11. August 2006 William Davis (0)
The recognition of the metabolic syndrome as a distinct collection of factors that raise heart disease risk has been a great step forward in helping us understand many of the causes behind heart disease.

Curiously, there's not complete agreement on precisely how to define metabolic syndrome. The American Heart Association and the National Heart, Lung, and Blood Institute issued a concensus statement in 2005 that "defined" metabolic syndrome as anyone having any 3 of the 5 following signs:





Waist size 40 inches or greater in men; 35 inches or greater in women

Triglycerides 150 mg/dL or greater (or treatment for high triglycerides)

HDL-C <40 mg/dL in men; <50 mg/dL in women (or treatment for reduced HDL-C)

Blood Pressure >130 mmHg systolic; or >85 mmHg diastolic (or drug treatment for hypertension)

Glucose (fasting) >100 mg/dL (or drug treatment for elevated glucose)


Using this definition, it has become clear that meeting these criteria triple your risk of heart attack.

But can you have the risk of metabolic syndrome even without meeting the criteria? What if your waste size (male) is, 36 inches, not the 40 inches required to meet that criterion; and your triglycerides are 160, but you meet none of the other requirements?

In our experience, you certainly can carry the same risk. Why? The crude criteria developed for the primary practitioner tries to employ pedestrian, everyday measures.

We see people every day who do not meet the criteria of the metabolic syndrome yet have hidden factors that still confer the same risk. This includes small LDL; a lack of healthy large HDL despite a normal total HDL; postprandial IDL; exercise-induced high blood pressure; and inflammation. These are all associated with the metabolic syndrome, too, but they are not part of the standard definition.

I take issue in particular with the waist requirement. This one measure has, in fact, gotten lots of press lately. Some people have even claimed that waist size is the only requirement necessary to diagnose metabolic syndrome.

Our experience is that features of the metabolic syndrome can occur at any waist size, though it increases in likelihood and severity the larger the waist size. I have seen hundreds of instances in which waist size was 32-38 inches in a male, far less than 35 inches in a female, yet small LDL is wildly out of control, IDL is sky high, and C-reactive protein is markedly increased. These people obtain substantial risk from these patterns, though they don't meet the standard definition.

To me, having to meet the waist requirement for recogition of metabolic syndrome is like finally accepting that you have breast cancer when you feel the two-inch mass in your breast--it's too late.

Recognize that the standard definition when you seen it is a crude tool meant for broad consumption. You and I can do far better.
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Low HDL makes Dr. Friedewald a liar

Low HDL makes Dr. Friedewald a liar

17. March 2007 William Davis (5)
There's a $22 billion industry based on treating LDL cholesterol, a fictitious number.

LDL cholesterol is calculated from the following equation:

LDL cholesterol = Total cholesterol - HDL cholesterol - triglycerides/5

So when your doctor tells you that your LDL cholesterol is X, 99% of the time it has been calculated. This is based on the empiric calculation developed by Dr. Friedwald in the 1960s. Back then, it was a reasonable solution, just like bacon and eggs was a reasonable breakfast and a '62 Rambler was a reasonable automobile.

One of the problems with Dr. Friedewald's calculation is that the lower HDL cholesterol, the less accurate LDL cholesterol becomes. If it were just a few points, so what? But what if it were commonly 50 to 100 mg/dl inaccurate? In other words, your doctor tells you that your LDL is 120 mg/dl, but the real number is somewhere between 170 and 220 mg/dl. Does this happen?

You bet it does. In my experience, it is an everyday event. In fact, I'm actually surprised when the Friedewald calculated LDL closely approximates true LDL--it's the exception.

Dr. Friedewald would likely have explained that, when applied to a large population of, say, 10,000 people, calculated LDL is a good representation of true LDL. However, just like saying that the average weight for an American woman is 176 lbs (that's true, by the way), does that mean if you weigh 125 lbs that you are "off" by 41 lbs? No, but it shows how you cannot apply the statistical observations made in large populations to a single individual.

The lower HDL goes, the more inaccurate LDL becomes. This would be acceptable if most HDLs still permitted reasonable estimation of LDL--but it does not. LDL begins to become significantly inaccurate with HDL below 60 mg/dl.

How to get around this antiquated formula? In order of most accurate to least accurate:

--LDL particle number (NMR)--the most accurate by far.

--Apoprotein B--available in most laboratories.

--"Direct" LDL

--Non-HDL--i.e., the calculation of total cholesterol minus HDL. But it's still a calculated with built-in flaws.

--LDL by Friedewald calculation.

My personal view: you need to get an NMR if you want to know what your LDL truly is. A month of Lipitor costs around $80-120. A basic NMR costs less than $90. It's a relative bargain.
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Comments (5) -

  • Mike

    3/18/2007 1:52:00 AM |

    What is shocking is that enormous prescriptions for statins are written based on the calculated LDL.

  • Dr. Davis

    3/18/2007 1:16:00 PM |

    Yes, $22 billion last year, in fact. All prescribed for a number that is a crude estimate, sometimes a complete fiction. Imagine your state trooper ticketed you because his radar device said you were doing 60 mph when you were really doing 35 mph.

  • Anonymous

    2/6/2008 1:37:00 AM |

    Why NMR over the other tests Berkeley Heart Lab or VAP?

  • Anonymous

    7/2/2008 7:02:00 PM |

    I don't understand.  If in this example, the doctor (wrongly) thinks the LDL number is 120mg/dl, how does that cause the prescription of Lipitor? Unless I'm reading it backwards, and the doctor is actually telling the patient their LDL is 170mg-220mg, but unwittingly, it's actually 120mg/dl.

    And, if a low HDL causes the LDL number to be inaccurate, does that also cause the total cholesterol number to be inaccurate too?

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When MIGHT statins be helpful?

When MIGHT statins be helpful?

7. April 2011 William Davis (17)
I spend a lot of my day bashing statin drugs and helping people get rid of them.

But are there instances in which statin drugs do indeed provide real advantage? If someone follows the diet I've articulated in these posts and in the Track Your Plaque program, supplements omega-3 fatty acids and vitamin D, normalizes thyroid measures, and identifies and corrects hidden genetic sources of cardiovascular risk (e.g., Lp(a)), then are there any people who obtain incremental benefit from use of a statin drug?

I believe there are some groups of people who do indeed do better with statin drugs. These include:

Apoprotein E4 homozygotes

Apoprotein E2 homozygotes

Familial combined hyperlipidemia (apoprotein B overproduction and/or defective degradation)

Cholesteryl ester transfer protein homozygotes (though occasionally manageable strictly with diet)

Familial heterozygous hypercholesterolemia, familial homozygous hypercholesterolemia

Other rare variants, e.g., apo B and C variants

The vast majority of people now taking statin drugs do NOT have the above genetic diagnoses. The majority either have increased LDL from the absurd "cut your fat, eat more healthy whole grains" diet that introduces grotesque distortions into metabolism (like skyrocketing apo B/VLDL and small LDL particles) or have misleading calculated LDL cholesterol values (since conventional LDL is calculated, not measured).

As time passes, we are witnessing more and more people slow, stop, or reverse coronary plaque using no statin drugs.

Like antibiotics and other drugs, there may be an appropriate time and situation in which they are helpful, but not for every sneeze, runny nose, or chill. Same with statin drugs: There may be an occasional person who, for genetically-determined reasons, is unable to, for example, clear postprandial (after-eating) lipoproteins from the bloodstream and thereby develops coronary atherosclerotic plaque and heart attack at age 40. But these people are the exception.
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Comments (17) -

  • Might-o'chondri-AL

    4/8/2011 12:21:11 AM |

    I don't know how individuals with mis-sense SNP for gluco-kinase regulatory protein (ex: GCKR rs780094) fit into the pattern. They get more liver steatosis (fat build up) with attendant elevated LDL and triglycerides, despite less fasting glucose and less fasting insulin numbers; while their 2 hour blood glucose runs high (GCK gene is very determinate of 2 hour glucose levels), showing down-regulation of the homeostatic model for Beta cell function (HOMA-B).

    Normally GCKR regulates triglycerides and determines persons glycemic traits by governing how glucose is stored and how it is dispersed. GCKR also geneticly regulates the availablility of substrate used for de-novo lipo-genesis.

    Gene SNP of protein phosphatase 1regulatory (inhibitor) subunit 3 B (PP1R3B rs4240624) manifests increased liver steatosis  and both elevated LDL and elevated HDL; with low fasting glucose. PPP1R3B codes for controling protein and modulates the break down of glycogen (storage glucose moleccule).

    Together PPP1R3B and GCKR are integral to blood sugar dynamics and the levels of lipids in circulation.

    If Doc's regimen counter-balances individual missense genetic workings, like those above, then that is impressive corrrection achieved through intervention . I presume for people with liver steatosis missense mutations (ie:  SNPs like above) elevated LDL treatment using statins would be bad for their liver.

  • Dr. John

    4/8/2011 1:10:14 AM |

    Statins might be helpful if you have bacterial pneumonia:
    http://www.bmj.com/content/342/bmj.d1907.extract?sid=f762e55c-1a0b-4ef3-81c4-f31cc472a372

    That's because the rapidly growing pneumococcal bacteria are very susceptible to HMG-CoA reductase inhibitors (statins). The bacteria have similar cholesterol compounds (hopanoids) in their membranes, essential for their membrane function. With the statins blocking the hopanoids, they die....very quickly.

    All bacteria have a mevalonate pathway.  The HMG-CoA reductase enzyme is inhibited in bacteria and are VERY toxic to bacteria. So thus, you have a "statin-benefit" because it kills the bacteria, before it kills or injures the patient.

    Statins can essentially inhibit biological life forms.
    Dr. John

  • Dr. William Davis

    4/8/2011 1:11:01 AM |

    HI, Might--

    As usual, you've come out of left field with a totally unexpected issue!

    I'm not sure how this genetic variant fits into this argument. It is, to my knowledge, a very rare diagnosis.

  • Might-o'chondri-AL

    4/8/2011 6:40:15 PM |

    I don't envy Doc trying to sort out who needs what treatment. Genetic high cholesterol entails over 50 amino acid variations out the jumble of 692 amino acids assembled into relevant complexes.

    Pro-protein convertase subtilisin/kexin-9 (PCSK9)is involved in familiar hyper-cholestemia. Those who make too much PCSK9 (in the liver and small intestine) rapidly degrade their cholesterol receptors and can't pluck much LDL out of circulation; plasma cholesterol rises.

    Should one's genetics foster making too little PCSK9, then cholesterol receptors don't degrade. This promptly shunts cholesterol into the liver lysosome (an organelle inside a cell)for break down; thus they  measure low cholesterol in the blood.

    I speculate Doc's diet, in "normal" genetic people up-regulates cholesterol reception. Which means his program has the epigenetic effect (from diet dynamics) on "normal" liver/small intestine genes in a way that less PCSK9 is expressed

    The caucasian anglo-saxon PCSK9 D374Y mutation causes 4 times the normal cholesterol in patients. Their risk factor for pre-mature death is 10 years earlier than even more benign PCSK9 mutations; so Detective Doc Davis is willing to prescribe statins for people like them.

  • Anonymous

    4/9/2011 2:59:55 AM |

    I might be one of these poor souls.

    Eating a strict diet, one Dr Davis would be very proud of... I'm lean as can be, feel great, but my cholesterol shot through roof (while HDL dropped).    

    Frown

  • Might-o'chondri-AL

    4/9/2011 4:53:48 AM |

    Hi Annon.,
    Internet self-diagnosing shouldn't replace a good medical consultant. My comments are not qualified medical assesments; am a layman.  

    My favorite cousin has had her cholesterol testing well over 300for several decades, and is now in her late 70s. Like Doc chided me earlier, there are "genetic variant" being "very rare diagnosis."

  • Lucy

    4/9/2011 11:47:29 AM |

    What do you think about KIF6?   I was tested and found to be a non-carrier, and I was subsequently told that statins would likely not benefit me as much as diet/lifestyle changes (I'm ApoE 3/4 as well).  Does that also mean that niacin would not help?

  • Anonymous

    4/9/2011 12:52:56 PM |

    To say the least, I am very disappointed in Dr. Davis' stance regarding ApoE 4 & statins. There is abundant evidence suggesting statins are counterproductive to brain health, which is much more pronounced in Apo E4's who are already at high risk for alzheimers disease. It isn't only about lipids, there is a larger picture to consider. The brain requires cholesterol.  Also, high cholesterol levels are associated with longevity in the elderly.

  • Might-o'chondri-AL

    4/9/2011 7:44:42 PM |

    Alzheimers and the relationship of ApoE4 is different than other ApoE isoforms (like ApoE 2 & 3). In normal people ApoE is integral to clearing amyloid Beta from the brain; it forms a conjugate (ApoE/AmyloidB)that is moved out across the brain blood barrier by LRP-1 (lipo-protein related protein 1).

    ApoE4 is acted upon (cleaved) in brain neurons, yielding rump fragments with unique Carbon- terminals; and,  ApoE4 degrades easier than ApoE 2 &/or 3. These ApoE4 fragments, when in a brain cell's cytosol, influence that cell's mitochondria hydro-phobic pattern of lipid binding.

    The ApoE4 fragment properties  do 2 unwanted things to the brain cell mitochondria. It decreases the mitochondria ability to perform tasks involved in glycolysis (glucose energy). And is antagonistic to PPAR gamma; PPAR gamma is what would otherwise promote adequate mitochondria bio-genesis.

    ALzheimer lesions show higher amounts when measured in individuals with concurrent Type II diabetes and the ApoE4 isoform. The ratio of insulin in the cerebro-spinal fluid to the amount of insulin in the blood also shows a difference depending on the specific ApoE geno-type.

    Alzheimer brains are using less glucose; patients show less receptors for insulin-like growth factor and insulin, as well as less insulin degrading enzymes. It is postulated that depending on the individual's ApoE variation there is a different amyloid Beta response to brain insulin.

    Normally one goes from glucose intolerance to hyperglycemia and then elevated insulin circulating as become diabetic. Yet experiments show that giving insulin improves diabetic neuro-pathy in the brain; it seems to be a way peripheral insulin resistance causes different tissues to respond.

    In Alzheimer experiments with supplemental insulin (nasal, etc.)administration cognitive function improved. This response was more significant in those with the ApoE4 allele (compared to other ApoE types with Alzheimers, who also improved cognition ).

    So, the Alzheimer enigma seems to involve energy format dynamics for ApoE isoforms more than specific levels of cholesterol. This is not a comment on ApoE homo-zygote genes relationship to cardio-vascular risk factors, or brain lipid metabolism.

  • homertobias

    4/11/2011 3:36:34 PM |

    Mito
    You sound like Suzanne Craft.  I like her work.

  • Medicomp INC.

    4/12/2011 4:06:52 PM |

    You make an excellent point here:

    ...eat more healthy whole grains" diet that introduces grotesque distortions into metabolism

    We are encouraged by transient sources that this is almost always the best alternative for other fattening foods, yet people never really delve deep into the cons of this transition either.  It truly does take dedication to be well-informed about the dietary changes you make in your lifestyle.

  • Anne

    9/18/2011 5:58:38 PM |

    I had a body scan a few years ago, and my plaque count was 1050, when they told me that 150 was considered high, I thought  I would implode at any moment, I went to a lot of different cardiologists and had all kinds of tests and they said to exercise and not  worry about the plaque. One Dr. put me on lipitor and 3 days later I could hardly walk from the muscle pain, he told me to stop taking it and I tried niacin and red rice with the same results. I don't know how to reduce the plaque, the Dr's all said it was hereditary . I am open to any advice.

  • Dr. William Davis

    9/20/2011 12:43:37 PM |

    Hi, Anne--

    Note that this is the blog that accompanies the Track Your Plaque program that focuses on just this issue. It means 1) identify all causes of plaque, then 2) correct them, preferably using natural means.

  • JK

    10/30/2011 4:52:34 PM |

    Dr. Davis,
    I don't know if you have already addressed this topic in prior posts but allow me to suggest that in lieu of consuming statin drugs, even for the aforementioned outliers, it is possible to achieve reduced LDL cholesterol and increased HDL cholesterol by supplementing with magnesium.
    (All the ensuing statements below I humbly attribute to Mildred S. Seelig and Andrea Rosanoff, "The Magnesium Factor," pages 139-147.)
    1. Statins (Lipitor, Zocor, Baycol, Mevacor, etc.) are designed to lower cholesterol by inhibiting HMG-CoA reductase, which is the enzyme responsible for the synthesis of cholesterol.
    2. These drugs when studied, not only lower cholesterol, but also reduce total mortality, cardiac mortality, the total incidence of heart attacks, angina, and other non-fatal cardiac events. (p.140.)
    3. They also made the blood platelets less sticky, they slowed the progression of plaques and stabilized them, and they reduced inflammation in the blood vessel tissue. (ibid.)
    All these results, and more, Seelig further informs the reader, are a result of reduced mevalonate in the cells, which is the direct result of an inhibited HMG-CoA reductase, which is the enzyme that statins are designed to inhibit.
    Now stay with me for a second because here is where it gets interesting.
    4. Magnesium is a natural inhibitor of HMG-CoA reductase. Here magnesium and statins are comparable (p. 141.)
    5. Magnesium also acts on two enzymes, phosphatase reductase and phosphohydrolase which reactivate HMG-CoA reductase. By its effects on these enzymes, which contrast one another, magnesium can either stop cholesterol formation or allow it to continue depending on the body's needs.
    6. Magnesium also activates another enzyme, lecithin cholesterol acyltransferase (LCAT) which, through this action, converts LDL cholesterol to HDL cholesterol -- increasing HDL and reducing LDL.  (Statins cannot do this.)
    In the interest of brevity, I'll conclude by saying that whereas statins are known to reduce cholesterol and perhaps achieve other cardiovascular benefits, this is due in large part to their suppression of mevalonate, brought about by their inhibition of HMG-CoA reductase.
    In contrast, magnesium not only inhibits HMG-CoA reductase, meaning that it would achieve the same results as statins in "1, 2, and 3 above," but it also converts LDL cholesterol to HDL cholesterol, achieved by its activation of LCAT, which is something that statins do less consistently.
    Further, instead of poisoning HMG-CoA reductase as statins do, magnesium inhibits it in ways that can be reactivated by other (magnesium dependent) enzymes so that the body can naturally make the mevalonate and cholesterol it needs.
    This is important because vitamin D is synthesized from cholesterol (when using the sun's rays), and cholesterol is also the precursor to testosterone, estrogen, and other steroids.
    So I encourage you to consider using Magnesium for those Apo-B cases that cannot be addressed by carbohydrate restricted diets.

  • JK

    10/30/2011 4:58:10 PM |

    Sorry, meant to say Apo-E cases.

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Talking heads

Talking heads

4. June 2008 William Davis (0)
Tne Philadelphia NBC affiliate's website carried this commentary from a colleague of mine:


Mark from the Lehigh Valley is curious about scans that can detect heart disease.

He asked, "I am in my early 50s. My father had a heart attack in his 40s. I am healthy with no symptoms of heart disease, should I consider a heart scan?"

"Well, Mark, occasionally family history needs to be considered more closely. If your father had coronary disease at a relatively young age at the absence of any known risk factor for heart disease for example diabetes, smoking, obesity, high blood pressure, than your level of risk should be considered more closely," Dr. Kevin Shinal, a cardiologist, said.

"There are a number of studies available to access [sic] your level of risk. One such study is a calcium score. A calcium score is a form of a CAT scan that access [sic] the calcium burden or presence of calcium in your coronary arteries. It assigns you a score and score is translated into a level of cardiovascular risk," Shinal said.

But the doctor warned because Mark doesn't have active symptoms, the scan probably wouldn't be covered by insurance.


Was there an understandable answer in there? I certainly couldn't find it.

Why pick on some yokel responding inarticulately to the local media's quest for content? Because this is, all too often, what the public hears: Ill-informed blather from someone who has little or no understanding of the issues. Maybe this doctor wanted his practice group to get some free publicity. "Doctor, could you just answer a few questions from viewers?"

Unfortunately, it's not just local media who are guilty of consulting with know-nothings with only passing knowledge of an issue. National media are guilty of it, too. The need to fill airtime with content is better filled with talking heads who present a compelling story, whether or not it is accurate or insightful, rather than an expert with deep insight into a topic who might not present as pretty a story. I've seen this countless times. A good portion of my day, in fact, is occupied responding to patient questions based on the misinformation presented in some media report.

My message of this brief rant: Be very careful of the messages delivered by the media, even if provided by some supposed "expert." In fact, I regard "experts" in health about as believable as politicians. Sure, sometimes they provide accurate information. But they often do not, or provide information with limited understanding. Or, worse, information intended to serve some hidden agenda.

Were the media to ask me to respond to the question, however, I would say:

"Yes, you should absolutely have a heart scan--yesterday! With your family history, there is no other way to accurately, easily, and inexpensively quantify the amount of coronary atherosclerosis in your heart's arteries. A stress test only uncovers advanced disease. A heart catheterization is overkill and absolutely not indicated in an asymptomatic man. Judging the presence of heart disease from cholesterol values is folly.

"What's left? A CT heart scan. So, yes, you need a CT heart scan ASAP with no doubt whatsoever."

But they didn't ask.
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DHEA and Lp(a)

DHEA and Lp(a)

16. January 2011 William Davis (25)
DHEA supplementation is among my favorite ways to deal with the often-difficult lipoprotein(a), Lp(a).

DHEA is a testosterone-like adrenal hormone that declines with age, such that a typical 70-year old has blood levels around 10% that of a youthful person. DHEA is responsible for physical vigor, strength, libido, and stamina. It also keeps a lid on Lp(a).

While the effect is modest, DHEA is among the most consistent for obtaining reductions in Lp(a). A typical response would be a drop in Lp(a) from 200 nmol/L to 180 nmol/L, or 50 mg/dl to 42 mg/dl--not big responses, but very consistent responses. While there are plenty of non-responders to, say, testosterone (males), DHEA somehow escapes this inconsistency.

Rarely will DHEA be sufficient as a sole treatment for increased Lp(a), however. It is more helpful as an adjunct, e.g., to high-dose fish oil (now our number one strategy for Lp(a) control in the Track Your Plaque program), or niacin.

Because the "usual" 50 mg dose makes a lot of people bossy and aggressive, I now advise people to start with 10 mg. We then increase gradually over time to higher doses, provided the edginess and bossiness don't creep out.

The data documenting the Lp(a)-reducing effect of DHEA are limited, such as this University of Pennsylvania study, but in my real life experience in over 300 people with Lp(a), I can tell you it works.

And don't be scared by the horror stories of 10+ years ago when DHEA was thought to be a "fountain of youth," prompting some to take megadose DHEA of 1000-3000 mg per day. Like any hormone taken in supraphysiologic doses, weird stuff happens. In the case of DHEA, people become hyperaggressive, women grow mustaches and develop deep voices. DHEA doses used for Lp(a) are physiologic doses within the range ordinarily experienced by youthful humans.
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Comments (25) -

  • Anonymous

    1/16/2011 4:39:07 PM |

    I recently had this test as part of my blood work and have a level of 34, which is very low.  My doctor advised just as you have to start low and go slow watching how I feel.

    This along with some other hormone supplementation has helped my overall well being and energy.  I can't remember when I had my last energy crash.  

    As always, Thanks!

  • Mike

    1/16/2011 5:50:53 PM |

    Interesting stuff, Dr Davis, regarding treating Lp(a) w/ DHEA.  

    What are your thoughts on the efficacy of increasing/maintaining natural endogenous secretion via strength training and/or caloric restriction?

    This is something I'm becoming more interested in as I creep closer to 40.

  • Dr. William Davis

    1/16/2011 9:35:42 PM |

    Hi, Mike--

    I should have mentioned that I only suggest DHEA supplementation for these purposes in people age 40 and over.

    Your idea of endogenous enhancement is the preferred, though relatively modest, route in younger people.

    Thanks for reminding me.

  • Hotwife Admin

    1/16/2011 11:48:46 PM |

    I’m very interested in trying DHEA for this very reason. I’m am a 43 year old male in good health but who had very high cholesterol. I am currently using high strength fish oil and niacin along with cutting out most carbs from my diet. I have lost about 7 kilo since doing this and had some great plummets in my cholesterol. Problem is as I live in Australia we cannot get access to DHEA without paying obscene amounts of money via compounding pharmacies and doctor scripts as it’s a class 1 drug that is illegal. I know in the states you can get it as a nutritional supplement but Australia is backwards in this sense. Do you or any readers know of any sympathetic doctors who are interested in male health and would prescribe DHEA? It seems criminal that we cannot access the health benefits of this because of government bureaucracy.
    Cheers from South Australia
    Dave

  • Might-o'chondri-AL

    1/17/2011 12:59:26 AM |

    Young people produce at least 12mg./day of DHEA; when we reach +/- age 30 our production of DHEA normally drops. I am led to believe that decline is +/- 2 mg./d. for every decade of our life past 30.

    So, for an average patient of (say) 50 years supplementing daily with 10 mg. DHEA: the first 4 mg. is serves to "top up" the natural ageing deficit. The remaining 6 mg. is providing a 50% bonus level for the circulatory system to use thwarting Apo(a).

    Sounds relatively safe intake. I'd like to hear if Apo(a)patients, who took it regularly in middle age, would be taking (say) +/- 15 mg. DHEA daily when they are in their 70's.

  • Becky

    1/17/2011 2:07:56 AM |

    I am 58 years old and was recently tested and had levels of 4.510 ng/mL.  What levels do you recommend as targets for someone wishing to treat Lp(a)?

  • Anonymous

    1/17/2011 3:51:24 AM |

    I have long been fascinated with DHEA but I read too many horror stories on Wikipedia and Consumerlabs.com about the dangers. Cancer, lowering of HDL, and aggressiveness are big turn offs. How do we balance these risks with the risk of heart disease?

    -- Boris

  • JC

    1/17/2011 1:30:34 PM |

    http://curezone.com/forums/fm.asp?i=1448411#i

    Problems with DHEA supplementation.

  • ben

    1/17/2011 2:50:08 PM |

    What do you think/know about magnesium oil's effect in raising levels of DHEA? I take oral magnesium in the form of Natural Calm (citrate i think) but three months ago I also started rubbing magnesium oil into my skin. I have read that this type of transdermal magnesium application raises DHEA levels. Any truth there, Dr.? Thanks

  • Anonymous

    1/17/2011 3:17:30 PM |

    What is a good brand name DHEA, and can it be found in less than 50 mg tabs?

    Thank you.

  • Anonymous

    1/17/2011 5:03:23 PM |

    Anonymous,

    I would recommend Life Extension brand of DHEA. I have had excellent results with Life Extension products over the years. They are a little more costly, but I believe the quality is top notch. Unfortunately however, the smallest dose of DHEA that LEF makes is 15mg.

    Here is what Ray Sahelian, M.D. says about DHEA:

    http://www.raysahelian.com/dhea.html

    I myself had low levels of DHEA and low testosterone and I took DHEA (starting at 25mg and going all the way up to 75mg) and while my DHEA levels went up to the upper end of the reference range, my testosterone only increased by 9%-10%. I ended up discontinuing the DHEA because I couldn't get my testosterone levels up sufficiently and I was concerned about possible longer term side effects even though I didn't really experience any of the horror stories you read about online.

    I don't have Lp(a) problems, but if I did, I would consider taking DHEA again in lower doses (15mg-25mg for me) however.

    Hope this helps.

  • Anonymous

    1/18/2011 2:51:56 AM |

    I've been taking the stuff since my mid-30s and found it to be great for general energy, mood and body composition. However, I've never been able to take more than 15 mg a day. That's low for a male, I know, but 25 or more and I get ferocious acne.

  • Maggie

    1/18/2011 5:53:12 AM |

    I was taking 10mg DHEA but have switched to 7-KETO (just 25mg a day at present). I believe that 7-KETO, as a naturally occurring metabolite reduces the risk of DHEA side effects, so was this a good idea?

    (I am a 50-something female.)

  • Dr. William Davis

    1/18/2011 1:21:34 PM |

    Hi, Ben--

    Sorry, no knowledge.

    I did ask one of the manufacturers of topical magnesium preparations (creams, epsom salts) whether they had any data in humans showing effects on magnesium blood levels. They said they had not generated any nor were aware of any.


    Several commenters--

    The "horror stories" surrounding DHEA all refer to the higher, supraphysiologic doses I mentioned, not the low, physiologic replacement doses we use for Lp(a).

    Also, this is about DHEA for Lp(a), not DHEA for youth preservation. Two different perspectives.

  • JC

    1/18/2011 1:39:27 PM |

    Q: I've been feeling really tired for a while now. My doctor checked my DHEA level which was very very low -- less than the level typical for an 80 yr. old woman and I am less than half of that! Could you please suggest some supplements for me? I know that there are DHEA supplements but these aren't available in Canada. Is there something else I can take? Thanks!





    A: I have never been a fan of hormonal substitutes, including glandulars. With hormone replacements there is a great risk of atrophying the glands that normally produce the hormones. There are two reasons for this. One is a feedback mechanism in which if high hormone levels are perceived in the body the gland will be shut down to compensate. Secondly, glands are like muscles and must be worked to be kept healthy. Substituting for the glands makes them weak over time. I have seen some people claim that DHEA does not atrophy glands like other hormones, but rather leaves the adrenals producing the same level of hormones. Of course even if DHEA was not atrophying the glands and was leaving the glands to produce DHEA at the same level then the adrenals would still be producing at a diminished output. Therefore, the DHEA would do nothing to boost adrenal performance.



    DHEA is classified as a weak androgen (male hormone). It is converted in to estrogen and testosterone, but not the balancing progesterone. This may lead to problems of elevated estrogen, including weight gain, thyroid dysfunction, problems with blood sugar, and problems with elevated testosterone, including increased body hair, and loss of scalp hair. There is also a lot of concern about the possibility of causing cancer or promoting existing cancers. There is not enough known about the actual long term effects of this hormone. Many of the studies on DHEA were done on rats, which do not have the same chemistry of humans. And the few human studies I have seen on DHEA were short term studies looking for improvement of certain symptoms, not side effects including the risk of adrenal atrophy. Overall I really think that DHEA supplements should be avoided!


    DHEA is normally thought to decline due to age, though this is not necessarily the case. Primary production of DHEA occurs in the adrenal glands. Therefore adrenal function may directly affect DHEA levels. And the majority of the people are exposed daily to two of the biggest weakening factors for the adrenals, stress and stimulants. Stress can be physical, such as pain, or emotional. And both can be increased by reduced adrenal function since the adrenals produce the anti-inflammatories and anti-stress hormones for the body. Stimulants include caffeine, ephedrine, pseudoephedrine, and nicotine. Various pharmaceuticals can weaken adrenal function. The best known of these are steroids, such as Prednisone. Though anti-seizure medications, antifungals, cold medications, asthma medications, etc. can also cause adrenal weakness.


    In short it is safer and more effective to build up your adrenal glands so they will produce their own DHEA at proper levels, rather than raising levels artificially to abnormally high levels. This is best addressed with vitamin C and pantothenic acid, the most important nutrients for proper adrenal function, and adaptogenic herbs. Adaptogenic herbs get their name from their ability to help people to adapt to stress by improving adrenal function.



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  • xenesis

    1/18/2011 4:08:03 PM |

    You have provided very nice information regarding testosterone supplements through your blog. Xenesis-T and Xenesis-EP for men and women a remedy for low Testosterone treatment, it will. It is the 100% natural supplement to overcome Testosterone problems.

  • Anonymous

    1/18/2011 4:51:44 PM |

    At a dose of 50 mg daily, DHEA has not resulted in any decrease of HDL for me.

  • Might-o'chondri-AL

    1/18/2011 7:02:49 PM |

    Adrenal genetic factors will not let everyone respond to "boosting". Of course, the same genetic quirks imply high dose DHEA (de-hydro-epi-andro-sterone)is not wise.

    Worldwide +/- 1:1,000 develop late onset congenital adrenal hyper-plasia; among Hispanics 1.9%, Italians 0.3%, Slavs 1.6%,
    Ashkenazi Jews 3.7% and caucasians generally 0.1%. Hirsutism (face hair) is an easy sign in women; adult acne for both genders.

    A genetic enzyme 21-hydroxylase deficiency is the rate limiting factor in 95% of these cases. Then low amounts of cortisol are made. Signals for more, by cortico-tropins, "whips" the adrenal cortex; trying to get more cortisol output. But, the inability to synthesize cortisol makes all those building blocks go into production of androgens.

    Additionally, there are 12 known genetic mutations of the gluco-dorticoid receptors. These make the body "resistant" to deal with the cortisol in circulation. Without de-activation (receptors a first step) into cortisone the cortisol level stays elevated.

    In this situation both adrenals are, in a sense, overworking for no purpose. Progressively this leads to arterial hyper-tension down the way. So-called gluco-corticoid resistance, as a syndrome, develops in 10% of the elderly.

    Point being that genetics, and the epigenetics of age, are some reasons why not everyone will respond to a "natural" plan. It also explains how different people respond to supplement dose of DHEA.

    Paradoxically, genetics that mean patient can't be made to do what others can backs up Doc Davis' clinical DHEA use. If it is for combating high Lp(a) with small doses of DHEA.

  • Anonymous

    1/19/2011 5:29:09 AM |

    I've never heard of topical magnesium supplements. It's awfully hard to imagine effective delivery of a cation/ionic salt through intact skin. Nor can I see any advantage in trying. Oral Magnesium supplements are readily absorbed and cheap. I'm also skeptical of claims that magnesium would optimize DHEA levels in most people. Magnesium is integral to the function of many enzymes, but unless it's the rate-limiting step in DHEA production and someone has a serious deficiency, I can't imagine how more magnesium would fix the issue. One CAN make a decent pharmacokinetic argument in favor of topical DHEA to minimize first-pass metabolism etc.

  • Onschedule

    1/19/2011 6:41:37 AM |

    There's nothing like a warm bath with Epsom salt... I do believe magnesium is well absorbed through the skin, though I am ignorant of how it compares with oral supplementation. I get the same effects (deep sleep, vivid dreams) as with oral supplementation, only more pronounced with the bath.

  • Kelly A.

    1/20/2011 5:55:41 PM |

    My Lp(a) result was zero when I tested it a few years ago.

    Was this inherited and will it likely always be absent? I can't find much if any info on nonexistent Lp(a).

  • Anonymous

    1/23/2011 10:49:00 PM |

    I take 12.5 mg DHEA twice daily with no side effects - I just feel better. I am sure I was deficient - I plan on testing soon. I'm 43.

  • kris

    2/28/2011 11:59:31 PM |

    i tried 25mg and it drove me nuts. cut it down to 12.5mg and all of the crazy symptoms gone and i feel much better ocer all. wife tried 12.5mg and she felt bad. she cut it down to 6mg and she is fine too. thank you so much Dr. Davis

  • Anonymous

    4/13/2011 10:53:52 AM |

    Thank you for your valuable post.  We have decided to share it with our global physician audience at PhysicianNexus.com:

    http://physiciannexus.com/forum/topics/dhea-and-lpa
    Jaerou Kim
    Team Member
    www.PhysicianNexus.com
    Physicians Comparing Treatments Worldwide

  • kim

    6/4/2011 11:28:12 PM |

    Boris,

    Based on 15 years of study and research, I would say (and truly without sarcasm) for you to stay away from Wikipedia (who get their info from google, FDA and American Medical Assoc) all of which are political agencies who DO NO ACTUAL RESEARCH THEMSELVES, but get their info from pharmacueitcal companies who HATE vitamins and nutritional supplements because they cannot patent them and make any money.

    The horror stories that you have read at those sites are simply opinions of people who took as the gospel media soundbites on reported research and did not search out viable valid resources who study the actual research reports.

    Dr. William Davis (of this site) is actually a very good resource for your valid health information.

    Now stay away from those silly sites you cited and you can Live long and prosper.

    Best of Health To You

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In search of wheat

In search of wheat

26. May 2010 William Davis (43)
Many people ask: "How can wheat be bad if it's in the Bible?"

Wheat is indeed mentioned many times in the Bible, sometimes literally as bread, sometimes metaphorically for times of plenty or freedom from starvation. Moses declared the Promised Land "a land of wheat, and barley, and vines, and fig trees, and pomegranates; a land of oil olive, and honey" (Deuteronomy 8:8).

Wheat is a fixture of religious ceremony: sacramental bread in the Eucharist of the Christian church, the host of the Holy Communion in the Catholic church, matzoh for Jewish Passover, barbari and sangak are often part of Muslim ritual. Wheat products have played such roles for millenia.

So how can wheat be bad?

What we call wheat today is quite different from the wheat of Biblical times. Emmer and einkorn wheat were the original grains harvested from wild growths, then cultivated. Triticum aestivum, the natural hybrid of emmer and goatgrass, also entered the picture, gradually replacing emmer and einkorn.

The 25,000+ wheat strains now populating the farmlands of the world are considerably different from the bread wheat of Egyptians, different in gluten content, different in gluten structure, different in dozens of other non-gluten proteins, different in carbohydrate content. Modern wheat has been hybridized, introgressed, and back-bred to increase yield, make a shorter stalk in order to hold up to greater seed yield, along with many other characteristics. Much of the genetic work to create modern wheat strains are well-intended to feed the world, as well as to provide patent-protected seeds for agribusiness.

What is not clear to me is whether original emmer, einkorn, and Triticum aestivum share the adverse health effects of modern wheat.

Make no mistake about it: Modern wheat underlies an incredible range of modern illnesses. But do these primitive wheats, especially the granddaddy of them all, einkorn, also share these effects or is it a safe alternative--if you can get it?

I've ordered 2 lb of einkorn grain, unground, from Massachusetts organic farmer, Eli Rogosa, who obtained einkorn seed from the Golan Heights in the Middle East. We will be hand-grinding the wheat and making einkorn bread. We will eat it and see what happens.
Tags :

Comments (43) -

  • Narda

    5/26/2010 3:53:55 PM |

    Wow! Thank you, so much for that link! That farm is only a few towns from us! We'll be sure to check it out! Smile

  • Matt Stone

    5/26/2010 4:00:20 PM |

    Interesting experiment.  I certainly know that wheat was held in very high regard by Robert McCarrison, Weston A. Price, and others that witnessed entire populations thriving off of wheat.  The Maycoba of Northern Mexico (Mexican Pima) would be another example.  

    This has always left me with some cognitive dissonance about the wheat issue, and a strong feeling that wheat intolerance in the modern world was a result of weak intestinal strucure and altered gut flora caused by non-wheat factors (such as refined sugar, nutrient-poor food, etc.).

  • Shady Lady

    5/26/2010 4:32:21 PM |

    Just curious if you plan to sprout it first. Can einkorn be tolerate by people with Celiac?

    I'm looking forward to the results.

  • Catherine

    5/26/2010 4:34:36 PM |

    Is this a religious or Christian blog? (Serious question.) I don't follow the reasoning that if something is mentioned in the Bible it wouldn't be unhealthy. Lots of things that people ate or practiced in the ancient world were very unhealthy.

  • StephenB

    5/26/2010 4:49:18 PM |

    Nothing like a little hands-on experimentation -- I like the spirit.

  • Anna

    5/26/2010 4:50:34 PM |

    Being in the Bible isn't much of a recommendation, IMO.

  • Anonymous

    5/26/2010 5:31:54 PM |

    It'd be interesting to see the results of your wheat test there.

    What about the other ancient wheat, Emmer? I think it can be found in Italian  pasta form, called Farro.

  • Helena

    5/26/2010 6:08:35 PM |

    Very interesting and important angle to speak about since those questions comes up very often... especially the "but we have been eating wheat for millenniums"... now we have a good answer! Thank you!

  • Richard A.

    5/26/2010 6:29:26 PM |

    Recently, I have discovered bread that is made from sprouted grain. How healthy this bread is relative to whole grain bread I do not know. The only store I can find this bread at is Trader Joe's.

  • Rob

    5/26/2010 6:29:26 PM |

    Short of growing and milling your own eikorn wheat, is there a viable option for the rest of us?  Is there an acceptable commercially-available (i.e. found at larger grocery stores) product like hard red spring or buckwheat that would be a better alternative with fewer of the downsides of the more traditional wheat flours?

  • Michael

    5/26/2010 6:58:24 PM |

    Looking forward to the results!  Thanks for the great content.

    MH

  • Ghost

    5/26/2010 7:02:26 PM |

    I look forward to the report, both on how the bread turns out, and how you react to eating it.

  • Thomas

    5/26/2010 7:26:06 PM |

    Fascinating. I will be very interested to hear what your experiences with this experiment will be.

  • babblefrog

    5/26/2010 8:10:47 PM |

    A quote from http://www.hort.purdue.edu/newcrop/proceedings1996/v3-156.html

    "The gluten of the einkorn accession had a gliadin to glutenin ratio of 2:1 compared to 0.8:1 for durum and hard red wheat."

    If that means anything.

  • Stan Ness

    5/26/2010 8:43:43 PM |

    Our preliminary studies have not determined that all types of einkorn can be universally tolerated by those with gluten intolerance.  Please use caution if you have celiac or some form of gluten intolerance.  On the plus side, Einkorn is one tasty, healthy grain…it just doesn’t yield as much as modern (hexaploid) bread wheat, so agribusiness is reluctant to plant it.  I'm posting studies about the health benefits of einkorn and including all findings on my website at einkorn.com.  I'm very interested to see how you like the taste Smile

  • Dr. William Davis

    5/26/2010 9:05:36 PM |

    Hi, Catherine--

    No, this is not a religious blog.

    I raise this issue because I hear this from patients.

  • Dr. William Davis

    5/26/2010 9:08:26 PM |

    Stan said exactly what I was going to say: There are insufficient experiences to know whether the gluten sequences in einkorn will activate the celiac response.

    Eli Rogosa tells me that she also has seen several celiac people tolerate einkorn.

    However, none of this should be construed as a clinical study.

  • nonzero

    5/26/2010 10:59:29 PM |

    Stoning people to death and slavery are in the bible, how can they be bad?

    *rolls eyes*

    Lately this blog has really become hit and miss.

  • Thrasymachus

    5/27/2010 12:08:30 AM |

    To neolithic humans wheat must have seemed to be a miracle food. It could be stored for long periods and transported long distances. They could grow it, store it, or trade for it. No longer did they need to worry every day about finding something to eat. They could wait out the winter with full stomachs and calm minds, and some small portion of the population could freed from food production. To do what? As it turned out art, culture, religion, scholarship, everything we think of as civilization.

    They may have even noticed that their primitive neighbors, who still hunted and gathered wild plants to eat, were larger and healthier. If they did, they probably regarded the greatly reduced fear of starvation and the ability of at least some to have some leisure probably seemed like very worthwhile tradeoffs.

    It is only very recently- this century, even for advanced civilizations- that worrying about what you eat has been an option.

  • Dr. William Davis

    5/27/2010 12:41:22 AM |

    Thrasy--

    Excellent perspective.

    No doubt: Agriculture permitted specialization of occupation and the trappings of culture to develop. Wheat facilitated this cultural evolution.

    Did it come at a price?

  • Rick

    5/27/2010 1:03:04 AM |

    Great post. Thanks for the open-minded approach. Nonzero, I think you're missing the point. Dr Davis isn't saying that something must be good because it's in the Bible, but he's saying that some people do ask that question, so it's appropriate that he should try to answer it.

    For you and me, perhaps he could just as easily ask: "Wheat has been used for millennia and has been the foundation of great civilizations; perhaps we shouldn't be too hasty to conclude that it's bad?"

  • HSL

    5/27/2010 3:36:07 AM |

    Weston A Price also observed that traditional cultures that consumed wheat did so after the wheat was soaked & sprouted or fermented in some way.  These processes are rarely used anymore and certainly not on a large commercial scale so the question isn't simply whether wheat has good or bad effects, but what has been done to it as well.

  • Anonymous

    5/27/2010 4:55:23 AM |

    Would you please clarify what exactly you mean by "we will eat it and see what happens"? Are you going to do a blood test after consuming the bread?

  • Anonymous

    5/27/2010 7:11:03 AM |

    The things one finds in the bible...Check this:

    In  Genesis  , Chapter Four, Eve bears Cain and Abel. 'And Abel was a keeper of sheep, but Cain was a tiller of the ground.' That 'but' in the middle of the sentence is the first clue to disapproval. This disapproval is confirmed by verses three to five. Abel and Cain bring offerings to God: Abel of his sheep and Cain, the fruits of the ground. God, we are told, had respect for Abel's carnivorous offering, but He had no respect for Cain's vegetarian one.

  • Abe

    5/27/2010 12:30:16 PM |

    Thrasy - I believe you're incorrect about the leisure comment.  Hunter/gatherers have been shown to have had far more leisure time than agriculturalists - it's just that they didn't need the trappings of society, since they did not produce anything that required customers.  And the oldest art in the world definitely existed before farming did...

  • DiegoCenteno

    5/27/2010 4:34:40 PM |

    My biggest concern with wheat is we are eating the seed and not the product of the seed. If you take a look and think about what a seed it makes sense.
    The seed is a body shield/ armor to protect the information inside to ensure the plant continues to survice. Now we are taking that very complex material made up of many proteins such as Lectin that they body simply can not digest, so it aggravates the lining of your digestive system.
    Not only does it not get absorb, but it also creates a auto-immune response as well as prevents nutrients the body is trying to absorb.

  • Anonymous

    5/27/2010 4:41:54 PM |

    regardless if you can tolerate ancient strains of wheat over current strains, what is the value add that you can't get from a normal diet of meats, veges, and some fruits eaten seasonally?? what is so special that u think u need to have wheat in ur diet in the first place?

  • girl

    5/27/2010 5:05:13 PM |

    The good and bad aspects of grain as a product of agriculture are thematic in the early Old Testament. Remember that Cain and Abel are one generation out of the Garden of Eden. Adam and Eve were gatherers until the fall; the first sin is plucking the forbidden fruit. At the time of the fall, God is the first to kill an animal, and at the same time, institutes agriculture through a curse upon the ground.

    When Cain kills Abel, it's the first murder. Why can't the farmer and the cowboy be friends? Because the farmer always wins.

    It's grain that saves Jacob's family of herdsmen when Joseph convinces the Egyptian pharaoh to stockpile reserves for times of famine. After the Egyptian enslavement, the Israelites are gatherers during the Exodus, but gathering manna doesn't satisfy them, so God later sends quail. But their goal is the land of milk and honey, an agricultural land -- a land that is only wrested from the Canaanites through violent, genocidal warfare.

    The food cleanliness restrictions of the Mosaic law center on avoiding foods contaminated by the cursed ground (i.e., cloven hoofs exposed an animal to the ground, but chewing cud is cleansing, so cows are okay but not pigs; similar distinctions apply to seafood).

    The association of the adoption of agriculture with war and oppression is an aspect of the story of the fall as well as the Exodus story (even later, King David is a shepherd) -- the writers of the Old Testament side with agricultural development, urbanization, and the advance of civilization, but they also show a deep cultural awareness of the cost.

    The theme never goes away; in the Christian New Testament, Jesus is both the Lamb of God, and the Bread of Life: the sacrifice of Cain as well as the sacrifice of Abel. In short, there many reasons to think that the Biblical story isn't simply that wheat is the best thing since sliced bread, even if Biblical wheat had a better effect on blood sugar.

  • Robert

    5/27/2010 5:40:27 PM |

    Judging by the number and severity of Western diseases ancient Egyptians had, I would not be in any hurry to mimic any of their dietary patterns. That said, I encourage patients to give up the grains altogether. Without any nutritional pros and quite a number of cons, the continued use of grains is only a matter of custom and addiction; neither of which contribute to health or longevity.

    Dr. C

  • Anonymous

    5/27/2010 7:02:10 PM |

    myths are often centered around varying methods of food production and often change as methods change.  A hunter gatherers religious myths will be much different than an agricultural society's myths. I think that bread is mentioned in the bible because it is primarily a collection of myths of an agricultural society.

  • Anonymous

    5/27/2010 7:56:43 PM |

    After decades of worsening hip pain, I stopped eating any wheat about five days ago, and am now pain-free.  Before, I could barely rise from my chair and could barely walk!  Now I rise up quickly and stride off with no thought of restriction.  I had abandoned weekly hard sprints last year due to the hip pain, but I may try again.  I had been eating two slices of sprouted, fermented whole wheat, and about two or three additional servings of other whole wheat products such as muffins, etc, each day.  I dropped the wheat after reading the recent post about a 25-year old man who gave up wheat with similar results.

  • Hoste

    5/27/2010 8:34:27 PM |

    "I don't follow the reasoning that if something is mentioned in the Bible it wouldn't be unhealthy. Lots of things that people ate or practiced in the ancient world were very unhealthy."

    Can you cite any examples staple foods of that time that were unhealthy? Wheat, maybe, but the awful foods of our modern times were not invented yet. I doubt we'd have the Diabetes and heart-disease epidemic if people stuck to a Biblical diet from a young age onward. Lentils too are a food that is mentioned in the Bible and (unlike Wheat) it has a negligible effect on my blood glucose.

    "
    And Jacob gave Esau bread and pottage of lentils. And he did eat and drink, and rose up, and went his way.  Genesis 25:34"

    I wonder if the large amount of fiber in the lentils might have reduced the hyperglycemic effect of the bread.

  • Chuck

    5/28/2010 1:13:40 PM |

    Genesis is one of our oldest history accounts written down from oral history that is much older. In summing up the large trends of the sweep of history as they knew it then, you can see them refer to the primal world and the original tribe in the garden of Eden and supported by nature but man, who decided to live in cities and who embraced knowledge and rules of society and agriculture, was considered to be "cast out" and God condemns them saying that Childbirth would now be painful etc.

    Now match that with what we know about the skeletal degradation of the Egyptians compared to the people a few hundred mile up the Nile still living Paleo and it fits.
    The story of Cain and Abel with God accepting meat and rejecting grains is consistent.

    These are our oldest stories, and as an likely Atheist, I think they correlate in an interesting way.
    http://www.amazon.com/Book-Genesis-Illustrated-R-Crumb/dp/0393061027

  • Murray

    5/28/2010 1:15:17 PM |

    Dr Davis,
    It's sad that you have patients that ask such inane questions. I can't believe there are people living in this century with such outdated belief systems. It must be difficult to deal with.

  • Meredith

    5/28/2010 2:00:00 PM |

    Hi Dr. Davis,  I can't wait to hear about your results from the einkorn grain you plan to make into bread!  I sure do hope it turns out well!  If it does then I will buy some and make bread at home and also turn it into  pastry floor to make deserts since I am a baker as well.

    Looking forward in great anticipation to the results of you experiments!  Thanks so much for your efforts in locating it!!!

    Sincerely,  Meredith

  • Bobber

    5/28/2010 2:26:24 PM |

    As Thrasy pointed out, clearly there were bad effects of the early grains.  The stature changed for one thing.  And longevity for another.  I guess I don't understand the primes of your research here.

  • Joe D

    5/28/2010 3:37:26 PM |

    Ya know what? I like you; you're a scientist/scholar in the classical sense. You dig into an issue and keep digging and searching until you find the answers, no matter how complex or simple.

    In the 1950's-60's the highest compliment we could pay someone was to say "You're cool". Well, you are. hehe. (Don't blush, we know you're old as the hills, just like me.) Keep up the good work Doc.

  • Dr. William Davis

    5/28/2010 5:30:42 PM |

    The question I'd to find answers for are:

    Is all wheat bad, ancient einkorn and emmer included? Or, is modern wheat that emerged in the last 40 years bad, while its predecessors were no worse than other carbohydrates like rice and potatoes?

    Because wheat is a readily-digested carbohydrate source, it is at least on a par with other carbohydrates. The question is where, how, and why it accumulated these other potential adverse characteristics.

  • Anonymous

    5/30/2010 1:24:52 PM |

    well it might not be an issue according to this news about wheat fungus;

    http://www.scientificamerican.com/article.cfm?id=virulent-wheat-fungus-africa

    Trev

  • Andy

    6/2/2010 11:46:16 AM |

    homemade bread? Sounds good!

  • Eli Rogosa

    6/4/2010 11:20:12 PM |

    Fascinating comments. Bill's research is exciting for all.  Thank you Bill!

    Years ago I found wild wheat growing in the Galilee when I was hiking. As an artisan baker and seed-saver, I began collecting, growing and baking with the vast biodiversity of heritage wheats, most of which are on the verge of extinction!

    Modern wheat is bred to be dependent on agrochemicals,  an empty harvest. In contrast, ancient and heritage wheats have evolved over millennia to have high nutritional value, are well-adapted to organic systems, have deep roots that absorb organic nutrients and are tall for good photysynthetic activity.  

    As for baking methods, sprouted, sourdough einkorn bread is delicious and full of life. I offer baking workshops and sell small amts of heritage grains so folks can grow your own.   Folks are welcome to visit our 12 acre seed conservation farm and bakery.   Email: growseed@yahoo.com

    Green Blessings,
    Eli Rogosa

  • Anna

    6/10/2010 3:52:24 PM |

    I used to buy TJ sprouted "flourless" bread, too, thinking it was a good choice for my grade school aged son, who was the only person in our family still eating bread.  I only bought 1 or 2 loaves a month for him, which he would consume within a few days (bread *is* an easy to prepare item for kids), so some weeks he had no bread or wheat at all.   I began to notice there was a marked difference in his behavior and moods when he ate bread vs the weeks when he didn't.  He had difficulty concentrating and quickly became frustrated with difficult tasks (whether schoolwork or something fun, but difficult,  like building a complex Lego structure).  I paid attention to his behavior and moods and other factors and determined the "sprouted" bread was a significant trigger.  

    Nearly all TJs whole grain breads have added gluten to boost dough performance and (rising and softer texture).   Truly fermented sourdough breads (with a long fermentation) are probably a better choice that simply "sprouted" wheat (who knows what "sprouted"  means with commercial bread anyway?), because long fermentation partially breaks down the gluten protein, which is difficult for humans to digest.  Sprouting merely neutralizes the phytate/phytic acid anti-nutrient content, but does nothing to the high gluten content of the wheat and added gluten ingredients (which are added to nearly any "soft" whole wheat bread as a dough enhancer).      

    My son didn't exhibit the negative behaviors when he ate a true sourdough bread that was long fermented  (many sourdoughs are imposters with sourdough flavoring or only weakly fermented for a short time).  I purchased that locally made bread at another "natural food store", not TJs.

    Nonetheless, for the past year+ we are a wheat and gluten-free family now, after my son and I tested positive with Enterolab for anti-gluten antibodies and other indications that gluten was provoking an undesirable immune response (as well as two copies of HLA genes that predispose to gluten intolerance and/or celiac and in my son's case, also fat malabsorption).

    I used to buy a lot of our food from Trader Joe's.  I still shop there regularly, but mostly for simple foods and ingredients for meals I prepare at home with local CSA subscription produce, meat puchased in bulk (or wild game from my sister the hunter), and "back yard"  eggs I buy direct from the producers.  Too much of TJ fare is still highly processed food that is little better than the stuff at the conventional supermarkets.  

    Also, someone mentioned Weston A. Price valuing wheat as a food.  True enough, but again, the point is that wheat has changed dramatically in just the past few decades.  The wheat of Price's time is not what is commonly available now.  Also, Price advocated freshly ground whole wheat.  Is commercial bread likely to be made with freshly ground wheat, or warehoused, fumigated, long-distance trucked stale flour that was ground who-knows when?

  • buy jeans

    11/3/2010 12:26:04 PM |

    think of the healing humans, but not of blogging

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How to Give Yourself Hashimoto's Thyroiditis: 101

How to Give Yourself Hashimoto's Thyroiditis: 101

25. January 2009 William Davis (18)
I borrowed this from the enormously clever Dr. BG at The Animal Pharm Blog.


How to Give Yourself Hashimoto's Thyroiditis: 101

--lack of sunlight/vitamin D/indoor habitation
--mental stress
--more mental stress
--sleep deprivation... (excessive mochas/lattes at Berkeley cafes)
--excessive 'social' calendar
--inherent family history of autoimmune disorders (who doesn't??)
--wheat, wheat, and more wheat ingestion ('comfort foods' craved in times of high cortisol/stress, right? how did I know the carbs were killing me?)
--lack of nutritious food containing EPA DHA, vitamin A, sat fats, minerals, iodine, etc
--lack of play, exercise, movement (or ?overtraining perhaps for Oprah's case)
--weight gain -- which begins an endless self-perpetuating vicous cycle of all the above (Is it stressful to balloon out for no apparent reason? YES)


If you haven't done so already, take a look at Animal Pharm you will get a real kick out of Dr. BG's quick-witted take on things.


We are systematically looking for low thyroid (hypothyroidism) in everyone and findings oodles of it, far more than I ever expected.

Much of the low thyroid phenomena is due to active or previous Hashimoto's thyroiditis, the inflammatory process that exerts destructive effects on the delicate thyroid gland. It is presently unclear how much is due to iodine deficiency in this area, though iodine supplementation by itself (i.e., without thyroid hormone replacement) has not been yielding improved thyroid measures.

I find this bothersome: Is low thyroid function the consequence of direct thyroid toxins (flame retardants like polybrominated diphenyl ethers, pesticide residues in vegetables and fruits, bisphenol A from polycarbonate plastics) or indirect toxins such as wheat via an autoimmune process (similar to that seen in celiac disease)?

I don't know, but we've got to deal with the thyroid-destructive aftermath: Look for thyroid dysfunction, even in those without symptoms, and correct it. This has become a basic tenet of the Track Your Plaque approach for intensive reduction of coronary risk.
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Comments (18) -

  • Bad_CRC

    1/25/2009 7:07:00 PM |

    Hmm, really?  So if I eat wheat (or was it 'carbs' generally?) and not enough animal fat, drink coffee, don't sleep enough, etc., Hashimoto's autoantibodies will start showing up in my blood?  And when I reverse the above, the antibodies will disappear and TSH, etc., will revert to normal?

    Any support for this in the literature?

  • dubyaemgee

    1/25/2009 8:12:00 PM |

    I suspect there needs to be some reeducation as to what is considered "normal" within the medical community as a whole. My TSH was last measured at 4.32, and is considered well within the range of normal, even though I've been complaining of hypothyroidism for a while now. Seems like we have to go into the doctor's office with steely determination to have these problems addressed.

  • mike V

    1/26/2009 2:03:00 AM |

    Drs Davis and BG:
    I think you are both on target with the attention you pay to hypothyroidism in relation to heart disease, and other related diseases such as obesity, diabetes, kidney and other hormone related problems.

    Question please:
    In your opinions:
    1 Is the high incidence of hypothyroidism in the population throwing 'off' the lab  norms for TSH, FT3, FT4 or can we assume the numbers used by most labs are based on world wide or historical values?

    2 Is 'Subclinical Hypothyroidism' real, or could it simply be a function of #1, or inadequate vitamin D3/iodine etc. I understand that 60% of the US population may be in that category.

    Thank you
    Mike V

  • Anne

    1/26/2009 2:26:00 PM |

    You mention the connection between wheat and thyroid. If you want to read more about that, go to The Gluten File. www.theglutenfile.com There you will find a section on thyroid disease.

    It is known that about 4-6% of those with Hashimoto's have celiac disease. I am sure that percentage would go even higher if one included those with non-celiac gluten sensitivity. There has been at least one study showing that thyroid antibodies disappear with the use of a gluten free diet.

  • Nameless

    1/26/2009 8:46:00 PM |

    Are there any studies showing wheat, vitamin D, etc. causing Hashimoto's? I suspect there isn't, but if population studies are looked into, perhaps you could find a correlation? Look at populations that generally don't consume much wheat, and see what their rates of Hashimoto's are. Or populations at upper latitudes vs those near the equator, and their rates of Hashimoto's.

    However, if wheat, lack of sleep, poor diet, etc. does cause Hashimoto's, wouldn't it alter the male/female ratio of who gets the disease? Why would women still be more likely to contract Hashimoto's, if the cause is diet?

    And in my case, several years ago I went to a low carb diet, restricted wheat, desserts consist of fruits/berries only, corrected my vitamin D levels, took fish oil, etc. I also tested negative for Celiac. Before these changes my thyroid tested normal (TSH in the low 1s). I was never overweight and exercised regularly too.

    And this past month I was  diagnosed with Hashimoto's (high antibodies, TSH in the 3s, thyroid scan all lumpy). So... if there is a correlation, shouldn't my thyroid have improved, not gotten worse?

  • G

    1/26/2009 10:00:00 PM |

    Bad_CRC,

    I think you need to have the genetic susceptibility. On the animal pharm blog, I've listed a few that scientists have already correlated to Hashimoto's
    --VDR polymorphs
    --HLA polymorphs

    I'm certain there will only be dozens others b/c these things (autoimmunity) don't happen alone.

    Add'l, perhaps these things are also just signals for 'hibernation'...??  Perhaps we are only inducing ancient signals that are meant to protect and increase survival (low melatonin, high carbs, wheat/stress, fructose (from the Italian sodas I forgot to mention!), gaining weight, slowing down to Eat-Eat-Eat/stress, etc).

    Any thoughts?

    There are a few links in the literature regarding higher TSH, lower T3/T4 during winter months and lower vitamin D in the serum. Of course!

    -G

  • mike V

    1/27/2009 2:32:00 AM |

    G
    I have no personal doubt that how well you choose your parents is of primary importance.
    My late mother, and two brothers and sisters have all been  hypothyroid.
    As in most diseases, I think other immune factors can be involved, some in the womb, some exposures in early childhood, while the immune system is still being 'programmed', others from bacterial or viral exposures.
    It is said that vitamin D is quite important in a balanced immune system, but it starts very low in typical breast milk, and in very young children, and can remain low throughout life in much of the population.
    Iodine deficiency was a critical factor in people not living near the coasts, until iodized salt was introduced in the early 20th century.
    Lack of timely exposure to bright light is well known to "mess" with our biological clock, moods, and immunity.
    I did not become aware that I was hypothyroid until my forties, and since have not found nutrition a major factor, until perhaps vitamin D.
    With the exception of vitamin D, I have not personally been aware that other nutrition has affected my treatment.
    Is there any co-relation between Hasimoto's, and other auto-immune conditions?

    MikeV

  • Dr. William Davis

    1/27/2009 11:53:00 AM |

    Mike V--

    The newest data, e.g., the HUNT Study, are analyses of events based on TSH. It therefore factors out the effect of population distributions.

    You are correct, however, in pointing out that previous analyses were flawed precisely for this reason.

  • mike V

    1/27/2009 5:13:00 PM |

    As usual thanks to all for the education, and for all you do to penetrate the blood brain barrier between the specialties, Big Medica, and us (the great 'unwashed'. Smile)

    MikeV

  • Pat Elliott ND

    1/27/2009 5:44:00 PM |

    Hi Doc,
    We are seeing a very high % of our patients with zinc deficiency - similar to the whole vitamin D thing. Just wanted to share this with you since zinc is also correlated to blood sugar and cholesterol problems. Would love to see what you find in your patients with regard to this nutrient as well.
    Regards,
    Pat Elliott ND
    www.elliotthealthcare.com

  • Anonymous

    1/28/2009 3:51:00 AM |

    Pat Elliott  --

    How do you define a zinc deficiency? I've read that serum zinc is pretty inaccurate (as is copper or magnesium serum testing).

    Looking at other biomarkers, or a zinc taste test?

  • Lou

    4/1/2009 11:54:00 PM |

    I'm guessing that when "Nameless" took up the low-carb eating plan, they may have also increased eating soy.  Soy can really mess up the hormones.  I think we can blame soy for all this thyroid trouble and fibromyalgia and fatigue related troubles.  Add to that inadequate fish oils, butter, after years of telling us to avoid fats and sunlight (vitamin D) and you get a nice picture of what has happened to far too many of us.

  • scall0way

    11/10/2009 8:35:12 PM |

    I know this is an old post but I'm just going through all the thyroid-related posts. My TSH got flagged at a 9 when I went for a physical a couple weeks ago, and further tests came back with a Hashimoto's diagnosis.

    I just don't know. I follow a gluten-free diet, in fact I avoid all grains. I avoid all sugars, I don't consume any high-PUFA vegetables oils. I have not eaten any sort of soy (except for rare splashes of fermented soy sauce here or there) in a dozen years. I always cook any veggies I might eat  that call into the goitrogenic category. I supplement with 5000 IU of D3 in gelcap format daily. I consume most of my fats as sat fats/animal fats. I take fish oil, cod liver oil. I love to eat sardines.

    Yet my thyroid apparently has slowly been getting worse over the last couple years. My TSH is definitely higher than it was in 2007, and that was higher than it was in 2006 - slowly been climbing over the last few years until finally the doctor red-flagged it.

  • Anonymous

    7/29/2010 10:42:48 AM |

    I have Hashimotos. Was diagnosed at 15. Had it long before then. I am convinced it is genetic when I look at other family members (although no-one else has been diagnosed). I am on 'correct' dosage of thyroid hormones but many of the symptoms still exist and I would LOVE to blame my GP but the fact is that they are overworked and are doing the best with what they have - like the rest of the population. Recently diagnosed with anxiety by a psychologist. Does this cover the hashimotos symptoms completely or partially? Who knows? All I know is that I am drunk now as I am bone tired from trying and failing from everything from relationships to work - alcohol seems to be the only way out...although my psychologist has told me it isn't - just being tired and weak I guess. I'm sure you will delete this post as soon as you see it blog owner, but before you do, I hope a few Hashimotos/anxiety sufferers see one person struggling to be better despite the messy interference of life. Having a temporary failure right now but will be back on the horse again tomorrow like every other day.

    Love you all.

    XXX.

  • buy jeans

    11/3/2010 6:58:15 PM |

    JMC at the blog animal pharm has linked some fantastic resources from Loren Cordain and how the Paleo diet reverses autoimmune diseases (incl JMC's own rheumatoid arthritis). Wheat is not the ONLY culprit. Legumes, Dairy/casein, nutr'l deficiencies, excessive fruit/HFCS, lack of exercise, lectins, etc are part of the equation for autoimmunity disorders as well.

  • PureAlan

    1/24/2011 10:46:15 AM |

    What a brilliant idea! Thanks for sharing this information. I have hypothyroidism for almost 4 years and it was terrible. I am currently taking porcine thyroid .  Now I'm gaining back my normal life.

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Your heart scan is just a "false positive"

Your heart scan is just a "false positive"

15. August 2006 William Davis (0)
I've seen this happen many times. Despite the great media exposure and the growing acceptance of my colleagues, heart scans still trigger wrong advice. I had another example in the office today.

Henry got a CT heart scan in 2004. His score: 574. In his mid-50s, this placed him in the 90th percentile, with a heart attack risk of 4% per year. Henry was advised to see a cardiologist.

The cardiologist advised Henry, "Oh, that's just a 'false positive'. It's not true. You don't have any heart disease. Sometimes calcium just accumulates on the outside of the arteries and gives you these misleading tests. I wish they'd stop doing them." He then proceeded to advise Henry that he needed a nuclear stress test every two years ($4000 each time, by the way). No attempt was made to question why his heart scan score was high, since the entire process was outright dismissed as nonsense.

I'm still shocked when I hear this, despite having heard these inane responses for the past decade. Of course, Henry's heart scan was not a false positive, it was a completely true positive. I'm grateful that nothing bad happened to Henry through two years of negligence, though his heart scan score is likely around 970, given the expected, untreated rate of increase of 30%.

The cardiologist did a grave disservice to Henry: He misled him due to his ignorance and lack of understanding. I wish Henry had asked the cardiologist whether he had read any of the thousands of studies now available validating CT heart scans. I doubt he's bothered to read more than the title. The cardiologist is lucky (as is Henry) that nothing bad happened in those two years.

Do false positives occur as the cardiologist suggested? They do, but they're very rare. There's a rare phenomenon of "medial calcification" that occurs in smokers and others, but it is quite unusual. >99% of the time, coronary calcium means you have coronary plaque--even if the doctor is too poorly informed to recognize it.
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