The battle for natural hormones

The battle for preservation of availability of compounded natural hormones goes on.

It started with pharmaceutical manufacturer, Wyeth, who petitioned the FDA to disallow the mixing of pharmaceuticals, especially natural human hormones, by specially trained pharmacists at what are called "compounding pharmacies." These are pharmacies that have special equipment and where trained pharmacists can mix up specific preparations for dispensing. These are available by prescription.

For instance, I have been prescribing natural human testosterone and progesterone for nearly 10 years. I have found service to be excellent, with lots of learning materials provided to patients by the pharmacy. The pharmacists I've spoken to have been courteous and knowledgeable. Compounded hormones are also shockingly less expensive. While a testosterone patch from a pharmaceutical company costs around $4.00 per day, the same quantity of testosterone cream formulated by a compouding pharmacy costs around $0.50 per day--87.5% less.

Wyeth hides behind a smoke screen of concern over quality. But the price differences tells the entire story: they want to eliminate the inexpensive competition and hold us all hostage to the far more expensive, often inferior products that they produce. They'd sooner force a woman to use horse-derived Premarin than to allow her access to human estrogens and progesterone.

To me, this is an outrageous affront to our freedom of choice, both as consumers as well as a physician. If you feel as strongly as I do about opposing the unfair and bullying ways of Wyeth Pharmaceuticals and the FDA, the P2C2 association of compounding pharmacists makes writing a letter to your Senator easy by going to

http://iacprx.convio.net/site/PageServer?pagename=P2C2

Just enter your info and personalize the comments, and the e-mails will be generated for you.

Lipitor and memory

At first, I was skeptical. A book from a nutty author and physician named Duane Graveline kept on coming up in conversations with patients. His book, Lipitor: Thief of Memory , details his personal experience with dramatic changes in memory and thought while taking Lipitor.



Now this is a drug that I've seen used thousands of times. But I've now seen about a dozen people who have had distinct struggles with memory and clarity of thinking while taking Lipitor. Most took doses of 40 mg per day or more, though an occasional person takes as little as 10 mg. The association seems to be undeniable, since it improves after two weeks off the drug, recurs when resumed. Just today, I saw two people where this effect may be an issue.

Curiously, I've not seen it with any other statin agent. Unfortunately, uncovering any scientific data on the issue is a hopeless quest. Either it's very uncommon or, worse, the data has been suppressed.

Any way, I believe that Dr. Graveline was right: Lipitor, in a small number of people, does indeed seem to exert real detrimental effects on the mind.

If you take Lipitor, should you stop it in fear of long-term effects on your mental capacity? I think it's premature to toss the drug out based on this relatively uncommon relationship. This particular effect is likely to be idiosyncratic, i.e., peculiar to an occasional person but does not seem to apply to the majority, probably by some quirk of metabolism or penetrability of the barrier between the blood and nervous system tissue.

If, however, you feel that your thinking and memory have deteriorated on the drug, please speak to your doctor.

EKG's and heart disease


How helpful are EKG's for detecting hidden heart disease?

I pose this question because several patients asked this question just this week. It's also a frequent point of confusion and misperception.

Your EKG is nothing more than an expression of the surface electrical activity emitted by heart muscle activity. Multiple (12) leads are attached to the body simply to provide various "views" of this electical activity. EKG, or sometimes "ECG", is short for "electrocardiogram".

What modifies this surface electrical activity? Anything that modifies the electrical activity within the heart itself, or interferes with the detection of the activity. An old heart attack modifies the patterns of electrical conduction in the heart and that can change your EKG. An ongoing heart heart attack likewise. High blood pressure commonly creates changes in the EKG, as does lung disease. A bellyache can change your EKG, as can a stroke. (These non-heart-related phenomena probably are often due to changes in autonomic, or "automatic," nervous system activity.) The heart generates electrical activity in a predictable sequence that generates the heart beat, or "rhythm". EKG's are useful for monitoring heart rhythm, also.

Does having plaque in your coronary arteries have any effect on the EKG? None whatsoever, unless plaque rupture caused heart attack or is about to cause heart attack. So, you can have a horrendous CT heart scan score of, say, 3000, yet maintain a perfectly normal EKG, as long as the heart muscle is normal.

Then why bother with these iffy tests? They are indeed useful to diagnose the cause of active symptoms. For instance, go to the ER with chest pain and an EKG could show changes suggesting that the chest pain is a heart attack. EKG's are also useful for future comparison. Any change in EKG can suggest certain things, like new heart rhythm disturbances unrelated to coronary plaque.

Think of your EKG as just like buying a used car. Say I'm trying to sell you my 1999 Buick Century. It looks pretty good from the outside and I tell you that it has 70,000 miles and runs well. You ask to open the hood, look in the interior and take it out for a drive. I tell you no, you can't do that.

Would you buy the car? Of course you wouldn't. You were permitted only a very superficial examination of the car. You have no idea what's going on inside. Just because the paint job looks brand new doesn't mean the engine and transmission are good.

The same with your EKG: It's a superficial look at one aspect of this used car called your heart. If the EKG is normal, that's good, just like a good exterior on the Buick. But you cannot assume that the heart is otherwise normal.

View the EKG as a simple, superficial test that can only provide minimal reassurance, no matter how often you have it done.

A new Track Your Plaque record

Neal, a 40-year old school principal, and his young wife were terrified on learning of his CT heart scan score of 339, a concerningly high score for any age, particularly age 40.

To make matters worse, all of Neal's plaque was located in the critical left mainstem coronary artery, the shared stem of two of the three coronary arteries. A heart attack in this location is instantly fatal.

So, it was especially gratifying that Neal has set the Track Your Plaque record for largest magnitude of plaque reversal: 51% in his first year.

Studies that show a reduction in heart attack make the news. They talk about 1, 2, up to 6% regression, all achieved with high doses of statin drugs. Yet we are seeing huge, extraordinary quantities of heart disease reversal that haven't yet made headlines, amounts that far exceed those featured in the news. We should be encouraged by experiences like Neal's.

Watch for the upcoming Track Your Plaque newsletter for more details on Neal's story--how he came to the program, how he accomplished this huge effect, and why his experience was such a success. If you haven't yet subscribed, go to the www.cureality.com homepage and click on the upper right hand corner.

The Plavix Scam

Periodically, I'll see a flurry of TV ads for Plavix. It comes with a polished computer-animated cartoon that shows how platelets clump and form a blood clot, causing heart attack.

Imagine there's a pile of oil-soaked rags in a corner of your garage. I come by and tell you to get a good fire extinguisher to keep next to the rag pile in case they spontaneously ignite.

Does that make sense to you?

Wouldn't it be better to get rid of the oily rags and forget about the fire extinguisher?

Plavix is the fire extinguisher. The oil rags are your coronary plaque. The solution is to gain control over plaque behavior. Unfortunately, the TV ads (intentionally, I suspect) give the impression that blood clots just form out of the blue for no reason. Of course that's not true. It requires active, growing, inflamed atheroslcerotic plaque that ruptures, uncovering the "angry" and platelet-adhering material underneath the thin covering or endothelial lining.

Urging everybody to take Plavix is absurd. The TV ads urge many people who have no business taking the drug to take it. There are, without a doubt, groups of people who are better off taking Plavix and aspirin: people who are in the midst of heart attack, people who have unstable plaque, people with recent stents or bypass. Perhaps people at high risk for plaque rupture, e.g., extensive coronary plaque that has continued to grow.

These tactics are consistent with the experiences I've had with the sales representatives from the company (when I used to actually talk to sales reps; my office is now barred from them). The reps very aggressively would urge me to consider having everyone take Plavix. No kidding.


For us, i.e., for people who just have a heart scan score but interested in engaging in a powerful program of prevention and reversal, Plavix rarely provides any advantage. The answer is, just like our oily rag analogy, control the plaque, not put out the fire.

Lipoprotein(a) and small LDL

You won't find a lot of scientific validation for this, but it is my firm impression that small LDL, by some crazy means, has the capacity to "turn on" or "turn off" lipoprotein(a), Lp(a).

Recall that Lp(a) is a specific genetic trait, passed to us (if you have it) by mother or father. It falsely elevates LDL cholesterol and escalates heart disease risk more than just about any other known abnormality.

A frequent hint that Lp(a) might be present is a comment I hear often from patients: "My doctor said statin cholesterol drugs don't work for me. I tried them all and my cholesterol won't go down." Or, the result was substantially less than expected. That's because, when Lp(a) is lurking in your cholesterol value, it is unaffected by the statins.

It's been my in-the-trenches observation that, the more fully expressed the small LDL pattern becomes, the worse the Lp(a) behaves. In other words, if small LDL is suppressed effectively, Lp(a) doesn't seem to carry the same dangers as in someone who has plenty of small LDL. I don't know why this is. (I expect that the answer will come from someone like Dr. Marcovina at Stanford, who is at the forefront of Lp(a) structural research. Lp(a) is a complex molecule with several components. How and why it interacts with other particles remains a mystery.)

There are a little bit of data to confirm this. The Quebec Cardiovascular Study has presented some data to this effect, that the combination of small LDL particles and Lp(a) are a particularly lethal combination. We are trying to correlate our data from a CT heart score perspective to discern any statistical relationships.

This raises a very important therapeutic issue if you have Lp(a): the worst thing you can do if you have Lp(a) is become overweight. Excess abdominal fat is a huge trigger to create small LDL particles. Even though being overweight itself has no effect on the measured level of Lp(a), it activates small LDL which, in turn, throws gasoline on the Lp(a) fire.

If you have Lp(a), stay skinny.

Optimal medical therapy

I was re-reading some of the details behind the recently announced COURAGE Trial comparing angioplasty/stent in 1100 people compared to "optimal" medical therapy in another 1100. You'll recall that no difference was found.

In particular, over approximately 5 years, 20% of participants in each group died, experienced heart attacks, or strokes. Of those treated with "timal" medical therapy, 32% ended up getting a procedure like stents or bypass anyway due to deteriorating symptoms.

What is "optimal" medical therapy? I bring this up again because the study investigators in COURAGE, as well as in similar trials, say this with a straight face. Optimal medical therapy means aspirin and/or Plavix (the anti-platelet, aspirin-like blood thinner); "aggressive" statin drug therapy to reduce LDL cholesterol to 60-85 mg/dl; and "anti-ischemic" therapy (that reduces angina and the phenomena of poor coronary blood flow) using nitroglycerin preparations, beta blockers, and other drugs.

I do give credit to the investigators for having the courage to perform this trial in a world hell bent on doing procedures and still reporting the neutral outcome. But the notion of "optimal" medical therapy begs for comment.

Indeed, this is regarded as optimal by most practitioners. Some would even argue excessive, based on the low LDL target achieved. Would you be satisfied with a 20% likelihood of heart attack, stroke, or death or 5 years, a 1 in 5 roll of the dice? I would not. Recall that we aim for near-total elimination of risk.

What could have been further "optimized"? Plenty. For instance:

--What is the real LDL, not the fabricated, calculated LDL? The two can be commonly 100 mg/dl different.

--How about raising HDL to 60 mgd/?

--What about reducing the proportion of small LDL particles? After all, small LDL is the number one cause of heart disease in the U.S., not high LDL.

--What is Lp(a)? If you treat LDL with a statin drug, Lp(a) is unaffected and continues to trigger huge plaque growth. You will fail if this is not identified and corrected.

--What is vitamin D3? One of the most powerful facilitators of plaque reversal I know of.

--What are triglycerides? Triglycerides create hidden particles in the blood like intermediate-density lipoprotein, potent triggers for coronary plaque growth. Speaking of intermediate-density lipoprotein, that's another very important pattern to identify, the after-eating persistence of dietary fats.

--Why aren't they taking fish oil? With a 28% reduction in heart attack and 45% reduction in sudden death from heart attack, this alone would have halved the number of "events" in the "optimal" medical treatment group.

Of course, there's more. But the idea that aspirin, statins, and anti-ischemic therapy is somehow optimal is silly and sad at the same time. But that's the bias. The COURAGE Trial does represent a step forward, a step away from the "stent everyone and everything" mentality that motivates my colleagues, aided and abetted by their co-conspirators, the hospitals. But you and I know better. "Optimal" medical therapy, in truth, can mean a far better approach that can dramatically reduce, perhaps eliminate, risks for events like heart attack. The conventional "optimal" medical therapy will suffice only if you're content with a 20% likelihood of heart attack, death or stroke, or a 32% likelihood of an urgent procedure in your future.

Niacin, postprandial patterns

For a detailed report on the very important postprandial (after eating) patterns that contribute hugely to heart disease risk, read my recent article in Life Extension Magazine, available (no cost) at:

Uncovering a Hidden Source of Cardiovascular Disease Risk
at http://www.lef.org/magazine/mag2007/mar2007_report_heart_01.htm


For a report on using niacin to reduce risk of heart disease, see another report in the same issue of Life Extension:

Ask the Doctor: Using Niacin to Improve Cardiovascular Health
at
http://www.lef.org/magazine/mag2007/mar2007_atd_01.htm.

Also, keep your eyes open for a lengthy report focused exclusively on the Track Your Plaque program in an upcoming issue of Life Extension. I'll provide links in this Blog when it comes out.

What's better than fish oil?

One of the recent questions on our Track Your Plaque Forum related to what to do about a triglyceride level of 101 mg/dl while on fish oil.

Recall that, contary to conventional thinking like that articulated in the ATP-III cholesterol treatment guidelines, we aim to reduce triglycerides to 60 mg/dl or less. This is important to suppress the formation of abnormal triglyceride-containing lipoprotein particles, especially small LDL, reduced HDL, lack of healthy large HDL, VLDL. ATP-III advises a level of 150 mg/dl or less. Unfortunately, triglyceride levels this high guarantee appearance of all these undesirable particles and an increasing heart scan score.

What's better than 4000 mg of fish oil for its 1200 mg of EPA and DHA (omega-3 fatty acids)? More fish oil. In other words, the 4000 mg fish oil providing 1200 mg EPA + DHA is our minimum. A simple increase to 6000 mg to provide 1800 mg EPA + DHA is usually all that is necessary to reduce triglycerides and put a halt to the cascade of abnormal lipoprotein particles that trigger plaque growth. Occasionally, a somewhat higher dose may be required. Doses are best divided into two, with meals (e.g., three capsules twice a day).

Another important issue: An over-reliance on wheat products can also increase triglycerides. This includes any flour product like breads (regardless of whether it's white, whole wheat, or whole grain--they all raise triglycerides), pretzels, bagels, breakfast cereals, and pasta. A dramatic reduction in wheat-containing products will reduce triglycerides substantially, help you reduce your abdominal fat, reduce blood pressure, raise HDL and reduce small LDL, clear your mind, provide more energy, avoid afternoon "fogginess" . . . Huge benefits.

Valve disease and vitamin D

There are two common forms of heart valve disease: aortic valve stenosis (stiffness) and insufficiency (leakiness), and mitral anular calcification.

Both valve issues are regarded as evidence of senescence, or aging--the older you are, the more likely you will have one or both. Both conditions involve progressive calcium deposition and, to some degree, cholesterol deposition. They might be regarded as phenomena of "wear and tear" just like hip arthritis.

There are no known therapies to stall or stop the development of mitral anular calcification. However, several attempts have been made over the years to identify treatments that can slow or stop the progression of aortic valve disease, which is becoming increasingly common and is addressed by surgical valve replacement when severe. The most recent trials have examined whether high-dose Lipitor (80 mg) has any effect (it did not) and high dose Crestor (40 mg), which slowed but did not stop the deterioration of stiff valves.

It's been my suspicion that vitamins D and K2 may play a crucial factor in valve health. After all, vitamin D is the master controller of calcium deposition. Preliminary data also suggest that people who are intentionally made vitamin K deficient with the drug, Coumadin, develop twice the calcium deposition on aortic valves that non-Coumadin takers develop.

I saw a patient Friday, Marianne. In addition to a moderate heart scan score of 379 at age 71, Marianne had a leaky (insufficient) aortic valve. By an echocardiogram 18 months ago, the valve was moderately leaky. I put Marianne on vitamin D, 4000 units, to raise her blood level to 50 ng/ml.

Last week, I asked Marianne to have another echocardiogram. This time, no leakiness whatsoever--none. I have never seen this happen before. Although Marianne is only one example and we don't want to extrapolate too far from the experience of one person, it's hard not to attribute this phenomenal response to vitamin D supplementation.

I wonder what would have happened if we had added vitamin K2, as well?

Anyway, just another potential wonderful effect of vitamin D restoration.
Psssst . . . There's sugar in there

Psssst . . . There's sugar in there

You non-diabetics who check your postprandial blood sugars already know: There are hidden sources of sugar in so many foods.

By now, everybody should know that foods like breakfast cereals, breads, bagels, pretzels, and crackers cause blood sugar to skyrocket after you eat them. But sometimes you eat something you thought was safe only to find you're showing blood sugars of 120, 130, 150+ mg/dl.

Where can you find such "stealth" sources of sugars that can screw up your postprandial blood sugars, small LDL, inflammation, blood pressure, and cause you to grow visceral fat? Here's a few:

Balsamic vinaigrette
Many commercially-prepared balsamic vinaigrettes, especially the "light" varieties, have 3 or more grams carbohydrates per tablespoon. Generous use of a sugar-added vinaigrette can therefore provide 12+ grams carbs. (Some, like Emeril's and Wish Bone, also contain high-fructose corn syrup.)

Hamburgers
I learned this lesson the hard way by taking my blood sugar after having a hamburger, turkey burger, or vegetarian burger (without bun): blood sugar would go way up. The effect is due to bread crumbs added to the meat or soy.

Tomato soup
If it were just tomatoes, it would still be somewhat high in sugars. But commercially-prepared tomato soup often contains added high-fructose corn syrup, sucrose, and wheat flour, bringing sugar totals to 12 to 20+ grams per half-cup. A typical 2-cup bowl of tomato soup can have upwards of 80 grams of sugar.

Granola
Sure, granola contains a lot of fiber. But most granolas come packed with sugars in various forms. One cup of Kellogg's Low-fat Granola with Raisins contains an incredible 72 grams (net) carbohydrates, of which 25 grams are sugar.


Given modern appetites and serving sizes, you can see that it is very easy to get carried away and, before you know it, get exposed to extraordinary amounts of sugar and carbohydrates eating foods you thought were healthy.

And don't be fooled by claims of "natural" sugar. Sugar is sugar--Just check your blood sugar and you'll see. So raw cane sugar, beet sugar, and brown sugar have the same impact as white table sugar. Honey, maple syrup, and agave? They're worse (due to fructose).

Comments (13) -

  • Benpercent

    3/1/2010 10:04:29 PM |

    Regarding the hamburgers: Was the blood sugar increase due to some sort of recipe used or did you purchase the ground beef not knowing bread was added to it? A strange place to find it I'd say! I'll probably switch to grinding my own now.

  • Steve Cooksey

    3/1/2010 10:32:17 PM |

    Doctor Davis... YOU ROCK!!

    I'm a T1.5... who lost 78lbs, I have normal blood sugar ...for non-diabetics.

    NO meds, NO insulin... Keep Spreading the word... to ALL.

    Love your blog ...

    Steve

  • Anna

    3/2/2010 12:10:43 AM |

    I can pretty much count on higher BG readings when I eat at group meal gatherings away from home, unless I bring and eat only my own food.  I don't normally eat much processed convenience food, so I forget that boxed heat & serve breakfast sausage links can be full of sugar.  I also now know to steer clear of table grapes and fruit trays (I used to make sure to have fruit with the bacon or sausage and eggs for breakfast to deflect the comments from others, but now I don't bother with the fruit  because it's always too high-sugar.  

    At restaurants I ask for dressing on the side if I use dressing at all.  I dip my fork in the dressing before spearing a bite - that provides enough flavor without all the dressing.  Most of the time I avoid the dressings because they are made with soybean or canola oil anyway.  I ask for Olive Oil and Vinegar - not vinaigrette, which is often sweetened.  

    At home I always make salad dressing or simply toss with EVOO and a good vinegar, freshly ground SS & BP.  It's been years since I bought salad dressing.  Homemade is a breeze to make (even Ranch style) and economical, too.

    Frozen yogurt is far worse than full fat high quality ice cream.  Frozen yogurt almost always has more sugar and no fat or eggs to slow the absorption of the sugar.  Homemade ice cream is the best because you can control the sweetness level and use more cream and egg yolks (commercial is too sweet-tasting for me anymore, BG notwithstanding).  

    OJ - like a glass of pure sugar - absorbs into the blood stream nearly instantly.  I have a valencia orange tree in my garden but I don't dare drink the juice straight.  I put a tiny splash of freshly squeezed OJ or drop a squeezed orange wedge in a tall glass of Gerolsteiner sparkling mineral water (good source of magnesium).

    BBQ sauce & catsup - loaded with sugars - watch out for honey mustard sauce, too.

  • Anonymous

    3/2/2010 12:48:34 AM |

    Here is a link to a recent study that says vitamin D has no real link to heart health. Perhaps you can comment on this.

    http://www.reuters.com/article/idUSTRE6205AQ20100301

    Michael

  • zach

    3/2/2010 1:23:16 AM |

    I looked at the back of my vinegar and it has 5 grams of carbs per tablespoon, 2 of which are sugars. But the only ingredients listed are red wine vinegar and grape musts.

  • David

    3/2/2010 4:24:59 AM |

    Michael,

    That article isn't talking about a new study per se, but rather a review of several select studies. In other words, it's not really providing any new information. It's a (biased) interpretation of a sampling of the existing data.

    I found this quote from the article to be pretty funny:

    "Now, if there are specific instances of vitamin D or calcium deficiency, then that's a separate issue that should be discussed with a personal physician."

    Uh, except it's hardly a separate issue since nearly everyone is deficient in vitamin D.

    David

  • Anonymous

    3/2/2010 9:03:07 AM |

    grape musts? That should have given you a clue. Grapes are very high in sugar. It always comes down to the same thing: Always read the labels. Carefully. Never trust anything that is processed. Not even if you buy it in Health Food shops.

  • Peter

    3/2/2010 1:17:18 PM |

    You don't need to test your blood sugar.  You can figure whatever your favorite carbs are, those are the ones that are spiking your blood sugar the most.  

    Mostly this is because you ingest those in greater quantities since you like them, but partly because you choose those because the blood sugar rushes feel good.

  • David

    3/2/2010 4:50:50 PM |

    "You don't need to test your blood sugar. You can figure whatever your favorite carbs are, those are the ones that are spiking your blood sugar the most."

    No. This is not a reliable way to go about things, as it isn't always true. It's never good to simply trust your feelings. Being objective with a glucometer isn't difficult or expensive. There's nothing to lose.

  • caphuff

    3/2/2010 5:46:18 PM |

    re hamburgers, also watch out for worcestershire sauce! Just discovered (much to my dismay) that the brand I had been using contains molasses and high fructose corn syrup. Yech!

  • Nigel Kinbrum

    3/3/2010 10:23:18 AM |

    Michael said...
    "Here is a link to a recent study that says vitamin D has no real link to heart health. Perhaps you can comment on this.
    Calcium, vitamin D pills don't help heart: study"
    The RDA for Vitamin D is set for bone health. Therefore, an RDA dose of Vitamin D makes no difference to anything except bone health. It takes a dose about ten times the RDA to be effective elsewhere.

    If you give people one tenth the correct dose of a medication, would you be surprised that the medication is ineffective?

    Nige.

  • Kathy

    3/3/2010 11:13:22 AM |

    so easy to make homemade tomato soup, still a little high in carb's but nowhere near store boguht, handy if you absolutely must have a bowl of tomato soup.  Use tomato paste, water and some heavy cream and salt to taste.  you don't need the cream, but it tastes better.  One of the fastest "homemade' soups.  Keep in mind that tomatoes do have carbs, about 4 per 2 tbsp of paste.  You can add splenda to sweeten a little

  • renegadediabetic

    3/4/2010 2:26:14 PM |

    It's infuriating that sugar and starch show up in places you would least expect them.  You have to read labels very carefully.  I've been burned by failing to read labels.  Even better, eat real food prepared from scratch.

Loading
The case builds against wheat

The case builds against wheat

Looking back over the past few posts I've made about the adverse health effects of wheat, I was surprised to see just how many people have posted descriptions of their dramatic experiences following this route.

While I've seen it in real life many times, it always helps to have corroboration from others. Here is what a number of Heart Scan Blog readers and commenters have said:



Barbara W said:

It's true! We've done it. My husband and I stopped eating all grains and sugar in February. At this point, we really don't miss them any more. It was a huge change, but it's worth the effort. I've lost over 20 pounds (10 to go)and my husband has lost 45 pounds (20 to go). On top of it, our body shapes have changed drastically. It is really amazing. I've got my waist back (and a whole wardrobe of clothes) - I'm thrilled.

I'm also very happy to be eating foods that I always loved like eggs, avocados, and meats - without feeling guilty that they're not good for me.

With the extremely hot weather this week in our area, we thought we'd "treat" ourselves to small ice cream cones. To our surprise, it wasn't that much of a treat. Didn't even taste as good as we'd anticipated. I know I would have been much more satisfied with a snack of smoked salmon with fresh dill, capers, chopped onion and drizzled with lemon juice.

Aside from weight changes, we both feel so much better in general - feel much more alert and move around with much greater flexibility, sleep well, never have any indigestion. We're really enjoying this. It's like feeling younger.

It's not a diet for us. This will be the way we eat from now on. Actually, we think our food has become more interesting and varied since giving up all the "white stuff". I guess we felt compelled to get a little more creative.

Eating out (or at other peoples' places) has probably been the hardest part of this adjustment. But now we're getting pretty comfortable saying what we won't eat. I'm starting to enjoy the reactions it produces.



Weight loss, increased energy, less abdominal bloating, better sleep--I've seen it many times, as well.


Dotslady said:

I was a victim of the '80s lowfat diet craze - doc told me I was obese, gave me the Standard American Diet and said to watch my fat (I'm not a big meat eater, didn't like mayo ... couldn't figure out where my fat was coming from! maybe the fries - I will admit I liked fries). I looked to the USDA food pyramid and to increase my fiber for the constipation I was experiencing. Bread with 3 grams of fiber wasn't good enough; I turned to Kashi cereals for 11 years. My constipation turned to steattorrhea and a celiac disease diagnosis! *No gut pains!* My PCP sent me to the gastroenterologist for a colonscopy because my ferritin was a 5 (20 is low range). Good thing I googled around and asked him to do an endoscopy or I'd be a zombie by now.

My symptoms were depression & anxiety, eczema, GERD, hypothyroidism, mild dizziness, tripping, Alzheimer's-like memory problems, insomnia, heart palpitations, fibromyalgia, worsening eyesight, mild cardiomyopathy, to name a few.

After six months gluten-free, I asked my gastroenterologist about feeling full early ... he said he didn't know what I was talking about! *shrug*

But *I* knew -- it was the gluten/starches! My satiety level has totally changed, and for the first time in my life I feel NORMAL!


Feeling satisfied with less is a prominent effect in my experience, too. You need to eat less, you're driven to snack less, less likely to give in to those evil little bedtime or middle-of-the-night impulses that make you feel ashamed and guilty.



An anonymous (female) commenter said:

My life changed when I cut not only all wheat, but all grains from my diet.

For the first time in my life, I was no longer hungry -no hunger pangs between meals; no overwhelming desire to snack. Now I eat at mealtimes without even thinking about food in between.

I've dropped 70 pounds, effortlessly, come off high blood pressure meds and control my blood sugar without medication.

I don't know whether it was just the elimination of grain, especially wheat, or whether it was a combination of grain elimnation along with a number of other changes, but I do know that mere reduction of grain consumption still left me hungry. It wasn't until I elimnated it that the overwhelming redution in appetite kicked in.

As a former wheat-addicted vegetarian, who thought she was eating healthily according to all the expert advice out there at the time, I can only shake my head at how mistaken I was.


That may be a record for me: 70 lbs!!


Stan said:

It's worth it and you won't look back!

Many things will improve, not just weight reduction: you will think clearer, your reflexes will improve, your breathing rate will go down, your blood pressure will normalize. You will never or rarely have a fever or viral infections like cold or flu. You will become more resistant to cold temperature and you will rarely feel tired, ever!



Ortcloud said:

Whenever I go out to breakfast I look around and I am in shock at what people eat for breakfast. Big stack of pancakes, fruit, fruit juice syrup, just like you said. This is not breakfast, this is dessert ! It has the same sugar and nutrition as a birthday cake, would anyone think cake is ok for breakfast ? No, but that is exactly the equivalent of what they are eating. Somehow we have been duped to think this is ok. For me, I typically eat an omelette when I go out, low carb and no sugar. I dont eat wheat but invariably it comes with the meal and I try to tell the waitress no thanks, they are stunned. They try to push some other type of wheat or sugar product on me instead, finally I have to tell them I dont eat wheat and they are doubly stunned. They cant comprehend it. We have a long way to go in terms of re-education.

Yes. Don't be surprised at the incomprehension, the rolled eyes, even the anger that can sometimes result. Imagine that told you that the food you've come to rely on and love is killing you!


Anne said:

I was overweight by only about 15lbs and I was having pitting edema in my legs and shortness of breath. My cardiologist and I were discussing the possible need of an angiogram. I was three years out from heart bypass surgery.

Before we could schedule the procedure, I tested positive for gluten sensitivity through www.enterolab.com. I eliminated not only wheat but also barley and rye and oats(very contaminated with wheat) from my diet. Within a few weeks my edema was gone, my energy was up and I was no longer short of breath. I lost about 10 lbs. The main reason I gave up gluten was to see if I could stop the progression of my peripheral neuropathy. Getting off wheat and other gluten grains has given me back my life. I have been gluten free for 4 years and feel younger than I have in many years.

There are many gluten free processed foods, but I have found I feel my best when I stick with whole foods.



Ann has a different reason (gluten enteropathy, or celiac disease) for wanting to be wheat-free. But I've seen similar improvements that go beyond just relief of the symptoms attributable to the inflammatory intestinal effects of gluten elimination.



Wccaguy said:

I have relatively successfully cut carbs and grains from my diet thus far.

Because I've got some weight to lose, I have tried to keep the carb count low and I've lost 15 pounds since then.

I have also been very surprised at the significant reduction in my appetite. I've read about the experience of others with regard to appetite reduction and couldn't really imagine that it could happen for me too. But it has.

A few weeks ago, I attended a party catered by one of my favorite italian restaurants and got myself offtrack for two days. Then it took me a couple of days to get back on track because my appetite returned.

Check out Jimmy Moore's website for lots of ideas about variations of foods to try. The latest thing I picked up from Jimmy is the good old-fashioned hard boiled egg. Two or three eggs with some spicy hot sauce for breakfast and a handful of almonds mid-morning plus a couple glasses of water and I'm good for the morning no problem.

I find myself thinking about lunch not because I'm really hungry but out of habit.

The cool thing too now is that the more I do this, the more I'm just not tempted much to do anything but this diet.



Going wheat-free, along with a reduction in processed sugary foods like Hawaiian Punch, sodas, and candy, is the straightest, most direct path I know of to lose weight, obtain all the health benefits listed by our commenters, as well as achieve the lipoprotein corrections we seek, like reduction of small LDL particles and rise in HDL, in the Track Your Plaque program.

Comments (21) -

  • Anonymous

    10/29/2007 12:27:00 PM |

    Is the problem wheat in and of itself?  or is it with the food processing that goes into almost everything nowadays.  I wonder if people would be having the same problems if they ate a steady diet of Grandma's homemade bread instead of stuff off the supermarket shelf.

  • Dr. Davis

    10/29/2007 12:41:00 PM |

    Good point. In general, unprocessed is far better than processed. However, with wheat flour foods, I'm finding no difference. Both create weight gain, fatigue, increased blood sugar, small LDL etc.

  • Anonymous

    10/29/2007 1:26:00 PM |

    I am wondering which is better to use butter vs. a non-hydrogenated "smart balance" type of margarine. Can you address this? I am on a statin and trying to reduce my weight and raise my HDL while normalizing my other numbers.I would like to get off this statin (lovastatin - generic I think)Thanks! Greg

    PS- I use olive oil too and for awhile I was taking my local orgainic butter and mixing it half and half with organic olive oil for my own "blend" what do you think? That can also be done with organic canola oil for those who think olive oil is too strong of a tast.
    Thanks again!

  • Anonymous

    10/29/2007 3:42:00 PM |

    I wonder also if problems relate somewhat to modern forms of wheat, which has been adapted over the years for high yields, pest tolerance, etc. We have a daughter with celiac disease, and I read an article that maintained that the peptide chain implicated is not present in ancient forms of the grain, so they would be ok for celiacs. As far as processing goes, the article also suggested that the more time-consuming methods of making bread, like for sourdough, yield healthier bread. In short, it's what the modern world has done to wheat, not just wheat itself.

  • Anonymous

    10/29/2007 3:55:00 PM |

    Here's the article I mentioned in my last comment:

    http://www.westonaprice.org/moderndiseases/gluten-intolerance.html

  • Paul Anderson

    10/29/2007 5:55:00 PM |

    I can certainly concur with the comments made here.

    After a brief flirtation with wheat reduction i eliminated all grains from my diet and, almost effortlessly lost about 28lbs.  I also experienced an almost total elimination of bloating, tiredness and my bowell habits improved.

    I do wonder if going one step further and eliminating any food that casues cravings might also be a good idea.  For me that seems to be the case with cheese and milk products, chocolate and cashew nuts (possibly containing lactose in the flavouring).  Its seems to be one of life's ironies that we crave foods for which we seem to have an intolerance.

    Thanks for a generally excellent blog.

  • Dr. Davis

    10/29/2007 6:42:00 PM |

    Interesting thought!

  • Dr. Davis

    10/29/2007 8:03:00 PM |

    I believe those are very reasonable alternatives to butter. However, the real effect on LDL may depend on the size distribution of your LDL particles. Small, for instance, responds to carbohydrate restriction, not so much to saturated fat restriction.

  • Anonymous

    10/29/2007 8:20:00 PM |

    Thanks for the butter response. I do have borderline small LDL. I had the test done last year at my suggestion after reading the South Beach Diet Heart Program. My physician knew nothing about it and of course said insurance would not pay.I had the test anyway.
    The whole saturated fat/cholesterol in food theories are confusing; science seems to be changing on these long standing beliefs but it sure keeps me confused.
    By the way - do you think the sprouted grain breads are better if one is to eat wheat? Does sprouted wheat behave diffently in the body and have a different effect on particle size of the LDL?
    Thanks- Greg

  • Dr. Davis

    10/29/2007 9:09:00 PM |

    Yes, the Ezekiel bread has a glycemic index of 35, fairly low, and seems to be a better choice than conventional breads.

  • Anonymous

    10/30/2007 1:28:00 AM |

    I've ran accross another interesting effect of wheat. Dr. Loren Cordain, of Colorado State University has found that wheat contains a protein that diminishes vitamin D synthesis in the skin. Here's a link with the info.......
    http://mylonglife.com/blog/index.php/2006/05/16/wheat_made_whites_whiter

  • Dr. Davis

    10/30/2007 1:37:00 AM |

    VERY interesting!

    Loren Cordain has truly been in the forefront of this argument.

  • Bix

    10/31/2007 12:26:00 PM |

    anonymous, Doesn't heat denature lectins ... such as wheat germ agglutinin?  I'm wondering if there are other processes that inactivate these substances, such as fermentation?

  • Anonymous

    11/1/2007 1:08:00 AM |

    Is a diet plan available today that suggests options for a whole wheat/grain free diet?

    As I read Barbara W's comment, I wondered - what does she eat for breakfast? I have stopped eating cereal, and been eating oats instead. It's been working out for me. I have been able to lose 27 lbs and have another 20 lbs to go. But I do get hunger pangs every now and  then, and go offtrack. As Barbara says, eating out has been the biggest challenge.

    I want to give the complete wheat/grain free diet a shot. Can you provide some recommendations on where I can refer for food options for breakfast, lunch and dinner? thanks.

  • Dr. Davis

    11/1/2007 2:40:00 AM |

    Protein and fat rich foods like raw nuts, traditional fermented cheeses, and more liberal use of healthy oils like olive can provide feelings of prolonged satiety. Also, the Paleo Diet and South Beach diets both provide plenty of advice in this nutritional vein.

    Also, watch for our new Track Your Plaque diet due to be out sometime this fall on the www.trackyourplaque.com website.

  • TedHutchinson

    11/1/2007 10:37:00 PM |

    Readers here may be interested to listen to the presentation Loren Cordain gives entitled "Potential Therapeutic Characteristics of Pre-agricultural Diets in the Prevention and Treatment of Multiple Sclerosis"
    http://wildhorse.insinc.com/directms03oct2007
    While the talk is aimed at the MS audience it is interesting to understand the way diet may create autoimmune conditions.
    Some, like the members of the audience may find the science a little difficult, if you click on the slides you can just watch the slides and listen to the talk without the distraction of audience activity.

  • Anonymous

    11/3/2007 1:48:00 PM |

    Dr Atkins
    www.atkinsdietbulletinboaaord.com
    offers tons of great low carb recipes as does Dr Bernstein's Diabetic Sol'n board.

    Looking forward to your new TYP diet, assuming sat fat won't be as much the enemy???SmileSmileSmile

  • Dr. Davis

    11/3/2007 7:10:00 PM |

    I'm really struggling with the saturated fat issue. I'm having trouble reconciling the "sat'd fat ain't so bad" argument, as skillfully articulated by Gary Taubes and Robert Atkins, with what I see in real life--ill-effects such as substantial hypertensive effects and pro-inflammatory effects.

    Among the difficulties with saturated fat-rich diets, of course, is that they do not occur in isolation. Sat'd fat foods like sausage come along with wheat toast, syrup on pancakes, etc., a smorgasbord of food ingredients.

    Nonethless, I'm going back to some of the old literature again and re-read.

  • gc

    11/3/2007 11:57:00 PM |

    However, sat fats for those reformed low carbers comes along with sausage, eggs, tomatoe and cuc slices......not pancakes.


    .......cup of java with bit of real cream, not skim milk that zooms your bg and cravings.


    My long term doc of 21 yrs asked me to run a group for her overweight diabetic patients and asked me why now could I do this when for the last 20 yr she put me on all these diets and sent me to not these weight loss programs and I couldnt do it then.....

    why now...

    ( low low cal, low low fat, celery, apples, skim milk, grains grains grains, I was starved)

    she asked.

    I said:cause I had fats in my life and didn't get hungry. I cannot lose weight when I am hungry, when I don't have fats I am starved, most diabetics are starved as their bg are bouncing up and down all the time, low bg makes you want to eat a house and hi bg makes you want to  at a house.

    .....having some fats makes you feel satiated and then you don't obsesses about food when you are not hungry.

    Yet initially on Atkins I was eating 2000 cal a day and lost a ton of weight in a few months.

    ...not being hungry means you dont eat pancakes, and all that sugar as you know it will make you crave whereas at brekkie if you still feel hungry you can add an extra sausage, or extra egg and know you don't need to eat again for 5 hr or so as it holds you for the day, your bg don't move or move only a small amt.

    Eventually you chol all comes down eating some sat fats and lots of good fats, so does it contribute that much to inflammation as does the hi carbs???

    Dr A didn't promote sausage and bacon, in fact, he said not allot as it had nitrates,stay away from chemicals and eat whole foods.

    Wish I was more scientific, I can only go by all the tons of material I read and how I feel and what my lab tests reflect.

    I have had some of the tests you recommend but not all the advanced lipo protein.

  • Anonymous

    11/8/2007 7:26:00 PM |

    Dr. Davis, I am a wheataholic.  But if I think back over the course of my life, there have been times in which my wheataholism has been in "remission." The remisions all occured on trips to the coast of Spain/Gibraltar, Haiti, Tucson (AZ), and Gulfport (MS). At the time, I certainly didn't realize what was happening, but after reflection, I can see something out of the ordinary occurred. In each location, I was with a group, so I had to eat what they ate (wheat products) while we all worked or hiked outside. During those times, I cannot remember one time after eating a wheat product did I have cravings, much less uncontrollable cravings. I thought the sun had something to do with it and that it must be the stimulation of Vit. D production in my skin. But then I had to rule that out because upon my return from these areas (and back to office work in Washington DC) I had to curtail my starches because of the resurgance of cravings. Now I have come to believe that the strengh of the sun's light boosted my seratonin levels creating the ability to view food, including wheat and other starches, in a reasonable manner. I know this topic has now past, but if you have any comments on this, it truly would be welcomed.

  • http://www.art-gallery-newzealand.com

    12/31/2008 1:07:00 PM |

    Even though the case against wheat and specifically gluten is so cut and dry, why is it that people have to jump so many hoops to be diagnosed as celiac and there is no real recognition that having gluten antibodies in your bloodstream might be bad - but instead have to rely on TTG tests that only pick up about 80% of celiacs and not gluten sensitvity at all?  
    (I'm really struggling with this lassaiz faire attitude to something that is so toxic to so many people and BTW  thanks for blogging this. Wheat/gluten kills. And it's so insidious, it's in everything, and that can make it difficult for people to avoid it enough to get improved health effects.)

Loading