Addictive Foods

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

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

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

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

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

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

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

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

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

Heart Scan Curiosities #7

25. June 2007 William Davis (1)



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

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

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

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

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

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

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

The nutrition counterculture

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

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

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

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

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

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

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

Prescription vitamin D

23. June 2007 William Davis (32)
Niacin:

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


Fish oil:

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


Vitamin D:

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



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

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

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

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

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

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

Nutrition activist Mike Adams

20. June 2007 William Davis (1)












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

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

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

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

CT scans and radiation exposure

19. June 2007 William Davis (8)


The NY Times ran an article called

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

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



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


Where do CT heart scans fall?

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



Typical effective radiation dose values

Computed tomography Milliseverts (mSv)

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

Non-CT Milliseverts (mSv)

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

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


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

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

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

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

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



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

Mediterranean diet vs. American Heart Association Diet

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

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

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

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

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

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



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

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

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

Track Your Plaque in 50,000 BC

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

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

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

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

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

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

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

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

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

When pessimism wins

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


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


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


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


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


Hank did go along with a few pieces of advice.


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


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


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

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

Bad news on CoQ10?

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

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

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

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

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

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

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

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

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

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

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

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

Can I stop my Coumadin?

5. September 2010 William Davis (20)
Here I go again.

While I will try to keep this blog on topic, i.e., coronary heart disease prevention and reversal using nutritional and other natural strategies, I believe that a "critical mass" of frequently asked, though off topic, questions keep cropping up.

One such question revolves around Coumadin, or warfarin.

Somehow, my Nattokinase scam blog post draws traffic about Coumadin. I tried to make the point that a conventional blood thinning agent like Coumadin that undoubtedly has undesirable side-effects cannot be replaced by an agent that has an uncertain track record. In the case of nattokinase, no track record.

To illustrate how far wrong the "nattokinase as replacement for Coumadin" idea can go, here is a question from Anna:


I came across your blog while perusing.

I am a bit bummed because I have been on Coumadin (warfarin) for around 22 years since I was 6 years old. I have a mechanical heart valve (St. Jude's), as I have heart-related issues, including hypertrophic obstructive cardiomyopathy.

Well, it is just that the warfarin seems to interact with nearly everything. I feel like I can not get the nutrients my body requires. I desire to consume more raw foods and vegan foods, though I do not want anything to damage my heart valve or risk a stroke/heart attack or internal bleeding.

I have been underweight the majority of my life, malnourished , currently am still somewhat underweight, though enjoying food again, as I had what mimicked Crohn's Disease for several years (horrendous pain), from which I am in remission now. I was diagnosed with osteoporosis, which may or may not be caused from consuming warfarin.

Is it possible to get off of warfarin and effectively keep my blood thinned ? I currently take 1.5 mg to 2 mg dosage. Does the warfarin destroy Vitamin K and if so does that mean while on warfarin I never get the Vitamin K nutrients even if I did consume foods with it in it?

Thank you
Anna

No, sorry, Anna. Stopping Coumadin with your unique issues, i.e., a prosthetic mechanical heart valve (likely mitral, judging by your history of hypertrophic obstructive cardiomyopathy, in which the patterns of blood flow ejected from the heart disrupt the natural mitral valve function) and cardiomyopathy, can be fatal. Without blood thinning, the mechanical heart valve can trigger blood clot formation, since it is a foreign object implanted into the bloodstream.

There are no natural alternatives available with track records confident enough to bet your life on. Aspirin nor Plavix are blood thinners, but platelet inhibitors. These two agents, while they work for other forms of arterial (but not venous) blood clot inhibition, will not work for your unique situation.

Likewise, a purported oral lytic agent like nattokinase should not be substituted for Coumadin. Even if there was plausible science behind it, you should demand substantial evidence that it provides at least blood thinning equivalent to Coumadin. Should a blood clot, even a small one, form in or around the prosthetic valve, the valve can stop working within seconds. This can lead to death within minutes.

I believe it would be foolhardy to bet your life based on the marketing--let me repeat: MARKETING--of a "nutritional supplement" by supplement manufacturers eager to make a buck.

Nor are there any other nutritional supplements that can safely replace the Coumadin. I wish that were NOT true, as I am no stranger to the long-term dangers of Coumadin and I am a big believer, in general, in nutritional supplements. I am a BIGGER believer, however, in the truth. Weighing the options available to us today, there really is no rational choice but to remain on Coumadin.

By the way, I tell my patients to eat a substantial amount of green vegetables while they take Coumadin. I know that conventional advice is to reduce or eliminate green vegetables due to their content of Coumadin-antagonizing vitamin K. I think this is wrong, also. Green vegetables are the best foods on earth. They reduce risk for cancer, diabetes, bone disease, and coronary heart disease.

To obtain the benefits of green vegetables without mucking up your blood thinning (your "protime" or International Normalized Ratio, INR), I advise my patients who take Coumadin to eat green vegetables--but do so every day in relatively consistent quantities, so that the protime or INR is not disrupted and remains reasonably constant. It may mean that your total dose of Coumadin may be somewhat higher, e.g., 3 or 4 mg instead of 2 mg, but the dose is immaterial outside of blood thinning. That way, you obtain all the wonderful health benefits of green vegetables while maintaining fairly consistent blood thinning/protime/INR. Coumadin does not block all the health benefits of vegetables, only those related to vitamins K1 and K2.

With regards to protecting yourself from the osteoporosis promoting effects of Coumadin, I would be sure to follow a program of natural bone health, such as the one I discussed in Homegrown osteoporosis prevention and reversal. You will have to be extra careful, however, with the vitamin K2. Ideally, you have a doctor knowledgeable about vitamin K2 who can assist you in managing K2 intake while on Coumadin. This is something you can definitely NOT manage on your own. (I am a big believer in self-managed care, but this is way beyond the limit.)

Lastly, it is my belief that anyone with an inflammatory bowel condition, such as Crohn's disease or ulcerative colitis, should absolutely, positively, and meticulously AVOID WHEAT and all other gluten sources (such as rye, barley, and oats). Even if you test negative for celiac markers (e.g., anti-gliadin antibodies, emdomysium and transglutaminase antibodies), the enhanced intestinal permeability will allow wheat proteins, such as gluten, to gain ready entry into the bloodstream. Not to mention that wheat should have no place in the human diet anyway, in my view.
Tags :

Comments (20) -

  • Myron

    9/5/2010 7:09:35 AM |

    Coumadin is considered a Natural Medicine having been derived from mold acting on Sweet Clover.

    Most Pharmaceutical Drugs have a Natural Basis.

  • Anonymous

    9/5/2010 8:32:30 AM |

    What about using heparin derivatives as a replacement of Marevan / Coumarin?

  • Anonymous

    9/5/2010 8:38:52 AM |

    As mentioned in Wikipedia, low molecular weight heparin (LMWH) is used in pregnancy. It should be possible to change Marevan / Coumarin with LMWH.
    http://en.wikipedia.org/wiki/Marevan#Pregnancy

    Heparin can not be taken orally, so you have to get injections if you decide to change medication.

  • Dr. William Davis

    9/5/2010 9:54:16 AM |

    Yes, indeed.

    But anyone who has taken low-molecular weight heparin injections will tell you it's no picnic. The injections can be painful and leave a bruise. After a few weeks, you can feel like a pincushion and be riddled with bruises. Not a happy alternative.

  • Chris Masterjohn

    9/5/2010 4:56:00 PM |

    Hi Dr. Davis,

    Great, although somewhat depressing, post.

    What is the point of taking the K2 when K2 interferes with the therapy (as Vermeer's group showed) and the dose will have to be adjusted?  The drug interferes with the recycling of vitamin K so it should affect both forms equally.  Are you hoping it may shift the balance of residual vitamin K activity towards the bones and blood vessels?  That seems to make some sense if there is substantial residual vitamin K activity.

    Chris

  • Anonymous

    9/5/2010 6:13:38 PM |

    Chris, I think you are going down the right path with your thinking.  Some K2 survives warfarin therapy as evidenced here:


    "In conclusion, our study indicates that in a rat model
    arterial media calcification is prevented by a high dose of
    MK-4."

    http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ProduktNr=224160&Ausgabe=229786&ArtikelNr=75344

    The question then becomes how high a dose is therapeutic in humans and can you get it from diet alone?

    I'm a prisoner of life long warfarin therapy and have consciously shifted my K intake to K2 by eating lots of eggs, cheese and grass fed/finished beef instead of green leafy vegetables because of the way warfarin hammers conversion of K1 to K2.  Sure green leafy vegetables have health properties but they won't help with warfarin driven arterial calcification and osteoporosis.  So far I have avoided taking a K2 supplement and adjusting warfarin dosage because I don't have confidence in the consistency of the K2 in a supplement form.  It becomes another wildcard.  But the bottom line is I really don't know if there is enough K2 to make a difference from food alone.

  • Anonymous

    9/5/2010 6:19:24 PM |

    Dr. Davis, do you have any thoughts on arginine supplementation as a driver of nitric oxide production for the purpose of blood vessel dilation?  I am showing signs of venous insufficiency from a blood clot in my leg suffered over a decade ago.  You mention aspirin and Plavix as platelet inhibitors that don't impact venous clotting.  Arginine also affects platelet activity and I can't find anything definitive about whether or not that is an issue with warfarin.  Arginine is also associated with mitigating atherosclerosis which would seem to make it a good choice for people on warfarin.

  • Anonymous

    9/5/2010 8:04:38 PM |

    Dr davis

    after reading your blog two things have stuck in my mind. one about the role of vaccines in development of disease. and two role of GM foods in destroying health.

    kindly shed light on it. im splitting my hair over it

    Smile

  • Anonymous

    9/5/2010 8:37:04 PM |

    This topic has to be of great interest to the many people on Warfarin for atrial fibrillation,  particularly the issue of warfarin-induced calcification and osteoporosis.  This article http://bloodjournal.hematologylibrary.org/cgi/content/full/109/8/3607 suggests that levels of 45mcg of K2 supplementation would be safe, but what is a therapeutic dose and how does it work with Warfarin? (One of the authors has ties with Natto Pharma, seller of K2; they also suggest it is a safe dose.) Until specific studies are done, we will not know how it works.

    Will one of the newer anticoagulants in the pipeline, such as Dabigatran, which I understand is not a vitamin K agonist, be approved soon and will it be effective?

  • Anonymous

    9/6/2010 3:16:19 PM |

    Dear Dr. Davis:

    This topic is really distressing.  My father has been on Warfarin for 10 years due to atrial fib. I can't help but wonder if his increasingly worsening calcium scores were due in part to Warfarin. It seems to be an extremely nasty - but necessary - drug.

    Over the past year he has been increasingly tired and two months ago had a triple bypass. He has been on a low carb diet, lost 25lbs and started taking fish oil and 5,000 i.u Vitamin D3. He is not taking any K2, but he does eat green vegetables every day. He recently started taking 10,000 i.u. of D3.  Should anyone taking larger D3 doses who is also on Warfarin be worried about arterial calcification? How does one find a doctor in Milw. or elsewhere who has knowledge about K2 and Warfarin? What else can Warfarin users do about their heart disease?

  • Dr. William Davis

    9/7/2010 1:45:50 AM |

    Sadly, there are no data--none, zero, zip--that address the end result of taking vit K2 in any dose or any form while on warfarin.

    No doubt: It will drive INR down, driving warfarin need up. But there are no data on what effects will result at the bone or artery level.

    I wish that weren't true, but we cannot invent data where it doesn't exist. It also cannot be extrapolated from existing data or experiences without incurring substantial risk.

    Sometimes, we just need the data.

  • Anand Srivastava

    9/7/2010 7:14:21 AM |

    How does Omega3 supplementation help?
    I have read that Omega6 is one of the agents that triggers blood clotting.
    Also I read that coumadin actually works by inhibiting action of K1/K2.
    So adding K1/K2 will actually be against the coumadin therapy.

    But since Omega6 is required for the signalling that causes blood clots. If you reduce the Omega6 and increase the Omega3 then the blood clots should not happen naturally.
    It will be like the Inuits.
    Their arteries are in a bad shape but they never get a heart problem, because they do not get blood clots in their blood.
    The only problem is that they don't get blood clots while bleeding also.
    So if you use excess Omega3 with very little Omega6 you will be doing the same. But the side effect is that you have to be careful about bleeds.
    I would think that the same problem will be there for coumadin

  • Anonymous

    9/7/2010 5:20:15 PM |

    Dear Dr. Davis:

    The FDA Advisory Council is meeting regarding Dabigatran on September 20th and word is that its approval is expected by the end of the year or early 2011. I have even seen Boehringer-Ingelheim ads on the online JACC to the effect of "Coming Soon - Pradaxa" (the brand name).

    Will this be the paradigm-shifting Warfarin alternative for AF patients?  As Dabigatran is not a Vitamin K agonist, will its users be able to also use food and supplemental sources of Vitamin K2?

    Apart from the supposed reduction in bleeding risk, will Dabigatran be a preferable anticoagulant for long-term Warfarin users?

  • Chris Masterjohn

    9/8/2010 7:07:28 PM |

    Dear Dr. Davis,

    Did you mean that there are no data on whether K2 will protect against the heart valve calcification that occurs on these drugs, or that there are no data showing its effect on INR?

    Vermeer's group compared vitamin K2 as MK-7 to K1 and showed that it is much more potent at driving down the INR value:

    http://bloodjournal.hematologylibrary.org/cgi/content/full/109/8/3279

    By the way, since you are a fan of K2, if you haven't already seen it, you might enjoy the large review I wrote on it back in 2007, which argued that it was the "Activator X" discovered by Weston Price:

    http://www.westonaprice.org/abcs-of-nutrition/175-x-factor-is-vitamin-k2.html

    Love your blog!

    Chris

  • Chris Masterjohn

    9/8/2010 7:12:27 PM |

    Anonymous, I have seen that study but I don't think it shows how much residual activity of K2 there is, or to what extent it can protect against calcification for someone on warfarin.

    The reason is that K2 potently interferes with these drugs.  In the study, they used a massive dose without cranking up the warfarin proportionately.  However, if you take K2 and you actually need to be on these drugs, your doctor will have to adjust the dose of the drug according to the dose of K2 you are taking.  So it is not very apparent that it is actually possible to obtain the beneficial effects of K2 while taking these drugs.

    (As a side point, the massive dose of K2 could provide enough K2 in these studies to allow each molecule to act once and then get converted to the epoxide form without being recycled, and actually exert a meaningful effect.  Off memory, I don't remember whether they did calculations to show whether there was residual reductase activity (i.e. activity of the enzyme that recycles vitamin K, which is the target of warfarin), but the principle that high dose K2 protects against calcification does not show that the dose of warfarin used allowed residual activity of the enzyme, necessariliy.)

    Chris

  • Anonymous

    9/8/2010 9:03:01 PM |

    Sounds as if AF patients should ask their physicians to change them to Dabigatran as soon as it comes out. Less bleeding risk, no constant monitoring and, importantly, the ability to avail oneself of good nutrition without worrying about INR's. The British Heart Foundation is campaigning for the drug to replace Warfarin.  

    Used widely to get rid of rat infestations in post-Katrina New Orleans, maybe Warfarin will soon be relegated to only killing rats.

  • Chris Masterjohn

    9/8/2010 10:10:20 PM |

    Anonymous,

    Good points -- warfarin was actually developed specifically as a rat poison, so if it came back into fashion post-Katrina, that's nothing new.

    Chris

  • Lacie

    9/10/2010 10:21:24 PM |

    I spent 18 unhappy months on Warfarin after a DVT/pulmonary embolism episode due to oral contraceptive use (I have Factor V leiden).  Happily, my physician took me off blood thinners last year after a doppler scan to confirm all of my clots were gone.

    If you really need a blood thinner (artificial heart valve, active blood clot, severe prolonged a-fib, homozygous Factor V leiden), there's just no good alternative to Warfarin at the moment.  Several alternatives have been tested and rejected due to severe side effects.

    A lower-risk propensity to blood clotting (hterozygous Factor V leiden, mild, short-duration a-fib, etc.) might respond to vitamin E.  I started taking it while on Warfarin and my INR readings shot up from 2 to 4.5.  See study by Harvard researcher Robert Glynn, published in September 25, 2007, issue of Circulation journal

  • Holistic health Blog

    6/29/2011 1:07:21 PM |

    Surely the answer is to take the nattokinase, keep a close watch on the INR & if it goes up significantly titrate the warfarin down.

  • Sal P

    5/15/2013 6:40:08 PM |

    Hello Doc,

    I have the same conflict as many here. I take Coumadin for my mechanical heart valve but I do eat green veggies such as broccoli, spinach, or a small salad everyday. I also take Omega 3 daily. My PT INR is usually around the required goal of 2.0. As long as I have this consistent INR reading, is it safe to continue to to have all the above mentioned in my body? I am hoping that my Coumadin dosage can be lowered with the same INR results.

    Please Advise

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