6 months, 37 lbs. That's pretty good. Immediate feedback is a strong tool for pretty much anything we do. When all we have is a scale, it takes a while for the result to show up. And we're never sure what we did that did it. But when we check blood sugar, we have the result right there and then. Like you said, we know exactly what's the cause and can act on it with total confidence.

No problem with this but for the cost.
At six (one before, one after, more if you're "grazing") sticks a day @.40 usd each test strip, we're spending $72/mo.
This must be lowered somehow.

To Anonymous,

$72 / mo is only possible if you are eating different for different meals for the entire month. This is highly unlikely.

Diabetics or pre-diabetics making dietary adjustments based on an objectively measured parameter, such as this, is genius. (I believe constant blood-sugar monitoring is what led Dr. Bernstein to adopt a low-carb diet.)

But what about someone who's not diabetic...a person prone to hypoglycemic episodes for instance.

Seems such an individual's tendency to "overshoot" insulin output in response to incoming carbohydrates would quickly (too quickly)lower blood-sugar levels...giving the false appearance that all is well. Even though much of that glucose got partitioned into fat cells.

Keep up the good work Doc! I'm a personal trainer who regularly sends low-carb disbelieving physician clients of mine to your site. They can obviously receive this kind of info with a more open-mind from a fellow physician than from me.

I have a very similar story!  I lost 30 lbs in just over two months and this blog and Dr. Davis was the entire reason.  Total cholesterol down over 30% and triglycerides down over 50%.  LDL is much reduced too.  My only concern now is HDL.  It will not move an inch!  Started fish oil, then waited then started vitamin D supplementation.  Waited another couple months and earlier this week I started Niacin.  My HDL actually went down as Dr. Davis said it would while I was losing weight.  Then went right back up to 22 were it's been for years.  Might try wine and dark chocolate in moderation and if ALL ELSE fails I will have to submit to exercise.  My most sincere thanks Dr. Davis and keep posting actual patient experience.  It's very motivating.  Can't wait to read about a patient with a "stuck" HDL marker.

It costs too much money to buy the strips. I know doctors can get give you prescriptions for the strips at lower costs, but that isn't something my doctor would do.Too bad, it sounds interesting.

For those having issues with the cost, ask yourself this: what is my health worth?  This motivational tool is key to losing weight and changing your lifestyle intelligently.

With 25.1% of Americans either diabetic or prediabetic, it's about time we start thoroughly and intelligently educating patients about how to maintain normal blood glucose levels. The reality is most Americans continue to eat an American diet, conclude blood sugar control thru diet to be impossible, and fall into a never-ending cycle of insulin resistance, pessimism, false comfort in high levels, and an exaggerated concern of hypoglycemia which they use to rationalize running around with blood sugars in the 200s. Proper education and a glucometer the two best tools to combat these epidemics, and yet only a tiny percentage of the population really understands the disease process and proper regimen to maintain good glycemic control. And it's no wonder with the ADA telling people who consider themselves "moderately active" (as most overweight, inactive people do) to eat 45 grams of carbs per meal.
Dr. Davis, do you have any suggestions on how to develop a glucose tolerance test patients could perform on themselves at home simply using a fingerstick? Do you think there's value in something as simple as checking a fasting blood sugar, drinking a 20 oz Coke, and then taking fingerstick readings at 1 hour and 2 hours?

What I learned from testing was that brown rice and black beans raise my blood sugar 60 or 70 points, and that if I stayed away from grains, beans, and sugars, my blood sugar doesn't budge.  It didn't take many strips to figure this out, the bigger expense is that rice and beans were way cheaper than fish, meat, and cheese.

Concern for one's health is a straw man, it's usually everyone's concern; however cost IS an arbiter, otherwise we'd all have "Cadillac" health plans. Technology will lower the strip costs, or eliminate them. In the meantime some do without.

It is easy to find a free meter and it will come with at least 10 strips. This is enough to tell you if your blood sugar is spiking after eating. That is what I did and then I was able to convince my doctor that, in spite of my "normal" fasting BG, I needed a prescription for testing supplies as my postprandial blood glucose was spiking over 200.

Once I figured out what foods were causing my blood sugar to go high, and totally eliminated these foods, testing became much less frequent. The only time I test now is if I add in a new food.  I will also test throughout the day every once in a while to be sure my BG is not creeping up even with the low carb lifestyle.

When I started doing this a little over 2 years ago, I lost 15-20 lbs and have remained stable. I no longer have daily episodes of hypoglycemia caused by crashes after a blood sugar spike.

To penny-wise, pound foolish anonymous,

I would tend to bet that the price of strips is kept artificially high and it is not lack of technology that is the problem.  However, think of what you'd spend on a dinner out, a movie, or even a doctor's visit--and a doctor's visit won't give you half of the information about your health that a canister of strips will give you.  Anything a doctor does is a single snapshot in time, not ultimately helpful on a day-to-day basis.  Testing your blood sugar systematically for various foods works if you pay attention to what it tells you and modify your behavior accordingly.

Anonymous,

No, health concern is most definitely not a straw man.  Yes, most people will give lip service to their health being a top priority but words mean little.  If you observe the hierarchy of priorities in that person's life based on their ACTIONS you will usually quickly see the truth of the matter is that health is NOT one of their top priorities.  It is called cognitive dissonance and it is endemic to our society, unfortunately.

If someone is not willing to give up their Starbucks, movies, pricey wines, or any number of other extras in their life in order to obtain something that has tremendous possibilities for improving their health then by their actions they are stating clearly their priorities.  Words mean little at that point except to misdirect, evade or confuse the issue.  The actions tell the tale.

I would end by saying that your statement about health usually being everyone's concern is simply not true...not because most everyone doesn't say it, because they do, but because most everyone doesn't act according to their words.  It has always been true that you can tell a tree by it's fruit.

I also want to point out that the old biblical term for cognitive dissonance is "hypocrisy".  I usually avoid that term nowadays, though, since it cuts too close to the heart of the matter and therefore makes people very uncomfortable if not downright offended.

Thanks, Anne, for making a crucial point: Keep costs low by only assessing a previously untested food or combination of foods.

In other words, if you know that a 3-egg omelette with olive oil and green peppers results in an excellent blood sugar response, don't bother to check it again.

"Stuck" HDL was posted 30 Dec. so this may  still interest some.

The Linosa study gives low HDL as 54% heritable, and low HDL accompanied with concurrent high Triglycerides as 31% heritable.

The Erasmus Ruchpen study classes HDL as 43% heritable; with both sexes having the same HDL and Triglyceride genetic pre-disposition.

The Healthy Twin (Korea) study classes low HDL as 77% heritable and Triglycerides as 46% heritable.

Our individual genetics are probably not from those study pools. However, it has been theorized that the genetic tendency for most Caucasians (like the Korean twins)is to low HDL.

The ratio of Apoliprotein B to Apoliprotein A1 has an inverse effect on HDL. Doc has described to us how he clinically deals with ApoB;  HDL reading might not "move" much but being pro-active is preventative.

@Ensues,

You might try increasing sat fat a little. Coconut oil, butter, lard used in cooking can help drive up HDL. It also drives up total cholesterol, but as a ratio, HDL goes up more.

Metformin can help with weight loss in the Non Diabetic patient. A great addition to the glucose meter

$72 a month is cheaper than weight watchers.

Taking niacin to raise HDL worked for me, but it raised my fasting GLU to over 160. Another dangerous side effect for me is that even a small dose will cause me to fly into a rage with the least provocation.

Wal-mart sells a test kit with 50 test strips for under $20 (side-kick).

This raises a good question: what is the ideal weight for any individual?

Ensues, Here is a post on Inhuman Experiment about  hibiscus tea  increasing HDL and lowering LDL.

Dr. Davis

I had my HbA1C checked while I was eating roughly 60% of my calories from carbohydrate and it was 4.9%. After 3 months on a low-carb diet I had it checked again and it had risen slightly to 5.0%. How could this possibly happen?

@Many...

Thanks for the tips.  I never cease to be amazed by how supportive this community is.  I was a SAD poster child always "trying" to follow government guidelines.  I made a list of all of the "little" changes I made to conform better.  Whole wheat pasta, skim milk, whole wheat bread, no chicken skin etc etc etc.  My damaged metabolism took hit after hit after hit.  My triglycerides were over 1000.  My PCP advised to avoid greasy fried foods.  It's comical (and sad) looking back on it.  My glucose meter has a permanent place in my laptop bag and my weight goes down every week AND my health improves. Thanks again for the suggestions and data.

Ensues

I eat the same foods everyday, so I don't have to test my blood sugar very much. I save money on test strips (I use freestyle lite) and I save money since I buy food in bulk.
I think it's important to not eliminate foods just because they raise blood sugar. It's also the combination of foods that affects the glycemic response. There are ways to eat oats and other potentially high glycemic foods with minimal glycemic response. I don't like elevated sugar, but after trying to live on flax alone, I became too depressed to continue. Flax is ok for 1 meal, but that's it for me. One example. I eat semi-pureed sauerkraut with glucomannan and dulse flakes and I get less glycemic response than with sauerkraut alone.

I forgot to post my other example of food combining. Quick oats can be processed in a food processor for 2-3 minutes and added to nut butters or perhaps even added to eggs and meats, although I've only tried oats with nut butters. If I eat oats alone once daily, I spike to 150. If I eat oats twice daily, I don't go above 120, so it's about previous meals and also the time of day for me.

Though it's bizarre to me that spending money on health isn't widely accepted as being a good investment, there is a fairly easy way to avoid doing so and still get this information.
Why doesn't the good doctor create a central repository that lists various foods/meals and the BG response to them. There must be variation between individuals, but generally speaking, a "bad" food is a bad food. I understand that the point of the process is to rein in recalcitrant patients who need to see what the food is doing, but for those who don't want to spend the money or don't want to do this for another reason, but who do have self-control, we could just share info on which foods cause the biggest response. Presumably they would be grains, sweeteners, high-lactose dairy and fruit eaten on an empty stomach. Meals comprised of mostly meat and green veggies with a serving of carbs (25g or so) should not elicit such a response.

Travis Culp,
The 'Glycemic Index' may be what you are looking for. To see a very good listing and discussion check out www.mendosa.com
At his site there is a link to Excell listing of GI, this is nice as you can reorder it in assending /desending order. There are also  a book.
Ed

My husband was diagnosed as a diabetic and I am prediabetic so I read Dr. Bernstein's book and started testing, testing, testing as suggested. When I went to get the testing strips refilled the pharmacy said I could not get more yet as I was using them too often!  After explaining what I had done and that I did not know I was only allowed to use a certain number of sticks a day (two), they refilled it but I think that is wrong for the insurance companies to restrict that.  I was glad to read the posts that once you know a food combination does not elevate sugars then you don't need to test then.  That helps a lot.  Thanks for all of your input.  It is a big help to me.

Really liked the way you used to help Jack loose his weight. The results are pretty good and appreciable.
Thanks for the post and awaiting to read more.

Is it really possible to get NO increase in BG?

I am using this plan and have stopped testing that a m fasting (which is always elevated, for some reason).
This has made me way less crazy.

So back to my question....
Yesterday my pre breakfast was 70; pp was 96.
Lunch was 92; 102

I seem to always have some increase so when peop say they have none, do they really mean none?

The other question; Is the 1 hr pp enough?
When I was testing 2 hr the reading was always higher.

So, as you can see, there's much less stress involved w 1 hr pp testing...but am I kidding myself?

Jem--

Some people digest and process carbohydrates more slowly, or the mix of foods slows the process.

Find your peak by performing every 30 minute checks, then use that time in future.

Does anyone have any experience with Mulberry Zuccarin for glucose control?  I read an article about it and came back here to find this thread, hoping for some insight.  Just snake oil, or is there something to it?

For people concerned about cost.  I bought a walmart store brand meter for 9.00 and 50 strips is 20.00   This meter/strips is a good brand,  have no trouble with it.  the pharmacist told me she used it personally with no issues.  I don't test every day every meal,  Great price.

Just anecdotal, but I had an experience that confirms your theory.  In the middle of a 21-day trip down the Colorado through Grand Canyon, I fell and fractured my arm.  I decided just to splint it up and continue the trip, since the pain wasn't too bad.

By the time I got to a clinic in Flagstaff, 10 days later, the doctor said everything had healed so well I didn't even need a cast.  

Needless to say, there is lots of free Vitamin D in the Grand Canyon in summer!  We were in the sun all day long.  Maybe it made the difference.

probably also has to do with the fact people are calcium deficient without vitamin d.

Isn't there evidence that the blood level vs benefit curve reverse itself ("U" shape) above around 60 ng/ml?  Maybe just under or at that safer???

Last fall I was happy with my blood level of vit D, 79 ng/ml, so I reduced my daily dose from 10,000 iu to 5,000 iu.   I just got my spring test result and my level dropped 23 points to 56 ng/ml.  I'm gonna go back to 10,000 iu, except maybe during the summer when I get a lot of sun.

How to Optimize Vitamin D Supplementation to Prevent Cancer, Based on Cellular Adaptation and Hydroxylase Enzymology" You can read Reinhold Vieth's justification for keeping 25(OH)D both high and STABLE here.
In order to regulate any system there has to be a means of both increasing and decreasing responses.
Where the upregulation and down regulation is performed by different substances both of which are derived from Vitamin D, it follows these have to be kept tightly controlled and always in balance.
Sudden rise in 25(OH)D causes a period of imbalance between those forces, during which too much immunosuppression may occur.
The further north people live the more extreme differences between Summer/winter status. It isn't surprising those flying to the tropics for short midwinter sun breaks end up catching something from recycled germs during the flight home.
Making sure your Vitamin D needs are met daily throughout the year evens out the percentage change in levels as naturally more vitamin D3 is made in low 25(OH)D skin than when 25(OH)D is high.

Correcting vitamin D deficiency BEFORE a winter sun break results in a lower increase in 25(OH)D.
Less change in status = shorter period of imbalance.

I don't have to remind readers here Ergocalciferol speeds up the catabolism of vitamin D Cholecalciferol has a longer half life. Using Vitamin D2 therefore promotes greater/faster swings in status and should be avoided.

Using Vitamin D3 supplements daily at amounts no greater than UVB exposed skin would naturally produce, most nearly replicates the changes in status human DNA would have evolved with.

Apologies to Dr Vieth for assuming the copy of the paper linked to above was non-copyright and putting it online.  I think it's important the public have access to the full text rather than just my garbled version of this important paper.

Thanks Dr. Davis for the post sharing you personal experiences.

DrStrange:

The relationship seems to follow a U-curve pattern, with very high levels being associated with hypervitaminosis D problems.

The levels mentioned by Dr. Davis seem well below the ones that can lead to toxicity. For example, a farmer in Puerto Rico had a level of 225 nmol/L (90 ng/mL), and had no signs of toxicity:

http://healthcorrelator.blogspot.com/2010/02/vitamin-d-levels-sunlight-age-and.html

From the post above, toxic doses seem to start around 50,000 IU per day. That's way more than the 10,000 IU or so that we get from sun exposure.

My only point of disagreement with Dr. Davis is about our ability to produce vitamin D from sunlight after age 40. There is research (post above too) showing that the elderly can produce as much as 80 percent vitamin D from sunlight as do 20 or 30 year olds.

Hi Dr.Davis.
I just wanted you to know that THIS PRACTIONER is running her own open label trial on 5-10 people with lp(a).  I will let you know the outcome.
I just read your trial on 45 CAC high scorers that you published in Am J of Theraputics last year.  I hear that the registration process to publish is a horrific process. I am glad you persisted,  I really wanted your raw data but...

I hope I'm not diverting from the topic here....I'm confused about the Vit D-Calcium interaction.

I believe I understand correctly that high Vit D levels allow the body to more effectively process calcium.

I don't understand how calcium requirements change with increased Vit D levels.  I have a blood level of 72 (D3) and 3 (D2).  But I haven't paid attention to my calcium intake.

Can anyone clarify the relationship between Vid D and calcium please?

Thank you in advance.

"The relationship seems to follow a U-curve pattern, with very high levels being associated with hypervitaminosis D problems."

Not hypervitaminosis D but rather reversal of D's benefits.  I had read that above 60 ng/ml the risk of prostate cancer increased again.  Just now searching for the study found on D council site, a recent article showing the likelihood that this outcome was because the research subjects had all gotten their higher D levels from Cod liver oil and the vitiman A in that is what reversed the benefits of D, not the high levels of D!  So seems I could well have been misinformed about that.

http://www.vitamindcouncil.org/newsletter/vitamin-d-vitamin-a-and-cancer.shtml

Just threw out all multivitamins in the house after hearing about vitamin A interfering with vitamin D absorption.

@ Dr Strange
Tuohimaa's team claiming they have found a U shaped curve for Vitamin D is based in Tampere, Finland latitude 61N
People at that latitude with high 25(OH)D levels have experienced a greater change in level from summer to winter or if they choose to take a winter sun break will experience further re-balancing of the immune system. Vieth argues it is the length and number of periods of imbalance that drive the effects Tuohimaa reports.

Now we have greater availability of effective strength D3 it will be easier for people at that latitude to attain and maintain the levels that enabled the Inuit to survive long winters with over 6000iu daily vitamin D3 provided from traditional diet.

@ Tom
Video of Heaney explaining the calcium/vitamin D story

The Vitamin D requirement in health and disease Heaney similar information in PDF form but in greater detail.
Bear in mind when considering Vitamin D and Calcium absorption that other co-factors work in synergy with Vitamin D.
Magnesium is required to power the  production of the active hormone Calcitriol that lowers PTH and magnesium also counterbalances the role of calcium as magnesium is a natural calcium channel blocker.
Each Vitamin D Receptor requires zinc.
Also Vitamin K2 mk4 is critical for healthy bone density transporting calcium from bloodstream to bone.

There has been at least one study done. Here's one with guinea pigs.
http://www.springerlink.com/content/w734p41874205516/

This is another area where common sence and experience shouldn't really require a study to initiate this course of action. Example; I saw the other day there was a "study" done on children that proved that what they saw on TV affected their actions. I'm sure many parents are glad that study "finally" came through!

New study on grains:

http://www.lef.org/news/LefDailyNews.htm?NewsID=9615&Section=Nutrition

"Published research shows eating two to four serves of wholegrain foods a day can reduce the risk of heart disease by as much as 40 percent - equal to the effect of cholesterol lowering drugs,"

To TED,

Thank you Ted for the information.  The Heaney video was very interesting and worthwhile.  It's interesting that he says optimal D3 for calcium absorbtion is between 80 and 120 nmol.  I'm at 70 nmol and thought I was fine!
The video is well worth watching.

nevertheless, I'm still trying to understand how much calcium I should be taking, assuming I get my D3 to 80 or so.

Your remarks about Magnesium, etc. are helpful.  Thank you.  But again, I struggle with how much?  

Tom

@ Jason
About Go Grains Health & Nutrition
Go Grains Health & Nutrition is Australia’s leading independent voice for grain foods and legumes in health and nutrition. Go Grains reviews the science and communicates the latest research on the nutrition and health benefits of grains and legumes in the Australian diet.

If you look at the membership of Go grains who do you see there?

Rather than being an INDEPENDENT organization wouldn't it be fairer to describe them as a TRADE ASSOCIATION.

Not surprisingly the report they are talking about reads more like an advertising promotion.
The Grains & Legumes Health Report

I haven't had time to read it all yet, but I think it may be prudent to read Stephan's blog at Wholehealth source considering how grains were traditionally grown and prepared before assuming that modern growing and milling is equivalent, safe or healthy.

Ted,
Another explanation, this one from Cannell, for the U curve found in Scandinavia is cod liver oil.  

People with the highest vit D levels may be consuming enormous amounts of cod liver oil and, thus, vitamin A.

Excess retinol may thwart the action of vit D by competing for certain nuclear receptors.

For vitamin D there is NO WAY anyone can give a precise amount because each person varies individually both in response to sun and supplement.
Take 1000iu/daily for each 25lbs you weigh for 2~3 months then get a
25(OH)D blood spot test (available from TYP)
then adjust intake less/more by 1000iu/d for each 10ng/ml you are above/below 60ng/ml.

Calcium is readily available and best used from food sources. It's better to check your Calcium Food sources at a Nutritional Database and only supplement with sufficient calcium to bring your daily total to The amount recommended for your age/sex
I would suggest a mix of calcium citrate calcium malate as probably the best absorbed.
See Calcium: Which Form Is Best? that you could take in the evening to distance it from the magnesium which is best absorbed in small amounts with each meal.
Krispin has good magnesium information she suggests up to 10mg per 1kg of ideal body weight daily she prefers albion patent chelates such as this. but Magnesium Malate is also well absorbed remember only 4% of Magnesium Oxide is absorbed so avoid any mixtures including oxide.
I've provided examples from IHERB because their UK shipping charge is cheapest. Vitacost, Swanson's Amazon etc may be cheaper for US readers depending on p&p. Code WAB666 intro $5 Iherb discount.

This is very useful information of Obesity. You can find more information about how to prevent heart diseases. I am very excited about your post, it's really amazing.

To Ted,

Thank you once more for this information.

I just read that calcium has been implicated in Prostrate cancer.  have you heard anything about this?

Specific mitochondrial calcium overload induces mitochondrial fission in prostate cancer cells.Overload of Ca(2+) in the mitochondria leads to their damage,....... our results show that combination of an apoptogenic agent and an appropriate calcium channel blocker provide therapeutic advantages.
Magnesium is a natural calcium channel blocker.

There is a similar theory suggesting too much calcium and too little magnesium is a factor in Breast Cancer.
Does a higher ratio of serum calcium to magnesium increase the risk for postmenopausal breast cancer?

Recipe for Magnesium/Bicarbonate Water Magnesium Hydroxide unflavored can be bought if you search several pharmacists , in UK £3.78~500ml.
Comes in larger bottles and less expensive than brand leader mint flavored Milk of Magnesia.
I use a Sodastream to carbonate tap water.

Do you know if anything helps for soft tissue injuries? I am still not fully recovered from a foot injury 5 months after the acute phase. The orthopedist expected it to take 4 weeks to heal and I'm a little concerned about how long it will take.

The above blog post is quite informative. Having good information related to bones and its requirements. I was not knowing that Vit D is so important for our bones. But good to know about that. Want to ask what are the natural resources of Vit D in our daily diet?

Quite an informative blog post. I know that inadequate amount of vitamin D in diet can lead to osteoporosis, which is a brittle bone disease. But are there any side effects of excessive intake of vitamin D.

Great post William, my friend is really having some bone problem, so this information will be quite useful for him. Looking forward for more post on the same topic.

I know someone who was in a car accident that resulted in very serious fractures of one arm and wrist.  He is in his late 60's and his injuries were not healing.  

I came to know this person about 6 months after the accident.   He was taking about 2 grams of  calcium per day thinking that this would help his bones, perhaps because the doctor told him to talk more calcium, but no supplemental  Vitamin D.   I told him that the should be taking at least 5000UI D3  per day pointing out that Walmart has 5000UI gel caps for cheap ($5 per 100 at that time) and that he was likely taking too much calcium.  He started taking more D3 although I am not sure how much since I didn't want to be pushy.  

It has been about 9 months now since he started taking more D3 and his injuries have healed and he has had surgery to remove most of the plates and screws that had been put in place.    Was D3 the reason for this?    I don't know but I am sure that it didn't hurt either.