How old are you?

George walks into my office. I ask him his age.

"I'm 21 years old," he declares.

Yet I look at George. He's got gray thinning hair, his posture is slumped forward rather than erect, the flesh on his upper arms hangs loosely, he's got wrinkles on his hands and face, brown spots on the back of his hands and arms. He looks more like 70 years old to me. "I don't think you're 21 years old. I think you're 70."

"Prove it," he says.

Okay. What now? Minus any formal identification like a driver's license, how do I prove that George is really 70-something and not 20-something? Not an easy thing, when you think about it. If George were a tree, I'd cut him down and count his rings. Is there such a phenomenon in humans?

This is actually a fascinating area of research, looking for reliable biomarkers of aging.

Among the most quantitative markers of aging is telomere length. Telomeres were once dismissed as nonsense sequences in DNA. However, more recent thought among geneticists is that telomeres shorten with aging and provide the body's cells a timeline of aging. This way, George's cells act like they are 70, not 13, and don't start producing gobs of growth hormone and testosterone in preparation for puberty.

What can slow or stall the shortening of telomere length? There are two I'm aware of:

1) Caloric deprivation--i.e., taking in fewer calories. This was among the theories explored by Dr. Roy Walford during his Biosphere2 experience, based on his work in mice that showed that caloric deprivation nearly doubled lifespan.

2) Vitamin D--Richards et al (2007) found that, the higher the vitamin D, the longer the telomere length. The highest vitamin D levels conferred a 5-year effective difference in telomere length.

So, if I could look inside George's cells and count his telomeres, I could judge with confidence whether he was 21 or 70. Or, he could take vitamin D sufficient to increase blood levels to a healthy range and be more like 65.

Comments (21) -

  • Ellen

    10/17/2009 11:20:26 AM |

    "gobs"


    Hahaha... I can so tell you are from Milwaukee. That is such a Wisconsin expression.  Laughing

  • LeonRover

    10/17/2009 9:44:35 PM |

    Another take on the Greek philosophical question: what is time? Even tho' they could count days and years, their answer was: "time is the measure of change". But perhaps that should be reversed to: "change is the measure of time".

    Doc, it seems to me the burden of proof was on the guy. You simply say: you only left high school three years ago? Gosh, there are no reports that any male has undergone the developmental changes I can see, in such a short time!
    Another point, the number of telomeres at the end of cells has to be calibrated against other measures, such as the sun going round the earth. All any particular individual has to claim is: my telomeres are lost 10 times faster than any one else's, now YOU prove otherwise.

    Y'all have a good day, now.

  • Anonymous

    10/17/2009 11:22:20 PM |

    "If George were a tree, I'd cut him down and count his rings"
    Too funny, Dr Davis.

    George's telomere's....reduced to T-stumps.

    Ellie

  • Telephone Triage

    10/18/2009 7:57:18 AM |

    Lovely blog...it is scary the way we are being attacked by the diseases at very early ages also.

  • Tim

    10/18/2009 9:26:05 AM |

    Al Sears says that high homocystein levels shortens telemores three times faster.

  • Peter

    10/18/2009 2:19:57 PM |

    I take vitamin D and I want to live longer.  I believe it will help because you said so,and I believe everything you say, including when you say you're not sure.

  • Peter

    10/18/2009 2:27:49 PM |

    Regarding "gobs", this is a popular expression in Oregon, too, and I'm not sure how you tell where an expression originated.

  • Dr. B G

    10/18/2009 6:41:26 PM |

    Very cool post, Dr. D!!!

    I've been into telomeres for awhile!!  Mag-deficiency is associated with reduced telomeres in vivo in rats(and reduced glutathione). HERE

    NAC can ameliorate some of the Mag-deficiency oxidative stress in vitro. NAC is the precursor for one of the most potent antioxidants, glutathione. HERE

    Glutathione peroxidases which generate more protective glutathione are selenium-containing enzymes. Selenium was correlated to longer telomeres and lower BP. Selenium.

    Glutathione strongly and positively affects telomere lengthening and telomerase activity. Role of nuclear glutathione as a key regulator of cell proliferation

    Curiously, (?via epigenetics and X-related telomere genetics?) maternal diet can shorten telomeres in rats. Epigenetics: maternal diet shortens aortic telomeres.

    Precursors of glutathione are:
    --NAC (sulfur proteins)
    --undenatured whey protein (sulfur proteins, like glutamine, arginine, taurine)
    --SAMe

    (PO suppl w/ GSH apparently doesn't work well)

    Of course there are many other ways to increase glutathione... Like the TYP program -- flavonoids, fish oil, alpha lipoic acid, MELATONIN, silymarin (WCCA's fave), selenium, magnesium, zinc, etc.

    I believe the omega-6:3 index is one of the best biomarkers for aging, at least until we can count our 'tree rings'! In post-MI rats, n-3 PUFAS increased glutathione and was incredibly protective. HERE

    The traditional 1960s rural Cretans shared the same low CAD rate as Japan with a high fat diet. To me,  the Cretan diet is  associated with high glutathione, selenium, low n-6, high high  n-3 ALA EPA DHA, 41% fat (like TYP Diet 3), intermittent fasting (Greek Orthodox practice), pastured-raised eggs, chicken, goat, mutton, wild seafood/snails, and very fatty sheep/goat yogurt and cheeses (rich in taurine and saturated fatty acids). HERE and HERE. And Simopoulus.

    -G

  • Dr. B G

    10/18/2009 6:41:26 PM |

    Very cool post, Dr. D!!!

    I've been into telomeres for awhile!!  Mag-deficiency is associated with reduced telomeres in vivo in rats(and reduced glutathione). HERE

    NAC can ameliorate some of the Mag-deficiency oxidative stress in vitro. NAC is the precursor for one of the most potent antioxidants, glutathione. HERE

    Glutathione peroxidases which generate more protective glutathione are selenium-containing enzymes. Selenium was correlated to longer telomeres and lower BP. Selenium.

    Glutathione strongly and positively affects telomere lengthening and telomerase activity. Role of nuclear glutathione as a key regulator of cell proliferation

    Curiously, (?via epigenetics and X-related telomere genetics?) maternal diet can shorten telomeres in rats. Epigenetics: maternal diet shortens aortic telomeres.

    Precursors of glutathione are:
    --NAC (sulfur proteins)
    --undenatured whey protein (sulfur proteins, like glutamine, arginine, taurine)
    --SAMe

    (PO suppl w/ GSH apparently doesn't work well)

    Of course there are many other ways to increase glutathione... Like the TYP program -- flavonoids, fish oil, alpha lipoic acid, MELATONIN, silymarin (WCCA's fave), selenium, magnesium, zinc, etc.

    I believe the omega-6:3 index is one of the best biomarkers for aging, at least until we can count our 'tree rings'! In post-MI rats, n-3 PUFAS increased glutathione and was incredibly protective. HERE

    The traditional 1960s rural Cretans shared the same low CAD rate as Japan with a high fat diet. To me,  the Cretan diet is  associated with high glutathione, selenium, low n-6, high high  n-3 ALA EPA DHA, 41% fat (like TYP Diet 3), intermittent fasting (Greek Orthodox practice), pastured-raised eggs, chicken, goat, mutton, wild seafood/snails, and very fatty sheep/goat yogurt and cheeses (rich in taurine and saturated fatty acids). HERE and HERE. And Simopoulus.

    -G

  • Matthew

    10/19/2009 12:54:33 AM |

    Dr. Davis,

    Have you heard about ELC (earlobe crease) as a possible key sign of aging? It seems that tons of studies show a very strong positive connection between younger people with an earlobe crease and CVD. What do you think?

  • David Throop

    10/19/2009 3:07:30 PM |

    Doc Davis,

    Last week, the U.S. Preventive Services Task Force came out with a review and with recommendations about using emerging risk factors for predicting and managing heart disease.  I think there's a lot in there that you'll agree with.  But they were negative about calcium scoring.

    Sandy Swarz, whose scholarship is pretty sharp, gives a summary.

    I'd really like to see your response to all this.

  • Michelle

    10/19/2009 7:54:03 PM |

    It is scary how many young people are getting elderly diseases. I know someone who died of a massive MI at the age of 26. I am also proof of that. I have CAD, hypothyriodism, Low Vitamin D, Low B12, gastritis, and valve disease and I am only 35. I am looking forward to being able to reverse some of these diseases naturally.

    Michelle

  • Dr. William Davis

    10/19/2009 9:58:42 PM |

    Hi, Matthew--

    I believe there's some evidence that ear lobe creases are associated with increased coronary risk, but I don't know of any data relating them in younger people specifically.

    I have one myself, and it's been there for as long as I can remember and does indeed correlate with my family's aggressive heart disease pattern.

  • Dr. William Davis

    10/19/2009 10:00:02 PM |

    Hi, G--

    As always, you are full of unique observations.


    Hi, Ellen--

    Perhaps I should have said "oodles."

  • rezzrovv

    10/20/2009 4:21:27 PM |

    Dr. Davis,

    See David Throop's comment above.  I actually came looking to see if you might have commented on this yet.  Curious your take.

    Scott Pierce

  • Anonymous

    10/22/2009 5:19:03 AM |

    Hi Dr. Davis,

    Have you observed a correlation between earlobe creases and coronary calcification among your patients?

    Thanks,

    David

  • Stan (Heretic)

    10/24/2009 5:06:47 PM |

    Hi Dr. B G,

    Interesting.  Magnesium deficiency vs telomeres length could also be explained as a secondary effect caused by the excessive metabolism of carbohydrates as the primary factor.  High magnesium intake is required for glucose metabolism, see for example Implications of oxidative stress in high sucrose low magnesium diet fed rats

    Similar situation may exist with glutathione, high glutatione may be a secondary marker for a diet high in dairy and (thus automatically) lower in carbohydrates.  This paper you linked Maternal diet influences DNA damage, aortic telomere length, oxidative stress, and antioxidant defense capacity in rats seems to be pointing to a high carb diet as one of the factors that may cause accelerated growth of low birth weight babies (the paper discusses human studies as well), which then is correlated with higher CVD risk, shorter telomeres and worsens other markers (bones abnormality etc).

       In contrast to this, high fat low carb nutrition seems to slow down babies and infants growth and slows the onset of puberty, which according to the logic presented by the papers discussed above, ought to reduce oxidative stress, slow down the shortnening of telomeres and reduce the CVD risk later in life.
    Regards,
    Stan

  • Dr. B G

    10/26/2009 4:44:49 PM |

    Hi Stan,

    Yes -- there are many implications to such data and other epi-genetic data. Low protein maternal  diets increase Met Syn for 2 generations in rat pups.

    Low Sat Fat maternal diets?  High carb, low protein, allergenic wheat maternal diets?  I believe we are epi-genetically affecting many future generations and their metabolism, growth hormone, thyroid hormone, leptin/ adiponectin and perhaps even vitamin D hormone pathways... This may explain why right now CAD and diabetes is rampant compared to just 1-2 generations ago. I have 80-90s year old patients how are 20x more healthier than my 30-40 year olds! Have we genetically predisposed ourselves to the 'over summer' mode that Dr. T at Nephropal has talked about by our mother's diets and her lack of sunlight, rich fatty foods, omega-3, and excess omega-6 in utero??

    I believe so.

    -G

  • Dr. B G

    10/26/2009 4:44:49 PM |

    Hi Stan,

    Yes -- there are many implications to such data and other epi-genetic data. Low protein maternal  diets increase Met Syn for 2 generations in rat pups.

    Low Sat Fat maternal diets?  High carb, low protein, allergenic wheat maternal diets?  I believe we are epi-genetically affecting many future generations and their metabolism, growth hormone, thyroid hormone, leptin/ adiponectin and perhaps even vitamin D hormone pathways... This may explain why right now CAD and diabetes is rampant compared to just 1-2 generations ago. I have 80-90s year old patients how are 20x more healthier than my 30-40 year olds! Have we genetically predisposed ourselves to the 'over summer' mode that Dr. T at Nephropal has talked about by our mother's diets and her lack of sunlight, rich fatty foods, omega-3, and excess omega-6 in utero??

    I believe so.

    -G

  • buy jeans

    11/3/2010 2:24:30 PM |

    However, more recent thought among geneticists is that telomeres shorten with aging and provide the body's cells a timeline of aging. This way, George's cells act like they are 70, not 13, and don't start producing gobs of growth hormone and testosterone in preparation for puberty.

Loading
What vitamin D form?

What vitamin D form?

In response to questions regarding why don't vitamin D tablets work, here are my observations.

When I first started correcting vitamin D levels around 3 1/2 years ago, people would begin with starting 25-hydroxy vitamin D blood levels of around 20 ng/ml.

Taking, say, 6000 units vitamin D as tablets over 3 months yielded blood levels of 24-30 ng/ml. Taking 6000 units in an oil-based form, and blood levels would commonly be 60-70 ng/ml.

In other words, tablets are very poorly absorbed. I also saw very erratic absorption with tablets, with tremendous variation in blood levels.

I witnessed this effect many times. I finally began telling patients to avoid the tablets altogether. It's simply not worth it. Taking dose X of tablets, you cannot predict what the blood level of vitamin D will be.

Now, you can sometimes make the tablets get absorbed by either taking with a teaspoon of oil (e.g., olive, flaxseed) or taking with an oil-rich meal. However, I am uncertain just how consistent the absorption is under these circumstances, not having done this enough times to know.

Oil-filled gelcaps are no more expensive than tablets (or perhaps a dollar more). Health food store employees and pharmacists don't know this. I have had many patients come to the office claiming they changed to tablets because that's all their health food store or pharmacy carried and the person behind the counter assured them it was the same. Blood level of vitamin D to confirm: right back down to the starting level or near it--little or no absorption.

The only way to know whether a preparation is absorbed is to check a blood level. But, in my experience, having checked vitamin D blood levels thousands of times, gelcaps never fail; tablets fail over 80% of the time.

Comments (36) -

  • TedHutchinson

    2/16/2009 9:13:00 AM |

    Effective strength D3 is not available over the counter in the UK. UK readers have to buy from the USA.
    http://tinyurl.com/8znjue
    Iherb do Now foods 5000iu D3 in olive oil capsules very cheap.
    Orders £18 or over are not only subject to Customs duty but our Post Office charges £8 extra to collect the tax.
    Using Iherb $5 discount code such as WAB666 reduces the price of 360 to under the tax threshold. Leaving the daily cost including P&P to 5.25p daily

  • TedHutchinson

    2/16/2009 12:01:00 PM |

    http://tinyurl.com/ch5262
    May I also draw readers attention to this half hour video from Cedric Garland about Vitamin D status and cancer incidence and progression.
    You will note Garland suggests 60ng 150nmol/l for lowest cancer incidence.

  • fritz

    2/16/2009 1:48:00 PM |

    Is the vitamin D from cod liver oil effective?

  • Anonymous

    2/16/2009 2:10:00 PM |

    Slightly off topic, but I just read that congress is going to vote on a bill to cut medicare coverage of vitamin D levels, so now we will have to rely on private insurance, or simply pay ourselves.

    Jeanne shepard

    By the way, I prefer not to be "anonymous" but the Google Blogger doesn't remember my password, and won't let me select a new one.

  • Anne

    2/17/2009 3:28:00 AM |

    Some of the vitamin D experts warn against using cod liver oil. http://www.vitamindcouncil.org/newsletter/2008-december.shtml

    One concern is too much vitamin A if you took enough of the cod liver oil to get the D you need. Another is that vitamin A and D compete with each other.

  • TedHutchinson

    2/17/2009 10:18:00 AM |

    fritz
    Read what Dr Cannell says about Cod liver oil here
    http://tinyurl.com/dh9b6k

    A typical 5ml tsp of CLO contains roughly 400iu. Most people require on average 5000iu/daily so the amount from CLO is insufficient.

    Jeanne
    Twice yearly $30, 25(OH)D blood spot tests, available by post from this source
    www.grassrootshealth.org/daction/index.php

  • Rick

    2/17/2009 10:49:00 AM |

    iHerb.com also has Country Life Vitamin D3 2500 IU (200 softgels).

    Thanks for answering the questions about tablets so quickly, by the way.

  • Tom

    2/17/2009 11:38:00 AM |

    For the benefit of UK readers, I'd like to second TedHutchinson's informative comment. I use the same product from the same supplier Smile

    It's worth noting that postage and packing cost from the US does not contribute to the value of the order for the purposes of taxes and extortionate 'fees'.

  • Matthew

    2/17/2009 1:08:00 PM |

    I don't understand why taking a vitamin D3 capsule will not raise level of 25(OH)D when consuming it with fat or meal containing fat. Should get the same results...

  • Anonymous

    2/17/2009 5:43:00 PM |

    First, let me say that I really love your blog.  I learn so much every time I come here.

    I do have a question for you.  What do you make of this site:

    http://bacteriality.com/2007/09/15/vitamind/

    On the surface, she appears to be a competent scientist, but she blames everything (and I do mean everything from macular degeneration to brain lesions) on too much Vitamin D and claims that the road to universal health should begin with driving one's Vitaman D levels to below 20 ng/mL.  A friend of mine just sent this to me in a panic.  Please let us know what you think.

    Thanks so much!
    Isabella

  • Steve L.

    2/17/2009 7:39:00 PM |

    The Costco effect.  I had been wondering why so many people use the tablet form.  Just noticed yesterday that tablet is the form of Vitamin D that Costco carries.

  • Diana Hsieh

    2/17/2009 8:54:00 PM |

    All of the vitamin D capsules that I checked in Whole Foods yesterday were composed of some kind of frankenfood oil in them, most notably soybean oil.  Can anyone recommend any brands that use something better?  

    (I have the same problem with my vitamin E complex, but I'm not convinced that I should be taking that anyway -- although it does seem to help the inevitable dry skin in winter here in Colorado.)

    BTW, my husband and I got our levels tested thanks to your recommendations.  Mine were excellent (probably thanks to many months of good supplementation), but his need some work (despite some more moderate supplementation).  Thanks for the info!

  • David

    2/18/2009 4:37:00 AM |

    Re: the http://bacteriality.com/2007/09/15/vitamind article...

    Anonymous,

    Dr. Davis wrote about this issue (more or less) last year: http://heartscanblog.blogspot.com/2008/03/marshall-protocol-and-other-fairy-tales.html

    David

  • Michael

    2/18/2009 5:55:00 AM |

    @ Diana Hsieh
    Don't know if this is available where you are (I'm in Australia) but I use this brand of D3 for this very reason. It's in fish oil, of reasonable potency.

    THOMPSON'S Vitamin D (1000mg) with Fish Oil (500mg) - 60 gelatin-free caps

    http://www.thompsons.co.nz/afa.asp?idWebPage=8403&ID=163&SID=663632930&Type=Products

    Product made in New Zealand. Hope this helps.

  • Anna

    2/18/2009 6:40:00 AM |

    Diana,

    Our family likes Carlson Vit D products.  They are definitely absorbable, because the whole family went from the low end fo the reference range to around 70-86 ng/ml in the past few months).

    Mostly we use Solar D Gems in the 2000 or 4000iU capsules.  There is a bit of Norwegian CLO & EPA?DHA in them, and lemon flavor.  They chew up easily, too, but can also be swallowed.

    The non-chewable capsules are much tinier and are made with sunflower oil, but even that is a very tiny amount in this very small capsule.

    The Carlson D drops in the 2000iU/drop dose is made with coconut oil (though it is fractionated, to keep it liquid).  But it's only a drop.

    I find very good prices at www.vitaminshoppe,com, usually for about 2-4 ¢ per each 1000iU (that's how I make price comparisons).  Plus Vitamin Shoppe has a frequent buyer program so purchases earn points toward fairly generous coupons (such as $5 off a $15+ purchase), and shipping is reasonable (sometimes free).  

    Or I buy Carlson Vit D3 at the local store when they are on sale (stores that sell a lot of Carlson product often pass along "mfg discounts" or "special buys").

  • TedHutchinson

    2/18/2009 11:09:00 AM |

    Isabella
    Mark London  MRL@PSFC.MIT.EDU has provided a detailed scientific rebuttal of the Marshall Protocol here
    http://tinyurl.com/cfod57
    Is the MP Treatment for Sarcoidosis Helpful for Other Chronic Diseases?

    MP’s Vitamin D Theories Are Not Supported by Lab Studies.
    Updated July 2, 2008

    Dr Davis has previously addressed this issue in the blog entitled
    The Marshall Protocol and other fairy tales

    Diana Hsieh
    The capsules I suggested are dissolved in olive oil.
    http://tinyurl.com/abbagz
    Carlson 2000iu sunflower oil $12.22
    http://tinyurl.com/abbagz
    Carlson also do Solar Gems in Cod liver oil.
    http://tinyurl.com/bclzom

  • Anonymous

    2/18/2009 1:35:00 PM |

    Diana Hsieh,

    I believe the NOW foods brand D3 formulations are suspended in olive oil.

    Carlson's Vitamin D3, 2,000 IU is suspended in sunflower oil.

    That being said, most of these D3 capsules are quite tiny, so I am not sure that they contain a huge amount of oil, unless you are taking more than 10,000 IU's daily (i.e., 5 capsules).

    As to sources, iHerb is the best and most user friendly, and I won't even give you my $5. discount code, as previous poster did.  You can sign up for your own discount number at the iHerb website.

    Hope that helps!

  • Sam

    2/18/2009 3:30:00 PM |

    Diana,

    I'm currently using Carlson 2000IU gelcaps which contain sunflower oil (omega-6, even if small quantities) and a few other more benign ingredients.

    When these are exhausted I'm switching to Carlson D-drops in which D3 is dissolved into medium chain triglycerides (MCT).

  • Anonymous

    2/18/2009 4:50:00 PM |

    Thanks everyone for the input.  I feel much better now and am off to take my gel-capped Vitamin D3.

    All my best,
    Isabella

  • TedHutchinson

    2/18/2009 9:21:00 PM |

    When researching Carlson Solar Gems earlier I mentioned they contain Cod liver oil but no Vitamin A Content is listed on the Carlson's website.
    So I emailed Carlson's to confirm the vitamin a content. They replied
    total Vitamin A is below 2% of the daily value which is the threshold above which the FDA requires you to list the Vitamin A content.
    As adult RDA for vitamin A is 700~900iu, below 2% of that is below 14~18iu. So there is really is no reason to avoid Solar Gems because of their potential Vitamin A content.

  • Anonymous

    2/19/2009 12:52:00 AM |

    Dr. Davis,

    Appreciate your elaborating the tablets vs. capsules point and thank you for continuing to take the time to write such informative posts!

  • Anonymous

    2/19/2009 7:46:00 PM |

    "Heart disease was once thought to be less of a problem for women than for men. Research now indicates that heart disease is the No. 1 cause of death among women in the US, while confirming that women with an intact uterus have a lower incidence of heart disease because they benefit from the uterine advantage." Visit http://www.truthout.org/021609R for the full article.

  • Anonymous

    2/20/2009 12:01:00 PM |

    Dr. Davis,
    Are gelcaps with dried powdered form of vitamin d3 as effective as oil filled gelcaps?

  • Ricardo

    3/26/2009 12:58:00 AM |

    Dr. Davis, "Americans Low on Vitamin D" - http://www.webmd.com/news/20090325/americans-low-on-vitamin-d

  • Anonymous

    4/22/2009 6:37:00 PM |

    I've had great results from powdered gelcap from D-Max (5000 IU) from Nature's health Supply, but a bit less from NOW olive oil gelcaps (5000 IU). Just a hunch, because I have an autoimmune disease and I'm trying to work out my symptoms. So no 25(OH)D test here.

    I'll try those Carlson's next.

    Great blog by the way!

  • Anna

    4/22/2009 8:49:00 PM |

    I just ordered some D3 to send to my 81 yo MIL and 46 yo SIL in London.  I'm quite sure they are going to very deficient (they just ordered the www.grassrootshealth.net home testing kit as it's a pain to get NHS to agree to test).  

    I found Bio-Tech D3-5 (5000iU cholecalciferol capsules  - powder in a tiny gelatin capsule) offered on Drs. Eades's Protein Power website at a great price, 100 qty for $8.  Shipping via UPS was $6.45 to my location for up to 10 bottles.  That makes the price per 1000iu incredibly low.  I bought a year's supply (8 bottles) to mail to my in-laws, plus two bottles for me.  Note I was very surprised at the small size of the box, but it did contain the 10 bottles I ordered, but the capsules and bottles are small and light, which is nice when ordering so much at once and mailing it again.  Fast delivery, even with UPS ground service.

    I just had another 25 (OH)D test drawn last week; I'll get the results tomorrow at my endo appt for my thyroid.  I was averaging 5000iU/day  supplementation with various Carlson D3 products, based on previous 25 (OH)D test results and supplementation levels.  So I'll switch to the Eades' Bio-Tech formula now and see how my 25 (OH)D is in late summer/early fall.

  • David

    4/22/2009 9:40:00 PM |

    Anna,

    I'd be very interested to hear a follow up from you when you retest after being on the Bio-Tech D3 for awhile. I'm of the mind that D3 in softgel form is more absorbable and hence more efficacious for raising and maintaining 25(OH)D levels, but I see many of the "big guns" (e.g. Cannell, Eades, etc.)promoting/selling the powdered Bio-Tech formula. Perhaps you could report back here with your results?

    David

  • Anna

    4/23/2009 6:27:00 PM |

    Dave,
    Sure.  I'll be retesting  thru my endo in 6 mo.  But I might do a mail-in test via www.grassrootshealth.net before that.  

    I'm guessing a gelatin capsule filled with a powder (might be an oily powder,too) is more absorbable than a hard tablet form.

    Btw, I just got my lab result for 25(oh)d---a nice 68ng/mL (after months of 5000iU D3 carlson oil gelcaps and/or oil drops .  Also was an easier winter than i've had in years, which I think might be due to more sunlight and Vit D.

  • David

    4/23/2009 7:59:00 PM |

    Thanks, Anna. 68 ng/ml-- Good for you! You know, all my life, I've had tough winters. I would always get very sluggish and depressed. I mean I would get really, really down. But ever since I've started the vitamin D, the winter blues are a thing of the past. This alone is probably the most noticeable effect I've ever had from taking any supplement. It's a very dramatic and welcomed change.

  • Herry

    5/27/2009 9:41:31 AM |

    I will read from time to time for that.

    http://allnutri.com/bid970/now+foods.aspx

  • Anonymous

    8/26/2009 6:34:03 PM |

    That means D3 in Calcium tablets like Citrical is probably poorly absorbed  too, am I correct?

  • David

    8/27/2009 10:27:06 PM |

    Yep.

  • Anonymous

    11/11/2009 8:42:39 PM |

    I found this site using [url=http://google.com]google.com[/url] And i want to thank you for your work. You have done really very good site. Great work, great site! Thank you!

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  • Anonymous

    12/13/2009 2:00:04 AM |

    yoo... amazing thread!

  • Anonymous

    5/4/2010 2:15:47 AM |

    GNC has Vit D drops.....do you feel this is good?

  • buy jeans

    11/3/2010 12:30:44 PM |

    Oil-filled gelcaps are no more expensive than tablets (or perhaps a dollar more). Health food store employees and pharmacists don't know this. I have had many patients come to the office claiming they changed to tablets because that's all their health food store or pharmacy carried and the person behind the counter assured them it was the same. Blood level of vitamin D to confirm: right back down to the starting level or near it--little or no absorption.

Loading
Are you hungry?

Are you hungry?

Eliminate modern high-yield semi-dwarf Triticum aestivum . . . and what is the effect on appetite?

A reduction in appetite is among the most common and profound experiences resulting from wheat elimination. I know that I have personally felt it: Wake up in the morning, little interest in breakfast for several hours. Lunch? Maybe I'll have a few bites of something. Dinner . . . well, I'd like to exercise first.

The wheatless report that:

--Appetite diminishes to the point where you can't remember whether you've eaten or not. It is not uncommon to miss a meal, perfectly content. Calorie intake drops by 400 calories per day, on average, calories you otherwise would not have needed but all went to . . . you know where.
--Hunger feels different: It's not the gnawing, rumbling hunger that plagues you every 2 hours. In its place, you will find that hunger feels like a soft reminder that, gee, maybe it's time to have something to eat because you haven't had anything in--what?--4 to 6 hours. And it's a subtle reminder, not a desperate hunt that makes you knock people aside at the food bar, steal coworkers' lunches stored in the refrigerator, salivating at the mere thought of food.
--The simplest foods satisfy--It no longer requires an all-you-can-eat buffet to satisfy, but a few small pieces of healthy food. (Yeah, but what happens to revenues at Kraft, Nabisco, and Kelloggs, not to mention the revenues at agribusiness giants ADM and Monsanto? Slash consumption by, say, 30%, you likewise slash revenues by 30%. What would shareholders say?)
--Even prolonged periods of not eating, i.e., fasting, is endured with ease.

Hunger and the relentless search for something to eat disappear for most people. By eliminating the appetite-stimulating properties of wheat, we return to a natural state of eating for sustenance, to satisfy physiologic need. We are no longer victims of this incredibly powerful appetite-stimulant called gliadin from wheat.

This is why many diets fail: They fail to remove this powerful appetite stimulant. You might eat only lean meats, limit your calories, and exercise 90 minutes per day, but as long as the gliadin protein is pushing your appetite button, you will want to eat more or you will have to mount monumental willpower to resist it. You can lose 20 pounds on phase 1 of the South Beach diet, for instance, only to regain it in phases 2 and 3 when "healthy whole grains" are added back.

So the key is to remove the gliadin protein from your life, i.e., eliminate all things wheat.

 

Comments (43) -

  • SamK

    12/6/2011 6:14:11 PM |

    Dr. Davis,
    The question arises - why has nature put the gliadin protein in a seed. If it is an appetite stimulant it is likely a predator will want more and more of it. That is not in the interest of the seed whose purpose is to propagate itself. Please let us know your thoughts.  Thank you for all that you do.

  • Howard

    12/6/2011 6:25:31 PM |

    The elimination of wheat may or may not have been what decreased my appetite enough to allow me to lose 100 lbs without much effort, but I did notice one effect that was even more important to me. I wrote about the complete remission of crippling arthritis in my post on http://guestdietblog.com/2011/05/a-story-about-gluten/

  • Kurt

    12/6/2011 6:39:55 PM |

    This hasn't been true for me. Your advice has helped me improve my cholesterol profile dramatically, lower my fasting blood sugar, lower my blood pressure, etc. However, there's been no change in my appetite, and I eat a larger volume of food now because I cut down on some high calorie foods like butter, cheese, etc.

  • Phyllis

    12/6/2011 6:56:35 PM |

    I too have noticed the diminished appetite, but also I have noticed a new and very pleasant feeling *after* eating. The feeling of fullness... of having had enough food, without the overstuffed feeling that I used to experience.
    It is truely a nice, warm, satisflied feeling.
    Going from a size 16 to a size 4 jeans is a nice feeling as well!

  • Princess Dieter

    12/6/2011 8:44:45 PM |

    I did notice an appetite reduction. Hubby did not. Maybe because I'd had a freaky bingey appetite and he never had...well...more noticeable. I could eat 5K calories a day, EASY, if I had wheat back in. For sure.  I do fine with 1500, 1600 now.

  • Mark Sanders

    12/6/2011 9:15:35 PM |

    One item I don't see mentioned here is heartburn.  I used to have severe episodes when I'd have to down a bunch of Tums and milk to deal with them, and they could occur anytime day or night.  I stopped eating wheat about 2 years ago,  for other reasons, and it took me about 2 months before I realized I wasn't having anymore heartburn episodes.  The occasional times my stomach might feel upset, I just drink water and it goes away.  Even though I've been free of these for the last 2 years, I still carry Tums around with me because I'm still paranoid it's going to happen again.

  • Ute

    12/6/2011 11:45:28 PM |

    Kurt, are you eating enough fats and proteins? I went paleo about a year ago, and I increased fats and protein. Lost almost 30lbs and my hunger is just as described in this post.

  • Donald Kjellberg

    12/7/2011 2:21:02 AM |

    It had a similar effect on my heartburn. I find it fascinating that one of the causes of heartburn is completely missed by my doctor and generally, the medical establishment. I also believe that I was eating much more, (due to appetite alterations, food reward, etc.), my full stomach, and excess fat also played a role in exacerbating the symptoms. Target the etiology and the problem vanishes. Much improved over targeting the symptoms allowing the precipitant to return again and again and again . . . .

  • Shreela

    12/7/2011 4:52:27 AM |

    Wow, I never put wheat and heartburn together, but now that they've been brought up together, I believe wheat may have been causing my heartburn too, which reappears whenever I fall off the wheat-wagon. BTW, whenever I fall off the wheat-wagon, my hypoglycemic symptoms are more likely to reappear too.

  • Might-O'chondri-AL

    12/7/2011 5:12:18 AM |

    Hi Howard,
    +/- 4% of the cell protein in wheat grain is LEA (late embryo-genesis abundant protein) that helps the plant bear up without osomotic failure when temperatures drop & also keeps the grain proteins from melding together when conditions get very dry. Modern wheat breeding has manipulated LEA protein conformations to improve crop cultivation habits; I think this fits into what Doc calls a "frankengrain" .

    The group 3 variety of LEA protein's high molecular weight molecules are not broken down readily by proteo-lysis in the gut . When they are taken up by the body the LEA protein is capable of "sensitizing" some individuals to it like an antigen irritant. We don't know what precise amino acid wings the LEA we ingest in a modern wheat breed have. And stripping gluten from the grain doesn't necessarily mean the LEA molecule is also removed.

    LEA can bind to IgE (immunolo-globulin E) from our joint's synovial mast cells. The subsequent release of histamine in the joint tissue incurs the auto-immune  response of  inflammation with  subsequent pain. I think LEA  "sensitization" is what you experience as arthritis due to wheat..

  • Dacia Felix

    12/7/2011 9:55:12 AM |

    For me, one of the effects of elimination of wheat was the  disappearing of dandruff. My dandruff was really bad and no special shampoos or treatments could alleviate the problem. A few months after giving up wheat,  I noticed that I no longer had dandruff!!!!  I even kept my hair unwashed for nearly a month, yet my hair remained dandruff free. Nowadays I wash my hair once a week instead of every day.

  • Susan Clarke

    12/7/2011 6:41:01 PM |

    Yeah, but chasing symptoms rather than looking for causes is the modus operandi of the entire US medical system. Well, most of it anyway.  Don't try to figure out what's causing the problem, just throw another drug at it.

  • puddle

    12/7/2011 7:27:19 PM |

    Yup. (and yup and yup and YUP)

  • calma60

    12/8/2011 12:05:14 AM |

    Just started eliminating wheat and reducing high carb foods around Thanksgiving. My fasting blood sugar used to be around 150; now it's 123. I actually have blood sugar readings after meals that are between 95-115. Once in awhile I get hungry, but I don't crave sweets like I used to. This program overall feels like something I can make a permanent change to.

  • Might-O'chondri-AL

    12/8/2011 12:13:05 AM |

    Hi D. Felilx,
    Dandruff relief from quitting wheat is likely due to eliminating the non-digestible wheat protein fragments  that you were sensitive to. Those wheat fragments had been going on to bind with  IgE put out from local basophils (basophils are +/- 0.6%, or 0.006,  of our bone marrow generated white blood cells). The degree of itchy scalp is a factor of the amount of histamine put out from those basophils. Usually a itch response is to hot extremes of both water and air; but some are wired to itch in response to cold extremes of water/air.

    When wheat protein fragments activate the basophil's IgE this causes the hair follicle wall to respond in an immunological manner & inflammatory cells in the follicle wall hold more sebum oil; with different dandruff results. In most individuals that sebum oil isn't used enough to normally  re-lubricate the surrounding scalp because the local increase of  sebum fatty acids gets taken advantage of and hijacked by the common scalp  yeast Pithyrosporum ovale. With the fast replication of lipo-phylic (fat loving)  P. ovale there is a lot of new progeny & sloughing off of  obsolete P. ovale cells, plus shed (lipid deprived) skin cells that we see as small "snowy" dandruff ; & this is usually accompanied by itching. The other situation is when the building up sebum seeps  to the surrounding scalp skin &  in this case the dandruff manifests as thick scales that usually doesn't provoke much itching; this is a scalp seborrhea & has a genetic predisposition to run in some families.

  • Dr. William Davis

    12/9/2011 3:25:32 AM |

    I don't think that wheat is aware that humans are a "predator."

    And the gliadin protein of modern wheat is not the natural form; it is the form created by geneticists.

  • Dr. William Davis

    12/9/2011 3:27:30 AM |

    The relief from acid reflux and "heartburn" is a very frequent accompaniment to elimination of wheat, as is relief from the cramps and diarrhea of "irritable bowel syndrome."

    Of course, it makes you wonder what else wheat is capable of in the gastrointestinal tract if this occurs so commonly.

  • Dr. William Davis

    12/9/2011 3:29:21 AM |

    This has happened to enough people, Dacia, that I believe it is likely to be a real association.

    This is a lesson I've learned about here and other online forums, as it's not something I purposely track in the office experience.

    This is yet another manifestation of how incredibly varied the skin expression of wheat's health disruptive effects can be.

  • Bob

    12/9/2011 4:17:23 AM |

    What about oat bran and steel cut oat meal? Are they as bad as wheat. They are supposed to be good for cutting LDL.
    Thanks

  • Annie

    12/11/2011 11:23:08 PM |

    Why would wheat be a pre curser to heart burn? I too suffer from bad heart burn on a regular basis and I can't seem to stop it.

  • Kurt

    12/12/2011 8:27:58 PM |

    Yes, I am eating enough fats and proteins.

  • Patrick

    12/12/2011 10:45:00 PM |

    No you are not...eat more butter and cheese!  Preferably from grass fed animals, as the "fat profile"  is proven MUCH better for human consumption.   Fat will NOT ruin your health...though it will ruin your cholesterol reading with those "cheapy" tests that ESTIMATE LDL measures.  NMR profiles are generally improved.   Check into Dr. Davis's archives for more on these topics.
    Yum.  Loves me some FAT!

  • Carl Crawford

    12/13/2011 9:20:07 PM |

    I believe you have a problem.
    I am not receiving your blog posts.
    Feedburner notifies me that my email addresses is in your database, but I receive no email notifications from your site.
    This has been a problem since you changed your site several months ago. Before that time I was receiving your emails.
    Could you look into this issue please?

    Regards, Carl

  • Dr. William Davis

    12/14/2011 2:52:22 AM |

    Oat products do not provoke appetite nor abnormal intestinal permeability like wheat. However, oats send your blood sugar sky-high. That's why we avoid it.

  • Lee Woodruff

    12/15/2011 2:32:28 PM |

    When I saw my Doctor eight months ago and told her my weight loss had stalled, she smiled and said "well you have  just reached an age where you can't loose a weight", and prescribed me a statin. In a sense she was right. Post 50+ the hormones are running against you. Well I'm now 28 lbs lighter, and at the lower end of my BMI and my tummy almost flat. Thanks basically to intermittent fasting, keeping the carbs down, oh and elimination wheat. The statin prescription went in the bin by the way,

  • Martyn

    12/15/2011 9:01:04 PM |

    A more general end-of-year thanks to you, Dr Davis, for the work you have done on the blog, and on Wheat Belly. I believe your work in practical preventative medicine is quite brilliant, and way ahead of its time.

    I have read every post, and look forward to reading more from you in 2012.

    Many Thanks

  • Lindas

    12/15/2011 9:16:12 PM |

    Dr. I have to take cranberry juice, (organic, concentrate, no sugar) for Urinary track infection,  BS goes to 119-127)  what to do?
    Also, D- Mannose, helps also, but know its a sugar?
    Prescribed Cipro, but cautious to take after reading side effects.

  • Lindas

    12/15/2011 9:19:47 PM |

    Yes, Doctor, I also want to thank you for the "against the grain" courageous stance you've taken!!!!!
    Much happiness and joy for you and your family in the year ahead.

  • Julie

    12/20/2011 5:51:38 AM |

    Sorry, my question is off-topic.
    But my father just had a stress test done because he had chest pain when exercising. Unfortunately, the test results were positive (abnormal). His doctor suggested doing Coronary angiography and possibly putting a stent in. As well as adding a beta-blocker. My father is already taking a statin.
    These results really scared me. What should he do to reduce the risk of a heart attack? Would you recommend any additional tests? Is it worth it to make a heart scan in this case?

    Thank you very much!!!!

  • Sam Sinderson

    12/20/2011 10:30:39 PM |

    Low carb is fine and doing so has "normalized" my blood sugar, reduced my hemoroid, increased hair growth and decreased nasel infections.  However, in doing a diet anaylsis I find I am eating 120 to 170 grams of protein, because of the addition of meat of all kinds and also cheese to my diet, which according to several other sources, Dr. Rosedale for one, is detremental.  If I limit my protein to 1 gm per kg of weight , I have seen recommended several places, plus a little becasue of my rather rigerous excercise program, I would be at 70 gm of protein per day.  Yesterday I did that, and I literally have to eat either olive oil or coconut oil by the tablespoon to get my calorie level up to 2200 or so to maintain my weight at 145 lbs and that is after 4 tbls of oil cooking two eggs in the morning!  Does Dr. Davis's protocal have any limits on protein?  My wife thinks I'm nuts eating coconut oil, which melts in ones mouth and is actually quite tasty.

  • Might-o'chondri-AL

    12/21/2011 10:02:35 PM |

    Dec. 2012  The Journal of the Norwegian Medical Association report of Arnold Berstad & Jørgen Valeur of Lovisenberg Diakonale Hospital explain that a meal's glucose monitored in the stomach registers in the brainstem which then reflexively signals the muscles in the stomach wall to relax.
    Quote: “... it can decrease the pressure on the stomach and reduce the sensation of being full....The problem is that ...the brakes on carbohydrate consumption are five metres further down, at the lower end of the small intestine....Fat, however, is absorbed higher up in the system and triggers a high-placed brake. It makes you quickly full."

  • Might-o'chondri-AL

    12/21/2011 10:04:18 PM |

    Journal's date should be 2011 Dec.

  • James

    12/23/2011 5:54:29 PM |

    I have eliminated wheat and all sugars & carbs for about 6 months. I have lost almost 30# (from 200 to 173) in those 6 months. But now I am stalled. I have been at 173 for almost a month and have done nothing different. I want to lose another 10-15#. I am 5' 6" and still have some abdomal buldge. My weight loss was an almost straight line down for 6 months. What causes this plateau? I understand that my caloric needs will have changed due to the loss of 30# and I have adjusted for that. Anyone have any ideas?

  • Might-o'chondri-AL

    12/24/2011 4:09:18 AM |

    Hi James,
          I can only relate an interpretation of my experimentation this last year plus. Since I never have struggled with my weight it may not translate to others. My goal was mainly to see what changes were possible in MNR tests of lipid particles I could achieve with Doc's insight (excellent results I'd say).
           I recently completed several months when my only fat intake daily was a combination of coconut oil (2 tablespoons daily , as 28 grams total fat) , plus fish oil (4.5 grams total fat, as 1 teaspoon = 1.5 gr. EPA + 0.75 gr. DHA), plus 90% chocolate's cocoa butter (60 grams, as 33 grams total fat), plus some olive and restaurants' cooking oils. And I also specify that there was no intake of animal fat (ie: no meat) , fowl fat  (ie: no chicken or eggs) or dairy fat (ie: only fat free dairy) - unless a restaurant used some in their food preparation.
           My experience without any low calorie restraint, nor over eating,  was that I lost weight and  continued to do so beyond what I find suitable. In other words I had to periodically resort to over ingesting carbohydrate calories to stop from getting too thin. Of course I made sure to keep my daily protein intake consistently high enough all throughout the year.
         When I started my experiment it was by daily using only 1 tablespoon of  raw unrefined coconut oil  & lost weight at nights.  I took my first ever MNR test after a handfull of months of this.
         After the initial MNR test I added the daily 1 teaspoon of fish oil , kept to the 1 tablespoon coconut oil (14 gr. fat) , but an irregular chocolate intake was daily limited to 40 grams (22 gr. fat) &  even lost more weight. I took a 2nd MNR test after 4 months of that to see what was doing with my lipids.
         Then I upped the daily raw coconut oil to 2 tablespoons, chocolate up to regularly 60 grams & kept fish oil at same 4.5 grams for 7 months before I took a 3rd MNR test . It was during this latest stretch of experimentation that I sometimes needed to regulate my weight upwards by deliberately adding back more carbohydrates - & I was not pursuing a daily very low carb intake anyway.
          All that staged experimentation seems to indicate that using coconut oil as my primary fat is what drove my weight loss. When I added in fish oil the weight loss rate was not noticeably accelerated & I can't distinguish it from the pattern  begun with coconut oil. However when I eventually  went up to 2 tablespoons of coconut oil daily I sometimes had to fight to just hold on to my weight. The chocolate intake seems to be less of a factor in my weight loss.
          So retrospectively, in my case I think the exclusion of animal/fowl/dairy fat kept certain specific fatty acids out of play and then the distinct fatty acids in coconut oil were both metabolized and incorporated in unique ways that resulted in sustained weight loss for me. I was concerned  that 2 tablespoons of coconut oil a day might be excessive yet last MNR done is superb (I don't seem to be ApoE 4).
         Doc, you may know, has several posts about using finger stick testing of your blood sugar before and after meals. He explains how to use a simple home glucose meter to know which meals spike your blood sugar and lose weight by controlling after eating glucose "excursions".

  • Might-o'chondri-AL

    12/24/2011 8:03:09 AM |

    Hi S. Sinderson,
    Since Doc hasn't answered you about his protein protocol yet this may orientate you. Protein intake can't exceed the ability of liver enzymes to make urea as a consequence of liver's nitrogen metabolism. Basically, if one is healthy,  beyond 3.9 grams protein daily per kg. of our body weight we can't  urinate all nitrogen "waste" from the kidneys adequately.
    1973 Rudman set a periodic daily physiologically safe upper limit of 3.8 gr./kg one weighs (ie: not always every day) .... 2000 Metges calculated a top long term daily protein limit should be 2 gr/kg one weighs .... 1996 Eades pegged exercisers wanting to lose weight should use 1.7 gr./kg one weighs....2010 Speth analysis of paleo-anthropology suggests no more than 35% of calories were ever from protein (ie: less than 3.9 gr/kg hunter weighed daily).

  • Kathy

    12/31/2011 4:42:45 PM |

    So.........
    Has this blog been abandoned by Dr. Davis, in favor of the Wheat Belly blog?

  • Laura

    12/31/2011 11:52:15 PM |

    Hi Might - regarding your 12/24 post on the coconut oil, etc. experiement.  If you did not eat dairy, meat, fowl or eggs (?) for protein what did you eat for protein.  I am very curious because I have been in a stall for a loooonnngggg time (about 6 months).  I also take coconut oil daily (2 tsp) and Omega 3 fish oil (950 mg of EPA & DHA combined).  I also should mention that I am diabetic (T2).  My carb intake is 30-60 grams per day.
    I am trying to find a way to break this stall and your post intrigued me greatly.  
    Thank you,

  • Might-o'chondri-AL

    1/3/2012 6:07:11 AM |

    Hi Laura,
        I buy 1 gallon of fat free milk & culture it into Kefir, which I then drain the whey from and go on to eat the milk solids. I roughly weigh the kefir "quark" that goes into the refrigerator because each batch will have it's own variable amount of whey remaining . Once I know the batch weight I do a simple calculation to divide the  total weight of that batch by 6 to know roughly how much protein is in a 1/6th portion.
        When I know much 1/6 of the kefir quark made from tthat 1 gallon of milk I will then eat one of those 1/6th proportioned amounts in the morning, again during the day a  2nd 1/6th amount  and  then a 3rd  final 1/6th amount of the kefir quark.  
       The result is that in 1 single day the milk solids are equal to 1/2 gallon of fat free milk.  I approximate this as containing, in total,  around 70 grams of protein which for me is a good minimum protein requirement . Then any other protein I eat in the day is not crucial & usually in form of nuts, hummus or  some stray egg ingredient which can't measure reliably. I think my daily protein consumption is around 120 grams or more protein daily  (I certainly am not eating only 1 gram protein per kg of my weight).
         In terms of people stalling on low carb & pseudo-paleo diets I do have some nuanced ideas if you'd like, but I don't know how applicable the research might be. It isn't like a formula & needs longer context to elaborate .

  • Might-o'chondri-AL

    1/3/2012 11:55:02 PM |

    Hi Laura,
    Please see what I also tagged you at Doc's next thread (1st in 2012) on this same blog.

  • Anna

    1/17/2012 6:04:22 PM |

    Dr. Davis....what do you say to people who claim they are emotional eaters and can eat over the "no appetite" feeling?
    Thanks.

  • pjnoir

    2/18/2012 12:10:49 AM |

    nothing satisfies hunger better than homemade beef or chicken stock,with beef being the best. One of my diet secrest when doing my low carb/Paleo regiment.

  • Are you hungry? | Paleo Primal Post

    10/24/2012 5:36:33 PM |

    [...] more here: Are you hungry? | Track Your Plaque Blog. .nrelate_related .nr_sponsored{ left:0px !important; }     /*     No Comments - Leave a Comment!   [...]

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"Make big money fast with CT scans"

"Make big money fast with CT scans"

Rather than the headline New Study Could Change Heart Disease Diagnosis And Treatment being run in Utah TV and newspapers, instead it should read:


Make big money fast with CT scans!

Is your bottom line shrinking? Have you fallen on hard economic times? Is competition from other hospitals and providers threatening your financial health?

Then we have a solution: Do a CT coronary angiogram on everybody! Look for disease in people with no symptoms, scare the heck out of them, and voila! Instant need for bypass surgery!

Ka-ching!! That'll be $100,000, please.

Do it again, and again, and again, and your hospital will be quickly in the black in no time!

And, for the savvy marketer, tell the newspapers that you're going to conduct a study to see if this approach works--even before the study gets started! Even if the study pans, you'll come out a winner because you did it in the name of "research"!




Apparently a group of cardiologists at the Intermountain Medical Center and LDS Hospital in Salt Lake City, with the financial assistance of Siemens, a manufacturer of CT scanners, is funding a 1000-patient study of diabetics, all without symptoms of heart disease, half of whom will undergo "screening" CT coronary angiograms (not heart scans) followed by bypass surgery, if "needed". The other half will receive conventional, "aggressive" medical therapy. "Aggressive" means cholesterol treatment, blood pressure control, and blood sugar control (no kidding).

The outcomes of the two groups will be compared after two years.

To understand the absurdity of this study, note that they are proposing what amounts to "prophylactic" bypass surgery, since the participants are without symptoms. Since there are no stress tests, a measurement of flow or functional capacity (exercise tolerance) cannot be factored in. Decisions will be made on the basis of severity of "blockages" in asymptomatic people, a hazardous notion that has never been shown to provide benefit. No doubt: Some diabetics with extensive disease may obtain benefit from screening, but many more will undergo what amounts to unnecessary bypass that provides no benefit. We already know from studies dating back over 20 years to the days of the original CASS (Coronary Artery Surgery Study) that putting asymptomatic people through bypass surgery willy-nilly does not reduce mortality.

Of course, the "aggressive" preventive treatment they propose is more like the least common denominator level of treatment. In fact, I would characterize the "aggressive" preventive treatment as ridiculous. Doing less would be malpractice. Much more could be done, but doing a lot more would pose a real challenge to the bypass arm of the trial.

But the smell of money drives such efforts: More CT angiograms, more hospitalization for bypass surgery. The payoff to the hospitals from this effort is likely to exceed $5 to $10 million, all money that they might not have otherwise seen. The ill-informed people in the local media gush with enthusiasm, the hospital acts like they are at the cutting edge of medical technology, the doctors pose as saviors.

All this time, real preventive efforts go unmentioned. No fish oil (28% reduction in heart attack, 45% reduction in sudden death from heart attack), no genuine diet efforts (i.e., not the diabetes-promoting American Diabetes Association diet), no effort to identify sources of coronary risk beyond LDL cholesterol (low HDL,small LDL,and postprandial or after-eating abnormalities, for instance, are prominent sources of risk in diabetics), no vitamin D. In my view, the preventive arm of the study amounts to doing virtually nothing beyond prescribing statin drugs.

Don't fall for it.

Comments (6) -

  • Anonymous

    5/31/2008 2:02:00 PM |

    Good timing for my father on this blog post.  It isn't heart disease but next week my father is driving to Chicago to have his head examined with an MRI to learn the potential of having an aneurysm. (I think I said that right, aneurysm)  I asked him why and he told me the exam is "free".  I don't much about how hospitals are run but from my experience every time I've been to one nothing was free.  If anything everything bought was 10 times normal price.  I've warned my father not to fall for scams - nothing is free dad.  My guess is this is a way for the hospital to drum up $100,000 business from the unsuspecting sucker.

  • Jenny

    5/31/2008 2:14:00 PM |

    Even more important is the danger from the high levels of radioactivity exposure caused by those scans. There was a study published that looked at the CT scan exposure of ER patients and found that the cumulative level was far over the level known to cause cancer.

    Science News report.

    CT scans should be used only when justified by a very real and present danger. And even then often X-rays would be a better choice.

  • Anonymous

    5/31/2008 3:41:00 PM |

    Just when I thought the profession could not sink lower!  This seems to be another example of the current philosophy - "sick until proven healthy."  Unfortunately, this type of doctor doesn't recognize anyone as healthy. Oy....

  • Jessica

    5/31/2008 4:53:00 PM |

    Great analysis.

    We hosted a health care forum on 14 May and during the Forum, one of the doctors said, "we're wasting money trying to prove that healthy people are healthy."

    So true.

    Asymptomatic and they're being entered into a study which includes invasive "bypass" as a clinical intervention?

    Brain dead.

  • PJ

    5/31/2008 11:36:00 PM |

    You know, that's actually terrifying.

  • jpatti

    6/4/2008 3:40:00 PM |

    I really can't *imagine* anyone signing up for this study.

    After a week of heartburn, I spent the night screaming and vomiting before an unsuccessful emergency angio.  And after all that, while on narcotics and IV heparin, I had to be "talked into" a bypass.

    I can't imagine doing it for the sake of science.

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A cure for pessimism?

A cure for pessimism?

Followers of the Track Your Plaque program know that we place great value on having an optimistic outlook. Not only are you more likely to be happy and successful in life, you are also far more likely to drop your CT heart scan score. Virtually everyone who has succeeded in dropping their heart scan score dramatically has been an optimist, including our most recent record holder who dropped his score an astounding 51%.

But what if you are a pessimist, someone who gripes and complains about everything, sees the bad in other people, blames others for anything and everything that goes wrong--yet you still desire to drop your heart scan score? Are you a lost cause? Should you just give up?

I don't think so. I will admit that, of all the hurdles we encounter in trying to purposefully stop or reduce heart scan scores, overcoming a pessimistic attitude is probably the toughest. Tougher than being overweight, maybe tougher than even Lp(a).

Perhaps there's a solution in two years of psychotherapy sessions with a counselor, or exploring unresolved childhood conflicts with a psychologist, or an antidepressant drug. Pessimism is, after all, a deeply-ingrained pattern of behavior, something that can't be changed just by suggesting it or simple self-realization.

The closest thing I know of to a quick and relatively easy solution for converting a pessimist to an optimist is very simple:

Do good things for other people.

Something peculiar happens to the pessimist when he/she starts to help others. They are less threatened by other people (since much griping is really fear in disguise), begin to see others as vulnerable creatures who could use their help rather than sources of annoyance, and a kinship with others is acquired.

Doing good things can mean giving blood, donating money to the Sierra Club or other charity, volunteering with the Boy Scouts, tipping the hard working waitress trying to pay for college more generously, paying compliments to people around you, helping a neighbor carry the groceries when you see him struggling, showing a child how to make a paper airplane . . .

Good deeds can take a million different forms. But it must involve you personally. It can't mean delegating a helpful activity to your spouse. You must also do it frequently, not just once a year. It doesn't have to cost money, it doesn't have to involve a lot of time (though your personal bodily involvement does yield the greatest return in optimism). These are things anyone can do and help make the world around you a little better.

If taking these small steps towards an optimistic attitude are too much for you, then I would worry that you are destined to fail in dropping your heart scan score.

Comments (3) -

  • Bix

    5/21/2007 4:11:00 PM |

    Love this post.

  • buy jeans

    11/2/2010 7:56:53 PM |

    I don't think so. I will admit that, of all the hurdles we encounter in trying to purposefully stop or reduce heart scan scores, overcoming a pessimistic attitude is probably the toughest. Tougher than being overweight, maybe tougher than even Lp(a).

  • Anonymous

    3/11/2011 12:57:27 AM |

    This is a great post.  I wish every doctor thinks like you!

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Don't neglect your magnesium

Don't neglect your magnesium

Magnesium is kind of boring. So most people don't pay too much attention to it.

Magnesium can be important, however. I saw an interesting phenomenon recently. A type I diabetic patient of mine (that is, an adult who developed diabetes as a child), Mitch, was experiencing wide swings in blood sugar: low low's and very high high's (300-400 mg/dl). Mitch's magnesium was only marginally low at 2.0 mEq/L. (Ranges for normal magnesium blood levels are usually 1.3–2.1 mEq/L or 0.65–1.05 mmol/L.) Note that Mitch's blood levels fall within "normal." I do not agree with these "normal" ranges. I shoot for 2.1 to 2.4 mEq/L, which I think is the truly normal range.

In addition to eating plenty of raw nuts and green vegetables, Mitch began supplementing magnesium with magnesium citrate, 200 mg twice a day (our preferred supplement form). He reported that the wide swings in blood sugar were nearly eliminated.

Mitch's dramatic benefit is just a great illustration of how magnesium can help control blood sugar metabolism. A type I diabetic is more sensitive to the effects, but anyone with type II (adult) diabetes, metabolic syndrome, or just a slightly high blood sugar could benefit from magnesium supplementation.

There's a number of ways to accomplish getting sufficient magnesium in your daily regimen. Track Your Plaque members, Be sure to read:


Your water may be killing you at
http://www.cureality.com/library/fl_03-002magnesium.asp

Magnesium: Water to the rescue! at http://www.cureality.com/library/fl_03-010magnesium2.asp

Comments (3) -

  • magnesium_matters@comcast.net

    3/4/2007 10:01:00 PM |

    1) magnesium increases insulin sensitivity, the ability of the liver and large muscles to sequester sugar in response to insulin. that isn't necessarily a problem in insulin-dependent diabetics but this one is an adult and could be showing some type 2 symptoms (insulin resistance.  Depending on serm magnesium as a guide to deficiency will miss the majority.  insulin dependent and type 2 diabetics lose magnesium every time their sugar rises.  serum magnesium is a notoriously poor guide to magnesium status.  may authorities in the field recomend prophylaxis in any magnesiu-wasting state. 3) citrate is a large molecule.  magnesium citrate is three fourths citrate.  citrate supplementation increases the absorption of magnesium slightly (over oxide) but it also increase the absorption and tissue uptake of aluminum and lead.  i prefer oxide.

    magnesium_matters@comcast.net

  • x.ds

    11/22/2009 1:04:07 AM |

    Why would the benefit of magnesium citrate to type-1 diabetes be due to magnesium and not to citrate ??? Citrate is a good metal chelator. It will lower pancreatic oxidative stress allowing better pancreatic function. Type-1 diabetes like other autoimmune diseases (such as arthritis) is due to oxidative stress and free metals are a major cause of oxidative stress in the body (the first cause by far however is drugs). In laboratory animals for example type-1 diabetes can be generated by giving them cereals and soy, two kinds of food that cause high level of oxidative stress. Link: http://docs.google.com/viewer?a=v&q=cache:-4wvlFXUWaMJ:www.nzfsa.govt.nz/policy-law/projects/a1-a2-milk/a1-a2-report.pdf+A+cereal-based+diet+%28mainly+wheat,+corn+and+soybean%29+called+NIH-07+is+often+used+as+a+standard+diabetes-promoting+diet&hl=en&sig=AHIEtbS5jjkwib8XkUB7hz_-flR3NbgY1g (search the second occurrence of "wheat").

  • buy jeans

    11/2/2010 9:15:37 PM |

    In addition to eating plenty of raw nuts and green vegetables, Mitch began supplementing magnesium with magnesium citrate, 200 mg twice a day (our preferred supplement form). He reported that the wide swings in blood sugar were nearly eliminated.

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When meat is not just meat

When meat is not just meat


The edgy nutrition advocate, Mike Adams, over at NewsTarget.com came up with this scary photo tour of a processed meat product from Oscar Mayer: Mystery Meat Macrophotography: A NewsTarget PhotoTour by Mike Adams







Along with increasingly close-up photographs of this meat-product, Adams lists the ingredients in Oscar Mayer's Cotto Salami:


Beef hearts
Pork
Water
Corn syrup
Beef

Contains less than 2% of:
Salt
Sodium lactate
Flavor
Sodium phosphates
Sodium diacetate
Sodium erythorbate
Dextrose
Sodium nitrite
Soy lecithin
Potassium phosphate
Potassium chloride
Sugar


As I reconsider the role of saturated fat in diet, given the startlingly insightful discussion by Gary Taubes of Good Calories, Bad Calories, I am reminded that not all meat is meat, not all saturated fat sources are equal.

I am concerned in particular about sodium nitrite content, a color-fixer added to cured meats that caused a stir in the 1970s when data suggesting a carcinogenic effect surfaced. The public's effort to remove sodium nitrite from the food supply was vigorously opposed by the meat council and it remains in cured meats like sausage, hot dogs, and processed meats like Cotto Salami. A 2006 meta-analysis (combined analysis of studies) of 63 studies did indeed suggest that sodium nitrite was related to increased risk of gastric cancer. This argument is plausible from animal models of cancer risk, as 40 animal models have likewise suggested the same carcinogenic association.

Also, fructose? This is most likely added for sweetness. Recall that fructose heightens appetite and raises triglycerides substantially.

I personally have a natural aversion to meat. I don't like the taste, the look, smell, and the thought of what the animal went through to make it to the supermarket. But, considered from the cold, carnivorous viewpoint of the question, "Is meat okay to eat?", among the issues to consider is whether the meat has been cured or processed, and does that process include addition of sodium nitrite.

Cotto Salami and similar products are not, of course, what carnivorous humans in the wild ate. This is a processed, modified product created from factory farm animals raised in cramped conditions and fed corn and other cheap, available foods. It is not created from free-ranging animals wandering their pastures or pens, eating diets nature intended. This results in modified fat composition, not to mention hormones and antibiotics added. These are not listed on the ingredients. Wild meat does not contain fructose or color-fixers, either.

So don't mistake "meat" in your grocery store for meat. It might look and smell the same--until you look a little closer.



Copyright 2007 William Davis, MD

Comments (7) -

  • Nancy M.

    12/18/2007 3:04:00 PM |

    Wasn't Good Calories, Bad Calories good?  Man, just what the medical world needs, a good wake-up call into how schlocky their science is (sometimes).  

    Did you finish the book yet?  Parts of it infuriated me at the stupidity and arrogance of people.  And I have to say it is getting harder and harder to have respect for medical "authorities" when you know the horrible science their training was based on, that they don't question the basis for these assumptions yet assume their patients are all idiots.

    I'd love to hear more of your comments on his book if you get a chance to blog about them.

  • MAC

    12/18/2007 3:05:00 PM |

    Would be interested in any comments you have as you "reconsider the role of saturated fat in diet" as a low carb diet appears to be beneficial in raising HDL.

    This research  from Jeff Volek was of interest: Jeff Volek, et al: Low carb diet reduces inflammation and blood saturated fat in Metabolic Syndrome. http://www.sciencedaily.com/releases/2007/12/071203091236.htm

    Also, Cordain makes the case in his FAQ for the Paleo Diet that saturated fat averaged 11% in wild animal carcasses.

  • Ross

    12/18/2007 5:50:00 PM |

    If you're going to buy something like salami, ham, bacon, sausage, or other meat product, the best source is often a deli that makes it on site.  Not only will the salami, ham, or sausage be made with fewer ingredients, but it's much tastier, fresher, and often a similar cost to mass-marketed processed meats.  

    This will not be practical for people everywhere.  Living in LA as I do, there are specialty delis all over the place and it isn't too hard to find locally made sausage, etc.  One alternative would be a deli that takes great pride in presenting the craft-made meat products of a smaller supplier.

    I've actually ignored what might be the best option of all, which is to make it yourself.  Simple ham, proscuitto, bacon, salami, many different kinds of sausage, etc. can all be made in the home with inexpensive tools and (for proscuitto and salami) a decent dry place where they won't be disturbed.  It's also fun!

    But at all costs, avoid anything made by oscar mayer or any other mass produced meat product.  It's all crap.

  • chickadeenorth

    12/20/2007 5:26:00 AM |

    Even Dr Atkins said no meats allowed that are processed or have nitrates, only meats like our ancestors ate, he said it was like "the kiss of death".I don't even considered those types of meat to have sat fats, but poision, they are all part of Franken foods to me, like Snackwell cookies.. If I have sausage I get a local German butcher to make organic elk meat into garlic sausage for us.To me low carb means nutrient dense whole foods.

  • Dr. Davis

    12/20/2007 5:36:00 AM |

    What's frightening is that, whenever I've discussed the Atkins' approach with people doing it on their own, they've virtually always included plentiful cured and processed meats.

    Somehow that part of the message didn't get stressed enough.

  • Dr. Davis

    12/20/2007 5:38:00 AM |

    In response to Nancy's first post:

    I'm embarassed to admit that Taubes was so tremendously unique and entertaining (in a nerdy sort of way) that I've savored each discussion slowly and carefully. So it's literally taken me two months to read his book. But I have enjoyed every word.

  • chickadeenorth

    12/21/2007 7:21:00 AM |

    Yes I think those of us who used the board and forum understood it better and we could call his office and talk to his nurse or leave him a question, lots misconstrued they should eat a lb  bacon a day, He said no nitrates and sat fats under 20 gr a day.I learned his big boo boo was eventually incorporating rungs adding breads, potatoes etc, they are the kiss of death IMHO.

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