Condition Afflicts Millions: Do you have “YBS”?

12. May 2014 Lisa G Nutrition (0)
After one of the harshest winters, spring has finally arrived.  The welcomed warmer temperatures and longer daylight hours infuse us with a sense of renewal and new beginnings.   Low and behold we begin to come out of hibernation and start the mad dash to engage in positive lifestyle changes such as eating better, exercising, proper sleep and taking appropriate nutritional supplements.  But invariably, life happens.  

Yep, just when you were about to get started, it happens.  YBS sets in.   I see this “condition” all too often with clients attempting to enter or re-enter into any number of behavior changes.  I will go so far as to say we all have been afflicted at one point or another in our lives.  I call this condition Yeah But Syndrome, or “YBS”.    It is often paralyzing and prevents those afflicted from moving into action, instead remaining in a state of inertia.  

There are many symptoms of YBS but the following are some of the most common.  

• Yeah I planned to go to the gym today BUT, the kids needed a ride to practice.  
• Yeah I really want to eat better BUT I don’t have the time.   
• Yeah I didn’t plan to eat the cake BUT my husband wanted too, so I did also.   
• Yeah I really meant to go to the grocery shopping BUT I was too tired, so I hit the drive- thru.  
• Or this is a good one. Yeah I meant to start today BUT, I’ll start tomorrow.  

But tomorrow never comes.  You get the drift.  We can all come up with a million yeah buts, in other words, excuses.    The good news is the treatment for YBS is simple--just do it!  Take action.  The reality of today’s 24-7 planet is there will always be something.  The kids, work commitments, family obligations and various projects that need your attention will perpetually be present in some shape or form.  The difference to make the difference is to learn to dance in the rain, not wait for the rain to pass.  When will all the stars align so that your world will be “just right” to start?  If not NOW, WHEN will you begin?  

The key word here is begin.   Far too frequently, I coach clients that shoot themselves in the foot before they start.   Instead of consuming yourself with all the barriers to entry, select reasonable, low-hanging fruit that is “doable.”    The art of lifestyle change is to avoid all-or-nothing thinking and begin to appreciate what you CAN do, versus focusing energy on what you can’t do.  What is one action you can do TODAY to move toward your wellness goal(s)?  Start to focus on what you can do in the mist of your existing life demands. This mantra is a friendly reminder: BE-DO-HAVE.  Be committed.  Do what it takes.  And you will have results.  

Lastly, if you think removing cereal from your morning routine it is too difficult and you can’t do it. Guess what-- you’re likely right.   What you think is what you get!   But what if you think instead, “I can do this.  There are many truly healthy options for breakfast to replace cereal such as eggs and veggies that will help me look and feel my best.”  Then guess what--you will!  This simple change in mind-set can start a tidal wave of change and prevent you from abandoning ship when life tosses you into rough waters.  Ongoing support is hugely important to sustain lifestyle changes.  Join the conversations in the Cureality Forum to engage the support of health coaches and Cureality Members to stay on track. 

We Need More.....Kettlebell

8. May 2014 Amber B Exercise (0)
You either love them or you hate them.

When you are in love with kettlebells, like I am, you enjoy the multi-muscle group movements.  Kettlebell workouts are fluid, like a dance, putting together a chain of movements that leave your heart pounding and sweat pouring.  Yes, there’s some sneaky cardio component to a kettlebell workout.   A great blend of aerobic and anaerobic conditioning.

If you hate kettlebells it’s because kettlebell exercises keep you honest with proper exercise execution.  Form is imperative to moves like the kettlebell swing or the kettlebell snatch.  Do it incorrectly and you’ll be either sore or have bruised wrists the next day.  But this is no reason to shy away from the kettlebell.  You have way too much to gain from this odd looking piece of exercise equipment.  

You will get a mega -caloric burn.  The American council on Exercise states that the average kettlebell workout burns 20 calories per minute.  That’s 1200 calories in just one hour.   Kettlebell workouts utilize many muscle groups to give you an efficient, total body conditioning workout.  

If you’re looking for a toned back side get a kettlebell.  The classic kettlebell swing works all the posterior muscles like your glutes, hamstrings, and lower back.  But only if you use correct form.  Otherwise you'll find yourself with nagging back pain, instead of a better butt.  

Kettlebell exercises are functional movements that will allow you to play hard without getting injured.  If you are an athlete, a nature enthusiast, or just want to keep up with the kids then you need to give kettlebells a try.  During a workout, the exercises will target movements that will make getting up and down off the floor easier, as well as bending over to pick something up.

If you are interested in doing kettlebell workouts start with a coach or take class.  You can’t fake form with kettlebell exercises or you could end up hurt.  I’m not trying to scare anyone away because good form is easy to learn.   Your body will memorize the correct movement pattern and you’ll be on your way to a successful kettlebell workout.  

Thyroid and the gut: Hidden health partners

8. May 2014 Chris K Thyroid (0)
Though I have personally dealt with both auto-immune thyroiditis (Hashomoto’s) and several gut issues (wheat sensitivity, gastritis, etc.), it was not until recently that I discovered how close the thyroid and gut work together to keep you healthy – and how problems with one can affect the other along with your overall health.
 
Most of us understand that the primary function of the gut, that 25 to 30 feet of “tubing” that includes everything from your stomach to your large intestines, is to process the food we eat and allow the “good stuff” (essential nutrients) to pass into our blood stream while keeping the “bad stuff” (harmful proteins) out. However, it may surprise some that the gut also holds as much as 70% of all the immune tissue in the body.
 
Now, imagine all the health havoc that could ensue if, suddenly, the gut stopped doing its job – particularly if it failed to stop toxic proteins from entering the blood stream and then mounted an overzealous immune response against them.  Sometimes, those overzealous immune responses reach beyond their intended targets to attack otherwise healthy tissues and organs – like the thyroid gland.
 
Recent studies indicate that thyroid hormones play a significant role in maintaining gut integrity, preventing leaky gut that can, in some cases, lead to auto-immune attacks against the thyroid.  A properly functioning gut also aids the production of thyroid hormones by converting some of the inactive “T4” thyroid hormone into the functional “T3” hormone.  Failure to simultaneously maintain both a healthy gut and a healthy thyroid can create a vicious cycle leading to chronic health problems and declining vitality.
 
What it all means is that to enjoy optimal health, you must promote good thyroid health to promote good gut health and vice versa.  Unfortunately, traditional medicine tends to focus on one issue to the exclusion of others.  A typical endocrinologist may treat your under active thyroid without spending a moment to address underlying gut issues.  A gastroenterologist will work alleviate a gut problem but will rarely address a potential thyroid problem.
 
This illustrates, once again, how our bodies work as a system and why it is necessary to bridge the “healthcare gaps” in traditional medicine by becoming personally responsible for your health.  I encourage everyone to consult the Cureality Program Guide and online Cureality Diet and Thyroid Health Tracks to learn more about how to optimize both your gut and thyroid health on your journey to realizing complete, whole-body health.

Omega-3 fatty acids likely NOT associated with prostate cancer

18. July 2013 William Davis Omega-3 fatty acids (6)
A weakly constructed study was reported recently that purportedly associated higher levels of omega-3 fatty acid blood levels and prostate cancer. See this CBS News report, for instance.

Lipid and omega-3 fat expert, Dr. William Harris, posted this concise critique of the study, exposing some fundamental problems:

First, the reported EPA+DHA level in the plasma phospholipids in this study was 3.62% in the no-cancer control group, 3.66% in the total cancer group, 3.67% in the low grade cancer group, and 3.74% in the high-grade group. These differences between cases and controls are very small and would have no meaning clinically as they are within the normal variation. Based on experiments in our lab, the lowest quartile would correspond to an HS-Omega-3 Index of <3.16% and the highest to an Index of >4.77%). These values are obviously low, and virtually none of the subjects was in “danger” of having an HS-Omega-3 Index of >8%. So to conclude that regular consumption of 2 oily fish meals a week or taking fish oil supplements (both of which would result in an Index above the observed range) would increase risk for prostate cancer is extrapolating beyond the data.

This study did not test the question of whether giving fish oil supplements (or eating more oily fish) increased PC risk; it looked only a blood levels of omega-3 which are determined by intake, other dietary factors, metabolism and genetics.

The authors also failed to present the fuller story taught by the literature. The same team reported in 2010 that the use of fish oil supplements was not associated with any increased risk for prostate cancer. A 2010 meta-analysis of fish consumption and prostate cancer reported a reduction in late stage or fatal cancer among cohort studies, but no overall relationship between prostate cancer and fish intake. Terry et al. in 2001 reported higher fish intake was associated with lower risk for prostate cancer incidence and death, and Leitzmann et al. in 2004 reported similar findings. Higher intakes of canned, preserved fish were reported to be associated with reduced risk for prostate cancer. Epstein et al found that a higher omega-3 fatty acid intake predicted better survival for men who already had prostate cancer, and increased fish intake was associated with a 63% reduction in risk for aggressive prostate cancer in a case-control study by Fradet et al). So there is considerable evidence actually FAVORING an increase in fish intake for prostate cancer risk reduction.

Another piece of the picture is to compare prostate cancer rates in Japan vs the US. Here is a quote from the World Foundation of Urology:

"[Prostate cancer] incidence is really high in North America and Northern Europe (e.g., 63 X 100,000 white men and 102 X 100,000 Afro-Americans in the United States), but very low in Asia (e.g., 10 X 100,000 men in Japan).”

Since the Japanese typically eat about 8x more omega-3 fatty acids than Americans do and their
blood levels are twice as high, you’d think their prostate cancer risk would be much higher...
but the opposite is the case.

Omega-3 fatty acids are physiologically necessary, normalizing multiple metabolic phenomena including augmentation of parasympathetic tone, reductions of postprandial (after-meal) lipoprotein excursions, and endothelial function. It would indeed make no sense that nutrients that are necessary for life and health exert an adverse effect such as prostate cancer at such low blood levels. (Recall that an omega-3 RBC index of 6.0% or greater is associated with reduced potential for sudden cardiac death.)

I personally take 3600 mg per day of EPA + DHA in highly-purified, non-oxidized triglyceride form (Ascenta Nutrasea liquid) that yields an RBC omega-3 index of just over 10%, the level that I believe the overwhelming bulk of data suggest is the ideal level for humans.

Are statins and omega-3s incompatible?

18. June 2013 William Davis (4)
French researcher, Dr. Michel de Lorgeril, has been in the forefront of thinking and research into nutritional issues, including the Mediterranean Diet, the French Paradox, and the role of fat intake in cardiovascular health. In a recent review entitled Recent findings on the health effects of omega-3 fatty acids and statins, and their interactions: do statins inhibit omega-3?, he explores the question of whether statin drugs are, in effect, incompatible with omega-3 fatty acids.

Dr. Lorgeril makes several arguments:

1) Earlier studies, such as GISSI-Prevenzione, demonstrated reduction in cardiovascular events with omega-3 fatty acid supplementation, consistent with the biological and physiological benefits observed in animals, experimental preparations, and epidemiologic observations in free-living populations.

2) More recent studies (and meta-analyses) examining the effects of omega-3 fatty acids have failed to demonstrate cardiovascular benefit showing, at most, non-significant trends towards benefit.

He points out that the more recent studies were conducted post-GISSI and after agencies like the American Heart Association's advised people to consume more fish, which prompted broad increases in omega-3 intake. The populations studied therefore had increased intake of omega-3 fatty acids at the start of the studies, verified by higher levels of omega-3 RBC levels in participants.

In addition, he raises the provocative idea that the benefits of omega-3 fatty acids appear to be confined to those not taking statin agents, as suggested, for instance, in the Alpha Omega Trial. He speculates that the potential for statins to ablate the benefits of omega-3s (and vice versa) might be based on several phenomena:

--Statins increase arachidonic acid content of cell membranes, a potentially inflammatory omega-6 fatty acid that competes with omega-3 fatty acids. (Insulin provocation and greater linoleic acid/omega-6 oils do likewise.)
--Statins induce impaired mitochondrial function, while omega-3s improve mitochondrial function. (Impaired mitochondrial function is evidenced, for instance, by reduced coenzyme Q10 levels, with partial relief from muscle weakness and discomfort by supplementing coenzyme Q10.)
--Statins commonly provoke muscle weakness and discomfort which can, in turn, lead to reduced levels of physical activity and increased resistance to insulin. (Thus the recently reported increases in diabetes with statin drug use.)

Are the physiologic effects of omega-3 fatty acids, present and necessary for health, at odds with the non-physiologic effects of statin drugs?

I fear we don't have sufficient data to come to firm conclusions yet, but my perception is that the case against statins is building. Yes, they have benefits in specific subsets of people (none in others), but the notion that everybody needs a statin drug is, I believe, not only dead wrong, but may have effects that are distinctly negative. And I believe that the arguments in favor of omega-3 fatty acid supplementation, EPA and DHA (and perhaps DPA), make better sense.



DHA: the crucial omega-3

22. May 2013 William Davis (5)
Of the two omega-3 fatty acids that are best explored, EPA and DHA, it is likely DHA that exerts the most blood pressure- and heart rate-reducing effects. Here are the data of Mori et al in which 4000 mg of olive oil, purified EPA only, or purified DHA only were administered over 6 weeks:



□ indicates baseline SBP; ▪, postintervention SBP; ○, baseline DBP; •, postintervention DBP; ⋄, baseline HR; and ♦, postintervention HR.

In this group of 56 overweight men with normal starting blood pressures, only DHA reduced systolic BP by 5.8 mmHg, diastolic by 3.3 mmHg.

While each omega-3 fatty acid has important effects, it may be DHA that has an outsized benefit. So how can you get more DHA? Well, this observation from Schuchardt et al is important:

DHA in the triglyceride and phospholipid forms are 3-fold better absorbed, as compared to the ethyl ester form (compared by area-under-the-curve). In other words, fish oil that has been reconstituted to the naturally-occurring triglyceride form (i.e., the form found in fresh fish) provides 3-fold greater blood levels of DHA than the more common ethyl ester form found in most capsules. (The phospholipid form of DHA found in krill is also well-absorbed, but occurs in such small quantities that it is not a practical means of obtaining omega-3 fatty acids, putting aside the astaxanthin issue.)

So if the superior health effects of DHA are desired in a form that is absorbed, the ideal way to do this is either to eat fish or to supplement fish oil in the triglyceride, not ethyl ester, form. The most common and popular forms of fish oil sold are ethyl esters, including Sam's Club Triple-Strength, Costco, Nature Made, Nature's Bounty, as well as prescription Lovaza. (That's right: prescription fish oil, from this and several other perspectives, is an inferior product.)

What sources of triglyceride fish oil with greater DHA content/absorption are available to us? My favorites are, in this order:

Ascenta NutraSea
CEO and founder, Marc St. Onge, is a friend. Having visited his production facility in Nova Scotia, I was impressed with the meticulous methods of preparation. At every step of the way, every effort was made to limit any potential oxidation, including packaging in a vacuum environment. The Ascenta line of triglyceride fish oils are also richer in DHA content. Their NutraSea High DHA liquid, for instance, contains 500 mg EPA and 1000 mg DHA per teaspoon, a 1:2 EPA:DHA ratio, rather than the more typical 3:2 EPA:DHA ratio of ethyl ester forms.

Pharmax (now Seroyal) also has a fine product with a 1.4:1 EPA:DHA ratio.

Nordic Naturals has a fine liquid triglyceride product, though it is 2:1 EPA:DHA.





Krill oil: Do the math

21. May 2013 William Davis (0)
The manufacturers of krill oil claim that the phospholipid form of omega-3 fatty acids, EPA and DHA, enhance their absorption. There are indeed some data to that effect:


Here are some representative krill oil preparations available on the market:


MegaRed Krill Oil:
EPA 50 mg
DHA 24 mg
Total omega-3s (EPA + DHA + other forms) 90 mg
Price: $28.99 for 60 softgels

Source Naturals (a fine company otherwise, by the way):

EPA 150 mg
DHA 90 mg
Total omega-3 fatty acids 300 mg
Price: $24.99 for 60 softgels

Alright, let's do some simple math:

Average volume of blood in the human body (all components): 5000 cc
Percentage of red blood cells (RBCs) by volume: 45%
Total volume RBCs: 2250 cc
Percentage of total volume RBCs occupied by fatty acids:

What tests are MORE important than cholesterol?

12. May 2013 William Davis (8)
In the conventional practice of early heart disease prevention, cholesterol testing takes center stage. Rarely does it go any further, aside from questions about family history and obvious sources of modifiable risk such as smoking and sedentary lifestyle.

So standard practice is to usually look at your LDL cholesterol, the value that is calculated, not measured, then--almost without fail--prescribe a statin drug. While there are indeed useful values in the standard cholesterol panel--HDL cholesterol and triglycerides--they are typically ignored or prompt no specific action.

But a genuine effort at heart disease prevention should go farther than an assessment of calculated LDL cholesterol, as there are many ways that humans develop coronary atherosclerosis. Among the tests to consider in order to craft a truly effect heart disease prevention program are:

--Lipoprotein testing--Rather than using the amount of cholesterol in the various fractions of blood as a crude surrogate for lipoproteins in the bloodstream, why not measure lipoproteins themselves? These techniques have been around for over 20 years, but are simply not part of standard practice.

Lipoprotein testing especially allows you to understand what proportion of LDL particles are the truly unhealthy small LDL particles (that are oxidation- and glycation-prone). It also identifies whether or not you have lipoprotein(a), the heritable factor that confers superior survival capacity in a wild environment ("The Perfect Carnivore"), but makes the holder of this genetic pattern the least tolerant to the modern diet dominated by grains and sugars, devoid of fat and organ meats.

--25-hydroxy vitamin D--The data documenting the health power of vitamin D restoration continue to grow, with benefits on blood sugar and insulin, blood pressure, bone density, protection from winter "blues" (seasonal affective disorder), decrease in falls and fractures, decrease in cancer, decrease in cardiovascular events. I aim to keep 25-hydroxy vitamin D at a level of 60 to 70 ng/ml. This generally requires 4000-8000 units per day in gelcap form, at least for the first 3 or so years, after which there is a decrease in need. Daily supplementation is better than weekly, monthly, or other less-frequent regimens. The D3 (cholecalciferol) form is superior to the non-human D2 (ergocalciferol) form.

--Hemoglobin A1c (HbA1c)--HbA1c represents glycated hemoglobin, i.e., hemoglobin molecules within red blood cells that are irreversibly modified by glucose, or blood sugar. It therefore provides an index of endogenous glycation of all proteins of the body: proteins in the lenses of the eyes that lead to cataracts; proteins in the cartilage of the knees and hips that lead to brittle cartilage and arthritis; proteins in kidney tissue leading to kidney dysfunction.

HbA1c provides an incredibly clear snapshot of health: It reflects the amount of glycation you have been exposed to over the past 90 or so days. We therefore aim for an ideal level: 5.0% or less, the amount of "ambient" glycation that occurs just with living life. We reject the notion that a HbA1c level of 6.0% is acceptable just because you don't "need" diabetes medication, the thinking that drives conventional medical practice.

--RBC Omega-3 Index--The average American consumes very little omega-3 fatty acids, EPA and DHA, such that a typical omega-3 RBC Index, i.e., the proportion of fatty acids in the red blood cell occupied by omega-3 fatty acids, is around 2-3%, a level associated with increased potential for sudden cardiac death (death!). Levels of 6% or greater are associated with reduced potential for sudden cardiac death; 10% or greater are associated with reduced other cardiovascular events.

Evidence therefore suggests that an RBC Omega-3 Index of 10% or greater is desirable, a level generally achieved by obtaining 3000-3600 mg EPA + DHA per day (more or less, depending on the form consumed, an issue for future discussion).

--Thyroid testing (TSH, free T3, free T4)--Even subtle degrees of thyroid dysfunction can double, triple, even quadruple cardiovascular risk. TSH values, for instance, within the previously presumed "normal" range, pose increased risk for cardiovascular death; a TSH level of 4.0 mIU, for instance, is associated with more than double the relative risk of a level of 1.0.

Sad fact: the endocrinology community, not keeping abreast of the concerning issues coming from the toxicological community regarding perchlorates, polyfluorooctanoic acid and other fluorinated hydrocarbons, polybrominated diphenyl ethers (PDBEs), and other thyroid-toxic compounds, tend to ignore these issues, while the public is increasingly exposed to the increased cardiovascular risk of even modest degrees of thyroid dysfunction. Don't commit the same crime of ignorance: Thyroid dysfunction in this age of endocrine disruption can be crucial to cardiovascular and overall health.


All in all, there are a number of common blood tests that are relevant--no, crucial--for achieving heart health. Last on the list: standard cholesterol testing.

Cranberry Sauce

21. November 2012 William Davis (3)
Happy Thanksgiving 2012, everyone, from all the staff at Track Your Plaque!

Here’s a zesty version of traditional cranberry sauce, minus the sugar. The orange, cinnamon, and other spices, along with the crunch of walnuts, make this one of my favorite holiday side dishes.

There are 31.5 grams total “net” carbohydrates in this entire recipe, or 5.25 grams per serving (serves 6). To further reduce carbs, you can leave out the orange juice and, optionally, use more zest.

1 cup water
12 ounces fresh whole cranberries
Sweetener equivalent to 1 cup sugar (I used 6 tablespoons Truvía)
1 tablespoon orange zest + juice of half an orange
½ cup chopped walnuts
1 teaspoon ground cinnamon
½ teaspoon ground nutmeg
¼ teaspoon ground cloves

In small to medium saucepan, bring water to boil. Turn heat down and add cranberries. Cover and cook at low-heat for 10 minutes or until all cranberries have popped. Stir in sweetener. Remove from heat.

Stir in orange zest and juice, walnuts, cinnamon, nutmeg, and cloves.

Transfer mixture to bowl, cool, and serve.


Apple Cranberry Crumble

18. November 2012 William Davis (0)
Apple, cranberry, and cinnamon: the perfect combination of tastes and scents for winter holidays!

I took a bit of carbohydrate liberties with this recipe. The entire recipe yields a delicious cheesecake-like crumble with 59 “net” grams carbohydrates (total carbs – fiber); divided among 10 slices, that’s 5.9 grams net carbs per serving, a quantity most tolerate just fine. (To reduce carbohydrates, the molasses in the crumble is optional, reducing total carbohydrate by 11 grams.)

Other good choices for sweeteners include liquid stevia, stevia glycerite, powdered stevia (pure or inulin-based, not maltodextrin-based), Truvía, Swerve, and erythritol. And always taste your batter to test sweetness, since sweeteners vary in sweetness from brand to brand and your individual sensitivity to sweetness depends on how long you’ve been wheat-free. (The longer you’ve been wheat-free, the less sweetness you desire.)


Crust and crumble topping
3 cups almond meal
1 stick (8 tablespoons) butter, softened
1 cup xylitol (or other sweetener equivalent to 1 cup sugar)
1½ teaspoons ground cinnamon
1 tablespoon molasses
1½ teaspoons vanilla extract
Dash sea salt

Filling
16 ounces cream cheese, softened
2 large eggs
½ cup xylitol (or other sweetener equivalent to ½ cup sugar)
1 Granny Smith apple (or other variety)
1 teaspoon ground cinnamon
1 cup fresh cranberries

Preheat oven to 350° F.

In large bowl, combine almond meal, butter, sweetener, cinnamon, molasses, vanilla, and salt and mix.

Grease a 9½-inch tart or pie pan. Using approximately 1 cup of the almond meal mixture, form a thin bottom crust with your hands or spoon.

In another bowl, combine cream cheese, eggs, and sweetener and mix with spoon or mixer at low-speed. Pour into tart or pie pan.

Core apple and slice into very thin sections. Arrange in circles around the edge of the cream cheese mixture, working inwards. Distribute cranberries over top, then sprinkle cinnamon over entire mixture.

Gently layer remaining almond meal crumble evenly over top. Bake for 30 minutes or until topping lightly browned.
Do your part to save on healthcare costs

Do your part to save on healthcare costs

13. December 2010 William Davis (37)
While many of the factors that drive the relentless increase in health care costs are beyond individual control, you are still able to exert personal influence over costs. Just as in political elections, your one vote alone may not count; it's the collective effort of many people who share similar opinions that results in real change.

I just got the new monthly premium for my high-deductible health insurance: Up $300 per month, putting my family's total premium over $2000 per month---for four healthy people. (My son fractured his wrist playing high school hockey earlier this year; that may explain at least some of the increase.)

I'm going to shop around for a better deal. However, shopping is likely to only stall the process. It will not address the systemic problems with healthcare that continue to drive premiums up and up and up.

So what can you do to help keep costs down? Here are a few thoughts:

Never accept a prescription for fish oil, i.e., Lovaza. Just buy far less costly over-the-counter fish oil. I treat complex hyperlipidemias, including familial hypertriglyceridemia, ever day. I NEVER use prescription fish oil. A typical 4 capsule per day Lovaza prescription adds around $280 to $520 per month to overall health costs (though your direct out-of-pocket costs may be less, since you shove the costs onto others in your plan).

Never accept a prescription for vitamin D. Prescription vitamin D is the mushroom or invertebrate form anyway. Just buy the human (cholecalciferol, D3) form from your health food store or "big box" store. They yield consistent increases in 25-hydroxy vitamin D levels, superior to the prescription form. And they're wonderfully inexpensive.

Eliminate wheat from your diet. If there is a dietary strategy that yields unexpected and outsized benefits across a wide spectrum of health, it's elimination of this thing we're sold called "wheat," you know, the genetically-transformed, high-yield dwarf mutant that now represents 99% of all wheat sold. Blood sugar drops, pre-diabetics become non-prediabetics, diabetics reduce need for medication or become non-diabetic, cholesterol values plummet, arthritis improves, acid reflux and irritable bowel symptoms improve or disappear, just to mention a few. Wheat elimination alone, I believe, would result in incalculable savings in both healthcare costs and lives saved.

Be sure to obtain iodine. In the fuss to cut salt use, everyone forgot about iodine. Lack of iodine leads to thyroid disease, usually hypothyroidism, that, in turn, causes cholesterol values to increase, weight to increase, and heart disease risk to double, triple, or quadruple. Iodine supplementation is easy and wonderfully inexpensive.

Over time, I hope that all of us can help develop the effort to self-direct more and more of our own health. Our Track Your Plaque program has shown me that, not only can people take the initiative to direct aspects of their own health, they can do it better than 99% of doctors.  

I'm sure there are many, many other ways to help reduce costs. Any suggestions?
Tags :

Comments (37) -

  • Chuck

    12/13/2010 4:07:49 AM |

    don't rush to the doctor for every sniffle, sneeze, bump or bruise.  too many see their doctors way too often.  also, don't rush to the ER everytime your kid cries for more than 60 seconds.

    get a plan that has a health savings account.  these typically have a very high deductible ($250 per individual) and cover one check up per year.  a lot of health care costs end up being out of pocket.  makes you think twice about frivolous health care expenditures.  also causes you to want to be a healthier person.

  • Patty

    12/13/2010 4:14:31 AM |

    Our premium for our the highest deductible option we could get health insurance, for 2 adults, went up $500. And neither of us have had any medical procedures, we take no prescriptions, and never even entered a doctor's office last year.  At some point, it's no longer insurance...it's highway robbery.  

    And we eliminated all grains from our diet earlier this year, so hopefully we will go another year without needing a doctor.  Really makes it hard to keeping paying that premium...

  • Ailu

    12/13/2010 4:57:49 AM |

    You are so right... it's crazy.  Our insurance premiums got so high we couldn't pay our other bills.. our deductible was $9800.  Add to that our regular Dr. bills and it was insane.  

    The clincher was when the naturalist lady down the street was dying of malignant melanoma. It had reached her lymph nodes.  Her family told me the drs insisted on operating to take them out, plus chemo.  But what does this crazy lady do?  She says "no way, I'm gonna go the natural route".  I mean, this lady is DYING.  She even smells like death.  Three weeks later I see her at the grocery store, and she looks like she just came from the gym.  "My goodness, you look so much better! What have you been doing?" She says "Oh, eating a lot of greens, I am so sick of greens! But it's keeping my PH between 7.2 & 7.4.  My naturopath said hardly no one dies of cancer, they just die of acidosis." It's now 3 months later, and the woman is running around like a teenager.  

    Well this was always my great fear. Cancer - w/o insurance. So now, I ask myself, why the heck am I going broke trying to pay for this insurance?  Stick a fork in me, I'm done. Feed me some greens.

  • terrence

    12/13/2010 5:01:06 AM |

    Come you guys, Saint Obama FIXED the American Health Care System. Didn't he... He really did, didn't he - he SAID he would...

  • Anonymous

    12/13/2010 6:37:50 AM |

    Dr. Davis, you forgot to mention that another big saver is never to buy prescription Niaspan, but instead buy over the counter Slo-Niacin or Endur-acin.

    One other big money saver is to invest in a pill cutter as most drugs cost the same for all dosage options. Have your Doc double your dosage and then just cut the pills in half and save 50% right off the bat.

  • Hans Keer

    12/13/2010 7:20:55 AM |

    I would say, start living a low-carb paleo lifestyle and you won't need supplementation and medical care (except from healing that wrist Smile ) at all. How do you do this? http://www.cutthecarb.com/getting-started/

  • Anne

    12/13/2010 8:41:56 AM |

    I really enjoy this blog and have got a lot of useful information from it over the years. But goodness, I know for sure that America is a dreadful place to live for health care ! I feel much safer in the United Kingdom where I know I get an excellent service from the National Health Service.

    Also, vitamin D3, oil based cholecalciferol, has recently become available here on prescription. It's a German manufacture called Dekristol and is good value - 50 capsules of 20,000 IU each costs about £20 to the NHS (l£7.20 directly to the patient). That's cheaper than any health food shop over here !

  • Dr. William Davis

    12/13/2010 1:01:20 PM |

    Yes, no Niaspan! That one completely slipped my mind.

    I used to be the largest prescriber of Niaspan in Wisconsin. Now I use Sloniacin or Enduracin exclusively. Compared to about $150-$170 per month for two tablets of Niaspan, the equivalent quantity of Sloniacin or Enduracin costs around $8.

    Thanks for reminding me, Anon.

  • Dr. William Davis

    12/13/2010 1:03:16 PM |

    Hi, Chuck-- Yes, indeed. In fact, that is probably what I am going to do personally.


    Hi, Patty--I've had that same impulse. Unfortunately, one hospitalization is enough to bankrupt most people, or at least strip you of all your savings and retirement money. That's yet another part of the story.

  • Roger

    12/13/2010 1:21:26 PM |

    I won't go to doctors that overcharge the insurance company. I changed plans and needed a refill of Flonase, which my previous doctor prescribed for hay fever. My new doctor wouldn't write the prescription unless I came in for an office visit, for which he billed the insursance company $500. He used the time to pitch his surgery services, saying if I was ever in the hospital and needed surgery, I could request him. I signed up for a different doctor.

  • Chuck

    12/13/2010 1:24:29 PM |

    i apologize if i mislead anyone.  our deductible is $2500 per indvidual not $250.  our family of 4 max is $3500.  once we reach that for the year for everyone, we have no more out of pocket.  the most we have spent out of pocket in a year (3 years on the plan) is about $500.  we have been fortunate.

  • Chris

    12/13/2010 2:41:23 PM |

    Unfortunately, I train a client whose doc insists he take niaspan and not an over the counter prep, even regular niacin, which I personally take. Even with insurance it still costs him $60.00 a month.

  • Judy B

    12/13/2010 3:18:44 PM |

    My husband and I try to avoid doctors except when it's absolutely necessary! We have found that eating low-carb and supplementing with D3, kelp, etc. that we are rarely ill.

  • Ken

    12/13/2010 3:33:38 PM |

    Dr. Davis
    Great advice! I am a midwestern hospital CEO, we employ about 2000 people. I had meetings recently to discuss next year's health plan changes and told everyone this stunning fact: 1% of our staff account for 35% of our plan expenses!
    I see little evidence of motivation to change behaviors. Like most Americans they are going to come to a doctor like you and want a pill to fix it.
    Keep up the good work

  • Anonymous

    12/13/2010 4:01:12 PM |

    In our company's employee benefits meeting last week, after they announced premium increases one of my buddies blurted out, "Hey, I'm on Obama-care.  Aren't you supposed to be paying me now?"  Pretty funny.

  • Anonymous

    12/13/2010 6:28:42 PM |

    exercise - even walking a few miles a day makes you healthier (1000 steps equals one mile) - eliminate the gym membership and do your own housework, gardening to stretch and strain a little for free

  • donna

    12/13/2010 6:29:00 PM |

    Don't know if this is helpful, but just ran across it:

    http://www.amazon.com/Prescription-Alternatives-Hundreds-Prescription-Free-Remedies/dp/0071600310/ref=sr_1_5?ie=UTF8&qid=1292264829&sr=8-5

  • Anonymous

    12/13/2010 8:06:12 PM |

    What is the best way to supplement iodine and how much?  Since cutting Mortons for sea salt I am sure I am not getting Iodine (except in occasional shell fish)  Any suggestions?  BTW my T4 Thyroxine was way below the reference range last visit to the DR.

  • Anonymous

    12/13/2010 9:37:43 PM |

    Agree with most of your recommendations, but not sure iodine supplementation is the best idea:
    http://thehealthyskeptic.org/category/health-conditions/thyroid-disorders/page/2
    Amy

  • Lori Miller

    12/14/2010 1:26:54 AM |

    Two words: Google Scholar. A lot of my former health problems were due to lack of vitamins and poor absorption. The medical papers and abstracts there helped me figure out why I wasn't absorbing them and what to do about it. Eliminating grain helps with this--grain is full of anti-nutrients. There have been a lot of other little things I've done to help absorb them.

    As for walking, I suppose 1000 steps equals a mile if you take 5'-3" steps.

  • Anonymous

    12/14/2010 2:01:41 AM |

    Ken says:
    "1% of our staff account for 35% of our plan expenses"
    Is it possible that they are sicker? I mean of no fault of their own making?
    "I see little evidence of motivation to change behaviors. Like most Americans they are going to come to a doctor like you and want a pill to fix it"
    Don't get me started on this one.
    BTW, Ken, what is your salary as a CEO? Isn't it driving the cost of health care?
    Well, Americans who think that universal health care equals "socialism," that history is dead, that "the rich are rich because they deserve to be rich," that an illiterate apparatchik (sorry, manager) can one day be  president of an university and another - CEO of some steel plant and yes, that life is simple and "it's up to you - to be healthy or not among other things" are getting what they  probably deserve. Yes, of course, there countless innocent victims, sadly the most sophisticated and decent.

  • Daniel A. Clinton, RN, BSN

    12/14/2010 5:02:00 AM |

    These suggestions all make sense, and will do absolutely nothing. The bottom line is that the United States spend 17.6% of our gross domestic product on healthcare (the highest % of GDP of any country in the world) to the tune of 2.5 trillion dollars. Until we remove profit from the equation and recognize that access to healthcare is a fundamental, universal right of every citizen in the year 2010, and establish a universal government-run healthcare plan, these suggestions will do nothing. They won't actually generate healthcare savings; they'll add profit to those who allow 44,789 Americans to needlessly die every year to preserve the perverse private insurer system that torments our country.

  • Anonymous

    12/14/2010 5:03:35 AM |

    I'd like to know where you keep getting the idea that wheat is genetically modified. None of the commercially available wheat is genetically modified. The varieties we have on the market are the result of selecting breeding practices. Selective breeding is not the same as genetic modification in scientific terms. Furthermore, hybridisation of varieties is not genetic modification, it occurs naturally. Here is an exert from one of my recent publications:

    The BBAADD genome was derived by hybridisation of a female tetraploid (2n = 4x = 28; genome BBAA) and a male diploid [Triticum tauschii L. (2n = 2x = 14; genome DD)] (Kihar 1944; McFadden and Sears 1944, 1946a, b; Kimber and Feldman 1987; Kimber and Sears 1987; Dvorak et al. 1998). The A genome originated from Triticum urartu L., while Aegilops speltoides L. is reportedly the donor of the B genome for both tetraploid and hexaploid wheats (Dvorak et al. 1988; Wang et al. 1997).

  • Paul

    12/14/2010 6:04:53 AM |

    "What is the best way to supplement iodine and how much?" - anonymous

    Judy B. gave you a hint... kelp.  It has the highest amount of iodine of any natural dietary source, AFAIK. I buy the dry powder form sold by Now Foods.  An 8oz. bottle only costs me $4 and lasts six months... not bad.

    A quarter teaspoon has 300 mcg (200% DV) of iodine, so that's what I put in my little BCAA/whey protein shake every morning to ward off any thyroid problems, and so far so good at 50 y.o.  However, you may need a much different dosage protcol if you already have thyroid problems.  Dr. Davis has some blog posts on the subject.

  • Dr. William Davis

    12/14/2010 12:44:38 PM |

    Anonymous about wheat's genetic profile:

    1) You're off topic here.

    2) Nonetheless, I've never said that genetic modification yielded modern wheat. It has been the extensive hybridizations that have yielded this modern monstrosity called "wheat," the hexaploid dwarf that makes millions sick.

    However, I suspect that this argument only matters to people who work in the wheat-generating industry. Who gives a damn how it was created if you have a debilitating illness from it?

  • kris

    12/14/2010 3:25:39 PM |

    I too have gone to the high deductible health care plan. It is a 10,000 deductible for each member but gives you a free annual exam with some standard bloodwork. Also gives a free gynecological exam, mamogram and pap test for women. An interesting difference with these policies is that they give you unlimited prescription coverage once you meet deductible where as prescription coverage on most taps out at $2000, a lot of which you paid for with prescription coverage. There are lower deductibles. With the $10,000 deductible, I pay around $370 per month for my husband and myself and opted to put my son on full coverage since it is so inexpensive for a young person.

  • Peter

    12/14/2010 4:10:47 PM |

    Since I've been following your advice my LDL has shot up, and a bunch of other markers are all improved: CRP, HgA1c, triglycerides, HDL, fasting glucose.  How can I tell if this is a good trade or a bad one?

  • Might-o'chondri-AL

    12/15/2010 2:17:42 AM |

    Iodine from the seaweed Kombu, Laminaria japonica gets stewed into anything you cook with it.
    Take a small piece, say an inch square and simmer it for extraction. Dr. Davis probably ate it as Dashi when a boy.

    Don't bother swallowing the cooked seaweed; you'll need unique genetics to digest it's poly-saccharide. Kombu has, among other good things, arsenate.

    Kelp digestability raw is dubious; maybe the surface iodine could dissolve for you. And kelp, which can incorporate arsenic, does not contain arsenate; which is what binds to arsenic to keep it from bio-availability.

  • Anonymous

    12/15/2010 5:05:35 AM |

    Rachael Ray on CBS today once again was pushing whole grains (especially wheat) as an important dietary component which “has been shown to reduce cholesterol 25%”. She doesn’t explain what type of cholesterol, nor provide her sources. This woman has done this often enough that I suspect she’s getting paid off by the industry.

  • Anonymous

    12/15/2010 6:45:11 AM |

    I quit Lovaza after I learned of the absurd mark-up. Life Extension seems to work fine.  I recently added niacin (rotten triglycerides and low HDL). I had tried the flush free junk for over a year. Now I use plain old immediate release Rugby, which runs about $20 a year at 1 gram a day. That would buy maybe four days worth of Niaspan. My next project is switching from Androgel to compounded testosterone. I have good insurance but it's insane that someone is paying $13,000 a year for a few hundred dollars worth of raw material and no real research innovation.

  • Anonymous

    12/16/2010 3:23:59 AM |

    I haven't seen a doctor in years. They won't give me herbs or real medicine - all they offer is toxic drugs. Conventional doctors are the enemy. They test for things behind your back and are essentially agents of the government. All medical information is used against you. Doctors hate me, because I won't go along with their way of doing things. They won't test vitamin D, hormones, or anything else I'm interested in. Doctors are very interested in my vaccinations and alcohol and illegal drug use, however. Marijuana is legal in my state for medical use, but I'd probably have to be on my deathbed to get a prescription from a regular doctor in this state. But they are more than happy to write a script for a toxic anti-depressant.

  • Anonymous

    12/16/2010 3:41:05 AM |

    Anonymous - For iodine, I use kelp capsules from Nature's Way and also Life Extension Sea-iodine capsules. My thyroid seems fine, so I guess they work for me. I average about 800 mcg iodine daily.

  • Anonymous

    12/18/2010 6:19:26 PM |

    Sorry, doc, but your advice really isn't entirely accurate.  Lovaza may only cost some patients a 30 buck copay per month which may be less than the cost of the appropriate dose of OTC fish oil if one takes it in the proper dose (which may be 8-10 caps per day as opposed to 2 BID of Lovaza).  Speaking of which compliance is therefore better with Lovaza too.  Personally, Walmart fish oil gives me terrible reflux and heartburn while I can't even tell I'm taking Lovaza.  Also, D2 in the form of prescription ergocalciferol is generic and the dose is 50000 Units per month at a cost of 15-20 bucks per year which is cheaper than D3 OTC.  There is also some reason to believe that D2 is more effective than OTC D3.  Cost efficient care needs to be individualized.  I am a physician and try to provide my patients with good medical advice that is cost effective as well.  And, BTW, I have no connections to the drug industry.

  • Dr. William Davis

    12/18/2010 9:40:34 PM |

    Anonymous Doc--

    Wow. Your comments are so far from the truth that I don't know where to start.

    If you read many of the previous posts on this blog, I hope you will see how far out of touch your comments are. D2 better than D3? Since when is the mushroom or invertebrate form of anything better than the real HUMAN form?

    Note that the discussion is how to save money for the overall system, not just keep more money in your pocket.

    Next time leave a name.

  • Chuck

    12/19/2010 2:54:13 PM |

    call me ignorant because i am not certain of this answer.  if the patient has a copay of say $30 on a prescription does the insurance also pay a certain amount for that prescription?

  • Dr. William Davis

    12/19/2010 3:10:01 PM |

    Yes, indeed, Chuck.

    Insurance will then cover another $100 or so. This is the cost we all bear through our health insurance premiums. This money goes straight into the pocket of GlaxoSmithKline, who are presently salivating over the great print-more-money franchise they have, thanks to the ignorance of the American public.

    I find it incredible that here and in related posts people have made comments like "So what? My insurance covers Lovaza." That is precisely the point: We all share the costs eventually, copay or no, with crippling health insurance premiums, while the drug industry makes out like bandits.

    How about a fly-the-entire-sales-force-to-the-Bahamas sales meeting this year?

  • Anonymous

    12/19/2010 5:53:32 PM |

    What's up with the coconut picture at the head of this blog?

    I searched and didn't find any posting about coconuts...

    Personally I have a severe coconut addiction and the picture flares it further.

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