Can I stop my Coumadin?

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.

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

Loading
Why does wheat cause arthritis?

Why does wheat cause arthritis?

Wheat causes arthritis.

Before you say "What the hell is he saying now?", let me connect the dots on how this ubiquitous dietary ingredient accelerates the path to arthritis in its many forms.

1) Wheat causes glycation--Glycation is glucose-modification of proteins in the body that occurs when blood glucose exceeds 100 mg/dl. Cartilage cells are especially susceptible to glycation. The cartilage cells you had at age 18 are the very same cartilage cells you have at age 60, since they lack the ability to reproduce and repair themselves. Proteins in cartilage are highly susceptible to glycation, which makes them stiff and brittle. Stiff, brittle cartilage loses its soft, elastic, lubricating function. Damaged cartilage cells don't regenerate nor produce more protective proteins. This allows destruction of cartilage tissue, inflammation, and, eventually, bone-on-bone arthritis.

Because wheat, even whole wheat, sends blood sugar higher than almost all other foods, from table sugar to Snickers bars, glycation occurs after each and every slice of toast, every whole wheat bagel, every pita wrap.

2) Wheat is acidifying--Humans are meant to consume a diet that is net alkaline. While hunter-gatherers who consume meat along with plentiful vegetables and fruits live a net alkaline diet (urine pH 7 to 9), modern humans who consume insufficient vegetables and too much grain (of which more than 90% is usually wheat) shift the body towards net acid (urine pH 5 to 7). Wheat is The Great Disrupter, upsetting the normal pH balance that causes loss of calcium from bones, resulting in decalcification, weakness, arthritis and osteoporotic fractures.

3) Wheat causes visceral fat--The extravagant glucose-insulin surges triggered by wheat leads to accumulation of visceral fat: wheat belly.

Visceral fat not only releases inflammatory mediators like tumor necrosis factor and various interleukins, but is also itself inflamed. The inflammatory hotbed of the wheat belly leads to inflammation of joint tissues. This is why overweight and obese wheat-consuming people have more arthritis than would be explained by the burden of excess weight: inflammation makes it worse. Conversely, weight loss leads to greater relief from arthritis pain and inflammation than would be explained by just lightening the physical load.

We need a name for this wheat effect. How about "bagel bones"?

Comments (48) -

  • Hans Keer

    11/13/2010 5:50:58 PM |

    Perhaps I could add a fourth factor: Arthritis is more and more sen as an autoimmune disease. Wheat is one of the most prominent initiators of autoimmune diseases http://bit.ly/a9Gvjk

  • Kathryn

    11/13/2010 5:51:53 PM |

    Not being critical or attacking your statements.  I do believe that wheat (& other grains in general) are detrimental to health.

    But my understanding is that pH in the body is in a very small window: between 7.35 and 7.45 is what i have read.  

    ??

  • terrence

    11/13/2010 6:12:25 PM |

    "Bagel Bones" - I like it!

    But, how about "Bread Bones", or "Bakery Bones"?

  • Pater_Fortunatos

    11/13/2010 6:43:03 PM |

    Kathryn

    blood pH and urine pH are quite different things, but the urine pH reflects the cost that body pay to maintain the blood ph in the range you just mentioned.


    Hans Keer thanks for the link.

    Dr Davis thanks for another great lesson of medicine , everyone could use it!

    I am waiting an article regarding "MEMBRANE UNSATURATION AND LONGEVITY" considering "Great Fish Oil Experiment" of Ray Peat.

  • Pater_Fortunatos

    11/13/2010 6:47:43 PM |

    Sorry for being rude, I should have said "I would appreciate"...

  • Anonymous

    11/13/2010 8:40:05 PM |

    food fractures

  • Anonymous

    11/13/2010 9:15:00 PM |

    Don't forget gluten triggering autoimmune disorders, like rheumatoid arthritis.

  • Evolutionary Diet

    11/13/2010 10:05:50 PM |

    I don't have arthritis yet, but bread sure causes me to have a lot of digestive problems. Unfortunately, I love bread, so it's a constant struggle.

  • Anonymous

    11/13/2010 10:22:11 PM |

    i love your articles on wheat and really liked the neurological impact of wheat as told by you dr. davis. great work.

  • Anonymous

    11/13/2010 11:59:29 PM |

    Wheat of Mass destruction

  • Jon

    11/14/2010 5:37:12 AM |

    Wow... Continually checking up on your articles has really opened my eyes to how bad wheat really is.

    I am somewhat of a bread lover, but after reading about the disabling effects of wheat, I think I'm going to become a vegetable lover instead.

    Smile Keep writing your articles to spread this unknown knowledge around!

  • Dr. William Davis

    11/14/2010 2:23:41 PM |

    Hi, Hans--

    Yes, indeed. Yet another path by which wheat can exert joint damage.

    I suspect that there is more to this autoimmune or inflammatory pathway than suggested by rheumatoid arthritis. Unfortunately, with negative serum markers for rheumatoid arthritis or "atypical" appearances of the joint inflammation, it is often just labeled "arthralgia" or a non-specific arthritis, treated with non-steroidal agents, then dismissed.

  • Dr. William Davis

    11/14/2010 2:25:19 PM |

    Hi, Kathryn--

    Pater's comments address your concern: Tissue and serum pH is indeed tightly regulated. But there's a price to pay to maintain normal pH when disruptive acids or bases (mostly acids) are introduced. This is reflected in urine pH, an expression of net change.

  • Stargazey

    11/14/2010 2:45:04 PM |

    So low urine pH=osteoporosis? Do we have a scientific citation for this?

    I've seen all over the internet that eating lots of meat causes low blood pH, which causes osteoporosis. Obviously, what we eat cannot influence our blood pH, or we'd be dead.

    But if low urine pH caused osteoporosis, wouldn't internists everywhere be advising patients to correct that? I see them prescribing drugs plus extra calcium plus vitamin D plus exercise, but never a word about changing the net pH of the diet. Odd.

  • Joseph

    11/14/2010 3:30:56 PM |

    It's nicely coincidental that you mention wheat as as a cause of low blood PH. I've just found I have low blood PH during a checkup, yes wheat is slightly acid but after doing a bit of research my thinking is that it was caused by the moderate to high protein, high fat diet I have been consuming on the recommendation of alot of paleo blogs.

    To answer Stargazey, here are 6 studies I found that support the link between protein, blood PH and bone density.

    Consumption of higher protein omnivorous diets promoted decreased bone mineral density after weight loss in overweight postmenopausal women.
    The control, nonmeat, chicken, and beef groups lost 1.5%, 7.7%, 10.4%, and 8.1% weight and 0.0%, 0.4%, 1.1%, and 1.4% bone mineral density, respectively.
    http://biomedgerontology.oxfordjournals.org/content/early/2010/07/05/gerona.glq083.abstract

    Results: After adjustment for age, sex, and energy intake and control for forearm muscularity, BMI, growth velocity, and pubertal development, we observed that long-term dietary protein intake was significantly positively associated with periosteal circumference (P < 0.01), which reflected bone modeling, and with cortical area (P < 0.001), bone mineral content (P < 0.01), and polar strength strain index (P < 0.0001), which reflected a combination of modeling and remodeling. Children with a higher dietary PRAL had significantly less cortical area (P < 0.05) and bone mineral content (P < 0.01). Long-term calcium intake had no significant effect on any bone variable.
    http://journal.shouxi.net/qikan/article.php?id=206948

    We conclude that excessive dietary protein from foods with high potential renal acid load adversely affects bone, unless buffered by the consumption of alkali-rich foods or supplements.
    http://jn.nutrition.org/cgi/content/abstract/128/6/1051

    Elderly women with a high dietary ratio of animal to vegetable protein intake have more rapid femoral neck bone loss and a greater risk of hip fracture than do those with a low ratio. This suggests that an increase in vegetable protein intake and a decrease in animal protein intake may decrease bone loss and the risk of hip fracture.
    http://www.ajcn.org/cgi/content/abstract/73/1/118

    Enduced acidosis caused the loss of calcium, sodium and potassium from the cells and bones of subjects
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292842/?page=6

    Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women
    http://www.ajcn.org/cgi/content/abstract/81/4/923

    Aside from protein, Ketone bodies are also acidic and cause acidosis in diabetics "diabetic keto acidosis" and alcoholics "alcoholic ketoacidosis"

  • Mike

    11/14/2010 3:56:53 PM |

    I find this topic extremely interesting, especially from an athletic standpoint.

    As far as acidity, osteoporosis, and Paleo, Don from Primal Wisdom delved into this in a nice 7 part series: http://donmatesz.blogspot.com/2010/03/paleo-diet-ph-does-it-matter-part-vii.html

    Add in resistance training, though, and the whole point of diet and osteoporosis becomes almost completely moot. VitD, Ca, K, P don't hold much against skeletal bone adaptation to picking heavy stuff up.

    While I've seen evidence of increased athletic performance by the addition of exogenous pH buffers (bicarbonate), I have NOT seen evidence of (quantifiable) ergogenic improvements due to an "alkaline" diet.  While there might be some merit there (I myself follow a fairly strict Paleo diet), attempting to be more "alkaline" by decreasing meat intake would only hinder my performance.

    Back on topic:  I'll echo what other have stated already, in that the mechanism for arthritis, specifically RA, would be auto-immune mediated with wheat gluten intake.  I'm surprised Dr. Davis did not mention this.

  • Lori Miller

    11/14/2010 5:04:58 PM |

    Eating very much carb in general makes my shoulder hurt. One of my dance teachers has said the same thing about her knees.

    FWIW, both surgical anesthetic (morphine?) and wheat make me feel lousy. I didn't have any withdrawal when I quit eating wheat.

  • Joe

    11/14/2010 5:16:54 PM |

    @Mike

    While exercise may mitigate some of the effects of Acidosis such as low bone density, stress (acidosis raises cortisol), risk of panic attacks (http://www.ncbi.nlm.nih.gov/pubmed/17713689); I've read acidosis is associated with many other diseases.

    The positive effects of bicarbonate during exercise are probably related to higher muscle protein catabolysis during acidosis which would probably continue after you stopped exercising.

    Another effect of protein is to lower serum testosterone and sex binding hormone globulin. Saturated fat raises it however (http://jap.physiology.org/cgi/content/full/82/1/49)

  • Mike

    11/14/2010 11:13:52 PM |

    @Joe,

    I have no doubts chronic acidosis has strong implications in many disease etiologies; I was just stating my experience (and opinion) on the effectiveness of an alkaline diet on athletic performance, and emphasizing resistance training for optimal bone density over dietary changes.

    On buffering:  I've personally trialed a few doses of sodium bicarb w/ short duration, highly glycolytic/lactate producing workouts, and the ergogenic (performance enhancing) effect has more to do with reduction in muscle fatigue secondary to reducing H+ ions than protein catabolysis.  I believe this is why many athletes have anecdotally adopted a "high alkaline" diet without actual quantifiable data on it.  By no means am I saying it's unhealthy (a diet high in vegetables and devoid of grains most surely IS healthy!), but it just doesn't make a difference, performance wise, like actual NaHC03 loading.

    I do agree on the effects of SFA and testosterone, though---hence my choice of whey protein and coconut milk PWO.

  • Stargazey

    11/14/2010 11:27:54 PM |

    Thanks for the references. Today is a work day for me, so I've only glanced at them, but it seems like the evidence either way is not overwhelming. I'll study it more carefully in the next few days as I find the time.

  • Andrea

    11/15/2010 11:07:16 AM |

    Hello Dr. Davis,

    I follow your blog regularly. Keep up doing the good work.I appreciate it.
    Regarding Oseoarthritis I slightly disagree:
    Osteoarthritis is one example of “The pitiful state of medical ignorance” as Dr. Mike Eades says. Patellofemoral syndrome can be rehabilitated. Your cartilage can actually get better! 80 % of Doctors and physiotherapists don’t know this. Health care system? Don’t get me started!
    I can't give you the link because the science stuff is in German.
    But here is a good post from Mark Sisson about the topic: “OA is not your destiny”.
    http://www.marksdailyapple.com/arthritis-diet/
    Here's what I have learned from my "private research":
    Movement is great for rehab but you have to start where you are. Too little load is bad for joints and too much load is bad.  Find the “magic zone” as physiotherapist Doug Kelsey says. Joints and ligaments need time to adapt. More time than muscles.
    Interesting fact I learned from smart PTs:  cartilage works actually better under load than without. Yup! Smile

    I am not too impressed by science because I know how it works. I always told my docs that the so called “chronic deseases” are not a disease but failure of self regulation in your body. This is the basic premise of Functional Medicine. Even if they believed me they shrugged their shoulders. They were not interested because they only had drugs and surgery as tools. And if you only have a hammer as a tool every problem looks like a nail.
    But here’s the good news: The docs slowly change their mind, even in Germany. Surprise…. Prof. Dr. Henning Madry, Arthritis Research, Saarland Medical School, Germany, says: Osteoarthritis is no wear and tear but a chronic disease like asthma and diabetes. Cartilage is damaged by accidents or sports injuries but very often it is induced by internal processes which are not understood. Cartilage gets weak and finally destroyed.This has nothing to do with aging per se. Many young people have OA today and many old people have no OA says Prof. Madry.
    Hey – that’s what I said for years! But I am not an MD – only a person with a brain.

  • Andrea

    11/15/2010 11:08:50 AM |

    Hello Dr. Davis,

    I follow your blog regularly. Keep up doing the good work.I appreciate it.
    Regarding Oseoarthritis I slightly disagree:
    Osteoarthritis is one example of “The pitiful state of medical ignorance” as Dr. Mike Eades says. Patellofemoral syndrome can be rehabilitated. Your cartilage can actually get better! 80 % of Doctors and physiotherapists don’t know this. Health care system? Don’t get me started!
    I can't give you the link because the science stuff is in German.
    But here is a good post from Mark Sisson about the topic: “OA is not your destiny”.
    http://www.marksdailyapple.com/arthritis-diet/
    I am not too impressed by science because I know how it works. I always told my docs that the so called “chronic deseases” are not a disease but failure of self regulation in your body. This is the basic premise of Functional Medicine. Even if they believed me they shrugged their shoulders. They were not interested because they only had drugs and surgery as tools. And if you only have a hammer as a tool every problem looks like a nail.
    But here’s the good news: The docs slowly change their mind, even in Germany. Surprise…. Prof. Dr. Henning Madry, Arthritis Research, Saarland Medical School, Germany, says: Osteoarthritis is no wear and tear but a chronic disease like asthma and diabetes. Cartilage is damaged by accidents or sports injuries but very often it is induced by internal processes which are not understood. Cartilage gets weak and finally destroyed.This has nothing to do with aging per se. Many young people have OA today and many old people have no OA says Prof. Madry.
    Hey – that’s what I said for years! But I am not an MD – only a person with a brain.

  • Andrea

    11/15/2010 11:10:15 AM |

    my comment - part 2
    Why are the causes of symptoms like OA not understood? Because nobody in the medical establishment looked for them. Big Pharma has no interest in research about the causes and definitively not in prevention or healing. Healthy people who are not drug junkies? Terrible for Big Pharma!
    Dr. Ron Rosedale, MD, says: “If you are going to treat a disease you need to get to the root of the disease….But the problem is that we don’t know what the root is, or we haven’t. (…) the problem is that medicine really isn’t a science, it is a business.”
    Nothing in the human body “just wears out”. Your pancreas doesn’t ” just wear out”. Stop eating tons of crap! Your liver doesn’t “just wear out”. Your eyes don’t “just wear out” – stop misusing and poisoning them. Read optometrist Jacob Liberman, PhD., or Leo Angart on why eyes get bad, you’ll be surprised. Liberman and Angart are seniors and don’t need the glasses they had as young men. Liberman’s deconstruction of “medical idiocy” in ophtalmology is great.

  • Monique

    11/15/2010 4:14:15 PM |

    Too much anything can be harmful. That is why you should have a nice balanced diet. Great, informative article.

  • Geoffrey Levens

    11/15/2010 7:59:50 PM |

    "Unfortunately, I love bread, so it's a constant struggle."

    There is hope!  My middle name used to be "toast", only 1/2 kidding.  I have eaten no bread for almost 3 years and the craving for it is gone. I have had a bite here and there and can feel the "hook" trying to reset so I just don't go there.  Most of the time I no longer even think about it. It does take time and persistence (stubbornness) to reset taste buds and mental concepts.

  • Daniel

    11/15/2010 8:37:26 PM |

    1.  There's no evidence for acid-base balance.

    2.  You missed a big one -- autoimmune reaction.

  • Dr. William Davis

    11/16/2010 2:34:33 AM |

    Funny, Daniel: I have an inch-thick file of research on acid-base disruptions from diet.

    Shall I file it in the fiction shelf?

  • Nick

    11/16/2010 3:15:02 AM |

    "Wheat causes glycation--Glycation is glucose-modification of proteins in the body that occurs when blood glucose exceeds 100 mg/dl. Cartilage cells are especially susceptible to glycation."

    Is there a citation for this claim?  I understand that there is evidence that when blood glucose levels exceed 140 mg/dl our organs can be damaged, but cartilage does not contain blood vessels, so why is it 'especially susceptible to glycation?

    To be clear, I don't eat wheat, but why single out wheat as a cause of arthritis if any food that raises blood glucose levels per the claim above would cause arthritis?

  • Daniel

    11/16/2010 4:48:44 PM |

    Dr. Davis,
    You can start by posting some links on your blog, I suppose.

    Wikipedia says this about acid/base balance: http://en.wikipedia.org/wiki/Alkaline_diet

    I think if you characterize your dietary advice in terms of getting adequate minerals, it would have more solid grounding than characterizing it in terms of ph.

  • rhc

    11/16/2010 6:43:15 PM |

    @Andrea
    Would you mind posting the link to the German research you were talking about? I'm German and would love to read it.
    day. Thank you!

  • Jack

    11/16/2010 8:41:17 PM |

    Funny, Dr. Davis, I've read well written pieces from WAPF and Stephen G. on why the acid/base balance theories are not well founded when picked apart.

    ACID BASE BALANCE

    So I dunno if storing your files on the fiction shelf is the best option, but you might wanna at least place it on the "still under review" shelf.

    -Jack

  • Anonymous

    11/16/2010 9:10:35 PM |

    What in medical science is not still under review, aside from how to set a broken bone ?

  • lala

    11/17/2010 3:24:55 AM |

    Thanks for your post and welcome to check: here.

  • Andrea

    11/17/2010 11:54:05 AM |

    @ rhc
    No problem - here is the interesting geek stuff in German:

    Claudia Dickinson:
    Der Knorpel - regenerativ und therapierbar!
    http://www.claudiaploke.de/download/physiomed/pm_4_2001.pdf
    I traveled from Berlin to Karlsruhe to get assessment and diagnosis from Claudia. Orthopedic doctors? Don’t get me started! As famous composer Hanns Eisler said: "My whole life I fought against stupidity – in music and elsewhere. I am afraid I have lost."
    I could write a book about stupidity (and denial of assistance & malpractice)  in orthopedics.

    Markus Gunsch:
    Die Behandlung des patellofemoralen Schmerzsyndroms mit Kompression und deren Wirkungsweise
    Gekürzte und überarbeitete Fassung der Diplomarbeit, die bei der Hogeschool van Amsterdam, Fakultät Gesundheitswesen, Institut Physiotherapie, Amsterdam im August 2004 vorgelegt worden ist.
    http://www.wsz-muc.de/_downloads/a_kg01.pdf
    http://www.wsz-muc.de/_downloads/a_kg02.pdf

    Gunsch:
    Patellofemorales Schmerzsyndrom_Kompression hilft
    http://www.wsz-muc.de/_downloads/PM_1_2010_Gunsch2.pdf

    Prof. Henning Madry, Universität Saarland: Arthrose ist keine "Alterserscheinung", sondern eine chronische Krankheit
    http://idw-online.de/de/news377579

  • Anonymous

    11/17/2010 1:29:24 PM |

    You need a TWEET THIS button on your posts.

  • rhc

    11/17/2010 3:54:42 PM |

    @Andrea,
    WOW l lots to read..will get to it later in the day. Thanks a lot!

  • Igor

    11/17/2010 7:30:56 PM |

    Hello

  • elpi

    11/18/2010 1:20:17 AM |

    I do have arthritis and I hate it. .I can't stand in cold places, so sad. Thanks for sharing. I should avoid wheat

  • Stargazey

    11/18/2010 2:23:40 AM |

    Joseph, thanks for the citations.

    It appears from this reference Acid diet (high-meat protein) effects on calcium metabolism and bone health, that a high dietary protein intake causes more absorption of calcium from food, and consequently more calcium excreted in the urine.

    From this reference Protein and calcium: antagonists or synergists?, because bone is 50% mineral and 50% protein by volume, a high-protein diet and calcium supplementation are essential for maintaining and enhancing bone status. If only one element is present in sufficient quantity, bone may actually be lost.

    As other commenters have indicated, acid-base balance has little or nothing to do with the process.

  • Anonymous

    11/18/2010 8:37:11 PM |

    dr. davis whats your take on brown rice?

  • Andrea

    11/18/2010 9:14:20 PM |

    @rhc
    you are welcome!  Smile

  • Plastic surgeon Los Angeles

    11/19/2010 5:38:34 AM |

    I thought you would say that the modern human is health conscious and keeps a right percentage of foods in the diet.At least what IO see is healthy buddies exercising everyday and etching for calorie free health food these days.

  • Stelucia

    11/19/2010 10:33:16 AM |

    Wheat is not the cause for Rheumatoid Arthritis but only a co-factor. It is more likely to be an infection as both doctors Wyburn-Mason and  Brown claim. As a former RA pacient who got healed using the Wyburn-Mason protocol, I tend to support the infectious nature of RA, not the autoimmune theory.

  • Anonymous

    11/19/2010 1:41:53 PM |

    dr. davis whats your take on brown rice? is it a good replacement for wheat? a cup full at mealtimes?

  • Maria

    2/8/2011 8:29:21 AM |

    hi,
    nice posting about wheat cause arthritis.These are many forms wheat cause arthritis are as follows.
    Wheat causes glycation
    Wheat is acidifying
    Wheat causes visceral fat
    Arthritis

  • JB

    10/7/2011 1:11:25 PM |

    I had joint pain in my elbows and fingers for 3 or 4 years and it was getting worse.  After researching on the internet I heard about the wheat - arthritis connection, so I though I'd give it a shot.  I've now been off wheat for four months and the joint pain is gone.  I've done "experiments" where I reintroduce wheat products for one meal and the joint pain will return for the next two days. I've also lost ten pounds and most of my wheat belly.  A no wheat diet takes some planning but well worth it.

  • Dr. William Davis

    10/8/2011 2:18:31 AM |

    That's pretty solid, JB.

    I call it the "on again, off again" phenomenon in which you stop wheat, the symptoms stop; resume wheat, they come back. The effect can be repeated at will.

    In my mind, that is pretty solid proof of an association.

  • Anne

    11/9/2012 2:41:59 PM |

    I have bought and read your book on wheat, and it was a great discovery for me. You see, my mother's family were Italians, and pasta, pizza, biscotti, and so on, is standard fare in Italy. So, I would never, ever have thought that my joint pain in the fingers could be linked to wheat consumption. But my mother also told me that there is a strong arthritis predisposition in the family. So, when I read your book I connected the dots.
    I have taken wheat out of my diet and the joint pain is gone (it was not a big pain, it was very subtle, I'm only 37, but I was wondering why I had it). Same as JB who left a comment above: I've done the test of eating a plate of pasta, and on the same day, a few hours later, the joint pain was back. So, I'm off the wheat, and I thank you so much for having written this great book!

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