Lessons from the 20-year statin experience

Readers of the Heart Scan Blog know that, while I recognize that statins are useful in a small segment of the population with genetically-determined disorders, they are wildly overused, misused, and abused. In my view, the majority of people taking statins have no business doing so and could, in fact, obtain superior results by following some of the strategies advocated in these pages.

Nonetheless, the 30-year long statin experience has taught us some important lessons. Statin drugs have enjoyed more "research" than any other class of drugs ever conceived. They have received more media attention and embraced by more physicians than any other class of drugs. Combine these social phenomena and I believe that several lessons can be learned:

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Are you using bogus supplements?

Are you using bogus supplements?

I consider nutritional supplements an important, many times a critical,part of a coronary plaque control program.

But use the wrong brand or use it in the wrong way, and you can obtain no benefit. Occasionally, you can even suffer adverse effects.

Take coenzyme Q10, for instance. (Track Your Plaque Members: A full, in-depth Special Report on coenzyme Q10 will be on the website in the next couple of weeks.) Take the wrong brand to minimize the likelihood of statin-related muscle aches, and you may find taking Lipitor, Zocor, Crestor, etc. intolerable or impossible. However, take a 100 mg preparation from a trusted manufacturer in an oil-based capsule, and you are far more likely to avoid the inevitable muscle aches. (Though, of course, consult with your doctor, for all it's worth, if you develop muscle aches on any of these prescription agents.)

Unfortunately, you and I often don't truly know for a fact if a bottle from the shelf of a health food store or drugstore is accurately labeled, pure, free of contaminants, and efficacious.

One really great service for people serious about supplements is the www.consumerlab.com website. They are a membership website (with dues very reasonable) started by a physician interested in ensuring supplement quality. Consumer Lab tests nutritional supplements to determine whether it 1) contains what the label claims, and 2) is free of contamination. (I have no reason to pitch this or any other site; it's just a great service.) They recently found a supplement with Dr. Andrew Weil's name on it to have excess quantities of lead!

What Consumer Lab does not do is determine efficacy. In other words, they do a responsible job of reporting on what clinical studies have been performed to support the use of a specific supplement. However, true claims of efficacy of supplement X to treat symptom or disease Y can only come with FDA approval. Supplements rarely will be put through the financial rigors of this process.

If you're not a serious supplement user, but just need a reliable source, we've had good experiences with:

--GNC--the national chain
--Vitamin Shoppe--also a national chain
--www.lifeextension.com or www.lef.org--A great and low-priced source, but they do charge a $75 annual membership that comes with a subscription to their magazine, Life Extension (which I frequently write for) and several free supplements that you may or may not need. Again, I'm not pitching them; they are simply a good source.
--Solgar--a major manufacturer
--Vitamin World
--Nature's Bounty
--Sundown

There are many others, as well. Unfortunately, it's only the occasional manufacturer or distributor that permits unnacceptable contamination with lead or other poisons, or inaccurately labels their supplement (e.g., contains 1000 mg of glucosamine when it really contains 200 mg). I have not come across any manufacturer/distributor who has systemtically marketed uniformly bad products.
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"Get regressive"

"Get regressive"

This caught my eye:



Niaspan, prescription niacin, now sold by Abbott Laboratories, is now promoting its advantages in regressing coronary plaque:



In patients with a history of coronary artery disease (CAD) and hypercholesetgerolemia, Niaspan (niacin), in combination with a bile acid-binding resin, is indicated to slow progression or promote regression of atherosclerotic disease.



And the new slogan: "Get regressive."



Interestingly, the new marketing campaign is based on relatively old data. They base this new claim on 3 studies:



1) Cholesterol-Lowering Atherosclerosis Study (CLAS)--a 1987
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Digging for the truth

Digging for the truth

I remain continually amazed how difficult it can be to gain an understanding of what is true and what is not true. I am particularly worried about the messages provided by agencies that stand to make enormous gains by persuading us to believe their version of the "truth".

For a moment, let's strip away the charitable covers of some financially-motivated organizations and see what they really look like:


Hospitals: The dream of hospitals is to shift the proportion of patients towards those with the most profitable diseases in well-insured patients. Heart disease is among the best paying diseases. HOSPITALS WANT YOU TO HAVE HEART DISEASE.

Doctors: Many (though not all) want to deal with diseases that pay well. Implanting a stent can pay several thousand dollars. Putting in a defibrillator can likewise pay handsomely, even better than stents. DOCTORS WANT TO STEER YOU TOWARDS PROCEDURES THAT REIMBURSE GENEROUSLY. Talk is cheap and pays poorly. Heart scans? Useless, since they're cheap. CT angiography? Now we're talking! $1800 dollars is a lot more interesting than $200 or so for a simple heart scan. CT angiograms also lead to catheterization, stents, hospitalizations.

Drug manufacturers: The holy grail for drug manufacturers is a chronic condition that is present in large numbers of people. An antibiotic, for instance, is a drug manufacturers waste of time: Short courses of treatment in relatively few people. Cholesterol drugs, blood pressure drugs, drugs to modify personality or some aspect of behavior--these you take for years, decades, or a lifetime, and millions are persuaded they need them. DRUG COMPANIES WANT CHRONIC CONDITIONS (WHETHER OR NOT THEY'RE DISEASES) IN PEOPLE WHO SURVIVE FOR A LONG TIME, NOT SICK PEOPLE.

Supplement manufacturers: What don't we need in the eyes of sellers of nutritional supplement? While a program like Track Your Plaque makes liberal use of supplements in a focused and, I believe, rational way, supplement sellers want you to take dozens or preparations of dubious value: milk thistle, hawthorne, ribose, hoodia, silymarin, hydroxycitric acid . . . Unlike the larger ambitions and bigger money of the pharmaceutical industry, the supplement industry is often driven by the momentary craze and the quick payoff. THE SUPPLEMENT INDUSTRY IS LOOKING FOR SUCKERS.

Food manufacturers: The holy grail for the food industry are foods that have high markups, are convenient (e.g., eaten right out of the box or package), and are purchased repeatedly. Even better, if a health claim can be added, it can ride the current wave of the public's health consciousness. Thus, Cocoa Puffs can be labeled "Heart Healthy". How about foods that have addictive potential and virtually ensure repeat sales? Eat some and you want more within 2-4 hours! As nutritionist Marion Nestle says, the mantra of the foods industry is "Eat More". It is my firm conviction that the epidemic of obesity in the U.S. is not due to laziness, video games, and computers. It is the fault of food manufacturers. FOOD MANUFACTURERS WANT US FAT AND HUNGRY AND WANT US TO STAY THAT WAY. What pays better, a 110 lb vegetarian woman who shops at the farmer's market and buys locally produced foods, or the 260 lb glutenous and always-hungry woman who fills her supermarket shopping cart with 15 cents worth of flour and sugar priced at $4.59 (cleverly disguised as a healthy breakfast cereal), instant mixes, convenient meals, energy bars, and chips?

Government agencies: User fees for the FDA paid by drug companies have caused the FDA to be beholden to drug company pressures. The USDA, charged with crafting the food pyramid, was created to support the farm industry and distributors of their products, not to disseminate public health. The food pyramid is the watered down end result of food industry lobbying and threats, not the scientific advice of nutritionists. GOVERNMENT AGENCIES SERVE INDUSTRY FIRST, THE PUBLIC SECOND.

Health websites: Read popular websites like WebMD for information and the conversation quickly steers towards drugs. "Natural treatments for cholesterol" talks about reducing saturated fat and then gushes about the wonders of statin drugs. Guess where 80% of WebMD's revenues come from? Yup, the drug industry. The same goes for many magazines, TV shows, and other media. MEDIA IS OFTEN THE TOOL OF BIG INDUSTRY.



I'm sounding like a conspiracy theorist. I don't believe that I am, but I am skeptical of the messages we often receive from the media, advertisements, news reports, websites, etc. It's left to you and me to use our judgment and decide what is truth and what is someone's version of a message crafted towards their hidden agenda.

I am hoping that the real truth will grow through a wiki-like phenomena driven and supervised by a collective knowledge that we all contribute towards. That will happen, most likely, on the internet. Just as Wikipedia overtook the revered Encylopedia Britannica in the blink of an eye at far less cost yet with greater depth and equivalent accuracy, so will it happen in health information. I'm uncertain of the eventual form this health-wiki will take, but it will shatter many smug and deeply-entrenched powers that at present continue to profit from mis-information.

Comments (9) -

  • JT

    7/15/2007 4:29:00 PM |

    Unfortunately you don't sound like a conspiracy theorist.  I even know of an example of a fortune 500 company receiving air time for one of their products by "respected" news agencies.  

    Back in the summer of 1999 or 00 one would have thought the supplement SAMe was the cure all for depression and arthritis.  Magazines Time, & Newsweek ran articles on it.  My memory isn't so good anymore but I believe one of them even placed SAMe on the front cover.  The nightly news NBC, CBS, and ABC all ran gushing reports on SAMe and its natural curing abilities.    

    I'd like to say that the news reporting was done because SAMe is truly a wonder supplement.  That is not the case.  It is a fine product I suppose but not the kind of product that deserves the enormous press coverage that it did.  The reason it received so much press is because the large multi national company asked them to do so.

  • Rich

    7/15/2007 9:41:00 PM |

    Dr. Davis, these comments are a huge inspiration.

    As a b-school prof, I know that pharma and hospitals are not intentionally exploitative, but the profit motive inexorably works its effects in all aspects of the decision process, and ethical standards are gradually stretched to the minimum limits of acceptability.

    I recently did a casual analysis of the ads in Reader's Digest. About 80% of the ads are for prescription drugs to treat lifestyle-inflicted illnesses, such as high BP, type 2 diabetes, and inability to sleep, as wells other highly questionable illnesses such as "restless leg syndrome, or RLS." Daytime TV is about the same. You may notice that the ads now say "talk to your prescriber" instead of "talk to your doctor" -- in other words, they don't care who prescribes it, only that it gets prescribed.

    THESE ADS ARE THE REVENUE SOURCES FOR THE MEDIA, WHICH MUST CATER TO THE ADVERTISERS IN ORDER TO STAY IN BUSINESS. PHARMA PAYS FOR THE RESEARCH IN UNIVERSITIES, AS WELL.

    People don't bite the hand that feeds them!

  • Dr. Davis

    7/16/2007 12:30:00 AM |

    Wow! I wasn't aware of that.

    Would you know who the company was?

  • Dr. Davis

    7/16/2007 12:36:00 AM |

    Rich--

    I had no idea that the proportion of pharmaceutical ads had grown to such an extraordinary number. The drug industry is not stupid--their direct-to-consumer advertising must be working in a big way.

  • JT

    7/16/2007 12:48:00 AM |

    Yeah, maybe I'm too cautious, but giving the companies name shouldn't be a problem in this case.  The SAMe pills were made by an Italian firm that had/has a contract with BASF.  (They could be a division of BASF.)  

    I was told by a BASF employee that their press department is very good and persuasive.  They wanted to create a buzz for the product.  70% of sales for health foods are generated on new products.  People like to rush out and try the new thing.

  • Anne

    7/17/2007 11:33:00 AM |

    Don't forget to include the "non-profits". Back in the 1950's my father, a physician, told me that the American Cancer Society did not really want to find a cure for cancer. From some of the things the American Heart Associaton promotes, I don't think they really want to stop heart disease.
    Anne

  • Dr. Davis

    7/17/2007 12:00:00 PM |

    I couldn't agree more.

  • Anonymous

    7/17/2007 5:42:00 PM |

    Thank goodness we have someone like you, Dr. Davis, who can help us sort through all these industries who are looking for "suckers".

  • Anonymous

    11/19/2008 3:07:00 AM |

    There is a very interesting 6 part documentary on youtube about marketing and the pharmaceutical industry. "Big Bucks, Big Pharma"
    Here is the link to part 6.

    http://www.youtube.com/watch?v=IVDTo8Rm1rE&feature=related

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Test your own thyroid

Test your own thyroid

134 people responded to the latest Heart Scan Blog poll:


When I ask my doctor to test my thyroid, he/she:

Accommodates me without question 45 (33%)

Questions why, but orders the tests 49 (36%)

Refuses because you seem "healthy" 20 (14%)

Refuses without explanation 4 (2%)

Ridicules your request 16 (11%)



That's better than I anticipated: 69% of physicians complied with this small request. After all, you're not asking for major surgery. You're just asking for a very basic test, as basic as a blood count or electrolytes. 36% of respondents said that their doctor asked why, but still complied; this is simply practicing good medicine--If there is a problem, your doctor would like to know about it.

However, the remainder--31%--were refused in one way or another. Incredibly, 11% were ridiculed.

Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.

Let's say you're tired. Ever since last summer, you've suffered a gradual decline in energy.

So you ask your doctor to assess your thyroid. He refuses. "You're just fine! There's nothing wrong with you."

You disagree. In fact, you are quite convinced that there is something physically wrong. What do you do?

You could:

--Drink more coffee
--Exercise more in the hopes that it will snap you out of your lethargy
--Sleep more
--Take stimulants of various sorts

Or, you could get your thyroid assessed and settle the issue. But how can you get this done when your doctor won't accommodate you, even though you have perfectly fine health insurance and are simply interested in feeling better and preserving your health?

You could test your thyroid yourself. This is why we're making self-testing kits available. Test kits are available here.

This is yet another facet of the powerful revolution that is emerging: Self-directed health.

Comments (15) -

  • Tom

    9/7/2009 2:47:55 PM |

    In addition to home kits we might create drop in health shops where healthy people are given a quick set of automated tests/scans and the results made available to them online.

  • Lincolnb

    9/7/2009 3:26:27 PM |

    This is a great tool as many of my clients mention their thyroids and wonder if there was a way to monitor it.  When will this be available in the UK?

  • Anna

    9/7/2009 4:11:56 PM |

    I'm not sure getting tested is as big of an issue as getting a proper diagnosis and treatment.  I know lots of women who have their their thyroids tested (at least minimally with a TSH) but the results are not properly interpreted or treated.   Usually they end up with anti-depressant meds or are told to eat less and exercise more (or both).

    My thyroid was tested for about ten years (mostly with just the TSH and total T4, not the full complement of thyroid tests) for more than ten years because of two infertility investigations and later, symptoms of fatigue, etc.  I didn't ask for these tests; they were routine as part of a panel or the doctor specified them.  

    My HMO network doctors failed to see that my TSH was slowly slowly rising in that decade because they only looked at the recent result and not the trend (and there was a faster rate of increase after 7-8 years of testing).  They also missed that my results  were always in the "upper end" of the reference range (in late 2002 at least two national medical boards said the upper range was suspicious of development of mild hypothyroidism and the range should be adjusted downward).  Last year when I brought these AACE and NACL recommendations to the attention of the local HMO network lab supervisor, he was unaware of of the new range recommendations and promised to look into it.  I was pleased to note the ref range was somewhat adjusted down a few months later.

    So for me, the lab tests were less an issue; I had numerous TSH and total T4 tests while my symptoms progressively increased, but with little good.  

    The biggest difficulty was getting a correct diagnosis and the proper treatment, instead of attempts to suppress symptoms with other meds (I felt in my gut this was the wrong approach and I mostly resisted it).  

    The best treatment I've tried to date has been desiccated thyroid hormone (I'm now taking 1 grain of Nature-throid daily); to get to this it took a full three years with a continual search to find a local doctor who would use and correctly interpret the right lab tests *and* take into account my symptoms.   I hear similar stories from other hypothyroid people.

  • Dr. William Davis

    9/7/2009 8:43:28 PM |

    Yes, absolutely correct, Anna. Getting tested is just the first step.

    Once tested, understanding what they mean is the next step. But at least you know where you start. It's certainly better than not having any data at all.

    Next hurdle: Getting treatment when you need it. A topic for future discussion!

    Lincolb--It is available in the U.K. by ordering.

  • Daddy

    9/7/2009 10:02:24 PM |

    I guess that's how CA and NY can justify putting restrictions on their sale.  Sheesh!  Reminds me of when CA was on the brink of criminalizing home-schooling.

  • Hot Cover Girls Central

    9/8/2009 1:28:17 AM |

    That's great! I will recommend that to my sister and friend who were always complaining that they might have thyroid problem.
    See yah!

    Cathy Young
    http://fashionhotcelebs.blogspot.com/

  • pooklaroux

    9/8/2009 3:18:20 PM |

    I have also been able to get my doctors to do TSH tests, but since my labs ate at the upper end of normal, they also pooh pooh my suggestion  that treating the thyroid might positively impact other issues they care about, like my cholesterol levels and my asthma.  But they would rather give me statins (which I refuse to take) and advair (which I take only because I have to be able to function.)  I think they have it in my notes that I am hypochondriac and uncompliant. So much for being proactive for my own health care! Now they think I am a nutcase!

  • Laura in Arizona

    9/8/2009 3:38:35 PM |

    I agree with Anna. My doc has routinely tested TSH for years. This past check up I told her I wanted more info on the thryoid because of my lack of energy and other symptoms. She ordered T3 and T4 along with TSH but nothing else. My TSH came in at 4.5 on a scale going to 4.5 which is a full point jump since my last test. My T3 is almost abnormal on the low end. However since they are within the lab's normal range, she says I am fine. I am making an appointment with doc #2 in my search for someone that knows what they are doing. I sure hope it does not take the 3 years to find him/her it took Anna!

  • Anna

    9/8/2009 4:06:54 PM |

    Laura,

    I'd also like to add that much of that 3 years looking for better care was also spent educating myself (I must have read every book available on hypothyroidism to get a sense of all the perspectives), so developed a sense of when to seek out another doctor's care and when to settle for "good enough for now".  

    For me, the hardest part was early on -  summoning the inner strength to get over my reluctance to find new care and thyroid hormone options.  I was acutely aware that my tactic might be viewed as "doctor-shopping" or hypochondria.   Each step wasn't always very far forward, but it was still progress in some way and far more therapeutic than stagnating (it didn't always feel like progress at the time, though).

    Good luck in your quest for better care and more thorough assessment of your thyroid function.  Be sure to get tested for anti-thyroid antibodies.

  • Anonymous

    9/8/2009 4:39:45 PM |

    Regular Doctors are always a crap shoot. If you don't mind switching Doctors, it is better to seek out a Doctor that you know will probably be receptive to alternative therapies right from the get go. Life Extension has a list of "Innovative Doctors" here:

    http://www.lef.org/Health-Wellness/InnovativeDoctors/

    Another good source for Doctors that would probably be receptive to taking a patients thyroid concerns more seriously can be found at the A4M site:

    http://www.worldhealth.net/pages/directory

    Likewise, if lipid disorders are your concern, you can find a Lipidologist at the following site:

    http://www.learnyourlipids.com/resources.php

    Hope this helps.

    John M.

  • kris

    9/8/2009 8:13:44 PM |

    here is the site to find thyroid hormones friendly doctors.
    http://www.armourthyroid.com/con_phLocator.aspx

    Dr Davis, I don't think that you are on there? LOL

  • Dennis Mangan

    9/9/2009 4:10:23 PM |

    Another option when faced with uncooperative doctors: order thyroid from an overseas pharmacy.

  • Anonymous

    9/19/2009 5:22:14 PM |

    You forgot the option of saying you look Healthy so the test is unnecessary and Ridiculing you -- but finally ordering the tests, because you wouldn't leave the room till he patronizingly agreed (hey, whatever works)... and it turns out I have multi-nodule goiter!!

  • Anonymous

    1/2/2010 10:25:33 PM |

    Your blog keeps getting better and better! Your older articles are not as good as newer ones you have a lot more creativity and originality now keep it up!

  • buy jeans

    11/3/2010 2:31:15 PM |

    Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.

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What WERE they thinking

What WERE they thinking

When the Dietary Guidelines for Americans were drafted and the USDA and U.S. Department of Health and Human Services charged with disseminating this information to us . . .

When the American Heart Association created its Total Lifestyle Change (TLC) diet to reduce cardiovascular risk and reduce cholesterol . . .

When the American Diabetes Association developed its diet to help diabetics manage their blood sugars and prevent hypoglycemia . . .


How did conditions like Familial Hypertriglyceridemia fit into this scheme?

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How to have a heart attack in 10 easy steps

How to have a heart attack in 10 easy steps

If you would like to plan a heart attack in your future, here are some easy-to-follow steps to get you there in just a few short months or years:


1) Follow a low-fat diet.

2) Replace fat calories with "healthy whole grains" like whole wheat bread.

3) Eat "heart healthy" foods like heart healthy yogurt and breakfast cereals from the grocery store.

4) Use cholesterol-reducing plant sterols.

5) Take a multivitamin to obtain all the "necessary" nutrients.

6) Take the advice of your doctor who declares your heart "in great shape" based on your cholesterol values.

7) Take the advice of your cardiologist who declares your heart "like that of a 30-year old" based on a stress test.

8) Take a statin drug to reduce LDL and c-reactive protein while maintaining your low-fat diet.

9) Neglect sun exposure and vitamin D restoration.

10) Limit your salt intake while not supplementing iodine.



There you have it: An easy, 10-step process to do your part to help your local hospital add on its next $40 million heart care center.

If you would instead like to prevent a heart attack in your future, then you should consider not doing any of the above.

Comments (48) -

  • Danny Roddy

    6/29/2010 1:52:30 AM |

    Hmmm the Kitavans break your first rule and they don't have any signs of heart disease.

  • Anonymous

    6/29/2010 2:10:36 AM |

    Danny,

    Multifactorial, much?  And of the 20% or so of TEI from fat, the Kitavans consumed most of that as SFA.  Quite a bit different from the Ornish recommended screw you fat down as low as you can go approach.

  • Josh

    6/29/2010 2:13:53 AM |

    Hmmm... maybe they're good on the other 9 steps perhaps???

  • Anonymous

    6/29/2010 2:22:35 AM |

    I'm just curious about the inclusion of a multivitamin. How does a multi increase your chances of a heart attack? Maybe the ones with iron? Thanks

    Elliot

  • Anonymous

    6/29/2010 2:24:04 AM |

    I would love to know the reasons behind these - would you be interested in posting brief explanations?

  • Jamie Scott

    6/29/2010 3:10:29 AM |

    I'm assuming the multi-vitamin is included for those types who can eat shite but as long as they are swallowing 20 vitamins & minerals everyday, they'll be fine and dandy... no need to change your diet when you can get everything you need from a pill you know.

  • hans keer

    6/29/2010 6:04:26 AM |

    Very good advice for thrill seakers. Perhaps, to make it even more exciting, you can advice them to consume lots of omega 6 containing vegetable oils. VBR Hans

  • HeartHealth

    6/29/2010 7:06:11 AM |

    This post is something one has to ead carefully as far as heart health is concerned. A source of information like this will help you understand so much about your health and how to deal with unexpected illness like heart attack.

    To me, if one learns something about health, it shows how care for yourself and how good you take care of your precious body.

    I say well done ! doc.

  • praguestepchild

    6/29/2010 7:46:05 AM |

    The Eades have a chapter about iron overload. Basically, our bodies have no mechanism for ridding excess iron, this historically happened naturally through blood loss: trauma and parasites. Then there's the famous study showing that beta carotene and vit A supplementation (18,000 people!) http://content.nejm.org/cgi/content/abstract/334/18/1150 Better to get things in their natural state, like from a vegetable, rather than popping a Centrum. I use a few supplements, mostly to try and make up for what I perceive as lacking from modern lifestyle, vit D for inadequate sunlight, coQ10 for lack of organ meat consumption, etc. I chucked the Centrum.

    Danny, the Kitavans also smoke a lot, so hey, that must be really good for your heart, also!

  • praguestepchild

    6/29/2010 7:54:08 AM |

    oops ... showed that vit A and beta carotene actually increased death rates by 28% for people at risk for lung cancer. The CARET study.

  • maxwell

    6/29/2010 10:14:07 AM |

    @Danny

    It depends if you consider coconut and fatty acids from fish as low-fat foods...i know i don't.

  • Chuck

    6/29/2010 11:43:45 AM |

    Kurt Harris will tell you about the Kitavans, Danny

    http://www.paleonu.com/panu-weblog/2009/11/2/im-so-bored-with-the-kitavans.html

  • Tony

    6/29/2010 12:33:36 PM |

    I have to say: On my old "American" diet, my LDL was 155, on a 20% fat diet, it was 113, and on a 10% fat diet, it was 95.

  • Jan

    6/29/2010 1:00:02 PM |

    Oh, my.  Well, I don't do any of these things any longer, so that's good.  However, I recently switched to natural sea salt after reading Sally Fallon's Nourishing Traditions, which is not fortified with added iodine.  Should I go back to the processed, bleached stuff?  I really don't want to, so how should I make sure I get enough iodine?

  • Matt Stone

    6/29/2010 1:28:08 PM |

    I would've kept my high-fat diet going for heart health, but I got tired of having chest pains.

  • Beth

    6/29/2010 5:03:42 PM |

    @Jan: No way, never go back to regular table salt. Stick with the good stuff. We have used Redmond's for years now and I was happily surprised when I first visited our new family doc and saw an empty Redmond's bag on his desk. I asked him why he had it there and he said it's the only salt he recommends to all his patients. My nurse (part of the same practice) actually told me to mix a tsp. of Redmond's in a glass of water each day for my thyroid. I also take supplemental iodine... and Vit.D because we live so far north we don't get much natural D absorption here, something about the angle of the rays.

  • Peter

    6/29/2010 7:56:04 PM |

    Pretty much I follow your advice but it seems like there are lots of indigenous cultures that eat unrefined carbs and seem to be much healthier than us.

  • Anonymous

    6/29/2010 9:53:05 PM |

    So what about Okinawa, Sardinia, Costa Rica and other places where little meat is consumed?  How do they live to be 100?

  • Linda

    6/29/2010 10:03:31 PM |

    In Okinawa they eat a lot of pork and cook everything in lard.

  • Anonymous

    6/29/2010 10:44:32 PM |

    I eat breakfast cereal because it's the simplest thing to prepare. All I need to do is mix milk and cereal and I'm done. In my half awake state, I funnel it into my tummy and I'm done.

    What is a good substitute for cereal that follows this beautiful simplicity? Help me check #3 off the list.

    -- Boris

  • Anonymous

    6/29/2010 11:27:40 PM |

    Dr. Davis,

    With respect to iodine, do you have any feelings regarding the use of granulated kelp?  For a while I had toyed with the idea of mixing it in a shaker with the seal salt I use, however the issue of arsenic levels made me hesitant to go that route.

    -Robert Daly

  • Anonymous

    6/30/2010 12:59:41 AM |

    @praguestepchild.  Well I can see by your picture that you are male.  For  50% of the population, menstruation might be a possible regular blood loss event. Just sayin'

  • Lori Miller

    6/30/2010 2:26:57 AM |

    My mother has #11: have your grown children live with you.

    I didn't tell her that #12, in susceptible individuals, is to live with your parents.

  • Lori Miller

    6/30/2010 2:57:56 AM |

    Re: iodine, I eat dulse, a wild Atlantic sea vegetable (read: seaweed). Properly prepared, it tastes good to me. To rehydrate it, I put it in a sealed container with salad overnight.

    The package says a 1/3 cup serving has 780% of the RDA of iodine and only 3g of carb, 2g of which are fiber.

  • Anonymous

    6/30/2010 8:26:59 AM |

    Please submit a clarification or list of what one SHOULD DO (instead ) DO rather than the list of things here - I'm completely confused now! - I'd like some sort of explanation  - I want to ensure that I have an excellent lipid profile, low cholesterol and low risk or neglible heart disease and atherosclerosis, what SHOULD one do ???

  • mongander

    6/30/2010 10:05:52 AM |

    While I don't use Dr Esselstyn's diet I'm impressed that 100s of his heart disease patients have totally avoided repeat heart attacks by avoiding animal fat.  This record goes back decades.  I've taken Dr Davis' advice and generally avoid wheat (except for a little wheat germ) but I see nothing wrong with unprocessed grains for most people.
    http://www.youtube.com/watch?v=AYTf0z_zVs0&feature=channel

  • Anonymous

    6/30/2010 1:49:46 PM |

    Anon,

    If you read this blog on a regular basis, you'd know what to DO.
    DO your homework!

    Jeanne

  • Anonymous

    6/30/2010 4:42:32 PM |

    Love to get your take on this Dr. Davis: http://www.msnbc.msn.com/id/38007231/ns/health-diabetes/

  • Kent

    6/30/2010 7:27:05 PM |

    Dr Davis,

    Speaking of heart attacks, a friend of mine's wife is in the hospital as we speak with heart attack symptoms. (Chest pains, numbness in arm, sweating, etc).  She is only 42 years old. They have been running a series of tests including the tropinin test from the sounds of what he describes, which has been flutuating up and down to high of 13. They have done a Catheter Angiography amd say everything "looks fine", with no blockages, and say they are puzzled at this point. They don't want to release her due the the chest pains and tropinin test and are considering tranferring her to another hospital.  Any ideas? also, does the cardio angiography rule out plaque blockages?

    Thanks!
    Kent

  • Anonymous

    6/30/2010 10:57:53 PM |

    What's wrong with yogurt?

  • Anonymous

    7/1/2010 12:06:34 AM |

    Hey folks,
    I see that the moderator side of things for this blog appears to have gone away in that posts appear straight away.  No doubt some culling will occur.

    For those who are new, check out this blog for key items such as Vitamin D, Vitamin K2, LDL particle size (making the distribution mode larger),  HDL (increasing it), effect of Niacin on LDL and tryglycerides (dropping), impact of low fat/high carbs diets on type II diabetes, Iodine impact on thyroid function and finally Omega 3/fish oil intake.

    All this info is on this blog or you can download an interview of Dr Davis with Jimmy Moore of http://livinlavidalowcarb.com

    As someone mentioned, you should do your own homework, and make your decision on what is best

    other sources, Baylor College's www.lipidsonline.org  and the Med journal Circulation, eg http://www.circ.ahajournals.org/cgi/content/full/99/4/591 tells you about antioxidants.

    This blog, IMHO, is a good motivator and launch point for literature research.  If you need more hand holding then spring for the TYP subscription, what is your health worth to you?.  Personally, I am fine with the web and that has given me the confidence I need to chose diet and ask questions of my FP.

    I take a 20mg statin with 2.5g Niacin (most effective combination to lower trigs and reduce CAD event...See lipidsonline.org ), I eat mostly vegetarian but some fish. I have steered away from high amounts of wheat, based on information presented in this blog, and lowered my exposure to PUFAs based on Chris Masterjohn's blog (http://www.cholesterol-and-health.com/Vegetarianism.html .  Vitamin D3 normalization (8000IU),  3g DHA/EPA and 120mu vitamin K2 round out the preventative measures for me personally,  Some other folks will swear by their approach. One size does not fit all.  Make an informed decision based on a dialog with your doctor.  

    be healthy, not paranoid
    Trevor

  • Dr. William Davis

    7/1/2010 1:19:29 AM |

    Lori--

    I love your numbers 11 and 12!


    Jamie--

    My comment about multivitamins was not meant to bash multivitamins per se. People often say to me, "I don't need to take vitamin D, fish oil, magnesium, iodine, etc. because I already take a multivitamin."

    It is folly to believe that you can obtain all you need from a multivitamin. It would have to be the size of a golf ball.

  • Anonymous

    7/1/2010 2:05:10 AM |

    Trevor again..... one other good source for nubbies

    http://dhaomega3.org

    Dr Bruce Holub University of Guelph

    shows biggest risk factors for all-cause morbidity (1st smoking, 2nd high blood pressure). 70% higher risk of CAD event from the combination of High Trigs and low HDL.... DHA/EPA Omega3 is key to lowering risk factors

  • Anonymous

    7/1/2010 2:22:09 AM |

    @ Trevor

    Wonderful summation Trevor. Most of the answers are here in Dr. Davis' blog.  With your dose of Statin, why aren't you taking CoQ10?

  • Ed Terry

    7/1/2010 1:19:20 PM |

    I recently saw a cardiologist to get an order for a second EBCT and I explained to him how I increased my HDL from 32 to 71.  I could see that he didn't have a frame of reference for processing that information.  He also commented on how all he knew about nutrition was what he learned in medical school.  I simply remarked "I understand".  I don't think he meets many well-informed patients.

    He also didn't think it was possible to reduce the calcium score.  Assuming he follows the ten rules listed by Dr. Davis, I think it's safe to say he never will.

  • Anonymous

    7/1/2010 4:02:39 PM |

    @ Ted,
    I hear you. That was a pretty dumb move by AstraZeneca.  Healthy people with no risk profile should not take any drugs "just in case".  

    Combination therapy of niacin and statin lowers the risk on CAD events by almost 90%

    @ Anon,
    I have used CoQ10 at the suggestion of my family physician.  But not so convinced of the need/expenditure.
    Trevor

  • Anonymous

    7/1/2010 5:16:36 PM |

    [citations needed]

  • Anonymous

    7/2/2010 5:49:09 PM |

    6 months ago after following a vegan diet my HDL had dropped to 21 and triglycerides were at 256. Now, with low-carb, niacin, vitamin d and fish oil HDL is at 61 with triglycerides at 98.

  • yvonne manecke

    7/3/2010 2:48:12 AM |

    What about people with the APOe 3/4 genetics? I was told by Berkley Labs that fish oils actually do the reverse for people like me. I  have had a 3 way bipass, am 52 yrs. old and can't get my HDL up past 32, even with 1500 mg niaspan. On an extremly low fat diet LDL went down to 76 but HDL didnt go up. What should a person do if they have hyperlipidemia and are APOe 3/4?

  • Yvonne Manecke

    7/3/2010 2:56:02 AM |

    Dr. Davis
    I sure wish I could find the truth for Apoe 3/4 people. I get conflicting reports about fats. I have spent the last 3 mo. researching and can see that your info is good for most people. What about us? I know that efa's are important to help ward off alzheimers, but I have been told that I can't process them and should count them in my daily fat allowance. Also Berkleys research showed that omega 3 helped all heart patients except APOe 3/4. What am I going to do? Yvonne

  • Dr. William Davis

    7/4/2010 1:10:42 AM |

    Hi, Yvonne--

    We will be having some conversations about the influence of Apo E genetics on dietary considerations in a future Track Your Plaque discussion.

  • Urgent Care California

    7/6/2010 8:35:40 AM |

    Your tips are really great. Thanks for sharing such a great post.

  • Olive Kaiser

    7/8/2010 4:20:40 AM |

    For the question about cereal for breakfast, use cooked brown rice or other whole grain cereal, gluten free if necessary.  Put it in the crock pot overnight with grass fed pastured milk, butter, honey and nutmeg or cinnamon.  Or crock pot it with delicious bone broth and some animal fat.  Add some lovely pastured cream and butter in the morning and a few bananas or berries, depending on the flavors you have going.  In the morning, just spoon it up and enjoy.  

    Next day if you have time, after it congeals in the frig, slice and saute it in bacon fat or butter until the edges are crispy.  Serve with a couple of over easy pastured soy free eggs.   MMMM!

  • gart

    8/4/2010 1:26:46 PM |

    Dear Dr. Davis,

    I'm new to your blog, which I find very interesting and full of what appears to be insightful comments and recommendations. I also find your "unorthodox" stance in many issues very refreshing. I would like to know:
    1.have you published research backing the advice you give on your blog?
    2. have your work been peer reviewed?
    3. could you, please, let me know where I can find them?

    Thanks in advance for your help.

  • Gart

    8/15/2010 8:45:17 AM |

    Dr. Davis,

    I really appreciate it if you could provide an answer to my previous comment regarding research backing your advice.

    Thanks!

  • gart

    8/20/2010 11:03:39 AM |

    Dear Dr. Davis,

    I'm extremely disappointed you haven't answered my question regarding your research, either in this forum or via e-mail. I want to give you the benefit of the doubt, otherwise I would have to conclude that your advice is baseless and does not carry any scientific weight.

  • thorfalk

    3/16/2011 1:00:57 PM |

    most of the stuff makes sense, but what is the issue with multi vitamins?

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