Thats funny Dr. At the Torrance CA location for the scan, they are doing a two for one in Feb so hubby and I will go for it. I am scared however.

Awesome, just awesome.Brilliant blog that has helped me ALOT so I am eternally grateful. Phil

I just had a heart scan. 44 year old female with family history of heart disease.  Both parents in 40's with heart attacks/by-pass surgery...My cardiologist ask if I had ever been diagnosed with a hiatal hernia and the scan looked somewhat like the one you show.  It looked like I had one Big Heart!  He told me to follow-up with my PCP.  I did, he is new for me and not sure I see eye-to-eye with him, but he insist a hernia can not show up on a heart scan, I told him, I saw it, I saw the scan, I saw the white circle...I have had GERD for 5-6 years now, nausea almost every morning on top of the reflux in the morning and my family always complain how long it takes me to eat! Guess what, I'm having an upper GI in the morning.  Thanks for this information...I thought maybe I was loosing my mind!

Are there any particular formulations of l-arginine that you are familiar enough with to recommend?

There is such a bewildering array of supplements available; it is sometimes overwhelming to try to make an informed choice.

Thank you

The brand we've used most frequently for its relatively low cost and palatability is the PowerMaker II, available from Life Extension (LEF.com) and Vitacost.com. I write articles for Life Extension but have no  interest beyond that with that organization. I have no relationship with Vitacost.

Please also see my post from yesterday. We've been discussing such a list of recommendations. We resist the idea of selling supplements because of the corrupting effect of doing so, and the erosion of credibility. However, I believe that in future we can recommend/endorse/approve certain supplements without putting our integrity in doubt.

Dr D-
So interesting to read your posts and excellent information! I will be a regular over here, and appreciate on a personal level everything you are commenting on, as I have been one of those *missed by the system* and am still out of range for the great docs that I am working with.

Just got onto the arginine/endothelial recommendations from a different resource, and appreciate your heads up here on the practical matters of how to turn things around.

We are on similar missions: over at www.CorePsychBlog.com I discuss a growing awareness of the real advances in neuroscience that often go overlooked in everyday psych care.

Interestingly, folks think the heart and the brain are two different topics, and so often we see what you are talking about with the heart over here directly effecting brain recovery and brain health - with all of the positive emotional and cognitive benefits arriving right along with good heart scan tracking.

Thanks again, look forward to talking one day,
Chuck

Dear Dr Davis - was  most interested to read your input on L-Arginine - AAKG (Arginine Alpha-KetoGlutarate).  We have been running a trial on using AAKG on horses with the inflammatory systemic condition, ESPA (Equine Systemic Proteoglycans Accummulation) which is showing considerable success in treating the inflammation that this condition brings with it.  At the same time we also use the Jiaogulan (Gynostemma pentaphyllum) herb.  We are finding that the 'Jia' herb bolsters the effects of the AAKG by supressing the iNOS and supporting the eNOS.

We have an enormous amount of information on this use on our yahoo groups list.  I should be most happy to direct your footsteps hence.

I myself take AAKG + 'J' for control of hypertension and for the inflammation due to AS/OA/DDD.  It works very well indeed.

I enjoy your blog spot, it is most interesting.  Thank you.

Mystral

I really have no adverse reaction to any supplement, except for two: magnesium and arginine. Magnesium is known to cause stomach distress, so I take a slow-release kind. As for arginine, I have tried to it several times, in different powder and slow-release formulations, and it eventually causes the following:
-Stomach distress from powdered arginine
-An unusual overstimulation from any kind of arginine, which manifests after a couple of days as pounding heartbeat (but not weakness),  slight anxiety, and difficulty sleeping. I know from extensive tests and from my vigorous daily workouts that there is no big problem with my heart that would cause this. It goes away when I stop the arginine. I can't believe that I'm the only person who experiences this effect.

That is interesting.

I suspect that there's an interesting lesson to be learned from your experience, but I'm unsure of what it is.

I too experience the pounding heart from taking arginine- it finally dawned on me tonight that it must be the culprit.  I always notice it most when trying to get to sleep.  Frustrating!

Hello!
I just found your blog and it is very interesting! I am an Arginine-lover and truly believe that it can make a big difference in peoples lifes. I have taken Arginine (5 grams a day liquid formula)along with L-Citruline (250mg), omega fatty acids, EDTA, OPCs, vitamins, and other natural supplements since August of 2008 and Love it! I sleep better, have more energy, and can work out much better. I did however notice the heartbeating at bedtime my first few days or week when I started taking the product, like some of you also point out, but that went away by itself and I have not felt anything since then. I actually feel pretty darn good! My allegies have improved like crazy.

Thank you for a good blog! / Helena
www.mi4freedom.blogspot.com

The “Arginine Paradox” is the name that some researchers in this field have given to the unusual property of l-arginine supplementation to “overpower” the blocking effects of ASDM. This is somewhat unusual in biologic systems in that an agent that blocks a receptor cannot usually be outmuscled by providing excess material for a reaction. Kind of like hoping that your car runs faster simply by topping up the gas tank.

Arginine is pretty important. Check http://www.arginineaminoacid.com

I assure you guys are doing great. Thank you for managing this blog. You can make even money playing casino online

Curious about your thoughts on NEO40. This Nitric Oxide supplement is touted as being Argenine free. I was given a sample this morning after a saliva test showed me slightly low for NO. I am not real sure about this supplement and have a relatively good BP, burn about 3500 calories a week through intense exercise, and eat a paleo style diet. Several years ago my cholesterol was 'high' but is now within clinical guidelines.

So, will I benefit from this product or one like it?

Love the blog and the information.

bill

Been on l arginine 2 weeks ,,,my blood pressure is great now ,,,,so glad I found out about this natural supplement ,,blood pressure meds had so many horrible side effects...

"hunger-gatherers"?

The original article said hunter-gatherers.

However, I like hunger-gatherers better.

Hunger is certainly quite a motivator to go seek food.

I don't know why they blamed the meat either as Ancient Egyptians  wouldn't have been eating indoor raised grain fed high omega 6 low omega 3 meats.  

It seems Beer, together with bread, oil and vegetables, was an important part of the wages workers received from their employers. The standard daily ration during pharaonic times was two jars containing somewhat more than two litres each.

When you have eaten three loaves of bread and swallowed two jugs of beer, and the body has not yet had enough, fight against it. But if another is satiated, do not stand, take care not to approach the table.

As a person who can't figure it out, the mummy scans are interesting.

It's not clear to me if saturated fat or grains and sugar are largely to blame for heart disease, or something else.

It made an impression on me that Jimmy Moore (low carb blogger who eats mostly meat) and Dean Ornish (who eats mostly grains and vegetables) both scored zero on their heartscans.  They both avoid flour and sugar, that might be a point of agreement and a possible explanation.  I wish I was privy to the nutritional studies that come out a hundred years from now: long-term studies of different diets.

On what ground are they basing their assumption that meat is the culprit?

It is just blatant and annoying!

Dr. Davis, I love the way your mind works.  Which only proves once again, that the advent of agriculture produced diseases of the metabolic syndrome, even in ancient Egypt.  Wheat, Beer, and date consumption indeed.  If the ancient Egyptians avoided all starch, grains, legumes, and sweet fruit in excess, particularly high fructose types, it is quite apparent that they would have been healthier and lived longer, even in those ancient times.  We should all take heed, and throw out the so called and wrong "healthy diet", the diet that advcates eating low fat and high carbohydrates. This is the dogma that for the last 60 years pervades all medical decisions.  For the sake of our good health we must,MUST all switch to the very healthy low carbohydrate and high saturated fat diet that our ancient genes crave.  If this is not true, how did we all get here?

Yep, the always ASSUME it's the meat or fat.  It just couldn't be all those "healthy whole grains."  

It seems to me that the Egyptian diet was a nutritionist's dream.

Thanks for blogging on this fascinating topic, doc.

Unfortunately, the media reports seem to emphasize meat consumption as if that was the conclusion of the researchers.

I'm betting they don't actually go that far in the JAMA article.

Ooops!

Yes, hunter-gatherers, not hunger-gatherers.

I have been reading about the wealthy ancient Egyptian diet. It is interesting that they used many types of vegetable oils. Many were high in omega 6. They often fried foods. The rich ate meat, bread and some dairy products. They used Honey(fructose) as a sweetner. So I ask the qestion. Was their diet much different than the modern diet?

I understand the McTut burger, although quite unhealthy, was all the rage.
This could explain it.

I love how the LA Times summed things up in their article about this study.

"Both groups, however, share some risk factors. The high-status Egyptians ate a diet high in meat from cattle, ducks and geese, all fatty.

And because mechanical refrigeration was not available, salt -- another contributing factor in heart disease -- was widely used for food preservation."

Sigh...

It occurs to me that the atherosclerosis could have been at least partially due to a vitamin D deficiency resulting from eating grain, which depletes the body of vitamin D.  

Dr. Davis, are you familiar with the theory that Europeans lost their skin pigment in part as an adaptation to eating grain?

If this was the dawn of grain-eating, it could also have been the dawn of selecting for lighter (not to say white, necessarily) skin pigments in grain-eating peoples.  (I think the same vitamin D depletion may hold true for eating dairy, so if they ate this, too, even more so.)  

I wonder if this was also the dawn of largely indoor living for some members of the population - like the wealthy and their servants - and if this could have contributed to a vitamin D deficiency.

but here we are again; Peter points out that there was no difference in calcium score between the veggie and meat diets, yet those of the paleo-diet religion will summarily dismiss this and continue to believe a meat diet is the healthy true diet for humans.  What was the life expectancy of Paleolithic man.... under 20 years maybe?  It wasn't until the diversification of diet that life span increased.... but maybe that is irrelevant if your point is to justify one's own choices

Hi, Helen--

No, I wasn't aware of that particular theory. I am aware of the notion that northern Europeans lost dark pigmentation as they settled in sun-poor regions. I was not aware that grain had added to it.

@Anonymous who claims that food diversity was the chief cause of the increase in life expectancy. First, ancient hunter-gatherers had a life expectancy of around 35 years. This dropped to under 20 years AFTER the advent of agriculture. Ask ANY anthropologist who can tell at a glance whether the bones they've found are pre or post agriculture (pre are strong, straight and healthy with no dental decay. Post are small, brittle, and diseased with plenty of dental decay.)

As to food diversity. It is estimated that hunter-gatherers had hundreds of different food choices ranging from animals great to small, insects, and hundreds of indigenous plants/nuts/seeds/fruits. Early agriculturists primarily ate the grains that could be cultivated locally, and their food choices dropped perilously.

As for mummies, only Egyptian royalty were mummified and ancient Egyptian royalty were known for their high-carb food depravity, where meals included plenty of honey, grains, starches, and beer. The feasts were frequent and included ritual bulimia so that the eating could continue indefinitely. That these people had heart disease should be no surprise to anyone.

As a final note, life expectancy is much less about living long, and more about infant mortality. Infant mortality did not go down significantly until the advent of modern medicine and birthing techniques in the 19th and 20th centuries (at least for western societies.)

@Allen - There's no evidence that ancient Egyptian royalty engaged in ritual vomiting during feasts. Perhaps it may have happened right at the end of the last dynasties when Rome's influence was strong, as purging during a Roman feast was not uncommon. BTW, feasting Romans would just vomit right at the table and a slave would clean it up. A vomitorium is not for vomiting, it's a kind of passageway.

Talking about an 'Ancient Egyptian diet' is a little silly anyway. Which kingdom/era? We're talking over thousands of years here with influences from many cultures and changing weather and environmental conditions. Modern analysis of residue in beer jars over various times shows that the ancient Egyptian beer was actually almost opaque and had a relatively high protein content, interestingly.

I believe the media does over-hype almost all health related issues, including drug drug interactions and adverse reactions.  With regards to taking your medication though, there have been several reports that confirm if you are non-adherent to your medication, you raise the risk of having another heart attack and possibly dying.

Since I am the subject of your blog, I'd be happy to comment.  The point of the story is that there are things you can do to prevent heart disease and an MI.  I don't believe this was spun by the media and I was happy to be part of it.  In fact I am confident that if people take this advice on warning signs seriously they have a better chance of survival and it could even save lives.  I'm happy I took part in the article, you should stop your scare tactics of the industry that albeit profitable is saving lives.

Brian Connell

I'll be damned if I stop criticizing the status quo in heart care.

You are entitled to your opinions. People are entitled to continue submitting their lives and health to the endless appetites of a procedure-obsessed health care system. I personally would rather seize control over my health and be provided truly effective preventive strategies. You clearly have not been provided this information.

I felt that your post was highly enlightening. http://www.howtorelievestress.org
has a lot of tips on managing your stress! I find this website very useful.It definitely helped me, and I can see an improvement in my condition already.

Yes - the media hypes almost everything to excess whether it be the weather, economy or health related procedures. I find it highly unlikely that prevention will ever be hyped in the mainstream since prevention is not a money maker and is not "exciting". Too much pharma revenue would be lost even if people took the simple step of normalizing vitamin D levels let alone any other "provocative" measures such as reducing sugar intake etc.


Bob

Surely there is a place for education in both prevention and emergency treatment. The problem is achieving a balance of emphasis.
While I have clearly benefited from the preventive approach, (0  score at 72) my wifes maternal uncles all died of MI in their 40's and 50's except for the one who made it to 60's inspite of a stroke. Her mother made it to 90following two MI's and with conventional treatment including two cabg's.
Until the better preventive approaches are given equal time, and a couple of generations have benefited, we will need both kinds of awareness.
Typical media articles (and cardiac advice) reflect the lifestyles, errors and distortions of the past 30 years. Dr D's advice is excellent, and I appreciate his frustrations at the long uphill battle.
mikeV

Mr. Connell,

(You're the second Brian to blog and start some *umm* drama) I'm sorry to hear about your event but I agree with you, it's good to get the news out.  

By generous measures, according to the statistics, you life will require 'saving' yet again in approx 15 yrs if you follow 'conventional' wisdom and your docs in Bakersfield (no doubt there adequate but not as good as DR. Davis and TYP -- Track Your Plaque program).  

(you are aware i hope that statins won't save your life, right?)

Good luck.

(FYI ask your Bakerfield docs to check: lipoprotein (a), homocysteine, and glucose -- you need to improve these to prevent those native vessels, bypassed vessels and stents from clogging up)

g

Hey Mike V., what have your preventitive measures been these past 72 years?

Thanks, Daniel

Hello g,

Not trying to start controversy, quite the opposite. My doctors are in Boston, not California, and the article that was posted by this ABC affiliate was never viewed by me, it was their edit of the AP.

Here's the real story URL:

http://www.cnn.com/2008/HEALTH/conditions/02/18/hm.young.heart.attack/

I participated in this article to provide a hopeful message which I believe is a much more positive headline and message and aired on CNN Headline news this past week.

All the best to all of you with your efforts for heart health and heart disease prevention.

Brian Connell

Dr. Davis --
Interesting discussion.
I assure you that I take my job as a journalist as seriously as you take your job as a doctor. I would never presume to assume that your motives were anything other than to do your job well.
While I may agree with many of your points (i.e. procedure-obsessed health care system, preventive health care strategies), I take issue with your assumptions of how I go about my work as member of "the media" -- IN NO WAY was my intention to over-hype anything.
The area we live in has an unusually high number of people with heart problems and heart attack deaths.
Is there no value in this story?

Nothing too surprising Daniel.

About 10 years ago I lost faith in the 'prevention' of the time which was low fat. I needed gall bladder surgery inspite of my 15 to 20 miles per week walking/running to offset sedentary profession.
Moved away from excessive carbs, and towards whole foods. Supplement a few places where diet and lifestyle still don't quite make it. Independently ended up surprisingly close to Dr D's recommendations emphasizing fish oil (3Gm), vitamin D3 (4000iu  depending on season), magnesium citrate, CO Q10.  
Diet leans toward mediterranean.
Oils: Limited to ev olive 20%, light olive and canola 40% ea. No other.
Wine: Pinot Noir. Tea: green and black.

Plenty of greens, small berry fruit, citrus.
Big on cheeses. Esp strong flavored, fermented varieties.
Omega 3 eggs
Throw in some spices, cocoa, walnuts, p-nuts,
I try to maintain variety, and not to get too hung up on any one nutrient.
My HDL moved from low 30's in my 40's to about 50 now.
No long term meds. except thyroid. Have not had a cold or flu this year. Tendency to tendonitis sometimes limits excercise to treadmill. Resting pulse 50.

FWIW My father passed with MI @ 76 (had signs of prior MI) Mother passed @ 92. Chief complaints: CHF, ARMD

Hope this is helpful.
MikeV

You summarized one of the main ideas propogated by this type of media: "1) Get yourself to a hospital ASAP for any symptoms even vaguely suspicious of heart disease, because they will know what to do. You'll be doomed if you don't."

I had "heartburn" for a week before I went to the ER, got an EKG and blood workup and was sent home with some antacids, feeling foolish for overreacting.  Two days later, after spending the whole night alternating puking and screaming, hubby took me back to the ER and they decided to transport me in an ambulance to another hospital for an emergency angio, which was followed up by a CABG.  In short, two days after a "good" EKG, I needed two surgeries to repair my heart.

I asked our internist to refer my husband for a heart scan and he wrote referrals for an EKG and stress test instead.  We skipped them and the heart scan is next month.  

A stress test doesn't show anything unless there's an actual *blockage* - a heart scan shows arteriosclerosis before it gets to that point.  And my own experience is that an EKG doesn't show anything even two days before an MI.  To hell with that.  

If hubby gets anything other than a zero calcium score, next step is a VAP lipid test to begin correcting his issues.

The whole *point* of the exercise is for him to *avoid* what happened to me.  Yes, it's wonderful they can do angios and bypasses, but... it's been EIGHT MONTHS since mine, and I still can't go back to work!

So yes, I'm alive and all, but it'd be damned preferable had I gone at it from a prevention standpoint a few years earlier.

Thanks Mike V, That's intersting - but it sounds like until you were 62 you practiced the low fat diet? Daniel

I didn't really have the scare tactics.  My heart attack was out of the blue.  I was in perfect health.  Or so I thought.  My PCP did say I had High cholesterol and was on meds for that.
2 weeks before I had my first MI(in the gym no less ) I had been going to my PCP with nausea.
I've been wondering if this was a precursor to the MI.
2 months latter I had a massive heart attack (the widow maker as you say ) causing a lot of damage to the heart muscle.  My EF was 25 it is now around 30.  My cardiologist reccomended an ICD which I have now.
I have devoted my blogg to helping people with their feelings in dealing with CHF and other heart problems, by telling my story.  It's very theraputic for me.
But I may be giving wrong advise.
I am no Dr. just a patient with heart problems.
Thank you for taking time with your blogg and for the information.
Some time when you have nothing to do, which I'm sure is rare. Check out my blog @ www.richosea.blogspot.com
I might have a lot of missinformation.  I also have an article coming out this month in EP Digest.  "A patient's perspective"
Thanks again
Rick O'shea

Over a decade ago, I was diagnosed with coronary artery disease.  I was told I needed a multiple bypass operation.   I was threatened with likely death if I did not agree to surgery.  Actually, I probably was close to having a plaque rupture, but I knew that surgery was not the answer.  I knew I had to get my dietary habits under control.  Because of metabolic syndrome, I also needed some additional medication.  

I got my diet under control.  My wife and I focused on home cooking with fresh foods rather than processed foods.  I have taken a truckload of pills during the past decade.  I began exercising regularly.  I changed careers to reduce my stress levels.  I had my cardiologist do check-ups on me quarterly.  But, I have been steadfast about declining stents and bypass surgery.  

Most recently, my wife and I have eliminated wheat and wheat flour from our diets, after reading Dr. Davis' book, "Wheatbelly".  This step actually substantially eliminated my exercise induced angina!  

I look forward to many more years of improved health.  I particularly enjoy sending some of my early interventional cardiologists annual Christmas cards containing greetings along the lines of the old Timex commercials, "Takes a licking and keeps on ticking."

That's excellent, Mark!

You bucked the hungry revenue-generating medical system.

Hi Mark:  Bravo on your choices.  I am being pressured to have a cath by a pushy cardio nurse.  My choice at this point is to have a C-RP test, since I have NO symptoms, just what the cardio MD SAYS showed up on the EKG, and 2 short episodes when I was wearing the heart monitor.  I don't like fear-mongering.  Not my style, and I'm inclined to push against that.

Any comments/suggestions will be appreciated.  I have, since a stroke @ 59, 14 years ago, made a living as a very active, ladder climbing painting contractor.

Bill in Charlotte

Just found this site and all the good information..my husband has very high tryglycerides (over 500, along with unreadable HDL/LDL-so not good) and looking for as many "natural" ways to help him as I can. We've improved our diet tremendously but due to the nature of his job he needs quick "boxed"  snacks to help him when he gets hungry between meals. He does snack on nuts but wondered if using the gluten free/organic/ trans-fat free/low sugar snack products that you can know find in stores be "safe"? They are made with things like oat,rice, almond and corn flour instead of the wheat. He definitly had the "wheat belly" you have described but it has actually gone down rapidly from eliminating many of the offending foods (beer) from his diet. We are going to start taking the fish oil and probably the niacin (dr. perscribed) for him but trying to avoid the statin drugs.Thanks and I think everything you've had to say is so true..at least it rings true for me!