Human foie gras

18. September 2010 William Davis (10)
If you want to make foie gras, you feed ducks and geese copious quantities of grains, such as corn and wheat.

The carbohydrate-rich diet causes fat deposition in the liver via processes such as de novo lipogenesis, the conversion of carbohydrates to triglycerides. Ducks and geese are particularly good at this, since they store plentiful fats in the liver to draw from during sustained periods of not eating during annual migration.

Modern humans are trying awfully hard to create their own version of foie gras-yielding livers. While nobody is shoving a tube down our gullets, the modern lifestyle of grotesque carbohydrate overconsumption, like soft drinks, chips, pretzels, crackers, and--yes--"healthy whole grains" causes fat accumulation in the human liver.

Over the past few years, there has been an explosion of non-alcoholic fatty liver disease and non-alcoholic steatosis, two forms of liver disease that result from excess fat deposition. The situation gets so bad in some people that it progresses to cirrhosis, i.e., a hard, poorly-functioning liver that paints a very ugly health picture. The end-result is identical to that experienced by longstanding alcoholics.



While Hannibal Lecter might celebrate the proliferation of human fatty livers with a glass of claret, fatty liver disease is an entirely preventable condition. All it requires is not eating the foods that create it in the first place.
Tags :

Comments (10) -

  • Anonymous

    9/17/2010 6:32:37 PM |

    What a great analogy.  Many thanks.

  • Anna

    9/17/2010 6:39:49 PM |

    Don't forget the fruit juices that everyone thinks are so healthy to drink in frequent and large quantities - let's not be fooled by 100% fruit juice labels, either (legal for juice processors to claim because the added sugars are concentrated fruit sugars instead of other sugars like cane or corn sugars) or otherwise.  

    Even though I no longer drink fruit juice, I'm veyr much enjoying reading the book, Squeezed, What You Don't Know About Orange Juice.  A bit dry at times because of all the narrative involving the 1960s-era FDA hearings on the of the exploding pre-squeezed OJ industry, it's still a great tale because of its parallels with other foods that are widely considered to be minimally processed (like dairy), yet are anything but.  There's a reason why orange and dairy processing plants look like refineries...

  • Anonymous

    9/17/2010 8:11:39 PM |

    Hannibal prefer Chianti with liver.

  • Bling

    9/17/2010 8:57:58 PM |

    Dr Davis, Glad to see you obviously read my comment on your previous post about "Foie Gras". Yes, I always thought it was uncanny that the medical profession never saw the similarities between Foie Gras and NAFL. Smile
    Meanwhile, I'm still here after a year on low carb, giving low carb a bad name because I am still so big. I'm off to find an NHS doctor to prescribe me Metformin since I think it's a good idea. I think I may have to fake diabetes though, since technically I am prediabetic. Wish me luck.
    Peace out.

  • john

    9/17/2010 9:20:42 PM |

    Hi Dr. Davis,

    I ate many carbs (including lots of sugar) in my younger years yet have always had good body composition...  

    Is fatty liver without obesity common?

  • Anonymous

    9/17/2010 10:41:17 PM |

    Did you blog on the unexpected benefits of gluten-free? I.e. no more IBS, no more heartburn, etc. In recent days, I have visited many blogs and I cannot find it. I have a hand written note that I found it on your site. Thanks

  • Anonymous

    9/17/2010 10:44:05 PM |

    I found the unexpected effects of a gluten free diet in September through a Google search. thanks.

  • Anonymous

    9/18/2010 3:00:10 AM |

    Clarification please, I'm a new reader: This avoiding "healthy grains" that is being advocated, is it the avoidance of wheat only?  Are oats, brown rice ok?
    Sarah

  • praguestepchild

    9/18/2010 11:30:14 AM |

    I eat a lot of paté and foie gras. I consider it to be an ideal food, except that one can actually OD on all the vitamins. It seems expensive but it's filling, a few tablespoons make a light meal.

    Ironic that a great way to avoid a fatty liver is to eat fatty liver.

  • homertobias

    9/18/2010 4:38:36 PM |

    Oh Dr. D

    You should let your sense of humor out more often!  It is delightful!
    Thanks for making me laugh this morning.

    Of course I love Silence of the Lambs and Anthony Hopkins in particular. And yes, it was eat his liver with fava beans and a glass of good chianti.

Add comment

Loading
Don't forget the pumpkin in the wheat-free pumpkin bread

Comments (3) -

  • Lori Miller

    12/25/2010 4:57:28 PM |

    If you have a small pumpkin, you can use that instead of the canned goop. Stab the pumpkin a few times and roast it for about an hour at 350, or until it's spongy. Scoop out the seeds (save them for roasting) and mash the flesh.

  • Anonymous

    12/25/2010 9:27:08 PM |

    Love this, thank you! We need these recipes so much!
    Penny

  • kellgy

    12/26/2010 3:18:52 AM |

    I think I will make this treat with a small pumpkin (thanks Lori) and I will use my trusty pressure cooker to shorten the cook time and maybe add a little vanilla like Richard A. suggested.
    I typically avoided the wheat biscuits and breads today along with the 90% sweets-laden party spread. The only non-sugar items on the table were a salad and veggie plate.  (I think I was the only one who noticed the huge disparity.)
    I suppose this bread can also be concocted with yams or acorn squash as an alternative to pumpkin if desired. I am going to have to experiment with the different flavors.

Add comment

Loading
Osteoporosis and coronary calcium

Osteoporosis and coronary calcium

4. March 2008 William Davis (9)
Several studies over the years have demonstrated a curious paradox:

People with more osteoporosis (thin bones) tend to be more likely to have coronary disease (heart attacks). They also tend to have higher heart scan scores (more coronary calcification as an index of atherosclerotic plaque).

People with more coronary disease and higher heart scan scores tend to have more osteoporosis.


In other words, regardless of which way you tackle the question--osteoporosis first or heart disease first--it leads to the same conclusion: Both conditions are somehow related.

I realize I harp an awful lot on this whole vitamin D issue. But, even after correcting the vitamin D blood levels of many hundreds of people, I remain enthusiastic as ever about the untapped potential of this fascinating factor.

So I couldn't resist showing this amazing comparison of how the long-term effect can be quite graphic.

The first scan is from a 46-year old man and shows normal coronary arteries without calcium and normal density of the vertebra (a common and reliable place to measure bone density).

























The second image is from a 79-year old man with both severe coronary calcification (and therefore severe coronary disease) and severe osteoporosis.
























It makes you wonder if the disordered metabolism of calcium through vitamin D deficiency allows transport of calcium away from bone and into coronaries. This has, however, been shown to not be the case. Instead, they are separate processes, each under local control, but sharing a common pathophysiology (causative factors).

An intriguing question: Would the 79-year old still look like the 46-year old had he begun increasing his vitamin D intake at, say, age 30?
Tags :

Comments (9) -

  • Anne

    3/4/2008 10:50:00 AM |

    Dear Dr Davis,

    Just this weekend I found this article on the web from a research scientist about vascular calcification and "osteoblast phenotype": http://www.medicine.manchester.ac.uk/postgraduate/research/studentships/nonfunded/yalexander2

    I contacted her and she told me that "resorption of bone in the skeleton co-exists with the deposition of bone in the vasculature" and sent me a diagram explaining it. She also told me that the medication I take for osteoporosis, Strontium Ranelate, which stimulates formation of osteoblasts and prevents resorption by osteoclasts, would help with vascular calcification.

    That photo of the man's osteoporosis is scary. Here's a link to one of the scans in the CT angiogram I had and now I can see the degeneration in my spine :-( And even in my sternum :-( I have been diagnosed with osteoporosis and I'm only 54 :-(

    http://i228.photobucket.com/albums/ee253/clermont_photo/ln019.jpg

    I have no calcification in my coronary arteries but there is some on my bicuspid aortic valve...I don't think you can't see it because of all that contrast media.

    Anne

  • Anonymous

    3/4/2008 1:29:00 PM |

    Perhaps it is Vitamin K (particularly K2) that is playing the role of 'traffic cop' for calcium, directing it TO bone while diverting it FROM arteries.

  • Olga

    3/4/2008 4:50:00 PM |

    Hi Dr. Davis:

    This comment is about an unrelated subject.  A well intentioned friend who is worried about my low carb life style sent me this article from the Canadian Broadcasting Corp. (CBC) website:

    http://www.cbc.ca/health/story/2008/03/03/heartdisease-study.html

    The article states that "Low-fat beats low-carb in diets to reduce heart disease" as if it were a done deal.
    I was wondering what is the relevance of reduced blood flow in the arms with respect to heart disease, and if this is the only parameter they measured, as they don't supply a link to the research article.  I find it hard to believe it holds as much weight as the huge drop in triglycerides and reduction of small dense LDL particles associated with low carb vs. high carb diets.  Just curious if you had seen this article.  

    Olga

  • mike V

    3/6/2008 4:05:00 AM |

    Re: Earlier post on Vitamin K


    See: "Vitamin K - Keeping Calcium in Your Bones and Out of Your Blood Vessels"

    http://blogs.webmd.com/integrative-medicine-wellness/2007/11/vitamin-k-keeping-calcium-in-your-bones.html
      
    From: WebMD
    MikeV

  • Stephan

    3/6/2008 8:53:00 PM |

    Hi Olga,

      I just reviewed this article on my blog.  It clearly shows LC is healthier than LF, but their interpretation of the data is WAY off base.  And interestingly, I have access to the full-length article so I saw some of the other things they measured.  Even though vascular reactivity went down in LC, vascular diameter went up.  So maybe it was just dilating less because it was already more dilated than in the LF group.

    Whole Health Source blog

  • Stan

    3/8/2008 2:54:00 AM |

    I noticed on various webmd and other fora that quite a number of long term vegetarians in their 50-ties and 60-ties seem to report osteoporosis (and coronary disease).  Q for Dr. Davis:

    - did you look at the dietary  connection among your patients, between being long term vegetarian and having higher or lower chance of osteoporosis than non-vegetarians?
    ,
    Stan (Heretic)

  • mike V

    3/10/2008 2:43:00 PM |

    stan
    It doesn't exactly answer your question, but did you read Dr D's post:

    "Should you become a vegetarian?"
    (Saturday, February 24, 2007")
    mikeV

  • buy jeans

    11/3/2010 2:39:23 PM |

    I realize I harp an awful lot on this whole vitamin D issue. But, even after correcting the vitamin D blood levels of many hundreds of people, I remain enthusiastic as ever about the untapped potential of this fascinating factor.

  • sinus surgery Los Angeles

    12/21/2010 3:27:01 PM |

    It is often said that the intake of milk ensures inflow of calcium into the body.But I have noticed that even those consuming milk in heavy doses do suffer from this problem...could you explain as to what could be the other reasons to it?

Add comment

Loading
Aspirin, Lipitor, and a low-fat diet

Aspirin, Lipitor, and a low-fat diet

17. April 2009 William Davis (0)
Despite all the hoopla heart disease receives in the media, I continue to marvel at how many people I meet who still think that aspirin, Lipitor, and a low-fat diet constitute an effective heart attack prevention program.

It doesn't. No more than washing your hands prevents all human infections. It helps, but it is a sad substitute for a real prevention program.

Of course, aspirin, Lipitor, and a low-fat diet is the same recipe followed by the unfortunate Tim Russert and his doctors. You know how that turned out. Mr. Russert's experience is far from unique.

What is so magical about aspirin, Lipitor and a low-fat diet?

There is a simple rationale behind this approach. Aspirin doesn't reduce atherosclerotic plaque growth, but it inhibits the propagation of a blood clot on top of a coronary plaque that has "ruptured," thereby reducing likelihood of heart attack (which occurs when the clot fills the artery). So aspirin only provides benefit if and when a plaque ruptures.

Lipitor and other statin drugs reduce LDL cholesterol, promote a modest relaxation of constricted plaque-filled arteries (normalization of endothelial dysfunction), and exerts other effects, such as inflammation suppression.

A low-fat diet is intended to reduce saturated fat that triggers LDL cholesterol formation and to encourage intake of whole grains that reduce cardiovascular events and LDL cholesterol.

If that is the extent of your heart disease prevention program, you will have a heart attack, bypass surgery, or stent--period. It may not be tomorrow or next Friday, or even next month. Aspirin, Lipitor, and a low-fat diet may delay your heart attack or procedure for a few years, but it will not stop it.

Some flaws in the aspirin, Lipitor, low-fat program:

--Aspirin can only exert so much blood clot-blocking effect. It can be overwhelmed by many other factors, such as increased blood viscosity, increased fibrinogen (a blood clotting protein that also triggers plaque), and plaque inflammation.
--Lipitor reduces LDL, but does not discriminate between the relatively harmless large LDL and the truly plaque-triggering small LDL--it reduces all LDL, but small LDL can still persist, even at extravagant levels since neither aspirin nor Lipitor specifically reduces small LDL, while a low-fat diet increases small LDL.
--Low-fat diet--A diet reduced in fat and loaded with plenty of "healthy whole grains" will trigger increased small LDL (an enormous effect), c-reactive protein, high blood sugar, resistance to insulin, high blood pressure, and an expanding abdomen ("wheat belly").


Aspirin, Lipitor and a low-fat diet do not address:

--Vitamin D deficiency
--Omega-3 fatty acid deficiency and the eicosanoid path to inflammation
--High triglycerides
--Small LDL particles
--Distortions of HDL "architecture"
--Lipoprotein(a)--the worst coronary risk factor nobody's heard of
--Thyroid status

In other words, the simple-minded, though hugely financially successful, conventional model of heart disease prevention is woefully inadequate.

Don't fall for it.

Tags :

Add comment

Loading
Diabetes: Better than hedge funds

Diabetes: Better than hedge funds

7. March 2011 William Davis (23)
Diabetes is where the action is.

While, for virtually all of history, type 2 diabetes was an uncommon condition of adults, the disease has spread so much to all levels of American society that even kids are now developing the adult form. Researchers from the Center for Disease Control and Prevention predict that, by 2050, one in three adults will be diabetic.

The diabetes market is booming, handily surpassing growth of the oil industry, the housing market, even technology. It makes Bernie Madoff’s billions look like small potatoes. In health, few markets are growing as fast as diabetes—-not osteoporosis, not heart disease, not cancer.

Americans are getting fat from carbohydrate consumption, becoming diabetic along with it. While kids hanging around the convenience store gulp down 26 teaspoons of sugar in 32-ounce sodas and 56-grams-of-sugar in 16-ounce frozen ices, health-minded adults are more likely eating two slices of 6-teaspoons sugar-equivalent “healthy whole grain” bread, wondering why last year’s jeans are too tight.

The U.S. is not the only nation affected. Globally, 2.8% of the world’s population are diabetic, a number expected to double over the next 20 years.

Pharmaceutical companies boast double-digit growth for diabetes drugs, growth rates that keep profit-hungry investors happy. Merck’s Januvia, for instance, introduced in 2006, recently catalogued 30% growth in sales, with annual sales approaching $1 billion. Recently FDA-approved Victoza, requiring once-a-day injection, is expected to reap $4 billion in sales per year for manufacturer Novo Nordisk. Such numbers can only warm a drug company CEO’s heart.

Most diabetics don’t just take one medication, but several. A typical regimen for an adult diabetic after a couple of years of treatment and following the dietary advice of the American Diabetes Association includes metformin, Januvia, and Actos, a triple-drug treatment that costs around $420 per month. Two forms of insulin (slow- and fast-acting), along with two or three oral medications, is not at all uncommon.

“Collateral” revenues from the other health conditions that develop from a diet rich in “healthy whole grains,” such as drugs for hypertension, drugs to slow the progression of kidney disease in diabetes, drugs for “high cholesterol,” and drugs for high triglycerides, and you have a pharmaceutical drug bonanza. You, too, would throw all-expenses-paid, fly-the-entire-sales-force-to-the-Caribbean sales meetings.

The global diabetes market has already topped $25 billion and is growing at double-digit rates. Forget the Internet, gold stocks, or solar energy—-diabetes is where the money is. This fact has not been lost on the very market-savvy pharmaceutical industry. As with any successful business, they have devoted substantial resources to develop and grow this booming business.
Tags :

Comments (23) -

  • Kurt

    3/7/2011 5:19:04 PM |

    Since I changed my diet to lower my cholesterol, my fasting blood sugar went from 98 to 82.

  • praguestepchild

    3/7/2011 5:51:32 PM |

    I'm not sure the pharmaceutical industry is any more market-savvy than any other industry, less I would say. They spend quite a bit of their time and money influencing politicians and doctors in an extremely distorted feedback loop of regulation, regulatory capture, and lots of sleazy baksheesh.

    I'd prefer to invest my money in a company that really is market-savvy in an unfettered market. Like Apple.

  • Patty

    3/7/2011 6:10:53 PM |

    I'm floored.  I had no idea that diabetics took so much medicine and spend so much money on it.

  • Might-o'chondri-AL

    3/7/2011 7:54:30 PM |

    285 million diabetics worldwide is a lot. There are also 100 strains of entero-virus ( a sub-group of picorna-viruses).

    Type 1 diabetic children show 60%with entero-virus in their pancreas beta cells. Type 1 is usually said to be an auto-immune destruction of beta cells.

    Type 2 diabetic adults show 40% entero-virus infection in beta cells; whereas, the general non-diabetic rate is 13% infected.

    4 genetic variants of the gene IFIA-1 enzyme inducing an immune response were identified. It affects how the immune reaction to picona-virus RNA inside a cell cytoplasm plays out; some get over-reaction of interferon Beta.

    Another genetic factor recently discussed involves the human inability to make the sialic acid NeuSGc. Gene CMAH enzymes aren't able to produce this sialic acid on the outside of our cells; it limits human, as opposed to other mammals, control of blood sugar.

    Some individual genetics have both less number of pancreatic beta cell and diminished size of the islets. They don't put out enough insulin to meet the demand.

    Maybe we'll see a vaccination program for specific non-polio entero-virus; it's worthwhile, even if not relevant to all diabetes. If I could patent reversal of fatty liver to overcome genetic pancreatic insufficiency riches would be mine.

  • Henry Lahore

    3/8/2011 1:47:18 AM |

    Vitamin D appears to both prevent and treat diabetes.
    http://www.vitamindwiki.com/tiki-index.php?page_id=339

  • Paul

    3/8/2011 3:54:25 AM |

    You know when an industry is growing by leaps and bounds by the amount of TV ad space they buy... it's startling how many commercials there are right now targeting the diabetic consumer.

    The one advertisement that I find most disturbing though is the one for Onglyza.  The ad says, "you exercise and eat right but your blood sugar may still be high, so you need extra help."

    This specific medication is designed to prevent after meal blood sugar spikes.  But, right there in the middle of the ad it shows a man (with a large wheat belly) eating a sandwich with what looks like two slices of "healthy whole wheat" bread.  This explains a lot (to me) when it comes to what kind of message this company is trying to send.

    It's a kin to producing an advertisement for Nicorette gum while showing young, attractive teens enjoying themselves smoking cigarettes.

  • Dr. William Davis

    3/8/2011 4:05:51 AM |

    Hi, Prague--

    Please don't mistake my tongue-in-cheek comments for investment advice.

    In fact, outsized profits or no, I wouldn't think of investing in what I feel is an industry governed by greed and the pursuit of perverse profits.

    Hi, Paul--

    Yes. It seems to say, "It's not your fault. We can help. Go ahead and enjoy your sub sandwich."

    50 years from now, they will look back and laugh at our dietary disasters, wondering why we never got it right.

  • Daniel A. Clinton, RN, BSN

    3/8/2011 4:09:47 AM |

    I suspect Vitamin D's role in protecting against diabetes is multifactorial. I suspect that viruses that may infect the Vitamin D deficient bounce off those with optimal Vitamin D. I suspect Vitamin D also plays a direct role in the beta cells of the pancreas. I don't know how restorative Vitamin D is, but I strongly believe Vitamin D has huge preventative effects, which is part of why we have such absurd Vitamin D recommendations.

  • Anonymous

    3/8/2011 6:24:18 AM |

    brilliant viewpoint doctor. lots of love.. Smile)

  • Anonymous

    3/8/2011 6:35:51 AM |

    The whole diabetic thing is astonishing to me. It's an epidemic and will cost us gazillions in health care money, and the pain and misery is going to be horrible. I have been a RN for 35 years and otherwise intelligent people just look at you blankly when you suggest changing their diet or even just walking. They say, "oh, my doctor is happy with my A1C of 7" or "he added another medication and now things are fine." Their lights are on but no one is home!!!

  • Anonymous

    3/8/2011 8:43:57 AM |

    I found an interesting page regarding Vitamin D and diabetes (among other things):

    http://www.vitamindwiki.com/tiki-index.php?page_id=339

    The conclusions from the available research are as follows:

    - It appears that > 2000IU VitD3 will prevent diabetes
    - It appears that > 4000IE VitD3 will treat (but not cure) diabetes
    - It appears that calcium and magnesium and needed both for prevention and treatment.

    Pretty interesting summary.

  • Kris @ Health Blog

    3/8/2011 8:50:51 AM |

    Those are really terrible news, I wonder if all those profits have something to do with how slow governments seem to be in waking up to the fact of how easily those diseases are preventable.

    It's incredible that all of this is so easily fixed with a simple change in lifestyle, yet nothing seems to happen.

    -Kris

  • Anonymous

    3/8/2011 8:59:44 AM |

    From an article on the Physorg.com website with the title: Researchers at the University of Saskatchewan have discovered, after a two-year investigation, that diets high in carbohydrates are a probable mechanism for the skyrocketing rates of Type 2 diabetes

    "The work by Kaushik Desai and Lily Wu, professors in the U of S College of Medicine’s Department of Pharmacology, focused on methylglyoacal (MG), which is produced naturally as the body metabolizes glucose consumed in carbohydrates.

    They found that high levels of MG produce all the features of Type 2 diabetes, including damage to insulin producing cells in the pancreas, insulin resistance and impairment of body tissue to use glucose properly. Their finding are set to be published in the American Diabetes Association journal Diabetes in March."

    And I thought the ADA wouldn't allow such findings to be published because they go against the ADA's "dietary" advice.

  • praguestepchild

    3/8/2011 12:16:08 PM |

    Dr Davis wrote: "Please don't mistake my tongue-in-cheek comments for investment advice.

    In fact, outsized profits or no, I wouldn't think of investing in what I feel is an industry governed by greed and the pursuit of perverse profits."

    I understood the irony. But the perverse profits are, IMO, a result of regulatory capture, and many other market distorting incentives like the unequivocal government acceptance of the diet-heart hypothesis.

    As far as greed goes, if you don't like "greed" perhaps you shouldn't invest in anything but simply donate it all to charity ;)

  • Stargazey

    3/8/2011 1:34:00 PM |

    This discussion is all very idealistic, but don't forget the fact that our government is totally and completely in the pockets of Big Food.

    Think of all the political contributions made by ConAgra, General Mills and Cargill. If the government started preaching against sugar, wheat and industrial oils, there would be hell to pay. It's much easier for our politicians to nurture an antidiabetes pharmaceutical industry than it is for them to go up against the massive clout of Big Food.

  • JEAN

    3/8/2011 4:08:40 PM |

    That's why, Stargazey, voting with your pocketbook is the only way, and blogs like this. Every time I come here, and to other similar sites, there's usually one poster who's so thankful they've found this information. And Paleo-Primal diets are now on the evening news, five years ago, that life style was considered to be fringe, nutters only accepted.
    So, one person at a time, but you've got to start somewhere.

  • Margaret

    3/8/2011 11:08:54 PM |

    I don't go for all these conspiracy theories.  I think it is just terribly difficult to get people to change their foodways and get exercise.

  • fatfree

    3/9/2011 4:18:04 AM |

    And fingerstick tests are also part of industry. Hm...

  • Might-o'chondri-AL

    3/9/2011 5:55:49 PM |

    http://www.pnas.org/content/early/2011/03/03/1019007108.full.pdf.+html.

    In utero epigenetics (& age) influence diabetes....
    ? Are you what your mother ate as well as what you eat ?

  • Might-o'chondri-AL

    3/9/2011 5:59:27 PM |

    Link got chopped; so, after second ".../03/" put this:

    1019007108.full.pdf.+html.

  • Might-o'chondri-AL

    3/10/2011 3:09:32 AM |

    http://www.ajcn.org/content/71/5/13445/T1.expansion.html

    Control may very well be via Doc's method. Diabetes progression may be individual.

    Epigenetic vulnerabilites chart
    includes glucose/insulin, insulin resistance, glycolysis in exercise, etc. Free full article link chart from is at right.

  • Might-o'chondri-AL

    3/10/2011 3:11:45 AM |

    Again chopped link; end reads "... T1.expansion.html"

  • body lift

    3/22/2011 11:33:21 AM |

    Really nice post. Thanks for share it.

Add comment

Loading
Trans fats to be banned

Trans fats to be banned

27. September 2006 William Davis (0)
Sometimes good may come from legislation.

The City of New York is contemplating a ban on trans-fat use by restaurants, bakeries, and other food establishments in preparation of their foods. (Trans-fats are also known as hydrogenated fats.)

At this point, I believe it's unclear, should this pass, what the response will be. If food preparers turn to butter, that's not much better. (Don't get fooled by the non-sensical argument of which is better, butter or margarine--they're both terrible.) Subtracting hydrogenated fats will no doubt cause major disruption of food preparation habits. It may even increase the cost of food slightly.



I believe that the true positive effect of this situation, however, will be the tremendously heightened awareness it will raise in the public, both in New York and elsewhere, on just how bad and pervasive trans-fats are. It may increase awareness that foods like donuts and pastries are not just about excessive quantities of sugars, but also trans-fat content.

If you're already a Track Your Plaque follower, you already know that the easiest way to dodge trans-fats in your diet is to minimize your use of processed foods--the cellophane-wrapped, pulverized, dried, just-add-water, microwavable and ready-to-eat foods that line supermarket shelves. Trans-fats are purely man-made. You won't find them--not a stitch--in green peppers, lettuce, olive oil, almonds. . .unprocessed foods. Watch for an in-depth report on trans-fats on the Track Your Plaque website in which we will detail the scientific evidence behind this movement, how to recognize when foods contain trans-fats, etc.
Tags :

Add comment

Loading
Lead to Gold: The alchemy of transforming nutritional-supplement-to-medication

Lead to Gold: The alchemy of transforming nutritional-supplement-to-medication

9. January 2009 William Davis (25)
Here's a recipe to make hundreds of millions of dollars. Others have done it and you can do it, too!

1) Identify a nutritional supplement that works.

Find some agent deemed to fall within the broad allowances of the 1994 Dietary Supplement Health and Education Act . However, because this agent is already in the public domain and is essential non-patent-protectable, you may need to develop some patent protectable aspect of its production, application, or encapsulation. This patent-protected aspect may or may not provide genuine advantage, but that's not your concern. Your concern is protecting your investment and providing the appearance of exclusivity.


2) Identify a medical indication for your product.

Choose a disease or condition that is likely to yield unquestioned efficacy, e.g., omega-3 fatty acids to reduce high triglycerides in people with familial hypertriglyceridemia (triglycerides >500 mg/dl). While this will restrict your ability to make market claims, it will not restrain your ability to sell or allow use of your agent for "off-label" applications. In fact, there are methods to surreptitiously promote the use of your product for off-label use, such as hiring experts to discuss the science behind your product with doctors who can prescribe your product. Ideally, your product's primary indication will provide a substantial market on its own to justify your investment. However, the eventual off-label sales can be substantial, even outstripping the sales generated through your primary indication.


3) Obtain at least $230 million to pay for the clinical trials required to obtain FDA approval.

You will also have to raise the capital to build the business to manufacture, distribute, and sell your product.


4) After FDA approval is obtained, your business is up and running, and distribution begins, start bashing the non-FDA-approved nutritional products that stand to compete in your market.

You could point out that only your product has actually passed through the rigorous FDA process. You could make claims regarding purity, potency, "approved by your doctor," etc., whether or not there is any truth behind the claim.


5) Buy that second vacation home in Aspen and the corporate jet you've been dreaming about! After all the risks you've taken, you deserve it!


That's it, plain and simple. It is a tried-and-true formula that has been applied many times.

It is a formula like this that brought Lovaza-brand omega-3 fatty acids to market, Niaspan brand of niacin, ergocalciferol form of vitamin D, Folbee (prescription combination B vitamins), with a slightly different spin for Synthroid (since the Armour Thyroid it is meant to replace is not a nutritional supplement, but a low-cost, generic thyroid replacement).

Whatever you do, don't EVER run a head-to-head comparative trial of your agent versus the nutritional supplement competition. For instance, NEVER compare Lovaza to supplemental fish oil capsules, matched milligram-for-milligram for EPA and DHA content. NEVER compare Niaspan to over-the-counter Sloniacin. NEVER compare Armour Thyroid to Synthroid. You never know what you might find. (Psssssttt! They might be equivalent!)

The formula is not a foolproof road paved with riches, however. There have been market failures, as well. Folbee, for instance, is hardly a household name. So there's risk involved, no question about it. But, should it all work out, the payoff can be big, VERY big, as it has been for Niaspan and Lovaza.

So, start thinking about how you might follow this formula for:

1) Cholecalciferol (vitamin D3)--e.g., for osteopenia, low HDL, or high c-reactive protein
2) Vitamin K2--also for osteopenia
3) Magnesium--for suppression of ventricular arrhythmias (especially Torsade de Pointes)
4) Iodine--for goiter and iodine deficiency
5) Vitamin C--for uric acid reduction

Who said you can't turn lead into gold?
Tags :

Comments (25) -

  • Dr. B G

    1/9/2009 3:01:00 PM |

    Dr.D...

    What curious insights...

    Don't forget the lobbyists who get the 'Gold' onto the Medicare and Medi-Cal/Medicaid formularies (approved drug lists) though cheap, OTC or generic alternatives exist.

    Guess who pays for these indirectly?

    BTW, this does not occur at the VA MC system level which has been awesomely managed and deliver I believe good healthcare and effective drug care.

    -G

  • Dr. B G

    1/9/2009 3:01:00 PM |

    Dr.D...

    What curious insights...

    Don't forget the lobbyists who get the 'Gold' onto the Medicare and Medi-Cal/Medicaid formularies (approved drug lists) though cheap, OTC or generic alternatives exist.

    Guess who pays for these indirectly?

    BTW, this does not occur at the VA MC system level which has been awesomely managed and deliver I believe good healthcare and effective drug care.

    -G

  • Jan Jones, M.A.in Education, B.S. in Education

    1/9/2009 4:09:00 PM |

    Dr. D,

    I was taking Armour Thyroid for several years(90mg)and levels were checked and remained 'normal'. Recently, having no rx insurance I found that the AT is considerably more expensive than synthroid, so my dr recommended I switch to the correct converted dosage to get the cheaper price.  I have been concerned that the synthroid is not as good, as effective, as the AT I was taking.  By your final comment on the post are you saying those meds are pretty equivalent in effectiveness, in your opinion? It would really help me to know if I have made a good decision to follow the price and not sacrifice effectiveness.

    Thanks,
    Jan

  • Anne

    1/9/2009 5:46:00 PM |

    I live in the UK where strontium in the form of patented Strontium Ranelate (Protelos) is prescribed for the treatment of osteoporosis. I am prescribed it. It works ! I've been having it 18 months and my bone density has increased and it doesn't have the side effects of the bisphosphonates. The 'supplemental' form strontium (strontium citrate for example) however is not available in health food shops in the UK. In the US the supplemental form of strontium is available in health food stores but Strontium Ranleate has not been approved by the FDA - strange !

    Still, I'm happy as the medication only costs me the flat rate prescription charge of £7 for three months supply....so there can sometimes be a benefit depending on where you live. It currently costs me just over £25 a month to buy omega-3 fish oil from my local health food shop so next time I see my cardiologist I'm going to ask him to prescribe me Omacor as it will save me tons of money if I can get it on prescription....don't know if he'll oblige though.

  • Jessica

    1/9/2009 10:23:00 PM |

    Gee, thanks for stealing my golden parachute, Doc.

    With my 401(k) having turned into a 104(k) this year, I planned on enacting my Vit D analogue project in 2009 with hopes of making it big.

    You've foiled my plan!

    (P.S. I was also going to ask Sally Fields to be the spokeswoman for my D analogue and in the commercial, she would say something like, "I thought taking Vitamin D and Calcium would help stop my bone loss, but turns out, it didn't." Then she should plug my FDA-approved drug. Oh wait, doesn't that commercial already exist?).

    Smile

  • Grandma S.

    1/10/2009 12:12:00 AM |

    Does anyone know a good Vit K2 to take, so many choices.  Thank you!

  • Lynn M.

    1/10/2009 6:25:00 AM |

    Jan Jones,
    Normally you can buy a generic Armour for much less than what Armour costs.  However, since this summer there has been a supply problem with the dessicated thyroid products, which has made some of the generic forms unavailable and may have driven up the Armour price.

    Cost aside, from someone who has been totally dependent on thyroid supplementation for 59 years because of a congenital disorder, Synthroid is not equivalent to a dessicated thyroid such as Armour.  Synthroid only has T4, whereas Armour has T4, T3, T2, T1, and calcitonin, which are all naturally produced by the human thyroid.  For an in-depth perspective of the superiority of Armour from a patient's point of view, see www.stopthethyroidmadness.com.
    Lynn

  • Jan Jones, M.A.in Education, B.S. in Education

    1/10/2009 3:25:00 PM |

    Lynn,

    Thanks for your perspective.  Since I switched about 3 months ago, I have thought I didn't feel quite the same on the synthroid but I was attributing some of that to the change.  Next week I will have my levels checked to see if it has remained in the "normal" range on the generic synthroid.  Even if it is ok, I am leaning towards asking the dr to go back to AT.  I am still wondering if Dr.D is categorizing it in the same group as the quasi-drug/vitamins he mentions, meaning it's not really any better. My dr seems to think they are equivalent.
    I have read the info on AT, which is why I started on it over 6 years ago and at the time I had rx coverage. Dr.D is correct in his assertion that one way or another it's all about $$.

    Jan

  • Sam

    1/10/2009 4:22:00 PM |

    Grandma S., I take Thorne Research MK-4 K2.

    It's a little pricey, but at dietary supplementation dosage of less than 1mg/day, a $60 bottle should last about 18 months. (1mg/day is one drop.)

    Search with google for vendors with the best price.

  • David

    1/10/2009 6:45:00 PM |

    Grandma S.,

    I can't speak for everyone, but I like Life Extension's K2 supplement. It's not terribly expensive, and has more K2 than a lot of the other brands. 100 mcg of MK-7, and 1,000 mcg of MK-4. It's not the only one that's good, of course, but I like it.

    Here's the link at LEF: http://www.lef.org/Vitamins-Supplements/Item01224/Super-K-with-Advanced-K2-Complex.html

    Also look for LEF's K2 for a cheaper price (w/ free shipping) at healthmegamall.com.

    Hope this helps!

  • Dr. William Davis

    1/11/2009 2:12:00 PM |

    Jan-

    Sorry for the imprecision.

    I believe that Armour thyroid is superior to T4-only preparations. While there are some published data to support this, real life makes it patently clear as day. People feel better, lose weight more effectively, have better cholesterol values, including Lp(a).

  • Lynn M.

    1/12/2009 7:59:00 AM |

    Jan Jones,
    The way you feel is a much better measure of thyroid sufficiency than any blood test.  Blood tests don't measure what is happening at the cellular level. Factors such as adrenal insufficiency and thyroid antibodies can leave a person with good thyroid levels in the blood but not enough hormone in the cells.

    I'm curious as to what levels you will be having checked.  The best blood tests for determining thyroid sufficiency are the Free T3 and Free T4, which measure thyroid hormone levels.  The TSH is a useless test for anyone already on supplemental thyroid. It is only an indirect measure of thyroid sufficiency and actually measures the pituitary hormone produced as part of a feedback loop. If you're supplementing, you've disturbed the normal feedback loop. I don't understand why doctors settle for the myriad of problems associated with TSH tests when they can directly measure thyroid levels with a Free T3 and Free T4 test.  But nonetheless the TSH test is considered the gold standard.  

    Even when I have been on too low a dose of generic Armour, as measured by hypo symptoms and low-in-range FT3 and FT4 readings, my TSH level was only .011 (ref range 0.35-5.50).  After years of supplementing, I guess my brain has learned that producing thyroid stimulating hormone (TSH) is useless.  Just one example of why the TSH test shouldn't be relied on.

  • mike V

    1/13/2009 5:18:00 AM |

    Lynn M
    I positively endorse your comments based on experience of >30 years of T4->T4+T3->Armour Thyroid->generic (Armour)
    The latter is actually shipped free of charge under Humana Medicare part D.(RightSourceRX)
    (An excellent price! Smile)
    MikeV

    PS:In earlier posts/comments re: thyroid,there was a suggestion that vitamin D3 supplements could significantly impact TSH readings. I would like to hear if this has been observed by others.
    M

  • Anna

    1/13/2009 7:25:00 PM |

    Having taken Levoxyl T4 in combination with a small dose of compounded, timed-release natural thyroid hormone when I was seeing a fantastic out-of-network endo (unfortunately, he was also out-of-state and the distance made it hard to use his services last year).

    Now my new (HMO network) endo prescribed  Levoxyl (T4) only, and I can say that T4 only wasn't right for me, though my labs were great (TSH about 1.0 and FreeT4 just fine).  I just didn't feel quite right on T4 alone.  

    I was able to convince the endo last spring to add Cytomel (T3) with the T4, which is much better than T4 alone, but not nearly as good as the combination of T4 and T3 in the natural thyroid extract in a ratio that mimics human thyroid physiology (98%-2%, Armour is a porcine ratio of 80%-20%).  

    So I think I'm going to continue looking for a new local doc who has the expertise to use compounded natural thyroid extract in the way that worked best for me, even if it means paying more out-of-pocket.  

    Like processed industrial food that will fill you up but won't nourish your body, some cheaper things just aren't worth the savings.

  • Dr. B G

    1/14/2009 6:01:00 AM |

    Mike V,

    I've noticed my own TSH improve from 1.3-1.9 to 1.0 on vitamin D supplementation to 25(OH)D 70 ng/ml. I stopped vitamin D this summer and noticed the TSH trended back up to 1.3.

    I've seen this trend for patients as well -- though the more wheat-damaged/addicted -- the less the improvement seen with vitamin D repletion. Guess that is to be expected.

    Yes -- there is limited science but there is a significant observation between lower TSH and summer months. I wonder WHY?? Smile

    Thank you for your info and all your insightful comments here!

    -G

  • Dr. B G

    1/14/2009 6:01:00 AM |

    Mike V,

    I've noticed my own TSH improve from 1.3-1.9 to 1.0 on vitamin D supplementation to 25(OH)D 70 ng/ml. I stopped vitamin D this summer and noticed the TSH trended back up to 1.3.

    I've seen this trend for patients as well -- though the more wheat-damaged/addicted -- the less the improvement seen with vitamin D repletion. Guess that is to be expected.

    Yes -- there is limited science but there is a significant observation between lower TSH and summer months. I wonder WHY?? Smile

    Thank you for your info and all your insightful comments here!

    -G

  • Anna

    1/14/2009 3:42:00 PM |

    Dr B G mentioned the seasonal aspect of thyroid function.  I definitely think there's something to that.  

    When I was first treated for hypothroidism by Dr. Kenneth Blanchard, who is located near Boston MA, he mentioned that many, if not most of his patients need a very slight dose-up tweak in the fall-winter months.   But I live in mild San Diego, so he wasn't sure if I'd experience that effect.  I saw him in early July that first time.  In hindsight, summer has always been my least hypothyroid-feeling time of year.

    But sure enough,  that fall I was dragging my knuckles.  The addition of an extra 50 mcg tablet of Levoxyl for a days, followed by just one more 50 mcg tablet of Levoxyl *a week* helped a lot throughout the winter.  Periodic lab draws were used in addition to my symptoms (or lack of them).  By the time I saw him again in June (with labs drawn and reviewed in the interim) I was back to the original dose.  

    This seasonal cycle has been my experience for three years since beginning thyroid hormone supplementation, and feels quite pronounced to me every Fall, but the dose adjustment needed is very minor.  I seem to have settled on a fall-winter cycle of 2 x 50 mcg Levoxyl 5 days a week, 1 x 50 mcg 2 days a week; and a late spring-summer cycle of 2 x 50 mcg 4 days a week, 1 x 50 mcg 3 days a week.

    And I don't think this cycle is temperature or weather-induced, but rather by less daylight, as the San Diego area usually has some of its warmest temps in the Fall (the winds shift from the onshore breezes to dry, warm winds from the desert).  The second time I called the endo to say I had some symptoms return or increase, he mentioned that my file indicated  that I called the same week the previous year.  So it's not that I was tuned into the calendar, either, it had to be pointed out to me, though now I am aware of it, of course.

  • mike V

    1/15/2009 7:42:00 AM |

    Dr B G, and Anna:
    Thanks for the interesting feedback.
    Vitamin D seems to be regarded as a hormone, or at least a prohormone, and I have seen it suggested that it may increase thyroid sensitivity in the tissues. If so I would expect the control feedback loop to lower the thyroid stimulating hormone (TSH) which of course calls for less to be secreted.


    My interest relates to the following.
    I have a 'night time only' wake up phenomenon, that is a sort of "adrenoline rush" with heart racing.
    This was rare at first but increased a month or two after a Fall vitamin D3 increase about two years ago.

    Now it prefers the half hour after falling asleep, or prior to normal AM awakening.
    My heart "plumbing and electrical" are in excellent order, and sleep apnea has been eliminated.
       Anna, did you have specific symptoms from the extra T3 fraction of porcine thyroid, or is it perhaps just a matter of preference, or of not feeling your 'best'?
    I have been using it for some years, and although aware, have not questioned it till now.
      
    I guess it could be a factor in my sleeping, even with the shorter half-life. My age (72) could also be a factor.
    My next step will be FT3, FT4 and 25(OH) testing.
    Thank you again for the respones.
    Mike V

    I would be interested to know if Dr D or anyone else believes that the higher porcine T3/T4 ratio has caused specific symptoms?

  • Anna

    1/15/2009 6:22:00 PM |

    Mike V,

    Vit D3 is indeed a hormone precursor.  The vitamin in its name is sort of misleading.  

    I've never taken Armour, so I can't comment on it.  I've always either taken straight T4 (Levoxyl); Levoxyl with a small dose of compounded natural [porcine] thyroid extract in a timed-release preparation; or Levoxyl (T4) with Cytomel (T3).  The later is what I am currently taking, prescribed by the endo in my HMO network.

    The Levoxyl with the added compounded thyroid extract was prescribed by Dr. Kenneth Blanchard (author of What Your Doctor May Not Tell You About Hypothyroidism).  He feels that the 80/20% ratio of T4/T3 in Armour is not the best ratio for humans; he says they do well initially, but over time, the T3 content is too high for humans.  He's an endocrinologist MD and has a PhD in biochemistry, and he's hypothyroid himself.  He prefers to Rx in a T4/T3 ratio of about 98/2% and uses 50 mcg tablets of Levoxyl because they have no dyes that can cause issues for some people, and the compounded thyroid dose (for the T3), using a formula to come up with the 98/2% amounts.  

    Dr. Blanchard is the one who came up with way I take the Levoxyl, 2 tablets some days and only 1 tablet some others, because the T4 has such a long half life in the body.  Averaging the dose like on a weekly basis seems to be fine, so I have continued to do that with my current local endo, but it does drive my current endo a bit batty, but he can find little to argue with it.  If my TSH is a bit too low I adjust how many days I take only 1 tablet up or down.

    I really needed that bit of extra T3 and noticed it in mental processing and daily productivity, though I don't think it was reflected in my labs at all.  So my HMO endo added a small dose of Cytomel, but it gives me about 6% T3 now, and my TSH was .06 last time instead of hovering arounf 1.0.  So I dropped 1 tablet of 50mcg Levoxyl one day a week. I'm about to get labs done again so we'll see.  

    If I had to chose my own ratio, I think I'd do best on just a bit more T3 than Dr. Blanchard allows, and just a bit less than I get in the daily 1 tablet of Cytomel, perhaps around 4-5%.  I also liked the timed release compounded version better than Cytomel, which wears off too soon due to its short half life in the body (and it's too small a capsule to divide, but I take the smallest dose).  

    I have been taking a lot more Vit D3 lately to a) get my 25 (OH)D level up and to fend off colds this winter.  It'll be interesting to see if that is also reflected on my thryoid labs.  I'll report if anything significant shows up.

    Incidentally, I also had some gluten and casein sensitivity and gene tests done by Enterolab (www dot entrolab dot com) recently, and I was positive for IgA antibodies (both gluten and casein), anti-transglutaminase IgA, and genes for gluten sensitivity (my son has similar results except he had one celiac gene and one gluten sensitivity gene - I know of  one person in my husband's extended family with celiac sprue).  I wanted to know this because gluten reactions often correlate to autoimmune hypothyroidism (I don't think I've ever had thyroid antibodies tested though).

  • mike V

    1/16/2009 2:50:00 PM |

    Anna:
    Thank you once again for your detailed response.
    I will check out Dr Blanchard for info on my query.

    MikeV

  • Dr. B G

    1/17/2009 2:04:00 AM |

    Mike V,

    Are you taking vitamin D or A in the evening?

    These stimulate people most frequently (as they are related to daytime-foods, right? and of course solar radiation exposures).

    Take these during AM or daytime hours only.

    Armour apparently has a short half-life -- consider with your MD and try taking only in the AM.

    Hope you feel better and resolve the nighttime waking!

  • Dr. B G

    1/17/2009 2:04:00 AM |

    Mike V,

    Are you taking vitamin D or A in the evening?

    These stimulate people most frequently (as they are related to daytime-foods, right? and of course solar radiation exposures).

    Take these during AM or daytime hours only.

    Armour apparently has a short half-life -- consider with your MD and try taking only in the AM.

    Hope you feel better and resolve the nighttime waking!

  • Anna

    1/17/2009 8:09:00 PM |

    Mike V,

    Another thought occurred to me.  How's your blood glucose? Is it steady from a fairly low carb diet?  Or could you be consuming too many carbs in the evening?

    Evening carbs can initiate insulin secretion at night and drive down BG.    While sleeping, the body  senses lowered BG (maybe not even too low) and prompts an adrenaline rush to quickly raise BG, because  the liver  is "dumping" some glucose into the bloodsteam.  That series of glucose regulatory events is enough to wake some with palpitations people at the times and in the manner you describe (especially early morning, about 3-6 am), and they often see morning BG ("dawn phenomenon" as the highest BG readings of the day.  

    Another thought is that if you are taking your Armour later in the day (I think many people take Armour in divided doses during the day), perhaps the last dose is too late and the relatively high T3 kicks in too strongly.  Or it could be just too much T3 for you.  In which case, a combo of T4 and Armour (to create a different ratio than 80%T4-20%T3) might be worth trying.  In my experience, though, the average endo or primary care doc doesn't want to fiddle like that, so good luck.  The ratios aren't hard to figure out (though I had to refresh my Jr High algebra memories Smile, so maybe you could ask your doc for some samples of 50 mcg Levoxyl and titrate it yourself to see how it goes.  Hopefully you have a open-minded doc.  

    BTW, I'm taking my Vit D earlier in the day now, too P (by 1 pm) because it might have been contributing to my "night owl" tendencies, too.  makes sense to not take it later than the hours of strong sun wavelengths, anyway.  

    Good luck, keep us posted.

  • mike V

    1/18/2009 8:15:00 PM |

    Dr B G & Anna:
    Thanks for your thoughts. Incidentally I think it is not insignificant that the topics of Vitamin D and and Hypothyroidism are some of the most 'commented' on Dr D's Blog. I am convinced that getting them both right is fundamental to overall western health and well being, and all is not yet fully understood.
      
    I have already pretty much eliminated the time of day, and dosing of thyroid and concluded that T should be taken in the morning, and I take nothing late at night. I have suspected for a while that T3 fraction could be a problem, but you read the Drs with T, you come across Dr John C Lowe who disagrees strongly with Ken Blanchard's position on T3. He himself has been taking solely T3 for decades without consequences!
    Many seem to agree that TSH is not a reliable indicator, and FT3 FT4 basal temperature,and 'how the heck you feel' should be relied on.
    Yet others suggest that we hypothyroids come in two types. Type 1 (low producers, and Type 2 (supposedly involving adrenal insufficiency). Maybe some of us can be both?

    Possibly vitamin D can stimulate both the tissue sensitivity to T, and/or the ability of various tissues to convert T4 to T3.
    *****************************

    The following caused my (young male, 'you MUST treat the TSH number) doctor to laugh uproariously.

    I told him that I had moderated my "wake up" problem with celery.
    However, with celery juice, you reach a point of 'diminishing returns'.
    When he asked why, I told him that celery juice is very seriously diuretic.

    http://www.herbs2000.com/herbs/herbs_celery.htm


    Excerpt:

    The essential oil found in the celery was studied in extensive clinical researches carried out in Germany and China during the 1970s and 1980s. In these studies, it was found that the oil possessed a calming effect on the functioning of the human central nervous system and could be used to alleviate nervous disorders. On further examination, some of the chemicals in the essential oil were also found to effect anti-spasmodic, sedative, and anticonvulsant actions on the human body. The effectiveness of the oil in treating high blood pressure problems have been confirmed in studies conducted on the essential oil of the celery in the Peoples Republic of China.  

    I am now trying the seed.

    MikeV

  • buy jeans

    11/3/2010 9:58:48 PM |

    It is a formula like this that brought Lovaza-brand omega-3 fatty acids to market, Niaspan brand of niacin, ergocalciferol form of vitamin D, Folbee (prescription combination B vitamins), with a slightly different spin for Synthroid (since the Armour Thyroid it is meant to replace is not a nutritional supplement, but a low-cost, generic thyroid replacement).

Add comment

Loading