Though the authors discuss both CT heart scans and CT coronary angiograms, they confuse the two and use the terms interchangeably.

A heart scan is a simple screening test for coronary atherosclerotic plaque. It detects the presence of calcium in the heart’s arteries, provided as a “score.” (Because calcium occupies 20% of total plaque volume, knowing the amount of calcium tells you how much total coronary plaque is present by applying this simple proportion.) Just having a high score should not prompt heart procedures, since people undergoing simple screening heart scans are without symptoms. However, a stress test may yield some useful information.

On present-day CT devices, heart scans expose a patient to 0.4 mSv of radiation on an electron-beam, or EBT, device, and on up to 1.2 mSv on a 64-slice multi-detector, or MDCT, device, compared to 0.1 mSv during a standard chest x-ray. CT heart scans are therefore performed with about the same quantity of radiation as a mammogram done to screen women for breast cancer, or about the equivalent of four chest x-rays on an EBT scanner, up to 12 chest-xrays on a MDCT scanner.

CT coronary angiograms, while performed on the same devices as heart scans, require x-ray dye to fill the contours of the coronary arteries. It also requires up to several hundred times more radiation. While new engineering innovations are being introduced that promise to reduce this exposure, the current devices being used today do indeed require a radiation dose equivalent to 100 to 400 chest x-rays (usually in the range of 10-15 mSv), a value that equals or exceeds that obtained during a conventional heart catheterization.

While heart scans are most useful to detect and quantify plaque that can help determine the intensity of a heart disease prevention program, CT coronary angiograms are generally used as prelude to hospital procedures like catheterizations, stents and bypass surgery. That’s because they are performed to look for (or rule out) “severe” blockages.
CT heart scans and CT coronary angiography are therefore two different tests that yield two different kinds of information, and yield two entirely different levels of radiation exposure.

This confusion from a major and respected media outlet like the New York Times is unfortunate, because it could persuade millions of people who otherwise could benefit from simple heart scans to avoid them because of misleading information on radiation exposure of a different test.

Thank you.

William Davis, MD

Red yeast rice alert

2. July 2008 William Davis (9)
While there have been some positive reports in the media lately about the cholesterol-reducing effects of red yeast rice, Consumer Lab has issued a very concerning report.

Because Consumer Lab is a subscription website (incidentally, the $20 per year membership fee is money well spent for insightful tests on many supplements, though new reports only come out a handful of times per year), I won't discuss the results of their red yeast rice in its entirety.

However, Consumer Lab testing uncovered several disturbing findings:

--The lovastatin content varied by a factor of 100, from 0.1 mg per tablet/capsule in one brand up to 10.6 mg in another brand. By FDA regulations, lovastatin is a drug and NO red yeast rice preparation is supposed to contain ANY lovastatin. Nonetheless, despite the marketing of supplement manufacturers, it is probably the lovastatin that is largely responsible for the LDL-reducing effect. The monacolins or mevinolins in red yeast rice add little, if any, further LDL-reducing effect.

--Several preparations contain a potential kidney toxin called citrinin. The Walgreen's product, specifically, contained substantial quantities of this toxin.



Interestingly, the FDA has taken repeated action against red yeast rice manufacturers and distributors because they continue to contain lovastatin. In the FDA's most recent action in August, 2007, for instance, Swanson's product and Sunburst Biorganics' Cholestrix, were both sent letters to stop selling their product because it contained lovastatin.

The Consumer Lab findings would explain the enormous variation in LDL-reducing effect of various red yeast rice products. In my experience, some work and reduce LDL 40 mg/dl or so, some fail to reduce LDL at all, others generate a modest effect, e.g., 5-10 mg/dl LDL reduction.

In effect, red yeast rice IS a statin drug, albeit a highly variable and weak one. Although readers of The Heart Scan Blog know that I am a big fan of nutritional supplements and self-empowerment in health, I am a bigger fan of truth. I despise B--- S---- of the sort that emits from some nutritional supplement manufacturers and drug companies.

I am puzzled by much of the public's readiness to embrace a statin drug if it comes from a supplement company while avoiding it if it comes from a drug manufacturer. Personally, I do not like the drug industry, their questionable (at best) ethics, their aggressive marketing tactics, their sleazy sales people.

But, in this instance, if a statin effect is desired, I'd reach for generic lovastatin before I purchased red yeast rice. The Consumer Lab report tells us that red yeast rice IS essentially a statin drug, an inconsistent one that often contains a potential toxin.

"Average amount of heart disease for age"

2. July 2008 William Davis (4)
A 72-year old woman came to my office after a complicated hospital stay (unrelated to heart disease). She'd undergone a CT coronary angiogram and heart scan as part of a pre-operative evaluation prior to a surgery for a non-heart related condition.

The heart scan portion of the test (I was impressed they even did this) yielded a heart scan score of 212. The CT coronary angiogram portion of the test revealed a 50% blockage in one artery, a lesser blockage in one other artery.

The cardiologist consulting on the case advised her that the amount of coronary disease detected was insufficient to pose risk during her surgical procedure. He also advised her that she had "an average amount of disease for age." He thought that nothing further was necessary since she was "average."

Say what?  

What if I told you that you have an average amount of cancer for your age? After all, cancers become more common the older we get. Who would find that acceptable?

Then why should ANY amount of coronary atherosclerotic plaque be "acceptable for age"? Coronary plaque is a degenerative disease that poses risk for rupture. While it is indeed common, by no means should it be acceptable.

I would bet that this same cardiologist would be from the same school of thought that would be eager to advise heart catheterization, stent, and other procedures--revenue-generating procedures--should she have a heart attack appropriate for age.

I wish that I could tell you that this silly comment was provided by some peculiar, "everyone-knows-he's-crazy" doctor. But it was not. It was a solidly mainstream physician. He pooh-poohs nutrition, laughs when asked about nutritional supplements, thinks anyone complaining about symptoms less than a full-blown heart attack is a baby. He is respected by the primary care physicians, lectures on the advantages of prescription medications. In short, he is your typical conventional cardiologist.

This is the way they think. I know, because I was one of them. Thankfully, something banged me upside my head one day (my Mother's sudden cardiac death) and tipped me off to the painful irony of the conventional approach to heart disease.

There is NO amount of coronary disease appropriate for age. This notion is a remnant of the paternalistic, "I-know-better-than-you" attitude of the last century of medicine.

The 21st century promises a new age.

Quantum leaps

29. June 2008 William Davis (6)
A reader of The Heart Scan Blog and member of the Track Your Plaque program posted this comment on The Heart.org:

*The facts speak for themselves.*

Dr. William Davis and Dr. William Blanchet, your patients thank you for the low cost PREVENTIVE care you prescribe. The published facts speak for themselves. It is indeed a sad state of affairs, that the larger cardiology community does not take the time to research the data and results you have been reporting. Unfortunately it is the patients who are the victims of the mainstream, inappropriate, treatment protocols, as evidenced with the ongoing high rate of CV death rate.

I am dumbfounded by the lack of open-minded inquisitive curiosity to thoroughly research your claims by many/most cardiologists. Understood, we are all busy, but that is no excuse to stick with practices that do not result in major breakthrough improvements in patient outcomes.

Then again, we are all humans, and when "we" are convinced that "our" approach is correct, "we" tend to conveniently ignore any evidence to the contrary. "We" like to believe "we" have been right all along.

A very insightful book, recently published, says it all in its title: "Mistakes were made (but not by me)."

From the intensity of the comments on this topic, it is clear that we are in the middle of a battlefield. It is to be hoped that the facts will become visible before too much smoke obscures the field, and before the patients are all dead.

George Orwell said it correctly, back in 1946:

“We are all capable of believing things which we know to be untrue, and then, when we are finally proved wrong, imprudently twisting the facts so as to show that we were right. Intellectually, it is possible to carry on this process for an indefinite time: the only check on it is that sooner or later a false belief bumps up against solid reality usually on a battlefield.”

And, after several posts that preventive care with EBT would be too costly.....

*Heroic*

Prevention is what matters, but it is not very heroic. A hospital that advertises the highest volumes in heart bypasses and other heart "repair" procedures, sounds to many like a go-to place when one gets into trouble with one's heart.

Cardiologists who perform impressive surgical procedures are heroes. Not unlike fire-fighters. We celebrate them (deservedly!) for rescues and life saving heroic actions.

We tend to not pay much attention to the folks that work hard to minimize risk of calamities in the first place.

Similarly, we recently learned that it is too costly to build schools that are earthquake resistant in China. Parents had to look at their children's bodies, crushed.

Is it too graphic to imagine 20,000 American bodies, who died of heart disease, piled up on a field?

What will it take before we make prevention our first priority?

AL, Ann Arbor, Michigan


The reader also tells me that, prompted by his father's death from heart attack while following conventional advice after heart catheterization, he has lost 50 lbs and corrected his lipid patterns on the Track Your Plaque program. The reader is currently struggling with full correction of his severe small LDL pattern and is following some of the advice we discussed on our webinar recently.

Another Heart Scan Blog reader, Stan the Heretic, posted this quote from scientist, Max Planck, in his comment:


"A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it." - M. Planck

(Max Planck was a German physicist who developed quantum theory, a disruptive set of ideas that supplanted other explanations of energy mechanics of the day.)


I fear that may prove to be the case for heart disease. The revenue-generating formula for heart disease management that dominates practice in cardiovascular medicine today is so deeply ingrained into the thinking and revenue expectations of practicing cardiologists that a preventive or reversal approach just won't cut it--even if it is vastly superior.

That's why it is important for you to take control yourself. You will be the one who obtains and applies the information that saves your life or the lives of those around you. It is, in all likelihood, NOT your doctor who will save your life, but YOU.

Body count

28. June 2008 William Davis (7)
Imagine the following headline:

War in Iraq a growing success: 20,000 Americans now dead!


If a newspaper ran that headline, we would all be outraged, and rightly so. Deaths in war are a tragedy. They are not something we celebrate.

Then why do we hear hospitals boasting about the number of bypass operations performed every year, number of heart catheterizations performed, number of heart attacks treated?


"_______ Hospital breaks 1000-heart bypass per year milestone"

"We treat more heart attacks than other other hospital in the state!"

"More people come to ________ Hospital than any other in the region!"



I hear this stuff on the radio, on TV, see it in newspapers and magazines, even on highway billboards every single day in Milwaukee.

Heart procedures, like deaths in war, are casualties of health.

They are not successes (though, of course, you can have a "successful" bypass). I see most procedures as a failure of prevention.

Death from heart attack is a failure of prevention. Tim Russert's death was a (unnecessary) failure of prevention. But so are bypass surgery, stents, and the like.

Such is the perverse state of affairs in hospitals and health: They celebrate illness. They glamorize it with ads displaying high-tech equipment, efficient staff in scrubs, "caring and friendly staff." But it is illness they are celebrating. Why? Because it has become a business necessity, a necessary strategy to remain competitive and profitable in the business called "healthcare" that makes money from treating people. The biggest return is from major procedures like bypass operations.

Every success in prevention denies the hospital an $80,000+ opportunity. You'll never hear that advertised.

Dr. Bill Blanchet: A ray of sunshine

26. June 2008 William Davis (4)
Another heated discussion is ongoing at The Heart.org, this one about Tim Russert's untimely death: Media mulls Russert's death as cardiologists weigh in

Although I posted a couple of brief comments there, I quickly lost patience with the tone of many of the other respondents. Should you choose to read the comments, you will see that many still cling to old notions like heart attack is inevitable, defibrillators should be more widely available, "vulnerable" plaques cannot be identified before heart attacks, etc.

I quickly lose patience with this sort of outdated rhetoric. However, our good friend, Dr. Bill Blanchet of Boulder, Colorado, has a far stronger stomach for this than I do.

Here, a sample of his wonderfully persuasive comments:


Heart disease cannot be stopped but we can certainly do better!

Goals we must achieve if we hope to solve the Rube Goldberg of coronary disease:

1. Find something more reliable than Framingham risk factors to determine who is at risk. Framingham risk factors are wrong more often than they are right. If you are comfortable treating 40% of the patients destined to have heart attacks, continue to rely on “traditional” risk factors only.

2. Treat to new standards beyond NCEP/ATP-III. These accepted standards prevent at best 40% of heart attacks in patients treated. This is unacceptable, and arguably why Tim is dead today! Why prevention protocols emphasize LDL and more or less ignore HDL, triglycerides and underemphasize blood pressure eludes me.

3. Motivate patients to participate in coronary prevention. Saying “you need to get exercise and lose weight” is not adequate motivation, it hasn't worked to date and probably won't work tomorrow. If you are satisfied saying it is "the patient's fault for not listening to me" so be it, that excuse doesn't work for me!

Currently “good results” consist of being able to convince 50% of patients at risk by traditional risk factors to participate in prevention and hopefully 30% will be treated to goal. Of those treated to goal, 60% of the heart attacks will still happen anyway. Mathematically we can hope to prevent <10% of heart attacks with this approach!

I have personally found a solution to this dilemma. It goes like this:

1. EBT-CAC [electron-beam tomography coronary artery calcium] is the most reliable predictor of coronary events period, the end! Anyone who disagrees has not objectively read the literature. The only test more predictive than the initial calcium score is the follow up score 12 to 36 months later. EBT predicted Tim Russert’s event 10 years before it happened; passing his stress test gave him inappropriate reassurance 2 months before he died. If only Tim had the benefit of a second EBT sometime over the last 10 years he and his doctor would have known that what they were doing was insufficient and improvements could have been made.

2. I treat to the standard of stable calcified plaque by EBT (<15% annualized progression, preferably <1% annualized progression). This correlates with a very low incidence of coronary events. Even the ACC/AHA 2007 position paper agrees with this. This is accomplished with aspirin, omega-3 fatty acids, diet, exercise, weight control, smoking cessation, treatment of sleep apnea, stress reduction, control of HDL, triglycerides and LDL cholesterol and excellent control of BP and insulin resistance plus the recent addition of vit D-3. Meeting an LDL goal of 70 is easy but prevents only a minority of events, treating to the goal of stable CAC by EBT is a challenge but when achieved, the reward is near elimination of heart attacks and ischemic strokes. This has indeed been my personal experience!

3. A picture of plaque in the coronary artery is a monumental motivator for patients to get on board to make things better. The demonstration of progression of that plaque despite our initial therapies gets all but a few suicidal patients interested in doing a better job. I think that similar motivational results can be had with carotid imaging; the difference is that CAC by EBT is clinically validated as being a much stronger predictor of events with progression and non-events with stability than any ultrasound test including IVUS.



Wow! I couldn't have said it better.

Sadly, I doubt even Dr. Blanchet's persuasive words will do much to convince my colleagues on this forum. And the cardiologists on this forum are likely among the more inquisitive and open-minded. The ones stuck in the cath lab day and night, or implanting defibrillators, are even less inclined to entertain such conversations.

While I admire Dr. Blanchet's energy for continuing to argue with my colleagues, the lesson I take is: Take charge of health yourself. If you wait for your doctor to do it for you, you could be in the same situation as poor Tim Russert. This is an age when your physician should facilitate your success, not prevent it or leave you wallowing in ignorance.

The Russert Protocol at work

25. June 2008 William Davis (6)
Without a concerted effort at prevention, heart scan scores (coronary calcium scores) grow like weeds. The average rate of growth is 30% per year.

Keith is an illustrative case. At age 39, Keith's heart scan score was 29, in the 99th percentile due to his young age. (In other words, young people before age 40 have no business having plaque. If they do, it's bad.)

True to conventional practice, Keith's doctor prescribed a cholesterol drug (Zocor), asked him to take a baby aspirin, and prescribed a blood pressure medicine. He asked Keith to cut the fat in his diet. His doctor even exceeded conventional (ATP-III) LDL cholesterol treatment targets.

Keith, an intelligent and motivated businessman, happily complied with his doctor's instructions. Eighteen months later, a 2nd heart scan showed a score of 68, representing an increase of 135%, or 76% per year.

This is the very same approach that the late Mr. Tim Russert's doctors employed: treat (calculated) LDL cholesterol with a statin drug, treat high blood pressure, reduce saturated fat, take aspirin. It was a miserable failure in Keith, whose plaque continued to grow at a frightening rate of 76% per year. It was also an obvious failure in poor Tim Russert.

Further investigation in Keith uncovered:

--Severe small LDL--80% of all LDL was small (despite a favorable HDL of 58 mg/dl)
--Measured LDL particle number (NMR) showed that "true" LDL was actually about 60 mg/dl higher than suggested by the crude calculated LDL
--An after-eating (postprandial) disorder (IDL)
--A pre-diabetic blood sugar and insulin
--Severe vitamin D deficiency
--Very low testosterone

All these patterns were present despite the steps Keith and his doctor had instituted. It's no wonder his plaque was undergoing explosive growth.

The conventional approach to coronary disease prevention is inadequate, more often than not a mindless adherence to one-size-fits-all template crafted to a great degree by drug industry interests and "experts" who often stand at arm's length from real live patients.

Keith's "residual" abnormalities are all readily correctable. He has since made dramatic improvements in all parameters. Among the strategies used is a wheat- and cornstarch-free diet that resulted in 12 lbs lost within the first few weeks of effort.

If you are on the "Russert Protocol," have a serious conversation with your doctor about the continued advisability of remaining on this half-assed approach to heart disease. Or, consider finding another doctor.

Petition to the National Institutes of Health

24. June 2008 William Davis (2)
A petition to the National Institutes of Health (NIH) is being circulated in response to the mis-statement made in an NIH-sponsored study, ACCORD.

The ACCORD Trial included over 10,000 type II diabetics and compared an intensive, multiple-medication group to achieve a target HbA1c of <6.0%, with a less intensively treated group with a target HbA1c of 7-7.9%. (HBA1c is a long-term measure of glucose, averaging approximately the last 3 months glucose levels.) To the lead investigators' surprise, the intensively treated group experienced more death and heart attack than the less intensive group. The conclusion suggested that intensive management of diabetes may not be a desirable endpoint and may result in greater risk for adverse events.

The petitioners argue that the problem was not with intensive glucose control per se, but the use of multiple side-effect-generating medications. Unfortunately, the ACCORD conclusions give the impression that loose control over blood sugar may be desirable.

The petition originates from the Nutrition and Metabolism Society, a non-profit organization seeking to promote carbohydrate restriction.


The petition reads:

National Institute of Health re: the ACCORD Diabetes Study: "Intensively targeting blood sugar to near-normal levels ... increases risk of death. "

This statement is untrue. This study lowered blood glucose levels only by aggressive drug treatment.

Preventative measures and proven non-drug treatments are being ignored by the NIH, ADA and many other governing agencies.

There is abundant scientific evidence proving a carbohydrate restricted diet can be as effective as drugs in lowering blood glucose levels safely. Many times diet is more effective than medication in controlling diabetes - all without side effects or increased risk of death.

I ask that the NIH publicly retract the above statement. It is misleading the public.

I also request that the NIH acknowledge the existing science and fund more research by the experts who have experience with carbohydrate restriction as a means of treatment for diabetes.

For more info, or to help people with diabetes, please e-mail info@nmsociety.org .

Thank you.



I added my comment:

In my preventive cardiology practice, I have been employing strict carbohydrate restriction in both diabetics and non-diabetics. This results in dramatic improvement in lipids and lipoprotein abnormalities, substantial weight loss, and improved insulin sensitivity. This experience has been entirely different from the heart disease-causing and diabetes-causing low-fat diets that I used for years.

I have a substantial number of diabetics who have been to reduce their reliance on prescription medication for diabetes or even eliminate them. In my experience, the power of carbohydrate-restricted diets is profound.

However, better clinical data to further validate this approach is needed, particularly as diabetes and pre-diabetes is surging in prevalence. I ask that more funding to further explore and validate this research be made available if we are to have greater success on a broader basis.



If you are interested in adding your voice, you can also electronically sign the petition. It is optional, but you can also add your own comments regarding your own views or experiences.

Wheat withdrawal

24. June 2008 William Davis (16)
It happens in the hospital every so often: A clean-cut, law-abiding person is hospitalized for, say, pneumonia, kidney stones, knee surgery, etc.

Everything's fine until . . . they're running down the hospital hallway stark naked, screaming about snakes on the wall, accusing nurses of trying to kill him, all while yanking out IV's and monitor patches.

It's called alcohol withdrawal. Alcohol withdrawal can range from tremulousness and sweatiness, all the way to delirium tremens, the full-blown form that leads to disorientation, seizures, fever, even death. Withdrawal can also be associated with a number of chronically used agents, such as sedatives/sleeping pills, pain medication/opiates, among others.

How about wheat?

I wouldn't have believed it, but after witnessing this effect countless times, I am convinced there is such a phenomenon: Wheat withdrawal.

You'll recognize it in someone who previously ate bread and other wheat flour-containing products freely, then eliminates them. This is followed by extreme cravings, usually for bread, cookies, or cake; profound fatigue; shakiness; mental fogginess; blue moods. The syndrome can last for up to one week.

Then, bam! Sufferers of wheat withdrawal report mental clarity superior to their wheat-crazed days, improved energy, decreased appetite and cravings, heightened mood, and, of course, fantastic drops in weight.

Why would removal of wheat from the diet trigger a withdrawal phenomenon? I can only speculate, but I believe that at least part of this response is due to a physical conversion from a glycogen (sugar)-burning metabolism to that of a fatty acid (fat mobilizing) metabolism. People who lived in the up-and-down cycle of craving and eating wheat constantly fed the sugar furnace for years and are enzymatically impaired in fat burning; they've been growing fat stores. Eliminating wheat deprives the body of this easy source of glycogen, forcing it to mobilize fatty acids in the fatty tissues. Sluggish at first, people feel fatigue, mental fogginess, etc. Once the enzymatic capacity for fat mobilization revs up, then these feelings dissipate.

Could it also relate to the opioid sequences apparently present in wheat? I wasn't even aware of this fact until a reader of The Heart Scan Blog, Anne, left this comment:

Wheat protein contains a number of opiod peptides which can be released during digestion. Some of these are thought to affect the central and peripheral nervous systems.

When I gave up gluten, I felt much worse for a few days. This is a very common reaction in those who stop eating gluten cold turkey.

Dr. BG provides a fascinating commentary on the addictive/opioid aspect of wheat addictions in her Animal Pharm Blog.

Whatever the mechanism, I believe it is a real phenomenon. It can, at times, be so overwhelming that about 20% of people who try to eliminate wheat find they are simply unable to do it without being incapacitated. Of course, that might be a lesson in itself: If withdrawal is so profound, it hints that there must be something very peculiar going on in the first place.