What role cholesterol medication?

A frequent conversation point among my patients, as well as participants in the www.cureality.com program, is "Are cholesterol medications really necessary?"

No, they are not. What IS necessary is to correct all manifest and hidden causes of coronary plaque. Among these causes, in my view, is LDL cholesterol of 60 mg/dl or greater. There are many other causes of coronary plaque--e.g., small LDL particles, unrecognized hypertension, Lp(a), hidden diabetic patterns, etc.--but reducing LDL to 60 mg is still an important part of a plaque-reversing effort.

Insofar as we wish to get LDL to this goal, the statin cholesterol drugs like Lipitor, Zocor, Crestor, etc. may play a role. However, they should only be considered after a full effort dietary program is pursued. Don't follow the American Heart Association's diet unless you want to fail. It's nonsense.

For a more detailed discussion of how to use nutrition and nutritional supplements to reduce LDL cholesterol, go to www.lef.org, the website for the Life Extension Foundation. I wrote an article for their magazine called "Cholesterol and Statin Drugs: Separating Hype from Reality". You'll find the article at http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1295&query=davis%20cholesterol%20natural&hiword=CHOLESTEROLA%20CHOLESTEROLS%20DAVI%20DAVID%20DAVIE%20DAVIES%20DAVIN%20DAVIO%20DAVISON%20DAVISS%20DAVIT%20NATURALBASED%20NATURALES%20NATURALIZED%20NATURALLY%20NATURALS%20NATURE%20NATURES%20cholesterol%20davis%20natural%20.)

Can your plaque-reversal efforts succeed without statin drugs? It depends on your causes. For instance, someone with small LDL and Lp(a) only may do great on our basic program and then add niacin. Unfortunately, another person with a starting LDL cholesterol of 240 mg/dl--sky high--will have more success with these drugs.

Believe me, I am no blind supporter of drug companies and their flagrantly profit-seeking practices which, in my view, are cut-throat, shoving anyone and anything out of their way to increase profits and market share. I share many of Dr. Dave Warnarowski's views on how vicious their tactics can be; see his recent Blog post at http://www.drdavesbest.com/blog/ called "I smell a rat".

Nonetheless, the deep and well-funded research of the pharmaceutical industry does yield some useful tools. You don't have to love the insect exterminator, but if your house is being eaten by termites, his services can be useful. Same thing with these drugs. Useful--not the complete answer, not even close, but nonetheless useful in the right situations. Sometimes antibiotics are necessary, even life saving. That's how cholesterol drugs are, too.

Take it all in the proper perspective. Your goal is not cholesterol reduction, per se, but plaque control, preferably reversal.

Supplement Mania!

Ever hear of "polypharmacy"? That's when someone takes too many medicines. People will have lists of 15-20 prescription medicines, for instance, with crazy interactions and oodles of side-effects.

Well, how about "poly-supplments"? That's when someone takes a large number of nutritional supplements.

Let me tell you about a 45 year old man I met.

In an effort to rid himself of risk for heart disease that he felt was likely shared with his family (brother and father diagnosed with heart attacks in their late 40s), Steve followed a program of nutritional supplementation. You name it, he took it: hawthorne, anti-oxidant mixtures, vitamins C, E, B-complex, saw palmetto, 7-keto DHEA, velvet deer antler, gingko biloba, policosanol, chronium picolinate, green tea, pine bark extract, St. John's Wort, CoEnzyme Q10, papain and other digestive enzymes...He became a distributor for a nutritional supplement company to allow him to afford his own extraordinary program.

To satisfy himself that he had indeed "cured" himself of heart disease, he got himself a CT heart scan. His score: 470, in th 99th percentile. Steve's heart attack risk based on this score was around 10% per year. High risk, no question.

For weeks after his scan, Steve admitted walking around in a daze, not knowing what to do. Years of telling himself that he had effectively dealt with his heart disease risk, now all down the drain.

When we met, I persuaded him that to think that this collection of supplements would reverse heart disease was magical thinking. We trimmed his list down to the essentials and got him on the right track.

Heart disease is controllable and reversible, but not this way. Don't fool yourself into thinking that some collection of supplements will be enough to stamp out your heart disease risk. Just like taking an antibiotic when you don't have an infection achieves nothing, so does taking the wrong supplements.

What does heart scanning mean to you?

CT heart scans can mean different things to different people.


What does a heart scan mean to you? There are several possibilities:

1) A way of reducing uncertainty in your future.

2) A tool to crystallize your commitment to health.

3) A device to help you track how successful your heart disease prevention program is.

4) A trick to get you in the hospital.

5) A moneymaking tool for unscrupulous physicians hoping to profit from "downstream" testing, particularly heart catheterizations.


Like anything, heart scans can be used for both good and evil. How can you be sure that your heart scan is put to proper use--for your benefit and not someone else's profit?

Simple: Get educated. Understand the issues, be armed with informed questions.

If, for instance, you're a 55-year old female with a heart scan score of 90, active without symptoms, and you're told to have a heart catheterization right off the bat---run the other way. This is bad advice. A heart procedure like catheterization at this score in an asymptomatic woman is very rarely necessary. That decision can only be made after a step-by-step series of decisions are made by a truly interested, unbiased party. (A stress test is almost always required in this situation before the decision can be made to proceed with a catheterization.)

Unfortunately, in 2006, getting unbiased advice from your doctor is still a struggle. That's why we started Track Your Plaque---unbiased information, uncolored by drug or device company support, with an interest in the truth.

Coronary disease is drying up!

I had an interesting conversation with a device representative this morning. He was a sales representative for a major medical manufacturer of stents, defibrillators, and other such devices for heart disease.

Since I'm still involved with hospital heart care and cardiac catheterization laboratories, this representative asked me if I was interested in getting involved with some of the new cardiac devices making it to market over the next year or two. "The coronary market is drying up, what with coated stents and such. We've got to find new profit sources."

Well, doesn't that sum it up? If you haven't already had this epiphany, here it is:

HEART DISEASE IS A PROFITABLE BUSINESS!

Why else can hospitals afford billboards, $10 million dollar annual ad campaigns, etc.? They do it for PROFIT. Likewise, device and drug manufacturers see the tremendous profit in heart disease.

The representative's comments about the market "drying up" simply means that the use of coated stents has cut back on the need for repeat procedures. It does NOT mean that coronary disease is on the way out. On the contrary, for the people and institutions who stand to profit from heart care, there's lots of opportunity.

Track Your Plaque is trying to battle this trend. Heart disease should NOT be profitable. For the vast majority of us, it is a preventable process, much like house fires and dental cavities.

Mammogram for your heart

With the booming popularity of "64-slice CT scans", there's a lot of mis-information about what these tests provide.

These tests are essentially heart scans with added x-ray dye injected to see the insides of the arteries. However, to accomplish this, a large quantity of radiation is required. In addition, the test is not quantitative, that is, it is not a precise measure that can be repeated year after year.

It is okay to have a 64-slice CT coronary angiogram. It is NOT okay to have one every year. That's too much radiation. However, a heart scan can be repeated every year, if necessary, to track progression or regression. Once stabilization (zero change) or reduction is achieved, then you're done (unless your life takes a major change, like a 20 lb weight gain).

The tried-and-true CT heart scan is the gold standard--easy, inexpensive, precise, and repeatable. Not true for 64-slice angiograms.

Is your doctor using "leeches"?

What if you went to your doctor for a problem and he/she promptly placed leeches on your body?

Yeccchhhh! Would you go back? I'd bet that you'd run the other way as fast as your bleeding legs could take you. Outdated health practices like "bleeding" are outdated for good reason.

Then why would you allow your doctor to approach your heart disease prevention program by checking cholesterol and then waiting for symptoms to appear? That miserable approach leads to tragedy and death all too often--ask Bill Clinton! He might as well have had leeches!

Don't allow your doctor's ignorance or disinterest impede your prevention program. Get your coronary plaque measured, then attack it from all sides by knowing all causes, hidden and obvious. That's why Track Your Plaque is such an effective program.

I often wonder why more doctors aren't using this unbelievably powerful approach to deal with heart disease. But when I see colleagues implanting stents, defibrillators, and the like for many thousands of dollars per patient, the answers are obvious. Given a choice of a rational, effective program of prevention that pays the doctor a few hundred dollars for his time, versus $2000 to $10,000 for a procedure, you can see that the temptation is irresistible for many physicians.

All in the family--What to do if there's heart disease in your family

What should you do if a close relative of yours is diagnosed with coronary disease?
This question came up recently with a patient of mine. The patient--a strapping, 47 year old businessman who looked the absolute picture of health--was undergoing bypass surgery. Although I'd met him for the purposes of plaque reversal, he was already having symptoms and his stress test was flagrantly abnormal, all discovered after a heart scan score of 765. On the day after the patient's bypass, the patient's brother came to me. Understandably concerned about his own health, he asked what he should do. The answer: get a heart scan.
Measure the disease with the easiest test available. If his heart scan score is zero, great--he's at exceptionally low (near zero) risk for heart attack. A modest program of long-term prevention is all that's necessary. What if his score is like his brother, should he get in line for his bypass? No, absolutely not! But he will need two things: 1) a stress test to ascertain whether or not he's safe (60% likelihood a stress test would be normal), and 2) an effort to determine how the heck he got so much plaque. (We favor lipoprotein testing, of course, for greatest diagnostic certainty.)
Message: Learn from the lessons your own family provides. Don't let this valuable information go to waste.
"I can't do it"

"I can't do it"

Anne sat across from me, bent over and sobbing.

"I can't do it. I just can't do it! I cut out the breads and pasta for two days, then I start dreaming about it!

"And my husband is no help. He knows I'm trying to get off the wheat. But then he brings home a bunch of Danish or something. He knows I can't help myself!"

Having asked hundreds of people to completely remove wheat from their diet, I witness 30% of them go through such emotional and physical turmoil, not uncommonly to the point of tears. For about 10-20% of people who try, it is as hard as quitting cigarettes.

Make no mistake about it: For many people, wheat is addictive. It meets all the criteria for an addictive product: People crave it, consuming it creates a desire for more, lacking it triggers a withdrawal phenomenon. If wheat were illegal, there would surely be an active underground trafficking illicit bagels and pretzels.

Withdrawal consists of fatigue and mental fogginess that usually lasts 5-7 days. Just like quitting smoking, wheat withdrawal is harmless but no less profound in severity.

People who lack an addictive relationship with wheat usually have no idea what I'm talking about. To them, wheat is simply a grain, no different than oats.

But wheat addicts immediately know who they are. They are the ones who can't resist the warm dinner rolls served at the Italian restaurant, need to include something made of wheat at every meal, and crave it every 2 hours (matching the cycle of blood sugar peaks and valleys, the "valley" triggering the craving). When they stop the flow of immediately-released glucose that comes from wheat (with blood sugar peaks that occur higher and faster than table sugar), irresistible cravings kick in. Then watch out: They'll bite your hand off if you reach for that roll before they do.

Break the cycle and the body is confused: Where's the sugar? The body is accustomed to receiving a constant flow of easily-digested sugars.

Once the constant influx of sugars ceases, it takes 5-7 days for metabolism to shift towards fat mobilization as a source of energy. But along with fat mobilization comes a shrinking tummy, reducing the characteristic wheat belly.

If you try to quit smoking, you've got "crutches" like nicotine patches and gum, Zyban, Chantix, hypnosis, and group therapy sessions. If you try and quit wheat, what have you got? Nothing, to my knowledge. Nothing but sheer will power to divorce yourself from this enormously destructive, diabetes-causing, small LDL-increasing, inflammation-provoking, and addictive substance.

Comments (20) -

  • Ghost

    5/30/2009 5:00:26 PM |

    I totally went through that. It took me several tries to quit wheat, and I still mess and have a cookie or a sandwich once every few months-- generally while eating at someone else's house. One thing that helps keep me straight: the ONLY time I get acne anymore is when I eat wheat or chocolate. So now when I think about how much I want a dinner roll, I try to imagine how many spots I will get on my face if I eat it, and ask myself if it's worth it.

    I have read in other sources that wheat, like A1 dairy (from Holstein cows, rather than A2 from Jersey or Guernsey or goats) contains opioid-like molecules, and this is why some people exhibit addictive behaviors in response to them-- and that people who are addicted to wheat also tend to react that way to milk. This certainly matches my own experience.

  • Nancy LC

    5/30/2009 5:15:50 PM |

    When I found out I have a reaction to gluten what I did was repeat to myself "Poison" every time I saw something with wheat (or gluten) in it.  When I smelled it, same thing.  Sometimes I'd use visualizations to imagine it was green and moldering like something poisonous.  It really worked to reprogram me.  I haven't once broken my conditioning and voluntarily ingested gluten, and I don't have the extreme reactions some people do, they can be pretty subtle and take a long time to really make themselves known.

    Maybe it's a technique that other people could find useful.

  • Gretchen

    5/30/2009 6:30:07 PM |

    If it takes a week, maybe you could try some weeklong retreats at which no wheat was available. People would have social support as well as a lack of temptation.

  • Anonymous

    5/30/2009 6:37:44 PM |

    Low Dose Naltrexone might help..

  • thania

    5/30/2009 6:53:33 PM |

    I understand that, I quit smoking 67 days ago, doing low carb, I dont miss as much wheat but rice yes. I have put on 20 lbs low carbing?? I havent ate more that before 1200-1800 cal, depending on the day. But I am a bit depressed dont feel like moving , so less work outs. The heavier I become the less I feel like moving, and I also am having hormonal changes...,
    I feel very unhappy, but dont want to smoke again, this time is for ever.

  • Anne

    5/30/2009 8:21:30 PM |

    I am not the Anne in your post, but I was addicted to wheat. It was my favorite food. I lived on and for breads. Then I discovered I was gluten sensitive and I did go through a withdrawal of about 4 days. After 4 days I noticed my health problems were disappearing. Depression, brain fog and joint pain are 3 of the many symptoms that disappeared. That was 6 yrs ago.  

    Of course giving up gluten does not mean I gave up sugar. I still got my sugar fix with candies and alternative grains. Then I found out my blood sugar was too high so I started eliminating anything that spiked it. I easily lost 20 lbs with low carb eating that got my blood sugar under control.

    Tell Anne that I had dreams about bread in the beginning - they will pass. Now the donuts, breads, cookies and cakes in the stores and at work don't even look good. In fact, I don't like the smell of bread anymore. It takes time, but the cravings do pass.

  • Tom

    5/30/2009 8:49:44 PM |

    I agree, although this leaves open the question of why some people get addicted to things and some people don't (the 10%-20%).

    Meditation and problem-solving seem to be effective cures for all varieties of addiction. Exercise might be used as a substitute for meditation.

  • Lena

    5/30/2009 9:36:50 PM |

    I cut out everything with gluten pretty much immediately once I figured out it made me very ill. That wasn't hard. As for reducing intake of other carbohydrates, I just did that gradually and avoided the desperate cravings. I don't see any particular need to cut down on wheat and refined carbohydrates in one drastic move. Maybe first week, reduce intake by 20%, then another 20% the next week, then in about a month you'll probably be doing fine.

  • Ed

    5/30/2009 10:08:58 PM |

    I've heard "wheat spikes blood sugar more than sucrose" before, and upon reflection, I'm not sure I understand it.

    I assume this is for an equal amount of carbohydrate, ie 100 grams starch (not 100 grams wheat) vs. 100 grams sucrose.

    The problem I see is you're comparing 100 grams of glucose to 50 grams glucose + 50 grams fructose. After looking at it that way, wouldn't you expect your blood *glucose* levels to spike higher with starch than with sugar?

    (Suggesting that sugar is the same as other carbohydrates has become my pet peeve. Technically fructose is a carbohydrate, but the human body processes it totally differently than glucose. It's like saying oleic acid is equivalent to linoleic acid because they're both lipids.)

    Anyway, I have worked grains, sugar and "vegetable" oils out of my diet and my waist just sort of evaporated, while not going hungry -- eating pretty much as much of anything else I want. I would offer moral support for anyone else trying to do the same. Keep at it, the effort is worth the result.

  • Captain Mikee

    5/31/2009 12:06:16 AM |

    Actually, if you are lucky enough to live near a chapter of Food Addicts Anonymous, I think you can get help there. Unfortunately, I do not.

  • Scott W

    5/31/2009 1:45:35 AM |

    I completely agree that wheat is addictive to many and I personally never eat it. However, I'm not sure that your basis for this position, as stated in your posting, passes the credibility test. You have related the addictive capacity of wheat to its starch load, rather than its gluten content.

    If the only reason that wheat is addictive is its starch, then the same position could be taken on potatoes, rice or bananas. But no one ever says they are addicted to boiled potatoes.

    Now, if the patient has a compromised metabolism (type 2 diabetic), then they truly do have a problem with all carbs - not just wheat - and the blood sugar swings that can result.

    However, I think that for a person of normal metabolism (good blood sugar control), it's not the carb content of wheat but its gluten that cause the addiction and other issues.

    Thanks for your ongoing willingness to share your insights from your medical practice.

    Scott W

  • mongander

    5/31/2009 3:25:09 AM |

    In addition to following Dr Davis, I also follow Dr Gabe Mirkin.  So I have compromised and quit wheat, but continue to eat whole intact barley and oats.  Have done well, losing over 60lbs, with the help of exercise.  Haven't had the comprehensive lipid tests nor the heartscan but at age 70, feel good.  Last total cholesterol was 158. Also take niacin, K2, and fish oil.

  • stern

    5/31/2009 4:30:57 PM |

    we need to restrict from carbs since we started with the poisenios wheat ,but we can get along with healthy carbs which is organic whole einkorn sourdough bread ,does any have a tip on how to rise it without yeast please let hear from you

  • Anonymous

    6/3/2009 2:24:54 AM |

    For rising sourdough try Kefir !

  • Shreela

    6/4/2009 12:35:42 PM |

    While waiting for my doctors to diagnose my gut ailment, I thought it sounded like I had a few gluten-intolerance symptoms and was desperate enough to try cutting gluten from my diet to see if I could stop the terrible pain.

    The pain did stop fairly soon after stopping wheat/gluten, so it seemed I had Celiac, so I continued being wheat/gluten free.

    After reading about how difficult it was for people because of the cravings, I searched for gluten free substitutes for baked goods and pasta. They were pretty expensive online, and that's not factoring in shipping prices. So I thought I'd tough it out if I got the cravings.

    I did get them. It was rough for about 2-3 days, then faded a little. Watching TV didn't help either! I decided to try out some local health food places and found one that carried a nice selection of gluten free baking mixes and pasta.

    My husband almost laughed as I fought off tears when I ate gluten-free muffins, after eating NO muffins for at least a month.

    And eating those gluten-substitute baked goods and pasta DID help reduce my cravings! So I'm guessing that once I past the rough first few days, maybe I was craving foods I used to enjoy but could no longer eat.

    Although Dr. Davis warns about gluten-free products still being high-glycemic and spiking blood sugars, I'm still suggesting that if you're not diabetic, and want an easier time going off the wheat, try gluten-free products to see if they offset your cravings, for it might be a combination-craving of both gluten, as well as comfort foods. After a few weeks off the gluten altogether, then wean down the gluten-free products if needed for normalizing blood sugars, weight-loss, and not spending so much on expensive gluten-free products.

    Meanwhile, my gluten-intolerance bloodwork returned negative! It looks like it was IBS triggered by insoluble fibers in whole wheats (and some other foods). But even though I discovered I can tolerate processed flour, I don't eat nearly as much flour/gluten as I did before this experience, since my borderline A1C dropped a lot after being off wheat products.

  • Anonymous

    6/4/2009 12:47:05 PM |

    In response to the sourdough , do you have a recipe using the Kefir? Thanks

  • Trinkwasser

    6/17/2009 12:56:14 PM |

    "If you try to quit smoking, you've got "crutches" like nicotine patches and gum, Zyban, Chantix, hypnosis, and group therapy sessions. If you try and quit wheat, what have you got? Nothing, to my knowledge. Nothing but sheer will power to divorce yourself from this enormously destructive, diabetes-causing, small LDL-increasing, inflammation-provoking, and addictive substance."

    It's worse! With wheat you have friends, relatives, bakeries and especially *mothers*, pushers all

    grrrrr

  • jpatti

    7/24/2009 11:57:04 AM |

    I've done induction to go back to low-carb several times when I'd gotten off track.  For me, it does feel like a withdrawal, and I tend to feel sick 2-3 days if I do it strictly, whereas otherwise I feel crappy for a week.

    I choose a time when my life will be relatively low-stress, roast a whole turkey and buy a bunch of pepperoni for snacking on.  Going meat-only for a few days makes the withdrawal pass faster.  

    After a few days of turkey and pepperoni, I add back in vegetables, then a few days later dairy, then later still, low-sugar fruits.  

    IME, that's fastest way to get through the ickiness.  

    And REMEMBERING the withdrawal is the best way to avoid having to go through it again.

  • Anonymous

    12/26/2009 3:09:37 PM |

    Hi, I can’t understand how to add your site in my rss reader. Can you Help me, please Smile

  • hopeful geranium

    5/19/2010 11:27:35 PM |

    Tom, the 10-20% addicts are not the same people for every drug.
    I was junkie, speedfreak, benzo addict, alcoholic, ether sniffer for years (decades). I chain-smoked when high (lucky to be alive smoking on ether) but always went off tobacco when sober - I could never get hooked on cigarretes, never had withdrawals, don't smoke now, but if I chose to once, it would be the only time.
    Apparently 20% of people don't have the tobacco addiction gene. Most don't smoke at all, but I enjoyed changing my consciousness with tobacco while high on other things. 20% of men where I come from are red-green color blind - I wonder if this is connected to the gene for no nicotine addiction.
    Perhaps nicotine, for all its effects, didn't interact with endorphin receptors, and for addicts, there is a link? This is known to be important for determining who gets alcoholism.

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