Heroin, Oxycontin, and a whole wheat bagel

25. January 2011 William Davis (27)
For a substantial proportion of people who remove wheat from their diet, there is a distinct and unpleasant withdrawal syndrome. Here are the comments of Heart Scan Blog reader, Scott, from Texas:

Hello Dr. Davis,

I've been experimenting with diet, converging upon a Paleo type diet, but I keep running into problems. I have isolated the problem to cutting out wheat.

Sugar, rice, fruit, corn, potatoes, etc. are relatively ok to add or remove from the diet, but cutting out wheat in particular brings on a moderate headache with heavy fatigue all day long. This resembles the wheat withdrawal symptoms I found on your blog. As I write this, I'm on day 8 of wheat-free. I consume a fair variety of meat and veggies each day with a moderate amount of white rice for carbs. Perhaps a bowl of corn flakes with milk and half a bar of dark chocolate a day. I've learned from experience over the past 5 months or so that none of these foods affect the withdrawal. It's purely wheat.

My question is, what is the range of times for withdrawal symptoms that you've heard from different people? Has there been anyone who never recovered from the wheat withdrawal symptoms even after many months?

It's very tough to get work done like this, and even though my body and head feel much healthier in general, my sinuses have cleared, don't have to take a big nap after I eat, etc., I don't want to go down a path where this is the way things are going to be forever. 


People who have never experienced wheat withdrawal pooh-pooh the effect. But, for about 30% of people, wheat withdrawal is a real, palpable, and sometimes incapacitating experience.

Beyond removing an exceptionally digestible carbohydrate that yields blood sugar rises higher than nearly any other known food (due to the unique amylopectin structure of wheat-derived carbohydrate), wheat withdrawal is a form of opiate withdrawal, somewhat like stopping heroin, Oxycontin, and other opiates. Stop eating whole wheat toast for breakfast, whole grain sandwiches for lunch, or whole grain pasta for dinner, and the flow of exorphins, i.e., exogenous morphine-like compounds, stops. You experience dysphoria (sadness, unhappiness), mental "fog," inability to concentrate, fatigue, and decreased capacity to exercise. It is milder than withdrawal from prescription opiates. Unlike withdrawal from more powerful opiates like heroine, there are, thankfully, no seizures or hallucinations. There are also no deaths.

In my experience, most people get through with wheat withdrawal in about 5 days. An occasional person will struggle for as long as 4 weeks. Thankfully for Scott, I've never seen it last longer than 4 weeks. (Interestingly, people who survive the withdrawal syndrome are often prone to a peculiar re-exposure phenomenon that I will discuss in future, i.e., they get sick upon re-exposure.)

The modern dwarf mutant variant of Triticum aestivum (that our USDA urges us to eat more of) contains greater proportions of gluten proteins compared to wheat pre-1970; glutens are the source of wheat-derived exorphins.

Incidentally, a drug company should be releasing a drug in the next year that will contain naltrexone, an oral opiate blocking drug, for a weight loss indication. They claim it is a blocker of the "mesolimbic reward system." I say it's a blocker of wheat exorphins.
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Comments (27) -

  • Tree

    1/25/2011 1:50:08 PM |

    Celiac disease is often noticed by people who go off wheat for health reasons, then when they try to eat it again, it makes them sick.  

    For the record, Corn Flakes contain barley malt which has the same protein, gliadin, as wheat.  I have celiac and the "formula" is no wheat, barley or rye because they are so closely related and have the same "gluten" protein.

  • Martin Levac

    1/25/2011 1:55:45 PM |

    Isn't it interesting. They treat obesity by fixing the "mesolimbic reward system" because they believe eating too much "food" makes us fat. But then you say wheat isn't food, it's a drug.

    Are we really eating too much "food"?

  • Emily Deans, M.D.

    1/25/2011 2:15:16 PM |

    A heroine is a very different concept than "heroin."  And withdrawal from oxycontin or heroin is unlikely to cause hallucinations or seizures (Trainspotting babies on the ceiling notwithstanding) - though it is exceedingly unpleasant, it is not typically medically dangerous.  Perhaps you are thinking withdrawal from alcohol, barbituates, or benzodiazepines, all of which can cause hallucination, seizures, or death if done without medical supervision.

  • Anonymous

    1/25/2011 2:35:18 PM |

    I have celiac and had similar problems when I first went off gluten.  It took me about a month to stop reacting.  I get quite ill whenever I accidentally am exposed to gluten, say at a restaurant.  My symptoms are migraine and flue like aching in my joints, plus severe fatigue.  None of my doctors thought I might have celiac by the way, because I am slightly overweight (BMI 25) and didn't have severe digestive symptoms, but there is recent research showing that many patients present with migraine as their only celiac symptom.

  • Dr. William Davis

    1/25/2011 2:47:15 PM |

    Oohh. Thanks for catching the typo, Dr. Deans. Fixed.

    By the way, I've seen plenty of hallucinations and seizures with opiate withdrawal, as well as benzodiazepine withdrawal. Or, perhaps it was combination addictions that were at fault.

    That, however, was not the point.

  • Emily Deans, M.D.

    1/25/2011 3:11:53 PM |

    I think the point was well-made - just didn't want anyone to fear that wheat withdrawal was medically dangerous (quite the opposite).  I've had a few cases where I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

  • Dr. William Davis

    1/25/2011 10:21:46 PM |

    Dr. Deans--

    I am VERY impressed you knew of this effect.

    I have tried this, too, in people who are, despite their best effort, unable to resist temptation to consume this drug-disguised-as-food called wheat.

  • Anonymous

    1/26/2011 12:24:48 AM |

    My health improved dramatically after I stopped eating wheat, grains, and other carbs, I even had a cataract disappear.  But it required nine months before I could adjust to the low carb way of eating. It's worth all the trouble, no more high blood pressure or diabetes medicine.  Most of my arthritic pain is gone, I am able think more clearly. Lost 30 pounds. No more allergies or indigestion.
    Thank you for writing this blog!

  • DK

    1/26/2011 4:08:13 AM |

    I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

    Nothing at all particularly telling I would say. Other than telling that opioid receptors are part of the reward circuit. Which is obvious and not disputed by anyone. Naltrexone main use is in treatment of alcohol dependence. Using your logic ethanol is an agonist of opioid receptors. Which is self-evidently not true. The effects are indirect.

  • Might-o'chondri-AL

    1/26/2011 5:30:17 PM |

    Question here:

    Is the "craving" for wheat due to psychoactive tri-peptides derived from wheat protein ?  If that is the molecule that "dopes" our opiod receptors then decreasing levels of tri-peptides as the day progresses will make some look for their wheat "fix".

    Naltrexone @50mg was FDA approved (1984) in 1984 opiod addition; to block receptors. I think the doctors here are referring to single evening doses of 3 to 4.5 mg.
    for screened patients.

  • BWR

    1/27/2011 3:08:46 AM |

    Here's what I don't understand: Why is it that entire countries of people who eat bread by the basket, like Spain, have exceptionally low levels of heart disease? This is a sincere question. I want to do what's right for my heart, but it seems to me that a naturally occurring sample size of several million people is pretty compelling. What am I missing?

  • Anonymous

    1/27/2011 8:25:08 AM |

    Jack LaLane on sugar:

    http://www.youtube.com/watch?v=LJVEPB_l8FU

  • Jonathan Byron

    1/27/2011 1:56:02 PM |

    Milk and dairy products are also a source of endorphin-like chemicals. Would it make sense to try to kick a wheat habit by temporarily drinking more milk?

  • Anonymous

    1/27/2011 3:42:20 PM |

    BWR

    It is possible that Spanish bread is made from a much healthier wheat variety.

    The devil is on the details.
    From a HSB comment May 24, 2010
    Here in France, Einhorn( Triticum monococcum) has been cultivated since the 9 th millennium BC in a small area of Haute Provence. It is called petit epeautre and it is truly delicious! It has very little gluten.
    There is much regulation in the cultivation in order to protect the genetic purity of this ancient grain. Like wines it has a AOC (appelation d'origine controlee

    Please note: Higher Mg and Lysine in einkorn

    Modern wheat has had much of the Mg bred out
    http://petitepeautre.com/nutritiona.html

    Scandinavian Journal of Gastroenterology
    http://www.einkorn.com/toxicity-of-einkorn-gluten/

    Same for casein in milk where A1 milk can be a serious problem and the casein is similar to gluten
    http://www.guernsey.net/~wgcf/PageMill_Resources/Acres_Woodford.pdf

  • Dr. William Davis

    1/27/2011 4:37:27 PM |

    Hi, BWR--

    There are some unanswered questions with this thing called wheat. As the anonymous commenter pointed out, there may be differences in strains grown worldwide. While 99% of all wheat grown today are dwarf variants of Triticum aestivum, there are pockets of agricultural adherence to older cultivars.

  • revelo

    1/27/2011 8:41:02 PM |

    I am perfectly willing to believe than many people cannot tolerate wheat. But this obsession with villifying wheat discredits Dr Davis's very valuable promotion of regular heart scans and other diagnostics, as well as D3, Iodine and other supplements.

    It isn't just the Spaniards. My own ancestors are a mix of French, German and English, and I don't seem to have any problems with wheat, rye, barley, to speak nothing of oats. Furthermore, I believe a heavy grain diet is precisely why I am able to keep my weight down and my test results good. I experimented with going to a somewhat more paleo diet recently and the result was to DECREASE my insulin sensitivity when I went back to eating oats. Now that I'm back to eating mostly oats, my insulin sensitivity has returned to normal. Worse, the paleo diet caused a surge in uncontrollable hunger. One particularly bad day, I ran through a dozen eggs, a pound of meat, another pound of nuts and all sorts of other food before my appetite finally settled down. I never had these uncontrollable appetite problems with my usual mostly oats diet, nor did I have problems when I used to eat mostly pasta (though I was younger then and had higher metabolism than now).

    Appetite is the key. If a food sends appetite soaring, then it doesn't matter how healthy that food is by itself--it will make you fat and thereby reduce insulin sensitivity and thus destroy you in the end. Conversely, if a food depresses appetite, then assuming it isn't absolute poison (like arsenic), eating that food will allow you stay lean, and by staying lean you stay insulin-sensitive (assuming you also do some daily exercise), and that is the ultimate key to avoiding most health problems, from what I understand. For some people, wheat and oats may very well be the keys to appetite suppression, and it is thus a disservice to condemn these foods for everyone.

  • Anonymous

    1/27/2011 10:47:13 PM |

    what do you make of this new study citing adverse effects of a high fat diet?

    http://www.ajcn.org/content/early/2011/01/26/ajcn.110.002758.abstract

  • Onschedule

    1/28/2011 1:21:46 AM |

    @revelo,

    In his practice of Cardiology, Dr. Davis has apparently observed great results with a good number of his patients that choose to avoid wheat. Apparently, an impressive enough effect, in his opinion, to make the statements that he does. These observations, and the recommendations he makes based upon them, hardly "discredit" his professional advice.

    It may be true, as you suggest, that not every single person will have a problem eating wheat, but a person's weight (or appetite) is not the only indicator of potential heart-health related issues. While wheat might not make everyone fat, it may still provoke immune response, inflammation, surge in blood glucose and triglycerides, etc.

    Anecdotally, thanks to Dr. Davis' advice regarding wheat, my 68 year-old mother lost 15% of her bodyweight in four months, without exercise, and without any other change in her diet except to replace the pastas and breads with eggs, vegetables, and meats. She had always taken great pride in the "healthy" foods she ate, but over the past twenty years had very slowly gained weight and a bloated appearance. She started crying during our last visit because she is so happy to "recognize" herself again in the mirror, and is wearing clothes that haven't fit in over a decade. I stopped eating wheat one year ago. Since then, I've dropped from size 34 to 28 pants and get compliments weekly concerning how young I look; I feel great and lab results (blood tests, radiology) are unbelievably improved.

    Wheat avoidance may not indeed be necessary for everyone; but, it's done wonders for *all* of those around me that have given it a good chance.

  • reikime

    1/28/2011 3:53:27 AM |

    Jonathan,
    Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines.

    This is one of the rationales for the gluten free- casein free diet that seems to greatly help some children on the autistic spectrum.  Sorry to be a spoilsport!

  • reikime

    1/28/2011 3:55:31 AM |

    oops!  typo alert ...sorry
    Subbing milk for the wheat would NOT work as milk...

  • Might-o'chondri-AL

    1/28/2011 7:55:05 AM |

    reikime,
    thanks for the answer.

  • reikime

    1/30/2011 12:39:45 AM |

    You're welcome Might-.

  • Olive Kaiser

    1/30/2011 3:13:16 AM |

    Check out www.theglutensyndrome.net

    I get folks who contact me from my site who have strange neurological symptoms when they either withdraw from gluten/wheat the first time or  flip flop on and off too much. I have a page on temporary adverse effects from going gluten free.

    Our 23 year old nursing student daughter experienced a very strange neurological effect from a 6 week gluten challenge after being strictly gluten free for 6 months.  Ischemia/reperfusion injury is a possibility, and gluteomorphin withdrawal also.  Her story is on the site.  For sure she is very strictly gluten free now, and doing fine 6 years after the experience. http://glutensensitivity.net/cases.htm#ztop

    In the book, "Mendel in the Kitchen, Nina Federoff, a strong proponent of GMO technology, relates how wheat was genetically altered by the 1950's by both x ray irradiation and chemical mutation, and the gluten levels were raised far above older varieties. The wheat today is not the same as our ancestors, at least not here in the States.

    FYI, a new lab (www.Cyrexlabs.com)  has just opened 2 weeks ago with much more complete gluten syndrome testing.  They are testing many more antibodies than previous standard panels, and expected to turn up many more folks with gluten syndrome.  They also teach that gluten can damage multitudes of tissues by molecular mimicry between gluten related antibodies and look alike innocent tissues all over the body.  The villi, which have been the gold standard target tissue in the celiac community, are turning out to be just one of many possible sites of damage.  

    Many folks have gluten/wheat related antibodies, but their main target of autoimmune tissue damage is in places other than the villi, such as the heart, nerves, organs, joint lining, etc.  Villi as the target tissue is found in relatively a few folks, and that is the tissue damage that has gotten most of the attention.

    Dr. Aristo Vojdani, PhD, Immunology, and others have accumulated a lot of research to support these theories, and they fit the gluten syndrome community like a glove.

  • Jonathan Byron

    1/30/2011 3:39:54 AM |

    >> "Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines."

    Right, but is the fundamental problem generally the morphine-like effect, or is it some other antigen specific to gliadins? My wife has hashimoto's thyroiditis, and the smallest trace of wheat, barley, or other gliadin grains quickly makes her miserable... she can feel her thyroid swell, she gets cold, she has other problems. Dairy does not have this effect. Since cutting out gluten from grains, her T3, T4, and TSH levels have returned to normal, while her anti-thyroid antibody level has dropped to very near normal.

    I am willing to consider that with some conditions (like autism), both gluten and milk can be a problem. It is not clear to me that if gluten is a problem then milk must also always be a problem. If the casomorph proteins allows some people to quit wheat with fewer withdraw symptoms due to the substitution of endorphin-like molecules, that could be a good thing.

  • reikime

    1/30/2011 10:37:28 PM |

    Jonathan,

    The issues your wife has with gliadin really dont seem related to the morphine like responses some people have with gluten and /or dairy.

    Sure some people that have a wheat/gluten intolerance can ingest dairy just fine...that said, if the microvilli are damaged from wheat and not healed yet, you are much more likely to have a problem with dairy.
    The tips of the villi are where lactase is produced.
    Also, if one is subject to the effects of gliadiamorphins, IMHO one would likely be sensitive to caseomorphins, because the unhealed intesine is permeable.. ie leaky gut syndrome. This allows proteins into the bloodstream that would normally not be there. (and to wreak havoc)

    Willing to say I may be wrong, though. Anyone?

    I spend alot of time on celiac  research issues, so naturally this is where my brain goes!  lol

  • Dr Charles Parker

    3/22/2011 1:02:56 PM |

    Great to see that others have identified gluten as a potential pathogen/allergen that can significantly contribute to both mind and body deterioration through compromised immune dysfunction. I know you, Dr Davis, often think of the heart as the canary in the coal mine, and I see the brain as a canary partner showing first signs of impending acute deterioration.

    This link will take you to a series of interviews I did with Dr Peter Osborne on similar issues as discussed in this posting:

    http://www.youtube.com/watch?v=dJCZmNzkRNA&playnext=1&list=PLD61FCED98A4A5C66

    Hope this helps encourage more discussion and awareness, and thanks for your excellent work!
    cp

  • Carb Flu « The Paleo Spot

    9/16/2012 4:53:03 PM |

    [...] The first couple of weeks without grains and sugars were not pleasant.  In the beginning, I had a headache nearly every single day.  By body was detoxing and coming off the caffeine, carbs and sugars.  I was crazy tired.  For several days, I was so ravenous I wanted to gnaw my arm right off my body (would somebody please pass the sea salt…?)  If this lifestyle is sooo healthy, why have I been feeling like I’ve been run over twice by a dinosaur?  The answer is simple and thanks to in-depth research before starting my journey, it is something that I anticipated would happen – I have been experiencing the classic symptoms of Low Carb Flu. [...]

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Wheat-free and weight loss

Wheat-free and weight loss

13. October 2007 William Davis (14)
With a heart scan score of 1222, Leslie could be in deep trouble in short order.

At 64 years old, Leslie had gained nearly 40 lbs since she'd given up a lot of her activities caring for a husband who'd developed psychological difficulties and stopped contributing to the household duties. A tall woman at 5 ft 9 inches, she held her 202 lbs well, but her lipoprotein patterns were a disaster:

--LDL particle number 2482 nmol/l--an equivalent LDL cholesterol of 248 mg/dl (drop the last digit)
--HDL 38 mg/dl
--Triglycerides 241 mg/dl
--90% of LDL particles were small
--Lipoprotein(a) 240 nmol/l

Blood sugar was in the pre-diabetic range at 112 mg/dl, C-reactive protein was high at 3.0 mg/l, blood pressure was somewhat high at 140/84.

Now, with the exception of lipoprotein(a), these patterns are exquisitely weight-sensitive. A reduction in weight would yield effects superior to any medication I could give her.

Processed wheat products were a big problem for Leslie: whole wheat bread, pretzels for snacks, whole wheat pasta. Yes, they sound healthy, even endorsed by the American Heart Association, often bearing "heart healthy" labels on the packages. Don't you believe it.

In particular, Leslie had the number one cause for heart disease in America: small LDL particles, a pattern that is magnified 30-70% by wheat products. Endorsed by the Heart Association? (As I often tell people, if you want heart disease, follow the diet advocated by the American Heart Association.)

Leslie was skeptical, worried that she would be hungry all the time and would have virtually nothing left to eat. Instead, when she returned to the office three months later, she reported that eating was easy, finding healthy foods not containing wheat was easier than she thought, she felt great, finding more energy than she'd had in years.

She'd also shed 30 lbs.

Leslie's lipoprotein patterns also reflected the weight loss. She achieved her 60:60:60 Track Your Plaque lipid targets, small LDL shrunk dramatically, blood sugar and blood pressure were back in normal ranges.

I see results like Leslie's several times every week. For those of us with patterns like Leslie's, or just obesity that accumulates in the abdomen, going wheat-free is among the most powerful single strategies I know of.

If you need convincing, try an experiment. Eliminate--not reduce, but eliminate wheat products from your diet, whether or not the fancy label on the package says it's healthy, high in fiber, a "healthy low-fat snack", etc. This means no bread, pasta, crackers, cookies, breads, chips, pancakes, waffles, breading on chicken, rolls, bagels, cakes, breakfast cereal. I find elimination of wheat easier than just cutting back. I believe this is because wheat is powerfully addictive. It's very similar to telling an alcoholic that a drink now and then is okay--it just doesn't work. They need to be alcohol-free. Most of us need to be wheat-free, not just cut back.

You won't be hungry if you replace the lost calories with plenty of raw almonds, walnuts, pecans, sunflower and pumpkin seeds; more liberal use of healthy olive oil, canola oil and flaxseed oil; adding ground flaxseed and oat bran to yogurt, cottage cheese, etc.; and more lean proteins like lean beef, chicken, turkey, fish, and eggs.

The majority of people who go wheat-free lose weight, sometimes dramatically. Most people also feel better: more energy, more alert, better sleep, less mood swings. Time and again, people who try this will tell me that the daytime grogginess they've suffered and lived with for years, and would treat with loads of caffeine, is suddenly gone. They cruise through their day with extra energy.

Even without weight loss, going wheat-free usually raises HDL, reduces the dreaded small LDL dramtically. It also reduces triglycerides, blood sugar, C-reactive protein, blood pressure. Blood sugar control in diabetics is far easier, with less fluctuations and sharp rises in blood sugar.

Success at this also yields great advantage for your heart scan score control and reversal efforts.
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Comments (14) -

  • Anne

    10/13/2007 3:49:00 PM |

    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.

  • wccaguy

    10/13/2007 4:13:00 PM |

    Hey Doc,

    How is it that you're always making posts about subjects I've got questions about?

    About wheat...  I've got weight to lose and I've been doing a low carb thing and have lost 12 pounds in 5 weeks (including a week where I cheated for an event and got thrown off for a few days).  By the way, thanks for turning me on to Jimmy Moore.

    There are some low-carb breads out there.  I picked up a loaf ("Rudy's") last night at the local Whole Foods.  It has 5 net carbs per slice.  Not bad for a twice a week binge.  But now I'm wondering if, despite the low carbs, the wheat content in the bread will be out to get me.

    Thoughts?

    Thanks again as always!!!

  • Anonymous

    10/14/2007 12:37:00 AM |

    Dr. Davis:  Do you concentrate on wheat because it is the most prevalent grain, or should we get all grains out of our lives?  

    I have lost weight since I got most wheat out of my life, but I could still stand to shed a few more pounds.  I am still eating steel cut oats for breakfast on occasion, as well as teff (an Ethiopian grain) with spiced lentils.  Should I get every grain out of my life?

    And what about carbs from fruit - are they just as bad as grains? I'm eating 3-4 fruits a day -- not the high glycemic stuff -- but carbs nevertheless (apples, plums, berries, grapefruit).

  • Dr. Davis

    10/14/2007 2:07:00 AM |

    I believe that the intensity of your efforts depends on how far you've got to go in weight loss. For full effect, I've found--time and again--that full elimination is most effective.

  • Dr. Davis

    10/14/2007 2:11:00 AM |

    The low-carb strategy is a tool for weight loss, not necessarily for health beyond weight loss effects.

    Fruits are part of a healthy diet that, I believe, should only be eliminated if you are employing a low-carb strategy for weight loss.  

    I'm undecided how far we need to go with the entire grain world. I have had good experiences with oats and flax. Unfortunately, I have no experience with teff. Wheat is th ebiggest problem by a enormous margin.

  • Anonymous

    10/15/2007 2:47:00 AM |

    hello again- can you talk about calcium - vit. D and men.
    I am a 51 year old man and have heard that calcium/vit D are good for weight loss and health. But also have read that calcium/dairy is associated with a prostate cancer. How much is too much?
    Thanks!

  • Dr. Davis

    10/15/2007 12:40:00 PM |

    Sorry, I have never heard of any association with calcium and prostate cancer. However, this Blog and the accompanying website focus on heart disease, for which vitamin D is fabulously effective, in my view.

    For more discussion, see both the multiple blog posts on vitamin D, along with extensive reports on the www.trackyourplaque.com websites.

  • G

    11/15/2007 4:33:00 AM |

    Low carb is associated with slowing prostate cancer growth... *hot off the press!*

    http://news.yahoo.com/s/hsn/20071114/hl_hsn/lowcarbdietmayslowprostatetumorgrowth;_ylt=AqKywxO4nIE22JRYZeq0O53VJRIF

  • Anonymous

    7/3/2009 8:30:12 AM |

    This blog have helpful content and information. Is there any formula to control diet and keep muscle tone with fitness? For more log on
    Personal Trainer- www.just4ufit.com

  • health

    7/21/2009 11:51:09 AM |

    Hello Dr,

    wow some really good solid inforamtion there, i hope you don't mind I took severalnotes to share with my family over dinner.. I might add if i may that coconut oil is a good health resource, it consists of short and medium chain fatty acids and be re-used a couple of times

  • Weight Loss News

    7/25/2009 9:53:11 AM |

    Hi Dr,

    wow thanks for sharing this powerful info with people, I thought the some of the foods stuffs you mentioned with wheat in them were actually good for you... perhaps in moderation or.... should it be cut out all together?

  • Jennifer

    2/27/2010 5:10:27 PM |

    I've tried various low-carb, low-calorie, and low-fat diets for the past couple of years. Although the Atkins diet is very popular, it made me feel somewhat unhealthy.
    The diet plan I'm on right now is the Medifast Diet. The caloric intake is roughly 800-1000 calories. However, it doesn't make my body feel weak. It is a bit of a pricey diet, but there are plenty of coupons available on the internet (i.e. http://www.swoopup.com/stores/deals/Medifast-Diet). You should never pay full price.
    My advice is just choose a diet plan which your body reacts positively to. No one knows your body better than you do!

  • buy jeans

    11/3/2010 6:59:31 PM |

    Processed wheat products were a big problem for Leslie: whole wheat bread, pretzels for snacks, whole wheat pasta. Yes, they sound healthy, even endorsed by the American Heart Association, often bearing "heart healthy" labels on the packages. Don't you believe it.

  • weight loss

    1/15/2011 1:18:36 AM |

    Wheat free diet is one of the most effective ways to lose weight. I am using that kind of method for over a year now and it gives me an amazing result.

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Burn off the fat

Burn off the fat

9. May 2006 William Davis (0)

If you've ever wondered just how many calories you're burning with various activities like yard work, driving, climbing stairs, etc. go to this great website that will calculate it for you: http://www.caloriecontrol.org/exercalc.html.

Here are some examples:


Dancing for 30 minutes(fast, e.g., tango): 193 calories
Yoga for 30 minutes: 204 calories
Washing the car for 30 minutes: 173 calories
Vacuuming for 30 minutes: 88 calories

(All are for a 170 lb person.)

As you see, physical activity does not necessarily have to consist of exercise. It doesn't require fancy equipment or expensive outfits. But it does require you to keep moving. Sedentary work is among the most common reasons I see in my patients for failing to control weight and its associated lipoprotein patterns, like low HDL and small LDL.

If your work is sedentary, then a minimum of 60 minutes of physical activity per day is necessary to begin to correct weight-related patterns. If you gauge by calories burned, then a useful goal is 500 calories per day in physical activity--at a minimum.
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Holidays are dangerous!

Holidays are dangerous!

29. May 2006 William Davis (0)
If you're on holiday from work today, make sure you're not on holiday from your health, too.

Too often, people come back to the office telling me that the holidays simply got out of hand--cookouts, picnics, family gatherings, etc.--and they simply couldn't avoid overeating, overdrinking, sitting around--and gaining 3-5 lbs in a weekend. (Our record is 10 lbs in a weekend!)

I don't want to harp on this issue and ruin your holiday, but I can't stress how important it is that you don't allow this to happen to you. Weight gained in a brief space of time has exceptionally destructive effects. Ever see the movie "Super Size Me"? It's an entertaining and well-done yet graphic portrayal of the damaging effects of rapid weight gain.

Enjoy your time off. Relax, enjoy your family and friends--but continue to pay attention to choosing the right foods, don't overeat, take time out to do something (or several things) physical. It'll pay off hugely in the long run.
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Statin drugs for everybody?

Statin drugs for everybody?

17. April 2009 William Davis (10)
Who is better off?

John takes Crestor, 40 mg per day:

LDL cholesterol 60 mg/dl
HDL cholesterol 60 mg/dl
Triglycerides 60 mg/dl
Total cholesterol 132 mg/dl



Or Sam:

LDL cholesterol 60 mg/dl
HDL cholesterol 60 mg/dl
Triglycerides 60 mg/dl
Total cholesterol 132 mg/dl

who obtained these values through vitamin D normalization (to increase HDL); wheat elimination (to reduce triglycerides and LDL); and omega-3 fatty acids (to reduce triglycerides).


Believe the drug industry (motto: If some statin is good, more statin is better!), then John is clearly better off: He has obtained all the "benefits" of statin drugs. They refer to the "pleiotropic" effects of statin drugs, the presumed benefits that extend outside of cholesterol reduction. The most recent example are the JUPITER data that demonstrated 55% reduction in cardiovascular events in people with increased c-reactive protein (CRP). Media reports now unashamedly gush at the benefits of Crestor to reduce inflammation.

However, on Sam's program, elimination of wheat and vitamin D both exert anti-inflammatory effects on CRP, typically yielding drops of 70-90%--consistently, rapidly, and durably.

So which approach is really better?

In my experience, there is no comparison: Sam is far better off. While John will reduce his cardiovascular risk with a statin drug, he fails to obtain all the other benefits of Sam's broader, more natural program. John will not enjoy the same cancer protection, osteoporosis and arthritis protection, relief from depression and winter "blues," and increased mental and physical performance that Sam will.

If our goal is dramatic correction of cholesterol patterns and reduction of cardiovascular risk, for many, many people statin drugs are simply not necessary.
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  • Joe E O

    4/17/2009 5:59:00 PM |

    The question I have - what happens if you eliminate wheat, add the fish oil, and niacin, normalize vitamin D and still don't hit the TYP target of 60-60-60? What's the thought process for deciding to take a statin???

  • Jenny

    4/17/2009 6:16:00 PM |

    Dr. Davis,

    Have you checked this out yet. It looks like something worth considering. I've heard some very interesting things lately about new microbes being found in association with diseases not considered infectious until now. The association of enterovirus with Type 1 and Type 2 diabetes also points to the inflammation potentially being nonautoimmune in nature and raises the question of whether Vitamin D is downregulated as part of the body's attempt to fight invasion.

    Since the studies I've found show raising Vitamin D does NOT have a positive impact on diabetes, though Vitamin D is low in diabetes, this is a serious concern.

    If we are eliminating inflammation but not organisms causing inflammation, long term the results may not be so good.

  • Anonymous

    4/17/2009 6:50:00 PM |

    A total cholesterol of 132 can be quite unhealthy considering that all cause mortality in the lowest quartile of total cholesterol is twice the death rate in the upper quartile of total cholesterol.  A paleo diet would produce more optimum cholesterol numbers (no grains, etc, as recommend here) but that diet varies by latitude with more carbs the closer to the equator one lives with total cholesterol varying accordingly.

  • Scott Miller

    4/17/2009 9:26:00 PM |

    Additionally, dig a little deeper and Sam likely has a much better LP(a) value than John.  He's probably sick fewer times during the year, and he's risk of getting cancer is half that of John's.

    Oh, and Sam probably has less bodyfat as a nice healthy side effect of wheat reduction.

  • Anonymous

    4/18/2009 4:16:00 AM |

    My HDL was suck at 38 since 2002. I went to 40mgs crestor mid 2008. I put myself on 2 grms of niacin, this fixed the perpetually high trigs, and the 40gms crestor crushed the LDL

    Then I found this blog and went on vitamin D.  I already had followed fish oil but not consistently so I fixed that.  After 4 months on Vitamin D, my HDL was up to 50 Smile
    oh...and my LDL dropped too.

    My Dr. told me I was a poster child for Crestor treatment but she allow the change back to 20mgs anyhow.  I did take a month off from crestor to get rid of the muscle/bone aches and pains and have now restarted 20mgs with no problems.

    I am going to spend a few months on 20mg and check the lipid profile, if good, next step is statin free for me.

  • Anne

    4/18/2009 8:59:00 AM |

    I eliminated wheat - and all grains - from my diet nearly three years ago (I eat low carb Paleo). My fish oils give me a total of 1680 mg EPA and DHA per day, and my vitamin D levels since last year have varied between 50 ng/ml and 80 ng/ml. However, my lipid profile is not like either John's or Sam's:

    LDL cholesterol 154 mg/dl
    HDL cholesterol 93 mg/dl
    Triglycerides 36 mg/dl
    Total cholesterol 255 mg/dl

    My cardiologist and endocrinologist are happy with my profile because they say the ratios are good, no one is asking me to take a statin. My calcium score is 0.

    I have read too that too low a cholesterol level is just as bad and, maybe worse, than too high !

    Anne

  • Dr. William Davis

    4/18/2009 11:32:00 AM |

    Hi, Jenny--

    Excellent point. Perhaps a topic for a future discussion.

    However, we do witness positive effects on various phenomena associated with diabetes when vitamin D is normalized: reduction in CRP, dramatic increase in HDL, modest reduction in triglycerides and small LDL, and reduction in blood sugar if insulin resistance is present.

    Will vitamin D replacement impact on cardiovascular mortality in diabetics? Uncertain, though I predict it does to a substantial degree.

  • JPB

    4/18/2009 3:55:00 PM |

    Plus John will likely experience some nasty side effects from the statin that Sam will not!

  • homertobias

    4/18/2009 8:00:00 PM |

    Jenny, love your blog, your spirit,and your free questing mind.

    My take on Vitamin D and Diabetes:

    In general, Vitamin D does better at preventing disease than ameliorating it once it exists.  There is soom good Finnish epidemiological evidence that supplementing Vitamin D to levels in the 50's can decrease the incidence of Type 1 diabetes in children.
    Proposed mechanism has to do with the leaky gut hypothesis.  D deficiency leads to impaired intercellular signalling through degredation of tight junctions between cells.  Adjacent intestinal lining cells can't effectively talk to each other. Bacteria, viruses etc "leak" through, The immune system gets overwhelmed, then the immune system notices that pancreatic islet cells look a whole lot like a portion of a proteus or klebsiella bacteria and whammo, you have type 1 diabetes, rheumatoid arthritis, etc.  

    Type 2 diabetes seems to be another story.  Since Vitamin D is often sequestered in fat, lowering serum 25-OH Vitamin D levels, and type 2 diabetics tend to be obese, therein may be part of the association.  

    But no one essentially dies of a Hgb A1c of, say, 6.7.  As you know, it's the sequelae -  the heart attacks, strokes, CHF.  I do recall one recent study on MI, diabetes, and Vitamin D levels.  It may be that D can help prevent the adverse sequelae of type 2 dm with no direct effect on A1c.

  • Jenny

    4/25/2009 1:09:00 PM |

    Dr. Davis,

    I just saw your reply to my earlier question.  The one decent study I've found suggests that dramatically raising Vitamin D has no significant effect on blood sugar.

    My concern is this: when we lower inflammation by raising Vitamin D are we putting out the fire or turning off the smoke alarm.

    Though inflammation clearly raises heart attack risk and lowering it does prevent heart attack, there are many other forms of inflammation that are important because it's a sign we are fighting off invaders that need to be fought off. So if we turn down inflammation we may be promoting microbe-stimulated cancers five years later.

    And if as some evidence suggests, cardiac inflammation stems from bacteria originally associated with gum disease, raising the Vitamin D might lower the inflammation but not bacterial infestation which over time cannot be good for us.

    Is there any evidence that Vitamin D does more than improve the markers like CRP (the smoke alarm) and actually eliminates the disease state?

    So far I am not seeing that in Diabetes.

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At what score should a heart catheterization be performed?

At what score should a heart catheterization be performed?

21. November 2008 William Davis (2)
That's easy: NONE.

(Although I've addressed this previously, the question has come up again many times and I thought it'd be worth repeating.)

In other words, no heart scan score--100, 500, 1000, 5000--should lead automatically to procedures in someone who underwent a heart scan but has no symptoms.

This question is a common point of confusion.

In other words, is there a specific cut-off that automatically triggers a need for catheterization?

In my view, there is no such score. We can't say, for instance, that everybody with a score above 1000 should have a catheterization. It is true that the higher your score, the greater the likelihood of a plaque blocking flow. A score of 1000 carries an approximately 25-30% likelihood of reduced blood flow sufficient to consider a stent or bypass. This can nearly always be settled with a stress test. Recall that, despite their pitfalls for uncovering hidden heart disease in the first place, stress tests are useful as gauges of coronary blood flow.

But even a score of 1000 carries a 70-75% likelihood that a procedure will not be necessary. This is too high to justify doing heart catheterizations willy-nilly.

Unfortunately, some of my colleagues will say that any heart scan score justifies a heart cath. I believe this is absolutely, unquestionably, and inexcusably wrong. More often than not, this attitude is borne out of ignorance, laziness, or a desire for profit.

Does every lump or bump justify surgery, radiation, and chemotherapy on the chance it could represent cancer? Of course not. There is indeed a time and place for these things, but judgment is involved.

In my view, no heart scan score should automatically prompt a major heart procedure like heart catheterization in a person without symptoms. If a stress test is normal, signifying normal coronary flow (and there are no other abnormal phenomena, such as abnormal left ventricular function), then there is no defensible rationale for heart procedures. Heart procedures like stents and bypass cannot prevent heart attacks in future; they can only restore flow when flow is poor, or stop the heart attack that is about to occur.

However, EVERY heart scan score above zero is a reason to engage in a program of prevention.
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Comments (2) -

  • Drs. Cynthia and David

    11/20/2008 11:08:00 PM |

    Thank you Dr. Davis.  Your efforts on behalf of patients are very much appreciated.

    I wondered if you would be willing to submit a comment regarding the new USDA guidelines for food intake.  Your experiences with improving and reversing heart disease using diet (cutting out wheat, starch and sugar, etc) are very important.  People like McDougall are still pushing the low fat vegan approach and being listened to, and the members of the committee are all low fat dogmatists.  I think your experiences as a practitioner would hold more weight than anything I could say (though I submitted my two cents anyway). See http://www.cnpp.usda.gov/dietaryguidelines.htm to submit comments.

    Thanks again for your efforts.

    Cynthia

  • Anonymous

    11/21/2008 4:10:00 PM |

    At the least, we should ask that the recommendations be based on research and not industry demands.

    Jeanne

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And you thought gasoline was expensive

And you thought gasoline was expensive

2. June 2009 William Davis (5)
In 1995, the Palmaz coronary stent was introduced, the brainchild of Drs. Julio Palmaz and Richard Schatz. Medical device manufacturer, Johnson & Johnson, priced the device at $2500 per stent.

Let's put this into perspective: At just 0.05 grams per 15 millimeter stent, that put the price of the common stainless steel used to manufacture the stent at $22,650,000 per pound.

Only after several competing stents finally made it to market did J&J reduce its price to its bargain price of $1200, or $10,872,000 per pound. And to think that most of us were shocked to find out that the U.S. military paid $200 for a hammer.

Since 1995, a competitive market for stents has developed, pushing prices down. Now, you can purchase a brand-new coronary stent for as little as $4,000,000 per pound.

Medical device manufacturers have been guilty of a degree of greed that would make many Wall Street bankers blush. That's why I call medical devices "the industry of infinite markups."
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  • Skeeter The Dog

    6/2/2009 1:03:34 PM |

    Interesting observation considering that medical doctors in the United States are part of one of the most successful cartels in human history.  OPEC ain't got nuthin' on the AMA!

    All humans are greedy; it is simply a matter of whether one's form of greed has greater positive than negative externalities as whether we call someone greedy or not.  But we are all greedy.

  • homebray

    6/2/2009 1:56:09 PM |

    I hope that you are suggesting that an ounce or prevention is worth a pound (in this case many pounds) of cure.

    Medical devices manufactures have very high engineering and regulatory costs which are all designed to ensure beneficial rather detrimental products. We can debate whether or not they are succeeding in this.

    However, don't you wish this same level of engineering and regulations were applied to manufactured "foods".  

    BTW they are made of Nitinol not Stainless Steel.

  • JD

    6/2/2009 2:32:17 PM |

    Interesting study posted on Dr. Eades' twitter.

    An inverse relationship between plasma n-3 fatty acids and C-reactive protein in healthy individuals

    http://www.nature.com/ejcn/journal/vaop/ncurrent/abs/ejcn200920a.html

  • Dr. William Davis

    6/2/2009 5:15:57 PM |

    Homebray--Yes. I wish I thought of that, the "ounce of prevention . . ."

    Palmaz-Schatz are stainless steel. Nitinol came several years later.

  • homebray

    6/2/2009 7:26:45 PM |

    Ah!  my mistake, sorry.

    I didn't' think you were suggesting that stents should be sold in bulk by the pound! Smile

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Dr. Bernadine Healy on heart scans

Dr. Bernadine Healy on heart scans

5. August 2008 William Davis (1)

A Heart Scan Blog reader brought the following tidbit to my attention.

Cardiologist and now writer for U.S. News and World Report, Dr. Bernadine Healy, wrote this editorial, a glowing endorsement of heart scans:

The approach is beautifully simple. Calcium accumulates in advanced plaques, so calcium visible in the heart's arteries indicates atherosclerosis. An exploding number of studies in the past few years have unequivocally shown that the calcium score predicts both heart attack and sudden death. As a generalization, patients with scores between 100 and 400 face three to four times the risk of a heart attack or death compared with others at the same age with a zero score. Over 400, that elevated risk more than doubles.

Most doctors rely instead on the Framingham calculator, which estimates a symptom-free person's risk of a heart attack in the next 10 years based on smoking history, blood pressure, cholesterol levels, sex, and age. It's available free online from the National Institutes of Health. Most people taking the test will have minimal or no coronary disease, though risk estimates over 9 percent should inspire vigorous preventive efforts. For some, however, coronary heart disease is sneaky, and Framingham will underestimate what lies ahead. Roughly half of those who suffer a major heart attack or sudden coronary death are symptom free. Calcium scores are additive to Framingham; they pick up the individual surprises by using X-ray vision to look inside the heart. No wonder insurance companies are scrambling to use coronary calcium scores—life insurers, that is.


Dr. Bernadine Healy is no small-time player. In addition to her academic credentials, she is former chief of the National Institutes of Health (the first woman to hold the influential post), former head of the American Red Cross, and former deputy director of the White House Office of Science and Technology Policy under the Reagan administration. An endorsement of CT heart scans, though written under the guise of a probing editorial, will do an enormous amount of good to overcome the hurdles in gaining wider acceptance of heart scans.

Those of us applying heart scans in everyday practice have long appreciated their enormous power to detect and track coronary plaque. Framingham scoring can't even touch the certainty and quantification provided by heart scans in day-to-day life. Hundreds of studies have validated their use, but they still suffer from lying in the shadows of the procedural bullies aiming to boost the number of heart catheterizations, angioplasties, stents, bypass surgeries.

Dr. Healy, a voice with great weight, not just a political figure but also a cardiologist and scientist, has done a great service to broadcast the message of heart scanning.
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  • Kathy Hall

    8/5/2008 1:33:00 PM |

    I just started going to a Dr. who specializes in Health and Wellness and he recommended this scan.  It is not covered by insurance.  It costs $350 here in the Detroit area.  Sounds like it's worth it.  
    My new doctor actually answers e-mail too.  What is this world coming to?

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