Heart Defects Simplified

12. October 2009 William Davis (0)


For as long as I've known him, echocardiography technologist, Ken Heiden, has had a deep fascination with congenital heart disease. Ken has just written a wonderful book on congenital heart disease called Heart Defects Simplified.

While this is a bit off-topic for the Heart Scan Blog, I know that there is a serious lack of helpful information for people with congenital heart disease and parents of children with congenital heart defects. So I asked Ken to tell us something about his book.



WD: I've reviewed your book and have been thoroughly impressed with the clarity and detail with which you handle a complicated topic. You somehow manage to make it easy to grasp, far more than any other resource I've used in past. Do you feel that your book serves a previously unmet need?

KH: This book serves an unmet need in that it presents the complex subject of congenital heart defects in a simplified manner. Most books on this subject are anywhere from 300-1700 pages in length and tend to be written for doctors. Further, most of these books have very few diagrams, and they rely upon their explanations to describe these defects.

Heart Defects Simplified is 104 pages in length, describes the most common defects, including surgical repairs, in a two-page format with full-color diagrams on the left and complete descriptions on the right of each chapter. The book is particularly written for sonographers, nurses and parents, but it is valuable for anyone interested in this subject. It is particularly useful in clinical situations because it is convenient to lay out at your side with a coil-bound format and durable pages. Further, there are appendixes which include "Surgical Procedures in Alphabetical Order," "Prevalence of Congenital Heart Disease," "Scanning Protocols for Echocardiographers," "Imaging Tips," a glossary and a worksheet for echocardiographers.


WD: I know that many people with loved ones who have congenital heart defects, particularly parents of children with such conditions, are often kept in the dark about the details of the condition. Is your book suitable for the non-technical reader, such as parents?

KH: This book is an excellent resource for parents. It is written in language that is understandable by parents as well as technologists and nurses. The full-color diagrams provide invaluable insight into this very complex world. Most importantly, this book attempts to make the subject of congenital heart defects accessible to anyone who wishes to comprehend this subject.


WD: I understand that people with congenital heart defects and parents are active participants in online discussion groups. Will your book serve as a resource for people who participate in these groups?

KH: This book is not only a resource for sonographers and parents, but the book is accompanied by a blog (HeartDefectsforEveryone.blogspot.com) that attempts to address many of the concerns commonly encountered with congenital heart defects. This blog is a work in progress, but I hope to provide a forum for parents, healthcare personnel, and others to share their questions and concerns about congenital heart disease.
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Why average cholesterol values can be so bad

Why average cholesterol values can be so bad

30. August 2007 William Davis (23)
Jack had been told again and again that there was absolutely nothing wrong with his cholesterol panel. His numbers:

Total cholesterol 198 mg/dl

LDL cholesterol 119 mg/dl--actually below the national average (131 mg/dl).

HDL 48 mg/dl--actually above the average HDL for a male (42 mg/dl).

Triglycerides 153 ng/dl--right at the average.


So his primary care physician was totally stumped when Jack's heart scan revealed a score of 410.


Lipoprotein analysis (NMR) told an entirely different story:

LDL particle number 1880 nmol/l (take off the last digit to generate an approximate real LDL, i.e., 188 mg/dl).

Small LDL 95% of all LDL particles, a very severe pattern.

A severe excess of intermediate-density lipoprotein (218 nmol/l), suggesting that dietary fats are not cleared for 24 hours or so after a meal.

And those were just the major points. In other words, where conventional cholesterol values, or lipids, failed miserably, lipoprotein analysis can shine. The causes for Jack's high heart scan score become immediately apparent, even obvious. Jack's abnormalities are relatively easy to correct--but you have to know if they're present before they can be corrected. A shotgun statin drug approach could only hope to correct a portion of this pattern, but would unquestionably fail to fully correct the pattern.

As I've said before, standard cholesterol testing is a fool's game. You can squeeze a little bit of information out of them, but there's so much more information that can be easily obtained through lipoprotein testing like Jack had.
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Comments (23) -

  • DietKing2

    8/29/2007 9:56:00 PM |

    Doctor,
    Have you ever heard of this?
    I hear you talking about Lp(a) quite alot and I'm not counting on my daily dose of Lipitor to straighten out whatever else might be going on backstage in my bloodstream, you know?
    Let me know what you think.
    Adam
    http://www.thecureforheartdisease.com/pauling/lpatent.html

  • Dr. Davis

    8/30/2007 12:36:00 AM |

    Hi, Adam--

    Yes, we've tried the Rath/Pauling formula informally but have never seen any substantial effect.

    Lipoprotein(a) is a very real phenomenon that clusters in high-risk families with heart disease. The treatment is specific, e.g., niacin, testosterone, and others. However, it must be measured specifically. Be sure to see the extensive conversations on our website, www.trackyourplaque.com.

  • Anonymous

    8/30/2007 2:53:00 AM |

    hello- I am new to your blog and just wondering your opinion on "The South Beach Diet" or what diet/book you recommend.
    I am a 50 year old male on a statin with a calcium score of 2. My lipid numbers are OK now but I really want to get off the statin and am totally confused by all the contradicting diet info out forthe public.Help!

  • Anonymous

    8/30/2007 3:21:00 AM |

    Hi Dr. Davis,

    I joined TrackYourPlaque today and appreciate your insight there.

    The story you relate in this post is incredible really and one I can relate to...

    10 years ago I had a mild heart attack at 43 which led to 3 stents.  5 years ago, just symptoms which got me to the hospital which led to a triple bypass.

    I've met with a lot of doctors, including cardiologists who appear often to know less about what they're doing than I have come to know through research and reading on the internet.

    I guess it's understandable that every adult patient wouldn't get sophisticated lipoprotein subfraction analysis as a matter of course.

    But you'd think that someone in my situation would get sophisticated input.

    My HMO was and is great for emergency conditions and has highly qualified surgeons and facilities.

    But after reading this post, I was struck again by how little informed and significant knowledge about best practice treatment methods one can really get in some HMO contexts.

    I know that I've spent a lot of time doing my own research to learn everything I could ('cause I don't want to die young) and I have to wonder sometimes what happens to folks with issues similar to mine who don't have a research and read orientation or the time to learn enough to protect themselves with preventative measures.

    Mid Life Male in CA
    aka "wccaguy"

  • Dr. Davis

    8/30/2007 11:45:00 AM |

    South Beach Diet is a wonderful program, at least phases 1 and II. Phase III, in my opinion, is too lax by including too much wheat. However, it is an overall solid and healthy diet. Also beware of its over-reliance on processed foods. The best foods for all of us are in the produce aisle, the ones with no labels.

    Our principal website, www.trackyourplaque.com, will also soon be releasing the NEW Track Your Plaque Diet that incorporates many of the concepts discussed here to help achieve control over heart scan scores.

  • Dr. Davis

    8/30/2007 11:50:00 AM |

    Mid Life Male--

    Yes. Lipoprotein testing, in my view, can make or break success in gaining control over your disease.

    Unfortunately, the lack of knowledge in this area is not confined to the HMO's. HMO's are, in fact, poorly represented in Wisconsin, yet ignorance among my colleagues regarding lipoprotein testing and other advanced measures of risk persists outside of the HMO setting. In short, it's everywhere. It's up to us to talk about it and spread the word.

  • Anonymous

    8/30/2007 3:02:00 PM |

    Hello- Greg here- I posted the South beach Diet question- thanks so much for the response. A couple questions:
    - Is your new book coming out actually a book to purchase or part of your membership web-site?
    - Can you tell me when it will be available?
    - I know you don't recommend wheat flour products but can you comment on sprouted grain bread line Eziekiel or similar brands, are these any better in moderation? Or should I just forget about bread entirely?
    - My calcium score was 2. That was about 3 years ago, now at 50 when should I have it done again?
    Thanks!
    Greg

  • Anonymous

    8/30/2007 3:19:00 PM |

    Greg - again- sorry, I might be confused here. My calcium score was 2 is that the same as a heart scan score?
    I am not sure I know the difference.
    Thanks!

  • Anonymous

    8/30/2007 4:11:00 PM |

    Hello- sorry for all  my comments but I just found your site and I am very impressed.
    I did a search for Splenda and didn't come up with much- can you comment on this product and the use of it in your program.I have dessert issues... I did enjoy the ricotta dessert on South Beach but what do you think of jello and the use of Splenda in desserts without wheat!There is so much on the web about the evils of Splenda- who to believe?
    Thanks!
    I really should just become a member I suppose.
    Greg

  • Anonymous

    8/30/2007 6:48:00 PM |

    Another question- do you have any thoughts on Dr. Gott's "No Sugar, No Flour Diet"? He is coming out with a cookbook this December to compliment this book.
    Thanks!
    Greg

  • Dr. Davis

    8/30/2007 8:20:00 PM |

    Sorry, no. I've heard of it but haven't yet read it. I like the title, however!

  • Dr. Davis

    8/30/2007 8:22:00 PM |

    In my experience, I've not witnessed any ill effects from Splenda or Stevia. I have seen plenty of mental cloudiness, however, with aspartame. I still think it's a good idea to keep your sweeteners, natural or synthetic, to a minimum.

  • Dr. Davis

    8/30/2007 8:23:00 PM |

    Yes, a heart scan score and a calcium score are the same thing.

  • Dr. Davis

    8/30/2007 8:26:00 PM |

    The New Track Your Plaque Diet will be a Special Report posted on the www.trackyourplaque.com website sometime in the next few months.

    With a starting score of 2, I would not recommend another scan for 3 to 5 years.

    I actually have a 18-month old loaf of Ezekiel bread in my freezer that I have not yet had a chance to play around with. So, no, sorry, no experience nor much knowledge of this specific product yet.

  • Anonymous

    8/30/2007 8:28:00 PM |

    Thanks for the responses.
    Can you tell me, in general, how often a person should have a heart scan done. As I said my last one was at 48 ( a score of 2)  I am now 50.
    Thanks!
    Sorry if I already asked this.
    Greg

  • Anonymous

    8/30/2007 8:56:00 PM |

    OK- I have been reading many of your posts today and thanks for your patience with my posting enthusiasm... I think I asked the same question twice!
    I have beed struggling for sometime with diet and my physician is no help.
    I did lose on South Beach but gained much of it back.
    I see that you recommend South Beach but as I read your postings it seems you lean toward a vegetarian diet too or am I reading into this.
    By joining the web-site would I get access to recipes and meal plans?
    Thanks for help and patience with the new guy.
    Greg

  • Dr. Davis

    8/30/2007 9:17:00 PM |

    Greg--

    South Beach is a wonderful program. Following a vegetarian diet is a choice, but not a necessary part of doing well on our program.

    Unfortunately, meal programs will not be found on the Track Your Plaque website, just discussion of principles and occasional recipes. We are working towards that, however.

  • Anonymous

    8/30/2007 9:45:00 PM |

    Thanks!
    I think I have been reading too much over the years as I have dealing with higher blood lipids and weight gain.
    The whole vegan/vegetarian crowd can make me nervous - The China Study, Ornish, McDougall, Fuhrman, Esselstyn, Pritikin, etc.... they all say theirs is THE way. I had the nutritionist write me back from the Pritkin Center and say South Beach (in the one study done) showed no decrease in LDL and that it is a horrible diet.
    Also there was an article between Ornish and Agatston in Ornish's column he writes for Newsweek where Dr. Agatston said Ornishes approach was aggressive but perhaps he should offer it to those that want to try it in the future ( I am not quoting correctly but you can google Ornish and Agatston and find the article) It kind of made me feel like he wasn't too proud of his program or maybe he was just trying to appease Ornish.... urrhhh... not sure.
    I know as the public we are really lead down different paths and the more I read the more confused I get.
    Best- Greg

  • Dr. Davis

    8/31/2007 11:33:00 AM |

    I always remind people not to  confuse diets meant to achieve WEIGHT LOSS and diets that correct causes of HEART DISEASE. There is a good deal of overlap but there can be crucial differences.

    The inclusion of abundant grains, for instance, from whole wheat or whole grain bread and breakfast cereals, magnifies undesirable small LDL particles and raises triglycerides, both powerfully related to increased coronary plaque growth.

    We use the heart scan score as our endpoint and guided along the way by lipoprotein patterns. I think this makes us worlds smarter about diet, what works and what doesn't.

  • Anonymous

    8/31/2007 1:32:00 PM |

    Thanks so much for all your help.
    I am wondering if your counsel patients at your clinic- either you or your staff.
    I am near LaCrosse, WI so not that far away. Or is it better just to join your site?
    I did have the LDL test and my particle size were a bit on the small side and as you know I have a calcium score of 2.
    Just wondering about next steps for myself- I know you cannot counsel via this blog, just looking for a general recommendation.
    Thanks!
    Greg

  • Dr. Davis

    8/31/2007 2:14:00 PM |

    Hi, Greg--
    I would suggest using our website.

    In all honesty, I do not do the website work to increase my practice. My practice is already bursting to overflowing. I am confident that the Track Your Plaque website can serve your purposes quite well.

  • Ask A Doctor

    8/13/2009 3:10:50 PM |

    I think that the lipoprotien tests should be included in the standard list for testing Cholesterol.

  • buy jeans

    11/3/2010 8:43:25 PM |

    As I've said before, standard cholesterol testing is a fool's game. You can squeeze a little bit of information out of them, but there's so much more information that can be easily obtained through lipoprotein testing like Jack had.

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Small LDL--a persistent bugger

Small LDL--a persistent bugger

10. November 2006 William Davis (1)
Sometimes, small LDL is easy to get rid of. Take niacin, for instance, and it can simply disappear from your body.

But other times, it can be aggravatingly persistent. Several times every day, in fact, I need to run through the checklist of strategies to reduce small LDL with patients.

How important is small LDL? In my experience, it is among the most potent causes behind coronary plaque known. It's a big part of the explanation why some people at an LDL of cholesterol of X mg/dl will have heart disease, while others with the same X mg/dl of LDL will not. When present, small LDL particles are much more likely to trigger atherosclerotic plaque formation. Small LDL particles magnify Lp(a)'s ill-effects tremendously. The data vary but small LDL probably increases heart attack risk at least three-fold.



Here's a checklist of strategies that I advise patients to consider to minimize the small LDL pattern:


--Lose weight to ideal weight--This is very important and effective.


--Fish oil--A relatively small effect unless triglycerides are high to begin with.




--Reduction of wheat products--This can provide a BIG effect. More precisely, a reduction in high-glycemic index foods is effective. But the biggest day-to-day high-glycemic food culprits are wheat products like breads, pasta, crackers, chips, pretzels, and breakfast cereals. "You mean whole wheat bread makes small LDL?!" Yup.


--Reduction of sweets--For the same reasons as reducing wheat products.


--Add raw almonds and walnuts--1/4 to 1/2 cup per day.




--Replace wheat products with OAT products, especially oat bran. This does NOT mean oat-containing breakfast cereals with added sugar and wheat, e.g., Honey Nut Cheerios, Cracklin' Oat Bran Cereal, etc. You might as well eat candy. Buy oat bran as plain oat bran--nothing added. Use it as a hot cereal or added to yogurt, "breading" for chicken, etc.




--Vitamin D--A variable effect, likely resulting from its beneficial effects on "insulin resistance".


--Exercise


--Niacin--Very effective but not always enough.


Among the choices, my favorites are weight loss, niacin, and reduction of wheat products. Those will give you the biggest bang for your buck.
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Comments (1) -

  • Cindy

    11/24/2006 5:04:00 AM |

    I've read that excessive carbohydrates in general are linked to small LDL and that those following a low carb diet, or reduce carbs below a certain level will not have small particle LDL, but will instead produce large fluffy LDL.

    Is this true? Is there an "optimal" level"? And do you feel that the large, fulffy LDL are less dangerous?

    I've also read that if Triglycerides are below a certain leve, this pretty much ensures the LDL we produce will be large particles. Thoughts?

    Thanks!!

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Heart scan tomfoolery

Heart scan tomfoolery

4. November 2010 William Davis (12)
Heart Scan Blog reader, Steve, sent these interesting questions about his heart scan experience. (I sometimes forget that this blog is called "The Heart Scan Blog" and was originally--several years ago--meant to discuss heart scans. It has evolved to become a much broader conversation.)

The answers are a bit lengthy, so I'll tackle Steve's questions in two parts, the second in another blog post.

Dr. Davis,

I had a heart scan last year. The score was 96. While not a horrible score, it
was a wake up call, and I changed my lifestyle.

I had another scan this year and the heart scan score went up to 105, but the
volume score went down from 141 to 136.

The report I received said this:

'The calcium volume score is less in the current study as compared with the
original or reference study. This is an excellent coronary result and indicates
that there has been a net decrease in coronary plaque burden. The current
prevention program is very effective and should be continued.'

This is all well and good, but I have two questions:

1. Am I really going in the right direction even though the heart scan score
went up 9%?

2. Here are results that make no sense to me:
- Left Main volume went up from 22.4 to 35.6
- LAD went down from 95.2 to 91.3
- LCX volume went down from 23.2 to 0
- RCA volume went up from 0 to 9.3

Why would there be so much variation from year to year, and why would the plaque
move from site to site?

Steve

Questions like Steve's come up with some frequency, so I thought it would be worthwhile to discuss in a blog post.

First of all, the conventional heart scan score, or "calcium score" or "Agatston score" (after Dr. Arthur Agatston, developer of the simple algorithm for calcium scoring, as well as South Beach Diet fame), is the product of the area of the plaque in a single CT "slice" image
multiplied by a density coefficient, i.e., a number ranging from 1 to 4 that grades the x-ray density of the plaque. (1 is least dense; 4 is most dense.) A density coefficient of 1 therefore signifies some calcium within plaque, with higher density coefficients signifying increasing calcium content and density. Incidentally, "soft" plaque, i.e., non-calcified, would fall in the less than 1 range, even the negative range (fatty tissue within plaque).

The volume, or "volumetric," score is the brainchild of Drs. Paulo Raggi and Traci Callister, who expressed concern that, if we cause plaque to shrink in volume, the density coefficient used to calculate the calcium score would increase (since they believed that calcium could not be reduced, contrary to our Track Your Plaque experience, thereby leading to misleading results. They therefore developed an algorithm that did not rely on density coefficients, but used the same two-dimensional area obtained in the standard heart scan score, but replaced the density coefficient with a (mathematically interpolated) vertical axis (z-axis) measure of plaque "height." This 3-dimensional volumetric value therefore provided a method to generate a measure of calcium volume. In their original publication, the volume score proved more reproducible than the standard calcium score. This way, any reduction in plaque volume would not be influenced by the misleading effects of calcium density, but reflect a real reduction in volume.

Callister and Raggi's study also highlighted that calcium scoring in any form is subject to variability. Back in 1998 (when their study was published), there was a bit more variation than today due to the image acquisition methods used. But, even today, there is about 9% variation in scoring even if performed repeatedly (with less percentage variation the higher the score).

Unfortunately, volume scoring never caught on and the calcium score has been the most commonly used value by most heart scan centers and in most clinical studies. And, in all practicality, the two values nearly always track together: When calcium score increases, volume score increases in tandem; when calcium score decreases, volume score decreases in tandem.

Steve is therefore an exception to the general observation that calcium score and volume score travel together. Steve's calcium score increased, while his volume score decreased. From the above discussion, you can surmise a few things about Steve's experience:"

1) In all likelihood, the changes in both calcium score and volume score could simply be due to variability, i.e., variation in the placement of his body on the scan table, variation in position of the heart, variation in data acquisition, etc. There is a high likelihood that neither value changed; both are essentially unchanged.

2) If the changes are not due to scan variability, but are real, then it could be that the calcified plaque is reduced in volume but increased in density. If true, this is probably still a favorable phenomenon, since plaque volume is a powerful predictor of coronary "events" and an increase in plaque density is likely a benign phenomenon. It would also raise questions about the adequacy of vitamin D and vitamin K2 status, both major control factors over calcium deposition and metabolism.

So, in all likelihood, Steve's apparent discrepant results are modest good news, especially since calcium scores can ordinarily be expected to increase at the rate of 30% per year if no action is taken. Experiencing no change in score, calcium or volumetric, carries a very excellent prognosis, with risk for heart attack approaching zero. (I'm impressed that Steve accomplished this on his own, something the majority of my colleagues haven't the least bit of interest doing.)

Part 2 of Steve's question will be tackled in a separate post.
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Comments (12) -

  • Ed Terry

    11/4/2010 4:27:46 PM |

    After two years my volumetric score decreased 14% annually, but my Agatston score increased by 33%.  For the Agatston score, a pulsation artifact was noted.  My cardiologist could not explain to me what that was.  Unfortunately, each scan was performed using a multi-slice detector CT instead of an EBCT.

    Could the increased Agatston score be due to the pulsation artifact?

  • Anonymous

    11/4/2010 10:32:18 PM |

    Can a person have a high calcium score yet "ideal" lipids -- low tris, high hdl and low ldl, very low crp?

  • David

    11/6/2010 8:35:57 PM |

    Anonymous,

    Yes. Lipids show you a snapshot of a single point in time, and are not a guarantee of anything. Think of it this way: Say you've been eating garbage all your life. Cookies, candy, pizza every night, etc. On top of this, you started smoking when you were 15. Now fast forward. You're 50 years old, you've been putting garbage in your body for almost your whole life, and it hits you: I need to cut this out. So you clean up your diet and give up the candy, cookies, pizza, and cigarettes. You get serious about getting in shape, and start exercising regularly. A couple years go by and you stay consistent with your new lifestyle. You get your lipids checked, and wow! HDL is nice and high, LDL is low, trigs are low, etc. This is great, but it doesn't tell you anything about the damage that's already been done over the last 50 years of bad habits. You could have developed a lot of plaque over your lifetime regardless of what your lipids say now. Lipids are sensitive to changes in diet, and change rapidly regardless of plaque burden.

  • pierogi

    11/6/2010 11:54:02 PM |

    Good questin..Good answer.
    However do good lipids stop,slow or reverse calcium score?

  • David

    11/7/2010 5:05:18 AM |

    pieroji-

    Regardless of the exact mechanism that is truly behind the arrestment of plaque growth, there are definitely certain lipoprotein patterns that are associated with low-risk and plaque regression, so those are the types of patterns we shoot for. The direction of the causal relationship and all the players involved is not completely clear in my mind, though certain lipoproteins, such as HDL2, seem to play an active causal role in such tasks as reverse cholesterol transport, reduction in inflammation, etc.

  • Sara

    11/7/2010 6:09:42 AM |

    the 4-60's is a great target for reversing cad:
    hdl, ldl, trigs, vit.d

  • Dr. William Davis

    11/8/2010 1:40:30 AM |

    Wow, David.

    Excellent description of how this works. Thanks for listening!

  • Samual

    11/9/2010 4:20:20 AM |

    Its fantastic Blog.The Infrastructure and technology are the reasons for India being touted as one of the favourite destinations as India medical tourism.

  • buy generic viagra

    11/9/2010 5:45:43 AM |

    Calcium are very essential for human bones..It improves the growth of bones.

  • pammi

    11/9/2010 10:34:21 AM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • Anonymous

    11/9/2010 5:52:54 PM |

    David -- thank you for your response.  Very helpful.  My problem is a doctor who is clueless about real risk factors.  She dismisses my concerns about heart health because she says I have "spectacularly high" hdl. At least she does not push statins on me.  Total cholesterol is high by  conventional standards and bounces around from 220 to 295, but the ratio between HDL and LDL and Triglycerides ("Tris") are always consistent and have been so for over a decade -- I keep my medical records.  Tris are generally under 50.  HDL is virtually always over 100.  C-reactive protein is always very low.  I do take small amount of thyroid meds -- 60 mg Armour plus 2.5mcg of cytomel.  I tried to explain that at my age -- I need to know what kind of hdl.  I also told her I am concerned about having ferritin at high end of normal (with no periods -- that may soon be even higher) and she laughed it off saying most women are worried about anemia. She had no idea about the different kinds of hdl.  I just turned 47 -- menstrual cylcles seemed to be stopping.  I am 5'2.5" and weigh 103.  I have not eaten wheat for around a decade and have been a low carber for much longer. I don't eat grains of any kind and vascillate between a paleo style low carb and one that includes some dairy. My family history is full of type 2 diabetes -- both parents and brother.  I have a meter and check my glucose fasting and post prandial etc.  Doc says I'm crazy.  I'm a stress eater and during binges -- I overeat nuts and nut butters or very dark chocolate -- 85% cocoa content.  I am never tempted by or crave baked goods or grains at all.  I was eating very small amounts of low carb fruit but find that it destabilizes my blood sugar and isn't worth it. Fasting is mid-80s but AIC has been edging up and doc does not understand that is why I am now testing after meals etc. Lately I've had extreme exhaustion and doc laughs it off as menopause symptom but I am concerned about my heart health.  I eat copious amounts of fat -- just love it -- not a carb craver.  Wondering if that could be insulin resistance? Any advice?

  • David

    11/10/2010 4:39:20 AM |

    Anonymous,

    If you're not happy with your doctor, I would suggest looking for a new one. Also, if you want an advanced lipoprotein analysis and your doctor won't do it, you can always do this yourself. Go to www.privatemdlabs.com and order an NMR LipoProfile. It's fairly inexpensive and super easy. You pay online, go get your blood drawn at a local lab, and then get the results emailed to you in a couple days.

    Wow, your HDL is really up there, and triglycerides are nice and low. Has it been this way all your life? Some people have a genetic deficiency of CETP (cholesteryl-ester transfer protein), which makes it so that the transfer of cholesterol between lipoprotein particles (like HDL to VLDL) is impaired. Of course, this means that HDL will go UP while trigs will stay pretty low. This also often leads to lower amounts of small LDL particles. Have you ever had your LDL size checked?

    I don't know what is causing your fatigue, but suggest that you keep pressing your doctor until you figure it out. Again, if your doctor just laughs off all your concerns, maybe it's time to look for a new doctor. Personally, I would reassess your hormone situation, including thyroid, and aim for optimal correction of all pertinent parameters.

    Have you had a heart scan? What better way to put your mind at ease and/or determine the true nature of your risk? There is a wealth of information here on Dr. Davis' blog as to why this could be a good idea to discuss with your doctor (hopefully she won't laugh it off!).

    David

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The most frequently asked question of all

The most frequently asked question of all

8. February 2007 William Davis (0)
The most frequently asked question on the Track Your Plaque website:

"Can you recommend a doctor in my area who can help me follow the Track Your Plaque program?"

This is a problem. Unfortunately, I wish I could tell everyone that we have hundreds or thousands of physicians nationwide who have been thoroughly educated and adhere to the principles I believe are crucial in heart disease:

1) Identify and quantify the amount of coronary atherosclerotic plaque present. In 2007, the best technique remains CT heart scans.

2) Identify all hidden causes of plaque. This includes Lp(a), post-prandial disorders, small LDL, and vitamin D deficiency.

3) Correct all patterns.


But we don't.

You'd think that this simple formula, as straightforward and rational as it sounds, would be easily followed by many if not most physicians. But Track Your Plaque followers know that it simply is not true. My colleagues, the cardiologists, are hell-bent on implanting the next new device, providing a lot more excitement to them as well as considerably more revenue.

The primary care physician is already swamped in a sea of new information, going from osteoporosis drugs, to arthritis, to gynecologic issues, to skin rashes and flu. Heart disease prevention? Oh yeah, that too. They can only dabble in heart disease prevention a la prescription for Lipitor. That's quick and easy.

Nonetheless, I believe we should work towards identifying the occasional physician who is indeed willing to help people follow a program like Track Your Plaque. As we grow, we will need to identify some mechanism of professional education and we will maintain a record of these practitioners. But right now, we're simply already stretched to the limit just doing what we are doing.

If you come across a physician who practices in this fashion and you've had a positive relationship, we'd like to hear about it.
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200 point drop in heart scan score

200 point drop in heart scan score

11. August 2007 William Davis (0)
Some of the math-savvy will have noticed that we often report drops in CT heart scan scores on a percentage basis. Unfortunately, it this were a competition (which, of course, it is not), this would be unfair.

A score of 50, for instance, that drops "only" 25 points would represent a 50% drop in score.

But someone with a score of 1050 who drops his or her score the same quantity, or 25, will have dropped their score less than 5%.

In other words, the magnitude of your starting score determines how large a percentage drop you achieve, even when the absolute, or real, quantity of plaque reversal is the same as someone who begins with a lower score.

I qualify this discussion in this vein because of Grady's story. Grady, a soon-to-retire attorney, started with a heart scan score of 1151. On the Track Your Plaque program, he saw his score drop nearly 200 points--200 points!

But, if we gauged Grady's success just on a percentage basis, he dropped his score only a measly 17% or so. (Imagine the headlines if this program were sponsored by a drug manufacturer. The Track Your Plaque program proudly has nothing to do with the drug industry.)

Of course, the Track Your Plaque program is not a competition. It is an effort to help everyone possible, the more the better. Even if Grady failed to set a new Track Your Plaque record gauged on a percentage basis, he will have achieved an extraordinary advantage in health: the virtual elimination of the dangers of heart disease.

With this drop in score, Grady's risk for heart attack plummets from a spine-chilling 25% per year to nearly zero. (I know of NO other program that can claim such a track record.)

Grady's full story will be reported in the August, 2007 Track Your Plaque newsletter. To subscribe or to just view when it is posted, go to www.cureality.com website, click on the upper right hand corner What Does My Heart Scan Show? graphic, which then takes you to the page to view the newsletter. Or, Track Your Plaque Members can just go to the Library and click on newsletter archives.
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