Addictive Foods

25. June 2007 William Davis (3)
Kraft Foods, Inc. is manufacturer of Kool Aid, Oscar Mayer, Kraft Macaroni and Cheese, Velveeta, Honey Maid Grahams, and hundreds of other processed food products. Post cereals also falls under the umbrella of Kraft with products like Raisin Bran, Post Toasties, and Fruity Pebbles. Annual revenues in 2006 for Kraft: $34.4 billion. A big operation with enormous influence over our eating habits.

Nabisco is manufacturer of Oreos, Ritz Crackers, Chips Ahoy and many others. Like Kraft/Post, it is also a big player.

While Nabisco was owned for several years by tobacco giant RJ Reynolds, in 2000 it was acquired by Philip Morris, another big tobacco manufacturer.

More recently in Spring, 2007, Philip Morris (now called Altria--you'd change your name, too, if it was synonymous with dirt) spun off its Kraft subsidiary for a big profit. However, the management structures remain intertwined.

In other words, despite the shuffling of shares, the two industries, big tobacco and big food, are in many respects one and the same.

Is it any surprise that the same industry that made billions of dollars pushing addictive nicotine products responsible for the deaths of hundreds of thousands of people is now intimately involved with addictive products produced and marketed by the processed food industry?

If you believe that food manufacturers are innocently and honestly conducting their businesses, simply think back to the testimony provided in front of Congress during the tobacco industry hearings. Broad deception, concealed truths, and outright lies were commonplace. There was no conscience involved. This was about money--and lots of it.

Why should the processed food industry, intimate with the tobacco industry, be any different?

If you want control over heart disease and your heart scan score, buy produce and buy local. Spend your time in the produce aisle, not the cereal or chip aisle. Unprocessed food, unadorned by bright labels, cartoon animals, American Heart Association endorsements, that's what we should seek.

Heart Scan Curiosities #7

25. June 2007 William Davis (1)



Here's a situation that crops up once in a while, occurring in perhaps 2% of heart scans.

The white within the circled area represents calcium, and thereby atherosclerotic plaque, situated immediately at the "mouth", or opening, of the the right coronary artery. What is somewhat unusual is that this plaque is not principally coronary, but aortic. That is, the plaque is mostly situated in the large vessel called the aorta. The three coronary arteries arise from the aorta.

In this instance, the aortic plaque involves the mouth of the right coronary artery. (In views not shown, the plaque also extends into the artery as well.) I call this a "double whammy" because the same plaque can post risk for heart attack and stroke.

Generally, aortic plaques pose risk for stroke. When aortic plaque fragments, little bits and pieces can travel upward to the brain and block an artery, thus a stroke.

In the coronaries, disrupted ("ruptured") plaques don't generally shower debris, but permit blood clot formation, resulting in heart attack.

This plaque, however, poses the theoretical risk of both heart attack and stroke because of its strategic location.

Should a plaque like this be handled any differently? I don't think so. But it does provide another reason to take atherosclerotic plaque in any artery seriously.

The nutrition counterculture

23. June 2007 William Davis (2)
When we look back over our American nutritional history over the last 50 years, it's hard not to come to the conclusion that much of the innovation in nutrition did not come from official agencies like the Food and Nutrition Board of the Institute of Medicine, the National Academy of Sciences, the FDA, the USDA, or the AMA.

Instead, it came from the popular culture. It came from bold, extravagant claims made by maverick figures like Ancel Keys, Nathan Pritikin, Dean Ornish, and Robert Atkins. Of course, some ideas have now fallen by the wayside, dismissed in a broad American "experiment" as ineffective, impractical, or kooky. But it permitted experimentation on an extraordinary scale with millions of people following a particular strategy at a time.

The advice of the official agencies tended to be reactionary. When nutritional deficiencies (remember those?) of the early 1900s were prevalent, they issued advice on food choices to help alleviate deficiencies. When deficiency transformed into excess after World War II, "smart" food choices from food groups and "sensible eating" became the theme.

Unfortunately, the advice was always adulterated by the enormous influence of various special interests, anxious to protect their national franchise. Powerful groups like the meat industry, wheat producers, and the dairy industry all made sure they had a big hand in crafting and influencing what was told to the American people.

The result: the advice offered by official groups has always represented the compromise of what some agency wished to convey to the people and the very powerful input of industry. What if the government decided to advise us what automobile to buy? Imagine the uproar in the auto industry when Washington tells us to buy Toyota for fuel economy and reliability. How long would that advice last?

That's why almost no knowledgeable adult follows the advice of the USDA, the National Academy of Sciences, or the Food Pyramid. I believe that we all intuitively recognize that the advice is watered-down, sometimes silly, sometimes downright unhealthy.

Nonetheless, the national experiment in diet that has taken place since 1950 has led to a collective wisdom of what is good and what is bad. The most productive conversations on nutrition therefore take place outside of the USDA and Washington. It occurs, instead, in places like bookstores, websites, and the media. Of course, there's lots of misinformation and profiteering in these sectors, as well. But like the enormous force unleashed by the collective wisdom of those contributing to the Wikipedia phemonenon, we've zig-zagged to something closer to the truth than ever uttered by an official agency.

Prescription vitamin D

23. June 2007 William Davis (32)
Niacin:

Over-the-counter: $2-5 per month
Prescription: $120 per month


Fish oil:

Over-the-counter: $3-6 per month
Prescription: $120 per month


Vitamin D:

Over-the-counter: $2 per month
Prescription: $70 per month



With vitamin D in particular, the prescription form is vastly inferior to the over-the-counter preparation. This is because the prescription form is ergocalciferol, or vitamin D2, not the effective human form, vitamin D3 or cholecalciferol.

When you're exposed to sun, what form of vitamin D is activated in the skin? It's all vitamin D3, no vitamin D2 whatsoever. Vitamin D3 is also far more effective than D2. People taking D3 (as long as it's oil-based) easily obtain healthy levels of vitamin D in the blood. People taking 50,000 units per day of D2 (the recommended quantity) remain miserably deficient, with minor increases in vitamin D blood levels. In short, D2 barely works at all. D3 works easily and effectively.

Moreover, D2 is the plant-based form. It is a form not found naturally in humans. D3 is the mammalian form, the same found in humans that exerts all its biologic benefits.

Then why is the prescription form of vitamin D2 (brand names Driscol and Calciferol) more expensive?

It's the same old pharmaceutical industry scam: Look for something patent protectable, regardless of whether it's superior to the non-patent protectable product, then sell it for exagerated profits. Though it is inferior and the science and clinical experience prove that it's inferior, you can still fool lots of people, including prescribing physicians. So what if you only make $50 or $100 million?

Don't fall for it. Prescription doesn't necessarily mean superior. In fact, the prescription form may be significantly inferior, as with vitamin D2. But the pharmaceutical industry carries such power and persuasion, who's going to know?

Nutrition activist Mike Adams

20. June 2007 William Davis (1)












I borrowed the above comic from the website of nutritionist, more properly nutrition activist and author, Mike Adams. His website, www.newstarget.com, was a pleasant surprise.

I was actually looking for some thoughts on pharmaceutical advertising and its pervasive and destructive effects and came across one of Adam's reports, Pharmaceutical television advertising is a grand hoax at http://www.newstarget.com/021526.html. The piece is a rant against the pharmaceutical industry's constant bombardment of the media, who have also been co-opted into their service, enticed by the enormous advertising revenues the drug industry brings.

But I was surprised to find an insightful, informative website on health issues, particularly healthy eating that rejects the manufactured food industry's intensive effort to persuade us to eat their products. While I don't agree with everything Adams has to say, his website provides some great food for thought. He also provides lots of downloadable information.

There's also some great laughs at his poke at the pharmaceutical industry with his Disease Mongering Engine at http://www.newstarget.com/disease-mongering-engine.asp, in which you get to create your own diseases. I got a real kick out of this.

CT scans and radiation exposure

19. June 2007 William Davis (8)


The NY Times ran an article called

With Rise in Radiation Exposure, Experts Urge Caution on Tests at

http://www.nytimes.com/2007/06/19/health/19cons.html?_r=1&adxnnl=1&oref=slogin&adxnnlx=1182254102-vQpytpx6W/Z9gvAaNPDZvA



“This is an absolutely sentinel event, a wake-up call,” said Dr. Fred A. Mettler Jr., principal investigator for the study, by the National Council on Radiation Protection. “Medical exposure now dwarfs that of all other sources.”


Where do CT heart scans fall?

Let's first take a look at exposure measured for different sorts of tests:



Typical effective radiation dose values

Computed tomography Milliseverts (mSv)

Head CT 1 – 2 mSv
Pelvis CT 3 – 4 mSv
Chest CT 5 – 7 mSv
Abdomen CT 5 – 7 mSv
Abdomen/pelvis CT 8 – 11 mSv
Coronary CT angiography 5 – 12 mSv

Non-CT Milliseverts (mSv)

Hand radiograph Less than 0.1 mSv
Chest radiograph Less than 0.1 mSv
Mammogram 0.3 – 0.6 mSv
Barium enema exam 3 – 6 mSv
Coronary angiogram 5 – 10 mSv
Sestamibi myocardial perfusion (per injection) 6 – 9 mSv
Thallium myocardial perfusion (per injection) 26 – 35 mSv

Source: Cynthia H. McCullough, Ph.D., Mayo Clinic, Rochester, MN


If you have a heart scan on an EBT device, then your exposure is 0.5-0.6 mSv, roughly the same as a mammogram or several standard chest x-rays.

A heart scan on a 16- or 64-slice multidetector device, your exposure is around 1.0-2.0 mSv, about the same as 2-3 mammograms, though dose can vary with this technology depending on how it is performed (gated to the EKG, device settings, etc.)

CT coronary angiography presents a different story. This is where radiation really escalates and puts the radiation exposure issue in the spotlight. As Dr. Cynthia McCullough's chart shows above, the radiation exposure with CT coronary angiograms is 5-12 mSv, the equivalent of 100 chest x-rays or 20 mammograms. Now that's a problem.

The exposure is about the same for a pelvic or abdominal CT. The problem is that some centers are using CT coronary angiograms as screening procedures and even advocating their use annually. This is where the alarm needs to be sounded. These tests, as wonderful as the information and image quality can be, are not screening tests. Just like a pelvic CT, they are diagnostic tests done for legimate medical questions. They are not screening tests to be applied broadly and used year after year.

Always be mindful of your radiation exposure, as the NY Times article rightly advises. However, don't be so frightened that you are kept from obtaining truly useful information from, for instance, a CT heart scan (not angiography) at a modest radiation cost.



Detail on radiation exposure with CT coronary angiograms on multidetector devices can be found at Hausleiter J, Meyer T, Hadamitzyky M et al. Radiation Dose Estimates From Cardiac Multislice Computed Tomography in Daily Practice: Impact of Different Scanning Protocols on Effective Dose Estimates. Circulation 2006;113:1305-1310, one of several studies on this issue.

Mediterranean diet vs. American Heart Association Diet

18. June 2007 William Davis (4)
In 1994, the Lyon Heart Study demonstrated a 50-70% reduction in coronary events in participants who followed a diet rich in vegetables, olive oil, fish, nuts, red wine, and enjoyed meals as a family activity. Various other studies have documented similar phenomena with less metabolic syndrome, better lipid patterns, less obesity with the Mediterranean lifestyle.

There are two fundamental differences between the Mediterranean diet and the diet advocated by the American Heart Association (AHA) for people with heart disease: the Mediterranean diet uses olive oil more liberally, such that fat calories can reach 40% of total; and, unlike the AHA diet, processed foods are not a part of the Mediterranean diet. Greeks, for instance, are far less likely to eat Count Chocula cereal for breakfast, or snack on Healthy Choice Premium Caramel Swirl Sandwich (ice cream sandwiches) or Malt-O-Meal Honey Nut Scooters. All three of these foods on listed on the AHA Heart-Check Mark heart-healthy program.

In other words, remove all the processed foods, and the AHA diet pretty closely resembles the Mediterranean diet. There are differences but they tend to be relatively small. If the only major difference is the presence of processed foods, wouldn't you therefore expect the AHA to embrace the Mediterranean diet?

Here's what their official stand on the Mediterranean diet states:

Does a Mediterranean-style diet follow American Heart Association dietary recommendations?

Mediterranean-style diets are often close to our dietary recommendations, but they don’t follow them exactly. In general, the diets of Mediterranean peoples contain a relatively high percentage of calories from fat. This is thought to contribute to the increasing obesity in these countries, which is becoming a concern.



The AHA is actually lukewarm towards the diet that was the first to show a dramatic decrease in heart attack and death. Why?

The answer is obvious, once cast in this light. To wholeheartedly endorse the Mediterranean diet might be seen as an indirect rejection of American processed foods. You know, the foods that have caused an extraordinary and unprecedented epidemic of obesity in the U.S., the foods that are manufactured by ConAgra, General Mills, Kelloggs--all also major financial contributors to the AHA, according to the AHA Annual Report.

I tell my patients: If you want heart disease, follow the American Heart Association diet. In my view, it is a diet founded on politics and money, not on health. How else could Cocoa Puffs be regarded as heart healthy?

Track Your Plaque in 50,000 BC

16. June 2007 William Davis (3)
Imagine we could send you back in a time machine to 50,000 BC.

However, our agreement: no modern tools or equipment. Just your brain, hands, and legs. And your landing spot will be tropical or semi-tropical, the same climate that humans spent much of their evolutionary time in.

Not only might you rub elbows with contemporaries like homo erectus and neanderthalensis, you'd also have to fend for your life and survival.

To eat, you will have to chase and kill wild game, all with your bare hands or crude tools crafted from sticks and stones. You will have to learn what wild berries, roots, and plants are edible and distingusih them from those that make you retch, make your bowels run, or kill you. You won't be able to cultivate grain, at least for a good long time, since you don't have a community that makes such an undertaking easier.

Instead, you are constantly on the run, from the moment you awake until you finally settle back as the sun sets, hopefully with a full stomach, but often empty and growling, anticipating the hunt and forage of tomorrow.

You are outdoors all day, except for the period when you hide in your cave or self-made shelter. You wear what little clothing you can make yourself from your kills, a skin or two. Your skin becomes a dark brown, a 5 foot 10 inch male will weigh 140 lbs, a 5 foot 5 inch woman 95 lbs. There are obvious downsides: your teeth will rot, you will be prone to infections, and predators view you as fair game.

But the result will be that many chronic diseases of modern life will no longer be worries for you. Heart disease? Highly unlikely. Do you need vitamin D? No, because you are outdoors virtually all day with most of your body surface area exposed to sun. Omega-3 fatty acids? You get those from the wild game you eat, since they have higher omega-3 content feeding in the wild, not eating corn like modern livestock. Since your body fat is minimal, just enough for survival, you don't need niacin.

In other words, many of the strategies of the Track Your Plaque program are modern necessities, responses to the "deficiencies" of modern life. Of course, I don't really have a time machine. I also doubt that you wish to hunt wild game every day, forage for plants and roots, run nearly-naked in the sun. You probably also have become accustomed to brushing your teeth and not viewing every animal as a potential threat to your life.

Nonetheless, I find this an interesting exercise for understanding the role of all the tools we use in the Track Your Plaque program for plaque control.

When pessimism wins

15. June 2007 William Davis (3)
When I first met Hank, I immediately sensed it: anger, hostility, fear. His heart scan score of 685 just made it worse.


He didn't want to be there talking to me. His wife was giving him a hard time. Work was a constant source of irritation. The receptionist at the front desk screwed up his paperwork. Our office charges were too much.


In short, Hank was a pessimist. A bad one.


All the nutrition information out there is bunk. Only he knew how he should eat right. It's stupid to take a lot of fish oil. "You want me to grow gills?"


Among the parameters we use in the Track Your Plaque program is blood pressure during exercise, which provides a surrogate measure of blood pressure during emotional stress, anxiety, etc. "No, I don't need that. I already exercise." No amount of justification could change his mind. "A guy at work had a stress test. They said everything was fine, then Bang! He drops dead. What good is that?"


Hank did go along with a few pieces of advice.


A repeat heart scan 12 months after the first: 870, a 27% per year rate of increase. That's about what would happen if Hank had done nothing, had taken no action to try and stop or reduce his heart scan score.


I don't know if Hank will ever succeed in dropping his score. In fact, I suspect that he will fail, meaning that plaque will grow and he will eventually, perhaps in a year, two or three, require several stents, heart bypass, or have a heart attack. In other words, Hank's pessimism is a self-fulfilling phenomenon: If he believes he will fail, he will. If he believes the world is a rotten place, it is.


Is it possible to "cure" someone like Hank of his deeply-rooted pessimistic attitudes? I don't know of any easy solutions for someone with attitudes as deeply-ingrained as Hank's. (See my prior post, "Cure for pessimism?" at http://heartscanblog.blogspot.com/2007_05_01_archive.html.)

I believe it does help to make someone aware of their attitudes and that it does indeed exert ill health-effects--if they will believe it. But this is a very tough nut to crack.

Bad news on CoQ10?

13. June 2007 William Davis (8)
A review of the effects of Coenzyme Q10 (CoQ10) on the muscle aches and weakness (myopathy) of statin drug therapy was just published in the Journal of the American College of Cardiology.

(Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy. J Amer Coll Cardiol 2007;49(23):2231-2237.)

This is not a study, but a review of the existing scientific and clinical data available on this topic. The study authors conclude with a lukewarm statement:

". . .there is insufficient evidence to prove the etiologic [causal] role of CoQ10 deficiency in statin-associated myopathy and that large, well-designed clinical trials are required to address this issue. The routine use of CoQ10 cannot be recommended in statin-treated patients. Nevertheless, there are no known risks to this supplement and there is some anecdotal and preliminary trial evidence of its effectiveness. Consequently, CoQ10 can be tested in patients requiring statin treatment, who develop statin myalgia, and who cannot besatisfactorily treated with other agents. Some patients may respond, if only via placebo effect."

Should the media get hold of this report, be prepared for the usual "Nutritional supplement no help for drug toxicity" headlines, or "Yet another nutritional supplement shows no benefit" with parallels drawn to vitamin C or E.

There are several issue that need to be factored into the discussion:

1) This is not a study, just a review. Thus, any biases of the authors are more likely to exert themselves.

2) The understanding of CoQ10 absorption among different preparations may be an issue. I just received a mailing from Life Extension that made extravagant claims about the superior absorption of ubiquinol, to be distinguished from ubiquinone, the more common form. They claim that eight-fold increased absorption and blood levels of CoQ10 are achievable with ubiquinol. Unfortunately, virtually all the supportive data are unpublished, proprietary observations, i.e., generated by companies who make or sell it. This is as reliable as drug manufacturers who publish glowing reports on their own drugs--perhaps it's true, but it requires unbiased corroboration.

3) Despite the lack of a large, well-funded clinical trial (all are small), the issue continues to live and breathe because of the powerful anecdotal experience.

In our experience, CoQ10 does work. It doesn't work all of the time, perhaps just 80-90% of the time. It does generally require higher doses (100 mg per day, occasionally more). It very clearly must be an oil-based gelcap (just like vitamin D) to work; capsules containing powder do not work.

It's difficult to doubt when someone starts a statin drug, develops the muscle aches and weakness, begins CoQ10 and obtains distinct relief, stops CoQ10 and aches and weakness return, then only to go away again with resumption of CoQ10 . I've seen this countless times.

We do need better information on CoQ10. There's no doubt about it. For people who obtain benefit from statin therapy, I think CoQ10 remains a useful solution. A better solution would be to get rid of the offending drug. But that's not always possible--e.g., LDL cholesterol 190 mg/dl despite the best diet and "adjunctive" food effort. Then CoQ10 can be very useful.
My personal experience with low thyroid

My personal experience with low thyroid

3. February 2009 William Davis (31)
Something happened to me around October-November of last year.

I usually feel great. Ordinarily, my struggles are sleeping and relaxing. As with most people, I have too many projects on my schedule, though I find my activities stimulating and fascinating.

I blasted through a very demanding November, trying to meet the needs of a book publisher. This involved sleeping only a few hours a night for several days on end, all after a full day of office practice and hospital duties.

But it was getting tougher. My concentration was becoming more fragmented. Getting things done was proving an elusive goal. Exercise became a real chore.

Although I usually force myself to go to sleep, I was starting to fall asleep before my usual bedtime, and I was sleeping longer than usual.

It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.

So I had my thyroid values checked:

Free T3: 2.6 pg/ml (Ref 2.3-4.2)
Free T4: 1.20 ng/dl (Ref 0.89-1.76)
TSH: 1.528 uUI/ml (Ref 0.350-5.500)

Normal by virtually all standards. I measured my first morning oral temperature: 96.1, 96.3, 95.9. Hmmmm.

My experience coincided with the Track Your Plaque and Heart Scan Blog conversations about low thyroid being enormously underappreciated, with the newest data on thyroid disease suggesting that a TSH for ideal health is probably 1.5 mIU or less. (More about that: Is normal TSH too high? and Thyroid perspective update .

Could this simply be a case of medical student-oma in which every beginning medical student believes he has every disease he learns about?

Despite the apparently "normal" thyroid blood tests, I took the leap and started taking Armour thyroid, beginning at 1/2 grain (30 mg), increasing to 1 grain (60 mg) after the first week.

Within 10 days, I experienced:

--Dramatic restoration of the ability to concentrate
--A boost in mood. (In fact, the last few blog posts before I replaced thyroid reflect my deepening crabbiness.)
--Large increase in energy, now restored to old levels
--Need for less sleep
--I'm warm again! (It's still <20 degrees, but I get easily stay warm while indoors.)

I am absolutely, positively convinced of the power of thyroid. I am further convinced from the clinical data, patient experiences, and now my own personal experience, that low levels of hypothyroidism are being dramatically underappreciated and underdiagnosed.

I shudder to think of what my life would have been like 6 months or a year from now without correction of thyroid hormone.

Now, the tough question: Why the heck is this happening to so many people?
Tags :

Comments (31) -

  • Brock Cusick

    2/5/2009 12:57:00 AM |

    Here's one theory:

    http://wholehealthsource.blogspot.com/2008/12/omega-6-linoleic-acid-suppresses.html

  • Anonymous

    2/5/2009 1:03:00 AM |

    For my last thyroid test my TSH came back at .752 - which I believe is good.  I get cold relatively easy so figured before testing that my results would come back problematic.  

    Then again I'm thin, with little body fat.  

    Don't know if this means anything for thyroid results, but I've noticed a dramatic feeling in coldness when I eat milk products.  If I have milk product, I become deeply chilled in the winter time.  So I've avoided milk for around 20 years for that and other reasons.  

    Since a feeling of cold goes along with hypothyroidism I've wondered if cows milk can cause thyroid issues.

  • Diana Hsieh

    2/5/2009 3:15:00 AM |

    Funny, the symptoms you describe are basically the same as those of my dog when she developed thyroid problems.  She was very weary and down, unable to do much, always cold, etc.  However, I suspect that you didn't have the problems with your fur like she did.  Smile

    Going on thyroid meds gave her a new lease on life: it took years off of her life in very short order.  I can only imagine how much of a difference it made for her mental state from the inside -- and I wish that we'd caught it sooner.  

    For a person, the ordeal would have been even worse.  At least my dog didn't know any better.

  • Darcy

    2/5/2009 4:29:00 AM |

    One theory floating around in the hypothyroid circle...Antibiotics have kept more of us alive than would have prior to antibiotics being invented. Poor thyroid function will lead to poor immune system function. Take away the antibiotics we were given as children for our various ear infections and strep throat and many of us grown adults would not have made it to adulthood. Now we're just grown adults with wide-spread thyroid problems.

  • Anonymous

    2/5/2009 12:26:00 PM |

    All that stress may have caused some adrenal fatigue which will lower tissue responsiveness to thyroid hormone. It would be interesting to know what your Reverse T3 was, as adrenal fatigue will reverse the T3 making it useless at the tissue level but still measurable as a normal total T3. With continuing adrenal fatigue and exogenous thyroid hormone you may start feeling "hyper" in the future even with normal numbers. Heart palpitations were my "hyper" symptoms while on thyroid for Hashimoto's but with still lowish lab numbers. This was then misdiagnosed as "anxiety" (palpitations do cause anxiety) and I was put on an SSRI. Years later I addressed the adrenal fatigue, am off the SSRI, and can tolerate exogenous thyroid without palpitations.

  • Olga

    2/5/2009 2:51:00 PM |

    Hi Dr. Davis:

    I was very interested in this post.  I have recently found out that the thyroid nodule I had excised 4 years ago was most likely a nodular goitre due to iodine deficiency.  I have never felt well since the surgery.  I was put on synthroid.  More recently I've been on Armour, since I consulted a complimentary physician.  He discovered that my iodine levels were very low.  I've started supplementing with Lugol's and now I've been able to go off the thyroid meds and I'm feeling much better.  I too have had thyroid problems every fall/winter since the surgery which resolve with the coming of spring.  Once I look forward to having my lipids rechecked once my iodine levels are normalized to see if it has any effect.  I was diagnosed with familial hypercholesterolemia 20 years ago.  Your blog has been a wealth of information.  Thanks so much.

    Olga

  • Nameless

    2/5/2009 9:40:00 PM |

    Have you considered that perhaps stress and lack of sleep simply caused your thyroid functions to become 'sluggish'?

    So instead of your thyroid being the cause of your symptoms, it was your lack of sleep + stress, which then caused your thyroid to work less effectively? Meaning... your thyroid issues, if there are any, were temporary, and restoration of sleep, etc. would result in an improvement?

    Armour would improve your symptoms under such a scenario too. But perhaps simply sleeping more, etc. would have done the same. Although this is a bad analogy, it's as if you took lots of caffeine or an amphetamine to keep yourself awake, more alert, etc. Yes, you would feel better, but taking better care of yourself, sleeping more, less stress would be the better option.

    Your hormone numbers are actually pretty good, by the way. I mean, no Endo or familty doctor would ever treat you with a TSH that close to perfect, and your hormone levels, although not perhaps ideal, really weren't that bad. And TSH, T3 and T4 all do fluctuate, not only day to day, but in the same day. Your TSH could come back close to 1.0 after a couple of night's of good sleep.

    Did you have your thyroid antibodies tested? That is the main cause of hypothyroidism, and can cause symptoms on their own, regardless of thyroid hormone levels (as least that's what I believe, but some doctors may think differently).

    I don't mean to sound negative with these comments, but I'm just playing Devil's advocate. It does sort of sound like you are finding thyroid disease everywhere, even in yourself, when it may not exist.

    Generally, for a proper  thyroid disease diagnosis, you can't go by a single test if your TSH is close to normal like that. A TSH >2-3, raised thyroid antibodies, and an ultrasound are usually used. If you come back abnormal on a couple of those, then yeah, you probably have Hashimoto's or some sort of thyroid problem.

  • Jenny

    2/5/2009 10:02:00 PM |

    If you have been low carbing, there is something I read about called Euthyroid Syndrome where your thyroid slows as response to the ketogenic state--the body thinks it is starving and slows down.

    This is different from thyroid disease. Very common.

    Unfortunately, it is impossible for us ordinary mortals who don't have prescription pads to get the thyroid hormone we need.  Doctors see the normal test results and refuse to prescribe.

    For me, the only cure is to up the carbs again (with insulin) since I can't get treatment.

  • Lola

    2/5/2009 10:33:00 PM |

    A lot of the Armour/natural throid fans and proponents say that your FT3 should ideally be at the top of the range, and FT4 at least in the top third. So, by the looks of it, you were in fact having something of a thyroid dip.

  • Scott W

    2/5/2009 10:39:00 PM |

    So...how do you convince a doctor to prescribe thyroid when your lab results don't support it?

  • Dr. William Davis

    2/6/2009 12:13:00 AM |

    All great comments.

    However, I've told everyone only part of the story. For instance, in patients we are seeing marked reductions in LDL and lipoprotein(a), not to mention improved energy, weight loss acceleration, and mood.

    As time passes, I am becoming more and more convinced that first a.m. oral temperature is the best way to identify low thyroid.

  • Nameless

    2/6/2009 2:12:00 AM |

    Improvements in lipid scores is another matter. It's not subjective anymore then.

    The question of why it's so common then is an interesting issue. You can't just assume it's lifestyle or lack of D, etc.  It is possible that's the cause, but it'd be a guess and not really scientific.

    I mean, we can safely assume you are following your own plan, yet  your thyroid may be sluggish there too.

    For Euthyroid Syndrome, you'd want to get your reverse T3 tested. At least that's what my doc said to test for. And as for getting treatment when your labs don't support it... umm... it's a problem. It's difficult enough getting treatment when your labs are abnormal.

    I'm glad Dr. Davis mentioned that there are patients with reduced LDL after treatment. I've recently been diagnosed with Hashimoto's -- TSH routinely >3 this past year, elevated antibodies, and two abormal ultrasounds later, an Endo is finally treating me. My lipids have been extremely stubborn, even though I follow a low carb, very little wheat diet, fish oil, normalized D, exercise, etc. My trigs won't go below 150 & LDL is in the 120ish range. Thankfully my Lp(a) has always been low 4-5. We'll see after treatment (assuming my endo doses me enough) if my numbers improve.

  • Anonymous

    2/7/2009 1:45:00 AM |

    The free t3 result you posted was low.  Very low.  This can cause a spiral of damage & disease.

    I am one who had a normal TSH even when my free t3 falls below the normal range.  The HPA Axis is at fault.  

    This situation is not as rare as some doctors like to think.  

    I do not believe doctors should rely only on TSH (a pituitary hormone.)  Free t3 is THE active thyroid hormone, and deserves the strongest attention.  

    I like to keep my ft3 at or just above the midpoint of the lab's reference range.

  • Anne

    2/7/2009 1:21:00 PM |

    Dr Dach reviews the book "Stop the Thyroid Madness" and links to other books and websites concerning thyroid/synthroid/armour issues. http://jeffreydach.com/2009/02/06/stop-the-thyroid-madness-by-jamie-bowthorpe.aspx

    I have been on Synthroid for years and now wonder if I would feel better on Armour. I am always cold and my skin, although less dry, it is still dry. I lost hair at one time. I am no longer losing hair, but I never grew back what I lost.

  • Anna

    2/7/2009 7:18:00 PM |

    Not long ago my son and I were tested for gluten (IgA antibodies, anti-tissue transglutaminase IgA, and genes, and we both tested positive but with a slightly different combination of genes that predispose.  

    Then it occurred to me that the hypothyroid symptoms greatly worsened during the years when I was eating the most gluten, at the end of my "bread machine phase" (bread machine recipes often specify high gluten wheat flours and added wheat gluten to boost rising performance and enhance texture) and when I was low carbing, but consuming LC bread products that contained not only soy, but added wheat gluten to boost protein and reduce starch content.  Gluten sensitivity and thyroid conditions often are related, but of course, I was not checked for anti-thyroid antibodies at the time.  

    I still eat LC, but a few years ago I did drop the LC bread and wheat products (and basically grains altogether) because they didn't fit into my goal to eat less industrially processed (fake) foods.  I'm not entirely paleo, but definitely eat in that direction, with very good results.  Wish I could say that was enough for my thyroid function to improve without added thyroid hormone supplementation, but I still take thyroid hormone (T4 and T3) to feel better.

  • Anonymous

    2/8/2009 12:40:00 AM |

    Unfortunately, it is impossible for us ordinary mortals who don't have prescription pads to get the thyroid hormone we need.

    For those in jurisdictions in which importation is allowed (or for those willing to risk ordering a medication that is probably not a high priority for prosecution):

    U.K. source
    S. Africa source

  • Trinkwasser

    2/8/2009 1:08:00 PM |

    I've heard a lot of similar stories in the UK - in many areas thyroid is not treated unless TSH is over 5 or even in double figures, and T3 and T4 tests are unavailable.

    Some people simply do not do well unless TSH is around 1 and it often takes a geographical move to obtain treatment, the effects of which can be dramatic and may include improved BG and "treatment resistant" depression resolving.

    Yet others need more subtle rebalancing until T3 and T4 are in range.

    As to causal factors, no clue, but this seems commoner that it's supposed to be.

  • Anonymous

    2/8/2009 5:39:00 PM |

    Dr. Davis I'd be interested in your experiences with patients with low testosterone levels and its relation to heart disease, plaque progression and metabolic syndrome. Has restoration to "normal" levels led to improved cardiovascular health?

  • JD

    2/9/2009 2:34:00 PM |

    Regarding Euthyroid Syndrome. The full name is Euthyoid Stress Syndrome. Dr. Eades says he did not see this effect in his patients. See the comments section of this link for further information. http://www.proteinpower.com/drmike/uncategorized/vampire-myths/

  • Nancy LC

    2/15/2009 6:43:00 PM |

    People practicing CRON, calorie restriction with optimal nutrition, also report low T3 levels.  In fact, they say low T3 levels is associated with longevity and seem to think it's a good thing.

  • lynn

    3/10/2009 1:41:00 AM |

    Yes there is a school of thought that Free T3 should be at the top of the range and free T4 mid range or higher. Since this is the school of thought that actually has success with patients feeling better, I would go with that. My TSH was totally normal like yours but my antibodies were pretty high. Although, that being said I have read that a TSH over 1 in a woman and 1.5 in a man is already in the danger zone http://www.thyroid-info.com/articles/dommisse.htm. Have you had your antibodies tested?

    There is a thyroid scandal going on all around the world where those of us with hypothyroidism are neither being diagnosed nor adequately treated.

    My temps have been in the 96's for years. God knows how long my thyroid gland has been being attacked.

    FYI it has been reported that most pateints feel their best on 3-5 grains of armour. There is even a theory that in healthy individals TSH is very, very low and that TSH only activates as a kindof emergency response.

  • mike V

    3/28/2009 12:28:00 PM |

    Here is a good NYTimes overview on treatment and controversy. 3/28/09

    http://preview.tinyurl.com/ckg6uq

    MikeV

  • ~MyGalSal~

    9/17/2009 12:42:09 PM |

    I could be a poster child for what no T3 can do to you.  I wonder if you could address the recent lack of availability of Armour thyroid and the disinformation regarding such.  I have resorted to ordering glandulars from NutriMeds but I am already suffering from a week of having to go back on levoxyl because of Armour not being available.  I have called many pharmacists and physicians and asked them what they are being told and virtually EVERYONE SAID NOTHING.  Any comments appreciated on this.  To me, this borders on criminal to abruptly stop the availability with confusing and contradicting reasons and all they will say is take a syhthetic.

  • Anna

    9/17/2009 9:27:14 PM |

    MyGalSal,

    The thyroid shortage is most acute at the corporate chain drugs stores.  They almost always order via dtisributers (middlemen) rather than direct from the maker.  

    Try a compounding pharmacy, either local or via online/mail order.  If you don't know of one, try this site:  www.iacprx.org/  Compounding pharmacies make individual preparations for all sorts of reasons.  They are often located near major medical centers.

    Many compounding pharmacies still have natural thyroid supplies (though they may be limiting refills to give everyone a chance during the shortage).  Compounding pharmacies also can compound a thyroid preparation specifically for you (though it is more naturally expensive than buying ready-made pills) if they still have a supply of the bulk thyroid extract powder, but your doctor will have to know how to write a prescription for compounded meds (my HMO endo didn't know how, I had to find out for him!).

    I've been able to get Nature-throid via a compounding pharmacy (they mail it to me), though lately I've had to be flexible and split larger dose tablets in half or take two of a smaller dose.  I don't mind, as long as I can still get Naturethroid.

    Janie Bowthorpe at Stop the Thyroid Madness blog has tips for maintaining your access to natural desiccated thyroid hormone, including having your doctor write your prescription as "broadly" as possible to so that the pharmacy can fill it with different brands or tablets cut in half, etc.  YOu may have to think outside of the "shopping center drugstore box" though.  

    I haven't tried this yet, but many people are having good luck ordering thyroid hormone from Canada (there is NO thyroid hormone shortage in Canada and Europe).  Again, Janie at STTM blog has posted specifics and communication with a Canadian manufacturer if you decide to try this route

    Good luck.

  • Anonymous

    6/16/2010 12:47:50 PM |

    It's your discovery, good job!

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    7/18/2010 8:27:14 AM |

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  • jpatti

    7/24/2010 3:30:38 PM |

    With regards to adrenal fatigue, there’s a new web site that gathers much of the information from Val, who’s been helping people treat adrenal fatigue and hypothyroidism, including rT3 issues, for a long time: http://nthadrenalsweb.org

    Highly recommended.

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    8/17/2010 10:02:05 AM |

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    11/3/2010 9:10:41 PM |

    It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.

  • Megaera

    2/23/2011 9:34:53 PM |

    Pardon me for sounding bitter, but you got to resolve effortlessly symptoms I had to endure for four years (actually they were much worse, but it took 3 years of being told I had perfectly normal TSH levels, so shut up, and then another year to get an appointment with an endocrinologist who said, why yes, yes, you do have a goiter, we'll try synthroidl.  Two years on that crap, which didn't help at all, eventually some t3 which didn't either, and finally a minimal dose of Armour Thyroid (1 grain) which keeps me from feeling quite so crap, but I can't lose weight -- ever -- and can't ever stay warm in winter, or regulate my body temp in summer.  I HATE doctors.  And no, I can't change endos, there are't any more endocrinologists in this area, I'm damned lucky I got this one.

  • Natasha

    6/13/2011 7:24:53 AM |

    I was diagnosed with Hypothyroidism April 2006. My doctor started me on 100 mc of synthetic drug a day. After being on the dose for 2 months TSH level was down to 1.4 and my area normal range is 0.2-4.5. My doctor decided to keep me on the 100mc Thyroxine a day to see how i went. 4 weeks later i started to feel alarming symptoms as if i had Hyperthyroid. So I decided to switched to bovine thyroid, so far I gained positive results.

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