Apo E4 and sterols: Lethal combination?

Phytosterols, or just "sterols" to its friends and neighbors, are a group of cholesterol-like compounds that are abundant in the plant world. Lately, however, sterols have proliferated in the processed food supply, thanks to the observation that sterols reduce LDL cholesterol when ingested by humans.

This must mean that sterols are good for you.

Uh oh. Wait a minute: There is a rare disease called sitosterolemia in which there is unimpeded intestinal absorption of all sterols ingested through diet. They must have really low LDL cholesterols! Nope. They develop coronary disease--heart attacks, angina, etc.--in their late teens and 20s. In other words, if sterols gain access to your bloodstream, they are bad. Very bad.

Conventional thinking is that only a modest quantity of dietary sterols gain access to the bloodstream. But there are two potentially fatal flaws in this overly simplistic line of thinking:

1) What happens when you load up your diet with "heart healthy" sterols, such as those in "heart healthy" margarines, mayonnaise, and yogurt, effectively increasing sterol intake 10-fold?

2) What happens in people with the genetic pattern, apo E4, that is carried by 25% of the general population that permits much greater intestinal absorption of sterols?

My prediction: Despite the fact that sterols reduce LDL, they may, in certain genetically-susceptible people, such as those with apo E4, increase risk for heart disease: heart unhealthy.

Here are two studies that suggest that greater sterol absorption in people without sitosterolemia are at higher risk for heart disease:

Alterations in cholesterol absorption/synthesis markers characterize Framingham offspring study participants with CHD

Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study

Glucomania

As I suggested in a previous Heart Scan Blog post, a glucose meter is your best tool to:

1) Lose weight
2) Cure diabetes
3) Reduce or eliminate small LDL particles
4) Achieve anti-aging or age-slowing effects


But it means getting hold of a glucose meter and applying it in a very different way.

Diabetics typically check fasting morning glucose and again several times during the day to assess medication effects. But you and I can measure blood glucose to assess the immediate effects of food choices--two very different approaches.

The concept is simple: Check a blood glucose just prior to a food or meal of interest, then one hour after finishing.

Let's take two hypothetical breakfasts. First, oatmeal, a so-called "low-glycemic index" food. Slow-cooked, stone ground oatmeal with skim milk, a handful of walnuts, just a few blueberries.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 175 mg/dl

I made those numbers up, but this is a fairly typical response for many adults. (This is why "low-glycemic index" is an absurd notion.) This kind of response causes 1) glycation, the adverse effects of glucose modification of proteins that leads to cataracts, kidney disease, cartilage damage and arthritis, atherosclerosis, skin wrinkles, etc., 2) high insulin response that cascades into fat deposition, especially visceral fat ("wheat belly"), and 3) glucotoxicity, i.e., direct damage to the pancreas that can, over years, lead to diabetes.

Next day, let's try a breakfast of 3-egg omelet made with green peppers, sundried tomatoes, and olive oil.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 93 mg/dl

This is a meal of virtually zero-glycemic index. This kind of response triggers none of the effects experienced following the oatmeal. Repeated over time and you fail to trigger glycation, you stop provoking insulin, and visceral fat mobilizes rather than accumulates: you lose weight, particularly around the middle.

We therefore aim to keep the one-hour blood glucose 100 mg/dl or less. If you start with a high fasting blood glucose of, say, 118 mg/dl, then we aim to keep the one-hour after-eating blood glucose no higher than the pre-meal.

It works. Plain and simple.

This makes the primary care docs crazy: "How dare you check your blood sugar! You're not diabetic." In truth, blood glucose meters are relatively simple devices to use. The test strips and lancets will cost a few bucks. (The meters themselves are either low-cost or free, just like Gillette sometimes sends you a beautiful new razor for free but expects you to buy the blades). These are direct-to-consumer products. While a prescription written by your doctor for a glucose meter and supplies helps insurance cover the costs, you can easily get these devices without a prescription. Some stores, like Target, keep their devices out on the shelves with the shampoo and bath soap.

Warning: Anyone taking diabetes drugs will have to consult with their doctors about the safety of such an approach. Because this approach can actually cure diabetes in some people, if you are taking some diabetes drugs, especially glyburide, glipidize, and glimepiride, you can experience dangerously low blood sugars, just as any non-diabetic taking these drugs would.

Diarrhea, runny noses, and rage: Poll results

Here are the results of the week-long poll asking the question:

Have you experienced a wheat re-exposure syndrome?
Yes, undesirable gastrointestinal effects 223 (41%)

Yes, asthma or sinus problems 51 (9%)

Yes, joint pains and/or swelling 85 (15%)

Yes, emotional or other nervous system effects 59 (10%)
No, nothing, nada  107 (19%)

No. Wheat is sacred and you're all nuts  13 (2%)


There are several interesting observations to make from this informal poll. First, as I have observed, the most common wheat re-exposure syndrome is gastrointestinal, usually involving cramps, diarrhea, and lame explanations to your dinner partner.

Second most common: joint pains and/or swelling.

Third: asthma or sinus congestion.

The incidence of emotional or nervous system effects surprised me a bit. I didn't expect 10% of people to share this effect. This is an effect I also experience personally, along with the gastrointestinal consequences.

To be sure, this is a skewed poll, since many people likely come to this blog in the first place because of such issues. But I was nonetheless impressed with the relatively modest proportion of people who did not share such a re-exposure syndrome: only 19%.

Beyond the interesting numbers provided by readers, a good many also provided some fascinating and graphic comments. Here's a sample:




Sassy said:

Reflux -- starts a day later and goes for up to a week. And Bloat:2-5 inches on my waistline in a day, lasting up to three. Miserable. And why, having experienced this once, have I done it often enough to verify the connection with certainty? I am working on that one.



Anonymous said:
Wheat increased hunger with even with only a small amount. Crackers in soup was enough to set it off.

Also, when I was trying to get off wheat, I noticed that 2 eggs and 2 bacon and I could go 5 hours before hunger, or 2 eggs and 2 bacon and toast was good for three hours before hunger. That was the final step to giving up wheat. Now three years and 59 Kg [130 lbs!] loss later, there is no doubt in my mind that wheat is evil, and I do not regard it as suitable for human food. I speculate that it increases ghrelin or cortisol.

Anna said:
For me, in the two years since I began eating Gluten-Free (Low Carb for 6 years), the few times I've had re-exposure to wheat, I've experienced fast onset and intense abdominal pain (known exposure during the daytime) and heartburn, indigestion, intense nausea, and disrupted sleep (exposures during evening meal not discovered until the next day).

My husband wants to think he's fine with wheat (though I know that he has at least one gene that predisposes to celiac), but IMO, he isn't. He eats no wheat at home because that's the default, and he's OK with that. But if he goes out to dinner at a restaurant that serves "good" artisan bread, he will indulge in a few bites (he does restrict his carb intake, so it's still a limited amount). More often than not, he will sleep fitfully on those nights, snore more, and wake in the night with indigestion. He wants to bury his head in the sand and will only acknowledge the discomfort being due to eating too many carbs, not the wheat itself. I notice he sleeps fine if he eats a small amount of potato or rice. Go figure.

Our 12 yo son has been eating GF for two years also. About 6 months into GF, he unknowingly ate wheat a number of times (licorice candy laces at a friend's house), which resulted in outbreaks of canker sores in his mouth each time. He also exhibits mood and behavior changes when he eats wheat, which is what prompted me to test him for gluten intolerance in the first place.

Mark said:
If I go for 3-4 days without wheat, grains or sugar and then go out and binge on a pizza and ice cream or something like that I become explosive within 20 minutes to an hour. It's like a wheat and sugar rage.(I'm not saying this is an excuse for rage, I'm saying it has happened to me and I believe partly do to re-exposure) It seems the combination of the wheat plus sugar can be the worst.

I get red rashes around my neck sometimes right away and sometimes up to a day or later and sometimes get bad diarrhea. 
I think it can be almost dangerous to cut things like gluten and sugar suddenly out of the diet without being very serious about keeping them out. I have found it very hard to cut out wheat without binging on it later after 4 or 5 days. I don't believe that my symptoms are just psychological either.

I was also diagnosed with ADHD as a young kid and then rediagnosed with adult ADHD by 3 different doctors. I also have bouts of mania at times too. I am considering trying to go completely gluten/refined carbohydrate free to see if it helps with the symptoms and gives me some relief.

I have never been tested for celiac or gluten intolerance but I would like to be. I think it would help explain to my girlfriend, family and friends why I can't go out and eat pizza or have a beer or ice cream. Right now they all think I'm a hypochondriac. At times I have experienced an intense fatigue the next day like I can't wake up and also sharp pains in my body and headaches.

Anonymous said:
I ditched wheat a year ago after my wife was diagnosed celiac. I immediately experienced a number of health improvements (blood lipids, sleep, allergies, etc.).

Fast forward: We all suffered some inadvertent wheat exposure yesterday via some chocolate covered Brazil nuts (of all things). This accidental A-B-A experimental design resulted in the following:

1. My celiac wife experienced what she calls "the flip" within an hour of exposure (i.e., intense GI distress).
2. My five-year old son went to bed with some wicked reflux.
3. I woke up with some twinges in my lower back and an ache in my football-weary left shoulder. I was also complaining to my wife about fuzzy-headedness that refused to respond to caffeine or hydration. I could only describe it as "carb flu"...

And then I read your post!

Anne said:
Depression, agitation and brain fog if I get glutened. Some times this comes with abdominal pain and a rash on my back - I think it is dose dependent. Cross contamination with wheat is a big issue when eating out. Needless to say, I eat out infrequently and then try to stick with the restaurants that are the most aware of gluten issues.

Terrence said:
Several weeks ago, I started Robb Wolf's 30 day challenge.

The first two weeks were brutal - calling it a withdrawal flu was a massive understatement. So, I thought I would try some wheat and see what happened (could not be worse, I thought). Well, it was.

I still felt extremely crappy, but I was now MASSIVELY GASSY - AMAZINGLY GASSY, for about 48 hours - flatulence on wheels, in spades. I did not go out at all in those 48 hours - when the gas came on, it went out, LONG, and QUICKLY and LOUDLY.

I am easing back into wheat and grain free. I am gluten free today and tomorrow (Sunday and Monday). I expect to try a small amount of wheat on Thursday, then maybe a little more the following Thursday.

Donald said:
I have limited wheat consumption severely over the last 8 months. I have lost 120 pounds, no longer have bouts of illness, asthma, depression, or low energy. I also take vitamin D and other supplements that have helped (many are from your blog recommendations).

Last week I ate a small piece of cake and dessert pizza. Shortly thereafter I started sneezing, had a scratchy throat, and runny nose. I called off sick the next day for fear of being contagious. My symptoms subsided quickly and I am now attributing them to the processed flour eaten at my work luncheon. I think it was an allergic reaction since I recall having much more severe symptoms fairly regularly in my wheat eating days. Those were attributed to an "allergy" of unknown origin back then.

John said:
I suffered from Ankylosing Spondylitis, Iritis, Plantar Fasciits, etc for a number of years. I restricted carbs, especially wheat and I've been symptom free for the past two years now.

Lori said:
I found wheat to be one of the worst things for giving me gas bloating and acid reflux, and I'd had sinus and nasal congestion my whole life. When I ate that cookie, it just re-introduced old problems. I can occasionally eat a gluten-free, grainy goody at my party place without any side effects. I also have a little sprouted rice protein powder every day.

Another odd thing about wheat: it was hard for me to stop eating it once I started. I could go through a whole box of cookies in one sitting, even though I wasn't a binge eater. But I can have a couple of gluten-free cookies and stop.

Paul said:
Except for one slip up this recently past holiday season, I've been sugar-grain-starch free since July 2008. Mental fog was the most noticable re-exposure symptom I had.

My mom has had the worst acid-reflux for 40-plus years. It had become so bad that she was on three medications just to deal with the symptoms. After much training and coaxing, I finally got across to her 
how to totally get off wheat. Not at all to my surprise, after being wheat free for a few weeks, she lost weight and her acid reflux was GONE!

But she had been addicted to wheat for so long, she relapsed, and the reflux fire soon returned. Wheat must be akin to heroin with some people. Even though they know it's very bad for them, they can't help themselves.

Onschedule said:
Re-exposure often leads to diarrhea for me, or such a heavy feeling of tiredness that all I can do is lay down and pass out. A local pizzeria makes a darn good pie, but since I started practicing wheat-avoidance, I can't keep my eyes open after eating there. I can't say for sure that it's the wheat causing it, but definitely something in the crust. Diarrhea, on the other hand, is definitely triggered by the wheat for me.

My mom complained of gastric reflux for years, but never filled the prescriptions that her doctors would give her. I suggested wheat-avoidance- gastric reflux disappeared within 3 days and hasn't returned (has been 6 months now). I've already commented elsewhere on this blog about how much weight and bloating she has lost...

Steve said:
Interesting that I should sit down, turn on my computer and find your poll. Having gone several weeks, maybe months, avoiding gluten, I took my daughter and her boyfriend out to eat because my wife has been working late at the office lately. Although I was thinking I would just eat my steak and chicken, I succumbed to the temptation of eating about a dozen greasy, breaded shrimp that my daughter and her boyfriend ordered. It's 1:39am and I still do not feel sleepy. My left nostril is completely blocked, my stomach feels bloated, really, really full and I've been burping. In your poll I checked sinus problems but could have chose gastrointestinal or nervous problems just as well. 


A few weeks ago my daughter brought home a pizza and, once again, despite my knowing that I shouldn't, I ate a couple of pieces. I was sick for two days. The pain in what I think was my transverse colon was so bad I thought I might have to go to ther emergency room. Before I ate the pizza I had never gone grain-free that long before. I did this after reading Robb Wolf's book. 


I AM CONVINCED. No more wheat for me! Please, Lord, give me strength.

LV said:
What don't I experience! I typically avoid wheat (and gluten for that matter) as I'm pretty sure it makes me sick, but when I slip (or someone else slips me some) I end up with massive amounts of joint swelling and tenderness, diarhea, cramping, gas, bloating and brain fog. I'm absolutely miserable. Just that alone is enough to keep me off gluten. I have RA, so if I have repeated exposures I'll have a flare which SUCKS!

The perfect Frankengrain

Pretend I'm a mad food scientist. I'd like to create a food that:

1) Wreaks gastrointestinal havoc and cause intractable diarrhea, cramps, and anemia.
2) Kills some people who consume it after a long, painful course of illness.
3) Damages the brain and nervous system such that some people wet their pants, lose balance, and lose the ability to feel their feet and legs.
4) Brings out the mania of bipolar illness.
5) Amplifies auditory hallucinations in people with paranoid schizophrenia.
6) Makes people diabetic by increasing blood sugars.
7) Worsens arthritis, such as osteoarthritis and rheumatoid arthritis.
8) Triggers addictive eating behavior.
9) Punishes you with a withdrawal process if you try to remove it from your diet.

I will develop a strain that is exceptionally hardy and tolerates diverse conditions so that it can grow in just about any climate. It should also be an exceptionally high yield crop, so that I can sell it cheaply to the masses.

Now, if my evil scheme goes as planned, I will then persuade the USDA that not only is my food harmless, but it is good for health. If they really take the bait, they might even endorse it, create a diet program around it.

Dag nabit! Such a plan has already been implemented. Another evil food scientist already beat me to the punch. The food is called wheat.

Diabetes: A study in aging

Diabetics experience long-term health difficulties, including atherosclerosis/heart attacks, peripheral vascular disease, hypertension, cataracts, kidney disease, neuropathies, male erectile dysfunction, osteoarthritis, and colorectal cancer. They also die, on average, 10 years earlier than non-diabetics.

In effect, diabetics compress their lives into a shorter period of time. They experience all the "complications" of aging at a younger age. People without diabetes, of course, can develop atherosclerosis, cataracts, kidney disease, etc., but they tend to do so later in life compared to diabetics.

One index of the rate of aging (but not chronologic age itself) is hemoglobin A1c, or HbA1c, a "moving average" of glycated hemoglobin, i.e., glucose-modified hemoglobin. Blood glucose glycates hemoglobin linearly and irreversibly; measuring HbA1c thereby provides an index of the last 60 or so days average blood glucose.

To put HbA1c values into perspective:

Average HbA1c of hunter-gatherers: 4.5%
Average HbA1c for Americans: 5.6%
American Diabetes Association definition of diabetes: 6.5% or greater
American Diabetes Association definition of adequate control of diabetes: 7.0% or less

Why do diabetics age faster? There are likely several reasons. One important reason is glycation, as indexed by HbA1c. Glycated proteins in the lens of the eye causes cataracts. Glycated proteins in cartilage leads to arthritis. Glycated LDL particles (apo B) leads to atherosclerosis. Glycated nerve cells causes neuropathy. And so on.

If glycation underlies many of the phenomena of aging, then we might surmise that:

1) The less you glycate, the slower you age.
2) The more you glycate, the faster you age.

Therefore, the higher the HbA1c, the faster you are aging.

What foods increase HbA1c? Carbohydrates. That bowl of slow-cooked, stone ground oatmeal? A one-hour after-eating blood sugar of 170 mg/dl is common. Your doctor says that's okay because it's below 200 mg/dl and you don't "need" medication yet.

Fish oil: The natural triglyceride form is better

If you have a choice, the triglyceride form of fish oil is preferable. The triglyceride form, i.e., 3 omega-3 fatty acids on a glycerol "backbone," is the form found in the body of fish that protects them from cold temperatures (i.e., they remain liquid at low ambient temperatures).

Most fish oils on the market are the ethyl ester form. This means that the omega-3 fatty acids have been removed from the glycerol backbone; the fatty acids are then reacted with ethanol to form the ethyl ester.

If the form is not specified on your fish oil bottle, it is likely ethyl ester, since the triglyceride form is more costly to process and most manufacturers therefore boast about it. Also, prescription Lovaza--nearly 20 times more costly than the most expensive fish oil triglyceride liquid on a milligram for milligram basis--is the ethyl ester form. That's not even factoring in reduced absorption of ethyl esters compared to triglyceride forms. Remember: FDA approval is not necessarily a stamp of superiority. It just means somebody had the money and ambition to pursue FDA approval. Period.

Taking any kind of fish oil, provided it is not overly oxidized (and thereby yields a smelly fish odor), is better than taking none at all. All fish oil will reduce triglycerides, accelerate clearance of postprandial (after-eating) lipoprotein byproducts of a meal (via activation of lipoprotein lipase), enhance endothelial responsiveness, reduce small LDL particles, and provide a physical stabilizing effect on atherosclerotic plaque.

But if you desire enhanced absorption and potentially lower dose to achieve equivalent RBC omega-3 levels, then triglyceride forms are better.

Here are cut-and-pasted abstracts of two of the studies comparing forms of fish oil.

Bioavailability of marine n-3 fatty acid formulations.

Dyerberg J, Madsen P, Moller JM et al. 
Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark.

Abstract

The use of marine n-3 polyunsaturated fatty acids (n-3 PUFA) as supplements has prompted the development of concentrated formulations to overcome compliance problems. The present study compares three concentrated preparations - ethyl esters, free fatty acids and re-esterified triglycerides - with placebo oil in a double-blinded design, and with fish body oil and cod liver oil in single-blinded arms. Seventy-two volunteers were given approximately 3.3g of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) daily for 2 weeks. Increases in absolute amounts of EPA and DHA in fasting serum triglycerides, cholesterol esters and phospholipids were examined. Bioavailability of EPA+DHA from re-esterified triglycerides was superior (124%) compared with natural fish oil, whereas the bioavailability from ethyl esters was inferior (73%). Free fatty acid bioavailability (91%) did not differ significantly from natural triglycerides. The stereochemistry of fatty acid in acylglycerols did not influence the bioavailability of EPA and DHA.
(Full text of the Dyerberg et al study made available at the Nordic Naturals website here.)



Eur J Clin Nutr 2010 Nov 10. 

Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters.

Neubronner J, Schuchardt JP, Kressel G et al. 
Institute of Food Science and Human Nutrition, Leibniz Universität Hannover, Am Kleinen Felde 30, Hannover, Germany.

Abstract

There is a debate currently about whether different chemical forms of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are absorbed in an identical way. The objective of this study was to investigate the response of the omega-3 index, the percentage of EPA+DHA in red blood cell membranes, to supplementation with two different omega-3 fatty acid (n-3 FA) formulations in humans. The study was conducted as a double-blinded placebo-controlled trial. A total of 150 volunteers was randomly assigned to one of the three groups: (1) fish oil concentrate with EPA+DHA (1.01?g+0.67?g) given as reesterified triacylglycerides (rTAG group); (2) corn oil (placebo group) or (3) fish oil concentrate with EPA+DHA (1.01?g+0.67?g) given as ethyl ester (EE group). Volunteers consumed four gelatine-coated soft capsules daily over a period of six months. The omega-3 index was determined at baseline (t(0)) after three months (t(3)) and at the end of the intervention period (t(6)). The omega-3 index increased significantly in both groups treated with n-3 FAs from baseline to t(3) and t(6) (P < 0.001). The omega-3 index increased to a greater extent in the rTAG group than in the EE group (t(3): 186 versus 161% (P < 0.001); t(6): 197 versus 171% (P < 0.01)). Conclusion: A six-month supplementation of identical doses of EPA+DHA led to a faster and higher increase in the omega-3 index when consumed as triacylglycerides than when consumed as ethyl esters.

Diarrhea, asthma, arthritis--What is your wheat re-exposure syndrome?

Have you experienced a wheat re-exposure syndrome?

As I recently discussed, gastrointestinal distress--cramps, gas, diarrhea--is the most common "syndrome" that results from re-exposure to wheat after a period of elimination.

Others experience asthma, sinus congestion and infections, mental "fogginess" and difficulty concentrating, or joint pains and/or overt swelling.

Still others say there is no such thing.

Let's take a poll and find out what readers say.

Marathoners, triathletes, and heart disease

Curious thing: People with lipoprotein(a) gravitate towards elite levels of exercise.

I tell my lipoprotein(a) patients that, if they want to see a lot of other people with lipoprotein(a), go to a marathon or triathlon.

This effect applies more to males than to females, just as the fascination with numbers seems to be confined to men, too. That's why I've posted in past about the "prototypical" lipoprotein(a) male.

I believe this is a big part, perhaps the only, reason why there seems to be a modest increased risk for cardiovascular events despite high exercise levels in marathoners. It has nothing to do with the exercise itself; it has to do with the kind of people who choose to exercise at this level.

The best fish oil

The best fish oils available are the liquid forms. Contrary to many people's expectations, the best liquid fish oils have no fishy odor or taste.

I use a lot of liquid fish oils because of the higher doses we use in the Track Your Plaque program, as well as our strategy of high-dose fish oil to reduce lipoprotein(a). Women, in particular, don't like taking the oodles of capsules required to achieve the higher doses we need. So the ladies really like the liquid forms.

The best liquid fish oils are non-fishy, highly-concentrated, and come in the better absorbed triglyceride form. Many capsules, including prescription Lovaza, are the less well-absorbed ethyl ester form. Several studies, such as this one, have now demonstrated that the naturally-occurring triglyceride form yields higher blood (RBC) levels of omega-3 fatty acids, likely due to more efficient digestion via pancreatic lipase.

While there are many good forms of fish oil and only a few bad, these are the best of the best:

Pharmax
The Pharmax Finest Pure Fish Oil with Essential Oil of Orange contains 1800 mg EPA + DHA per teaspoon. This is the preparation I've been taking.

Nordic Naturals
The Nordic Naturals lemon-flavored ProOmega Liquid contains 2752 mg EPA + DHA per teaspoon, the most concentrated of any fish oil I've seen.

(This list is not exclusive. These are just two brands I've used extensively with good results.)

These highly-concentrated, triglyceride forms are more expensive, due to their concentrated nature. 1 teaspoon Pharmax fish oil, for example, provides an equivalent quantity of omega-3 fatty acids as 6 standard fish oil capsules on a milligram for milligram basis, but more like 8 to 9 capsules when absorption efficiency is factored in. The triglyceride form is also more laborious to manufacture. On our Track Your Plaque Marketplace, our Pharmax 500 ml runs $58.95 list. (500 ml provides 100 teaspoons or 600-capsule equivalent.)

Note that, minus the protection of the capsule, liquid fish oils will oxidize if not refrigerated. So be sure to keep your liquid fish oil in the fridge.
Lp(a): Be patient with fish oil

Lp(a): Be patient with fish oil

High-dose omega-3 fatty acids from fish oil has become the number one strategy for reduction of lipoprotein(a), Lp(a), in the Track Your Plaque program for gaining control over coronary plaque and heart disease risk.

The original observations made in Tanzanian Bantus in the Lugalawa Study by Marcovina et al first suggested that higher dietary exposure to fish and perhaps omega-3 fatty acids from fish were associated with 40% lower levels of Lp(a). Interestingly, higher omega-3 exposure was also associated with having the longer apo(a) "tails" on Lp(a) molecules, a characteristic associated with more benign, less aggressive plaque-causing behavior.

Of course, the 600+ fish- consuming Bantus in the study consumed fish over a lifetime, from infancy on up through adulthood. So what is the time course of response if us non-Bantus take higher doses of fish oil to reduce Lp(a)?

We have been applying this approach in the Track Your Plaque program and in my office practice for the past few years. To my surprise, the majority of people taking 6000 mg per day of omega-3 fatty acids, EPA and DHA, will drop Lp(a) after one year.  Some have required two years.  Therefore checking Lp(a) after, say, 3 or 6 months, is nearly useless. (An early response does, however, appear to predict a very vigorous 1-2 year response.)

I'm sure that there is an insightful lesson to be learned from the incredibly slow response, but I don't currently know what it is.  But this strategy has become so powerful, despite its slow nature, that it has allowed many people to back down on niacin.

Comments (35) -

  • aerobic1

    7/8/2011 5:50:17 PM |

    Strange stuff that Lp(a).  The TYP protocol worked well for me a dropped my Lp(a) from 21 to 3.  But, was the reduction due to fish oil alone or the combination of fish oil and other TYP strategies?  If you had to rank each of the following strategies in order of effectiveness (from 1 to 10) for reducing Lp(a) what would they be?  5,000 MG EPA + DHA, 5,000 IU D3, 1,000 MG Slo-Niacin, low carb/high fat/high protein diet, elimination of grain, sugar and starches?

  • Jack Christoher

    7/8/2011 9:02:29 PM |

    Maybe PUFA's 2yr/life?

  • Might-o'chondri-AL

    7/9/2011 12:40:54 AM |

    Post got lost again, said "error" ....
    11 humans (rheumatoid arthritics) blocked their interleukin 6 (Il-6) signalling by regularly saturating the alpha chain of Il-6 receptors with  Tocilizumab reduced their Lp(a) as a side benefit;  relevant data:
    * starting Lp(a) = 34.5 (+/- 12.8) mg/dL
    * 1 month Lp(a) = 24.3 (+/- 7.6) mg/dL
    * 3 month Lp(a) = 19.9 (+/- 6.3) mg/dL
    EPA/DHA from anti-inflammatory fish oil also blocks Il-6;  so this may be operating mechanism where it too can lower Lp(a).

  • easybleeder

    7/9/2011 1:05:14 AM |

    my cardiologist believes in many of your protocols, but forbids me to take large dose of omega 3 epa/dha. i am on plavix/aspirin since stents in two arteries one year ago. i have thrombocytopenia, lower than threshold platelet count and lower rbc and hgb levels. his thoughts are this addition could cause bleeding episodes that could cause even more trouble. i understand and agree with him. my supplement intake has been limited, even ubiquinol because of my situation. no chance of ending plavix because of recently diagnosed mitral valve regurgitation during echo. any thoughts on your part or the community thoughts. i feel as if i am losing control of my health as i hold distrust for most traditional medical community.

  • cancerclasses

    7/9/2011 1:41:09 AM |

    My research of lipids & Essential Fatty Acids has taught me that the "insightful lesson to be learned from the incredibly slow response" of fish oil in the treatment of CAD & CVD is that fish oil is:  1.) the wrong substance (there are BETTER ones!) and dosage levels,  and 2.) largely ineffective in the face of continued intake of high carb & TRANS fat containing processed junk, fast & restaurant "foods" and grocery store vegetable oils.   Failure to make changes to correct bad dietary habits and failure to stop the intake of TRANS fats is the single cause of re-stenosis in CVD patients, which guarantees further atherosclerosis, thrombosis, strokes & heart attacks.

    Dr. Robert Rowen recently wrote about his re think of the whole fish oil thing in his June Second Opinion newsletter that somebody (not me) posted here: http://goo.gl/rPvRx  
    which he based on this:  http://goo.gl/uAiv2  
    and this:  http://goo.gl/j9MgY    
    and mostly this:  http://goo.gl/ZdORy  

    In regard to the drop in Lp(a) comment it should be noted that LDL, VLDL & their  fractions will correct in response to reducing carb intake alone, even without further dietary correction or supplementation.  There is also a nutritional supplement protocol known as the Linus Pauling therapy that is reported to lower Lp(a) by using vitamin C, L-lysine, and L-proline, but Joe Mercola advises the regimen "is ONLY for people with established CVD and/or elevated Lp(a) levels."

  • aerobic1

    7/9/2011 1:45:24 AM |

    easybleeder:  Check with your doctor to see if you may be a candidate for the newer antiplatelet meds  Prasugrel or  Ticagrelor.  Both have been reported to have a lower risk profile and mortality rate than Clopidogrel.  Prasugrel is reported to be useful for those with high thrombotic risk.  Go to: http://www.escardio.org/communities/councils/ccp/e-journal/volume8/Pages/antiplatelet-agents-alegria-barrero.aspx

  • cancerclasses

    7/9/2011 1:46:39 AM |

    Oops, I posted the search for Rowen's article, it's the top hit, but here's the real link:  http://goo.gl/DDp8P

  • Tyson

    7/9/2011 6:25:51 AM |

    Atherosclerosis is a slow process, so I am not surprised that strategies to halt or reverse it are also slow (but powerful).

  • majkinetor

    7/9/2011 12:05:32 PM |

    From "Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases"

    There have been a number of clinical trials assessing the benefits of dietary supplementation with fish oils in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. Many of the placebo-controlled trials of fish oil in chronic inflammatory diseases reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.

  • majkinetor

    7/9/2011 12:09:32 PM |

    I wonder, what is exact reason that some doctors don't recommend large doses of fish oil (and 5g EPA/DHA is large dose, its around 25-50 ml of liquid fish oil equals 2 - 4 tbsps), because that is what I heard as doctors response from several people with cvd problems. I always thought its because of rancidity. I put extra 200 IU of mixed tocopherol in my 100 ml liquid fish oil and keep it in fridge just to be sure.

  • Anne

    7/9/2011 2:32:05 PM |

    Thrombocytopenia and anemia - have you looked into a possible connection to gluten. Anemia is a very common problem in those with any kind of gluten sensitivity. If you do a PubMed search for "thrombocytopenia" and "gluten" you will bring up some references. There are also some references in The Gluten File - just scroll down to the bottom of this page

    Have you stopped eating wheat as recommended by Dr. Davis. It may be important for you to go 100% gluten free. Gluten can damage any and all organs and systems and you don't have to have celiac disease for this to happen.

  • Dr. William Davis

    7/9/2011 2:45:00 PM |

    HI, Might-o--

    As always, a fascinating suggestion. Sadly, there are no investigations that shed any light on precisely why. An anti-inflammatory mechanism is a very good possibility. I also wonder if there is an effect at the transcription level, given the modification of apo(a) tail length.

  • Dr. William Davis

    7/9/2011 2:47:04 PM |

    Hi, Easy--

    It sounds like you need an explanation for your thrombocytopenia.

    Putting the question of thrombocytopenia aside, I have never seen any excess bleeding when adding fish oil at any dose to aspirin and Plavix.

  • easybleeder

    7/9/2011 4:54:01 PM |

    prasugrel, while having a better cvd profile, in studies, i believe, has  a worse profile in bleeding episodes. it is usually given to those who are non-responders to plavix as determined by genetic profile (ususally done at time of angioplasty and afterwards). ticagrelor, unfortuneatly, has yet to gain FDA approval. maybe soon though. drs. will be slow to adopt to a new drug.

  • Might-o'chondri-AL

    7/9/2011 5:58:55 PM |

    Hi c-classes,
    That tweaked edible oil is a  formulation from Brian Peskin not the link's Rowen, M.D. remarking on Peskin's product inducing  better elasticity of blood vessels in comparison to fish oil.  There are other effects of fish oil's  EPA/DHA that  are not related to vascular elasticity;  such as the benefit of reducing Lp(a) that Doc Davis reports.  If you have decided to personally set a limit on fish oil intake it would be interesting to hear your experience.

  • cancerclasses

    7/9/2011 10:08:38 PM |

    Hi Might-o,
    Yeah,  that oops comment is a correction to a comment I submitted which has not yet passed the moderation.  You can find my original comment here:  http://goo.gl/fyVfH   and a related comment here: http://goo.gl/WrQKK

    As I note in the related comment I started taking fish oils around 2002 for shoulder pain due to 30 years of heavy construction work.  They were effective, but after researching Peskin's & MANY others work re lipids I found something better & stopped taking the fish oils, moved higher up the metabolic pathway and now follow Peskin's protocol & take around 2 or 3 grams of organic O-6 in either evening primrose, sunflower, safflower or hemp seed oils & 1 gram of O-3 organic flax to maintain his recommended 2.5 or 3 to 1 O-6 to O-3 ratio.  

    Haven't had a workup since my 45th b'day 9 years ago, but I have no health issues at all that I am aware of.   I occasionally check my bp with the free machine in drug stores, it's always within normal range between 117/77 to 121/81-82, no palpitations, angina or other symptoms at all.

    Only problem I've noted since starting that regimen is I seem to always be clipping my hair & nails, growth seems to have accelerated.

  • Mary A

    7/10/2011 1:16:23 AM |

    Is it safe to presume that adding  Dr.Peskin's edible oil formulation to my intake along with 2.5 Gm of fish oil would be beneficial?  Does fish oil not affect the vascular elasticity as well?  BTW, what is the recommended amount of fish oil   one should take daily?  I too am afraid of the potential of oxidation.  Is there any way to measure the level of oxidative stress related to taking too much fish oil?

  • Might-o'chondri-AL

    7/10/2011 5:10:42 AM |

    "Server Error" keeps eating my comments ... anybody else?

  • Might-o'chondri-AL

    7/10/2011 5:25:22 AM |

    Hi Mary A,
    Peskin is not a medical doctor, although some medical doctors use his protocols and products; Peskin thinks "parent"  omega 6 & omega 3 fatty acids are all that is needed for anybody to make enough "derivative" omega 6s & 3s (inc. EPA/DHA). His theory is taking fish oil is giving us the incomplete benefit of a "derivative" and incurs an excessive level over-loading in un-natural way  ;   claiming risks potential lower natural tumor cell killing, increased bacterial infection, worse  insulin resistance, less glucose tolerance, "resting" blood sugar rises, brain damage and discounts lower triglycerides as "irrelevant".  Doc Davis probably has heard of Peskin and still finds fish oil useful.

  • Denton Holland

    7/10/2011 9:00:12 AM |

    Does fish oil (or Borage oil)  to a regimen of Crestor (currently prescribed 20 mg/d) & Niancin ER (1g/d) make sense?   ...Have read that high doses of oils & statins taken together effectively cancel benefits of both.

  • cancerclasses

    7/10/2011 8:27:18 PM |

    Peskin did not invent the theory of the dangers of taking pharmacological overdose levels of omega 3 derivatives, it is a well known biochemical fact that has been thoroughly researched by many other groups.  Check any of his writings & you'll see he always cites the sources of his findings.  

    Peskin himself has only been led to his conclusions by simply analyzing ALL the available literature from many research groups, separating the true wheat from the false chaff, then he simply republishes the results of his analysis of the literature to make it understandable to all, some of which has been known & available for decades but has been either suppressed, discredited, discounted, sidestepped, ignored or just not talked about or publicized by the mainstream media because it's contrary to the financial interests of the medical & pharmaceutical "sick care" industries.

    A perfect example of that is M.D., Ph.D. biochemist Otto Warburg who was awarded the 1931 Nobel Prize for his work in defining the prime cause of cancer.  But who has ever heard of him & the prime cause?  It's staggering how few M.D.'s & oncologists have ever heard of him, or have ever been taught about Warburg in med school. And if the medical profession doesn't teach their students, it's a slam dunk guarantee that people will never hear about Warburg & the prime cause of cancer from their doctors.   I'm 53 years old & I had never heard of him or his work, & if I hadn't stumbled across Peskin I most likely would have lived my entire life, contracted some kind of cancer along the way, most likely prostate, then later would have died & STILL would never have known about Warburg.

    Anyone that wants to do more in life than just parrot the opinions published in the popular & "peer reviewed" press can find the true facts.  I find it quite ironic that at our point in human history, when we have even freely available to us the most powerful information & truth gathering tool ever devised by man, science is DEvolving into the realm of belief, tradition & superstition, and people are being polarized into affinity groups based on those beliefs, traditions & superstitions instead of gathering together to honor real scientific truths.

  • Might-o'chondri-AL

    7/11/2011 6:20:27 AM |

    Hi c-classes,
    Warburg is famous enough for describing cancer cells proclivity for performing aerobic glycolysis as an edge to thrive; I think this is best described as a modality of function and modern research is showing the causes  of cancer are complex. You may be interested in this weeks published details of the molecular development promoting cancer  cells replication; see journal Molecular Cell, vol. 43, issue 1, 122-131 "Failure of Origin Adaptation in Response to FORK Stalling Leads to Chromosomal Instability at Fragile Site".

    A synopsis : Kerem, et.all.,  give 1st details of how fragile sites of a single DNA molecule breaks in early cancer due to "perturbed" DNA replication; normally DNA copying slows and sometimes stalls at fragile sites so that the cell sometimes has to shift to use stress mechanisms in order to finish single molecules DNA copy. But, in the case of an incipient cancer cell which has already utilized the stress mechanics  that cell has no more stress mechanisms to call on that can do enough at a fragile site to keep proper replication going; then the DNA molecule actually breaks whereby normal protein expression suffers, functional changes occur and cancer defects particular to that type of cancer replicates.

  • Mary A

    7/11/2011 2:44:18 PM |

    I guess my question still remains does the edible oil formulations of Dr. Peskin hold any health benefits for a person and if so, then how much would a person take and with or without fish oil?  Are there any other blogs or websites that are dedicated  to his research?   BTW, great info Might-o'chondrl-AL and cancerclasses.

  • Mary A

    7/11/2011 4:20:08 PM |

    Forgive me for asking the previous question before I read Dr. Peskin's  website. I am not a scientist but the research he identifies seems to support his conclusions.  Cancerclasses, you seem to be a supporter of his.  Are you following his protocol and, if so, what have you experienced?  I would appreciate others opinions regarding Dr. Peskin and his protocol.  I think this is a very important area especially since many physicians and PhDs (i.e. Dr. Sears et al) encourage the use of fish oil in the dietary regime.

  • cancerclasses

    7/11/2011 9:39:09 PM |

    Hi Mary A:
    I have submitted several replies to this article that have not passed moderation and have not been posted here, just click on my name at the top of my comments & it will take you to my Twitter channel where I have posted my comments. Click on the link at the comment that starts with "My study & research of..."  then also click on the one 2 posts down about  bursitis & arthritis.  You may also scan my posts for anything else that interests you, as I post info there from a wide variety of subjects & sources I find interesting & relevant while conducting my own research.

  • Might-o'chomdri-AL

    7/11/2011 9:42:28 PM |

    Hi Mary,
    Peskin refers to 1988-1992 rodent studies showing brain "damage" from  extra EPA/DHA; maybe elsewhere he cites newer brain damage indications. The extrapolation to humans is not certain ; since we have +/- 1,100 million synapses per cubic mm. , while rodents have 1,397 million synapses per cubic mm.  Humans gain not only from having astrocytes 2.5 times wider than rodents, but also we function with 1 astrocyte for each 270,000 to 2,000,000 synapses in a neurological domain; while rodents must use 1 astrocyte for each 20,000 to 120,000 synapses in a neurological domain.

    As for Peskin's assertion that lowering triglycerides is "irrelevant" Doc Davis elaborated for us why they are worth controlling; when more trigs going into circulation hitched to VLD Lipid  this morphs into trig rich LDL and small LDL particles increase in numbers. The same trig laden VLDL  contributes to formation of some HDL,  but the result is rapid degradation of that HDL; so the HDL circulating is small HDL particles and the net amount of HDL is also reduced.  Doc Davis has been seeing human clinical success using fish oil (EPA/DHA) to lower the VLDL and co-administering niacin to act on reducing the number of small LDL particles (to ideally maximum 10% of total LDL number of particles);  while the fish oil & niacin combination work synergisticly to keep down circulating  triglycerides  (to ideally 60 mg/dL). This is a synopsis of what I l learned here.

    Peskin's PEO, "parent essential oils", are touted as offering measurably better vascular membrane flexibility in comparison to fish oil; this may not  (may be, I don't know) necessarily translate to reduction &/or protection from the circulating small LDL molecules that oxidize and foster plaque.  He quotes USDA that only 0.05 % of alpha linolenic acid we ingest is made into DHA and 0.20% made into EPA; extrapolating from there that supplementing EPA/DHA radically exceeds what we are designed to need.  The fact that age remodels many of our functions to me suggests that  taking extra EPA/DHA is akin to dosing one for  therapeutic purposes (ie:  reduce VLDL, trigs &  Lpa the theme of this thread) that are more critical to survival  from sudden death than vascular flexibility alone is.   If someone on Peskin's PEO protocol has before and after Lp(a) & NMR lipid profile data that would be interesting to see.

    Peskin exclaims fish oil raises blood sugar and insulin resistance; my own experiment 4 months after adding large dose of EPA/DHA  (also started niacin) laboratory data show I did  elevate my fasting serum blood sugar an extra 5mg/dL,  with HbA1c going up 0.3; yet had fasting insulin measuring only 4.1.  Personally I was happy to trade that  blip in  glucose tolerance for the drop in number of small LDL particles from 1,021 nmol/L (out of  1,676 nmol/L total) down to small LDL particles numbering 96 nmol/L ; and triglycerides dropping from 90 mg/dL down to 42 mg/dL.  Blood sugar control seems ammenable to more dietary interventions to compensate  against  and  I'm relieved to see Doc Davis'  advice worked for my unruly small LDL.

  • Mary A

    7/12/2011 4:58:59 PM |

    Thank you Cclasses and Might-o for your responses.  Could something so simple be so valuable as PEO.
    I did read Prof Peskin's Iowa study along with a couple of posted letters from physicians supporting the benefits of PEO found in their patients along with the results of an actual scan taken of Brian Peskin's heart  which showed NO plaque at all--.  Correct me if I am wrong but it is my understanding that if the intimal lining is healthy there is less /no inflammation. A healthy intimal lining prevents the events that cause a thrombus from occurring thereby preventing plaque build up and the adverse sequelae from developing. I know this is a simplistic understanding but, like I said, I'm no scientist.  It seems like it would be worth a good controlled study since Prof Peskin says positive results can be seen in as little as three months.   Hopefully, any study would include looking at various inflammatory markers as well as the total cholesterol profile.
    Might-O..I have been reading lately about the effectiveness of delta and gamma tocotrienols in reducing LDL, Lpa as well as increasing insulin sensitivity.  There is some research to support this.  I don't know if Dr. Davis utilizes this in his Tx protocols.

  • cancerclasses

    7/12/2011 7:39:41 PM |

    Yes, fats ARE simple, but you don't have to be a scientist to know that fats are crucially important to have as a regular part of our diets.  I find most people are seriously deficient in knowledge (which is intentional & by design) of the critical physiological & biochemical importance of regular dietary intake of essential fatty acids & good saturated animal fats, and thus are seriously deficient in those EFA's & natural saturated animal fats.  

    The medical & pharmaceutical "sick care" industries both perpetuate & exploit the public's fear of fats, cholesterols, protein, salt, etc, the very same substances that every one of our 100 trillion cells are made of, and this is why the average American is chronically sick & tired, diabetic, dehydrated, cancerous & cardiovascularly compromised.  As even you have learned & now know, there is NO omega 3 or derivatives in arterial intima & media, or even in human skin, it' all omega 6.  Yes it's true that a healthy arterial intima indicates less inflammation & vice versa, but EFA's & PEO's only facilitate healing & proper structural conformity, they won't PREVENT arterial damage if a person continues the high carb & TRANS fat intake that leads to the elevated serum glucose & LDL & VLDL levels that damage & alter the structure of endothelial cells & cholesterol.

    The studies you would like to see have been done, they are out there, Peskin writes about & references them all the time.  His book The Hidden Story Of Cancer and his website are not just about cancer, he includes a large amount of information about heart disease, statins, nutrition & related issues. Go to brianpeskin dot com & see Reports & Publications, and in particular go to Reports - Medical Reports - New Look LDL

  • Mary A

    7/13/2011 4:45:56 PM |

    Thanks CClasses for your help.  You are so right....the public at large have been taught to be afraid of so many things regarding their health.  Some try to seek out valuable information and others don't.  Many people look to their physicians to tell them all they need to know and that is a mistake.  Maybe with this new crisis going on in health care, people will begin to take an even more active role in their health.

  • cancerclasses

    7/14/2011 9:31:09 PM |

    @ easybleeder:
    Plavix CAUSES Thrombotic thrombocytopenic purpura (TTP).   From Wikipedia search Plavix,
    "Clopidogrel is an oral, thienopyridine class antiplatelet agent used to inhibit blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease. It is marketed by Bristol-Myers Squibb and Sanofi-Aventis under the trade name Plavix. The drug works by irreversibly inhibiting a receptor called P2Y12, an adenosine diphosphate ADP chemoreceptor. Adverse effects include hemorrhage, severe neutropenia, and thrombotic thrombocytopenic purpura (TTP).

    Also Google Brian Peskin, aspirin.   From the cover of his article "Aspirin Is Awful":   “...Low-dose aspirin, which enhances platelet adhesivity, increases thrombosis (clotting) when platelet adhesion dominates as the response to injury.” Buchanan, MR and Jejana, E, Journal of Clinical Investigation, 67503-508

    So your doctor has you on Plavix which ostensibly prevents thrombosis, but also causes thrombosis, and also has you on aspirin which causes thrombosis?!?!  His theory must be that the effects of the two drugs cancel each other out, so theoretically you should be perfectly healthy.  No wonder you feel so out of control.

  • cancerclasses

    7/14/2011 9:40:17 PM |

    Hi Might-o,
    Yeah, that oops comment is a correction to a comment I submitted which has not yet passed the moderation. You can find my original comment by clicking on my name at the top of my comment.

    I started taking fish oils around 2002 for shoulder pain due to 30 years of heavy construction work. They were effective, but after researching Peskin’s & MANY others work re lipids I found something better & stopped taking the fish oils, moved higher up the metabolic pathway and now follow Peskin’s protocol & take around 2 or 3 grams of organic O-6 in either evening primrose, sunflower, safflower or hemp seed oils & 1 gram of O-3 organic flax to maintain the biochemically optimum recommended 2.5 or 3 to 1 O-6 to O-3 ratio.

    Haven’t had a workup since my 45th b’day 9 years ago, but I have no health issues at all that I am aware of. I occasionally check my bp with the free machine in drug stores, it’s always within normal range between 117/77 to 121/81-82, no palpitations, angina or other symptoms at all.

    Only problem I’ve noted since starting that regimen is I seem to always be clipping my hair & nails, growth seems to have accelerated.

  • cancerclasses

    7/14/2011 10:17:21 PM |

    Mary A:  Sorry I didn't reply to this sooner.  Taking fish oils along with Omega-6 & Omega 3 would be redundant & that much Omega-3's would negate the effect & benefit of the O-6 by dominating the desaturase & elongase enzymes the body uses to produce the derivative forms of the fats that are further down the metabolic pathway, as PhD lipid researcher Mary Enig explains in her article "Tripping Lightly Down the Prostaglandin Pathways."  Just google the title of the article & also study the metabolic pathway chart there, I can't include the links here or this comment won't pass moderation.

    If you take a look at the O-6 & O-3 metabolic pathway chart in that article, it becomes readily apparent that by taking any single derivative form of O-6 or O-3 you are jumping into the pathway at the point of that particular derivative, creating an oversupply & IM-balance of that derivative, and you are also cheating your body & yourself out of ALL the other derivative forms your body needs & would otherwise use for the formation of the critical BALANCE of prostanoids, leukotrenes, lipoxins & thromboxins you'd have if you instead just took the parent base substrate Omega-6 & Omega-3 at the top of the pathway. People just don't understand the importance of supplying your body ALL and complete, natural organic forms of the materials it needs for ALL it's metabolic processes, and that's why people are sick & diseased.  

    To be completely truthful, there is a list of diseases & conditions that deactivate the desat & elongase enzymes necessary for the breakdown & utilization of the base substrate oils, so some  persons with those conditions require & will only benefit by taking the derivative forms.  However, in analyzing that list of diseases it's also easy to deduce that many of them only exist because of a primary & earlier deficiency of essential fatty acids.

  • Cholesterol and Heart Disease

    8/2/2011 6:23:02 PM |

    Hi,

    DR Davis recommends taking fish oil for curing heart disease, but I also read somewhere that fish oil is also anti-inflammatory and inflammation is the real cause of heart disease, not high cholesterol.

    What you think of that? Is inflammation more dangerous than high cholesterol?
    Thank you!

  • mgts24

    5/4/2012 8:49:06 AM |

    I'm new to the site, and I just wanted to say how much I'm appreciating it.  I began taking krill oil capsules a month ago, and haven't had a single heart palpitation since.  In fact they stopped after only two days of taking it.

  • heart disease in apes

    5/11/2013 1:43:29 AM |

    Hello there! This is my first visit to your blog!
    We are a team of volunteers and starting a new initiative in a community
    in the same niche. Your blog provided us beneficial information to work on.
    You have done a wonderful job!

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"How often do you call an ambulance?"

"How often do you call an ambulance?"

I asked one of the CT technologists at Milwaukee Heart Scan what quesetions are often asked by people undergoing their first CT heart scan.

"That's easy," she said. " 'How often do you call an ambulance?' "

She went on. "People are very scared when they have their heart scan. In fact, some people don't even want to see their heart scan images and don't want to know their score--even after they paid $200 for the scan!"

I think she's right. People often remember the headlines that some heart scan centers have used: "Heart scan saved so and so's life!," when a high score led to a heart catheterization, stents, or bypass surgery. It's the sort of headline that gives people the impression that ambulances pull up to the scan center whenever a score is high.

So, how often is an ambulance called to the scan center? Never. Not once. A CT heart scan score is NEVER an emergency.

Emergencies occur in other places when people can't breathe, or are having pain in their chest, or pass out, emergencies that should not take anyone to a heart scan center. When heart scans are used properly, it is the person without symptoms who undergoes a scan to look for hidden heart disease. This cannot lead to an emergency.

Of course, that doesn't mean that a high score shouldn't prompt quick action in the next few days or weeks, like seeing your doctor to discuss the results, undergoing a stress test, discussing how to stop the score from progressing.

But call an ambulance? Forget about it.

If you are contemplating a scan but are scared that it could lead to a 911 call, don't let that stop you. But, in the event that you go to an unscrupulous center or get bad information, be sure to be armed with the best information possible. One good start would be to take look at our free downloadable book, What does my heart scan show? available for free on the www.cureality.com website.

Comments (1) -

  • Anonymous

    11/27/2008 1:51:00 AM |

    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.

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