What role cholesterol medication?

A frequent conversation point among my patients, as well as participants in the www.cureality.com program, is "Are cholesterol medications really necessary?"

No, they are not. What IS necessary is to correct all manifest and hidden causes of coronary plaque. Among these causes, in my view, is LDL cholesterol of 60 mg/dl or greater. There are many other causes of coronary plaque--e.g., small LDL particles, unrecognized hypertension, Lp(a), hidden diabetic patterns, etc.--but reducing LDL to 60 mg is still an important part of a plaque-reversing effort.

Insofar as we wish to get LDL to this goal, the statin cholesterol drugs like Lipitor, Zocor, Crestor, etc. may play a role. However, they should only be considered after a full effort dietary program is pursued. Don't follow the American Heart Association's diet unless you want to fail. It's nonsense.

For a more detailed discussion of how to use nutrition and nutritional supplements to reduce LDL cholesterol, go to www.lef.org, the website for the Life Extension Foundation. I wrote an article for their magazine called "Cholesterol and Statin Drugs: Separating Hype from Reality". You'll find the article at http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1295&query=davis%20cholesterol%20natural&hiword=CHOLESTEROLA%20CHOLESTEROLS%20DAVI%20DAVID%20DAVIE%20DAVIES%20DAVIN%20DAVIO%20DAVISON%20DAVISS%20DAVIT%20NATURALBASED%20NATURALES%20NATURALIZED%20NATURALLY%20NATURALS%20NATURE%20NATURES%20cholesterol%20davis%20natural%20.)

Can your plaque-reversal efforts succeed without statin drugs? It depends on your causes. For instance, someone with small LDL and Lp(a) only may do great on our basic program and then add niacin. Unfortunately, another person with a starting LDL cholesterol of 240 mg/dl--sky high--will have more success with these drugs.

Believe me, I am no blind supporter of drug companies and their flagrantly profit-seeking practices which, in my view, are cut-throat, shoving anyone and anything out of their way to increase profits and market share. I share many of Dr. Dave Warnarowski's views on how vicious their tactics can be; see his recent Blog post at http://www.drdavesbest.com/blog/ called "I smell a rat".

Nonetheless, the deep and well-funded research of the pharmaceutical industry does yield some useful tools. You don't have to love the insect exterminator, but if your house is being eaten by termites, his services can be useful. Same thing with these drugs. Useful--not the complete answer, not even close, but nonetheless useful in the right situations. Sometimes antibiotics are necessary, even life saving. That's how cholesterol drugs are, too.

Take it all in the proper perspective. Your goal is not cholesterol reduction, per se, but plaque control, preferably reversal.

Supplement Mania!

Ever hear of "polypharmacy"? That's when someone takes too many medicines. People will have lists of 15-20 prescription medicines, for instance, with crazy interactions and oodles of side-effects.

Well, how about "poly-supplments"? That's when someone takes a large number of nutritional supplements.

Let me tell you about a 45 year old man I met.

In an effort to rid himself of risk for heart disease that he felt was likely shared with his family (brother and father diagnosed with heart attacks in their late 40s), Steve followed a program of nutritional supplementation. You name it, he took it: hawthorne, anti-oxidant mixtures, vitamins C, E, B-complex, saw palmetto, 7-keto DHEA, velvet deer antler, gingko biloba, policosanol, chronium picolinate, green tea, pine bark extract, St. John's Wort, CoEnzyme Q10, papain and other digestive enzymes...He became a distributor for a nutritional supplement company to allow him to afford his own extraordinary program.

To satisfy himself that he had indeed "cured" himself of heart disease, he got himself a CT heart scan. His score: 470, in th 99th percentile. Steve's heart attack risk based on this score was around 10% per year. High risk, no question.

For weeks after his scan, Steve admitted walking around in a daze, not knowing what to do. Years of telling himself that he had effectively dealt with his heart disease risk, now all down the drain.

When we met, I persuaded him that to think that this collection of supplements would reverse heart disease was magical thinking. We trimmed his list down to the essentials and got him on the right track.

Heart disease is controllable and reversible, but not this way. Don't fool yourself into thinking that some collection of supplements will be enough to stamp out your heart disease risk. Just like taking an antibiotic when you don't have an infection achieves nothing, so does taking the wrong supplements.

What does heart scanning mean to you?

CT heart scans can mean different things to different people.


What does a heart scan mean to you? There are several possibilities:

1) A way of reducing uncertainty in your future.

2) A tool to crystallize your commitment to health.

3) A device to help you track how successful your heart disease prevention program is.

4) A trick to get you in the hospital.

5) A moneymaking tool for unscrupulous physicians hoping to profit from "downstream" testing, particularly heart catheterizations.


Like anything, heart scans can be used for both good and evil. How can you be sure that your heart scan is put to proper use--for your benefit and not someone else's profit?

Simple: Get educated. Understand the issues, be armed with informed questions.

If, for instance, you're a 55-year old female with a heart scan score of 90, active without symptoms, and you're told to have a heart catheterization right off the bat---run the other way. This is bad advice. A heart procedure like catheterization at this score in an asymptomatic woman is very rarely necessary. That decision can only be made after a step-by-step series of decisions are made by a truly interested, unbiased party. (A stress test is almost always required in this situation before the decision can be made to proceed with a catheterization.)

Unfortunately, in 2006, getting unbiased advice from your doctor is still a struggle. That's why we started Track Your Plaque---unbiased information, uncolored by drug or device company support, with an interest in the truth.

Coronary disease is drying up!

I had an interesting conversation with a device representative this morning. He was a sales representative for a major medical manufacturer of stents, defibrillators, and other such devices for heart disease.

Since I'm still involved with hospital heart care and cardiac catheterization laboratories, this representative asked me if I was interested in getting involved with some of the new cardiac devices making it to market over the next year or two. "The coronary market is drying up, what with coated stents and such. We've got to find new profit sources."

Well, doesn't that sum it up? If you haven't already had this epiphany, here it is:

HEART DISEASE IS A PROFITABLE BUSINESS!

Why else can hospitals afford billboards, $10 million dollar annual ad campaigns, etc.? They do it for PROFIT. Likewise, device and drug manufacturers see the tremendous profit in heart disease.

The representative's comments about the market "drying up" simply means that the use of coated stents has cut back on the need for repeat procedures. It does NOT mean that coronary disease is on the way out. On the contrary, for the people and institutions who stand to profit from heart care, there's lots of opportunity.

Track Your Plaque is trying to battle this trend. Heart disease should NOT be profitable. For the vast majority of us, it is a preventable process, much like house fires and dental cavities.

Mammogram for your heart

With the booming popularity of "64-slice CT scans", there's a lot of mis-information about what these tests provide.

These tests are essentially heart scans with added x-ray dye injected to see the insides of the arteries. However, to accomplish this, a large quantity of radiation is required. In addition, the test is not quantitative, that is, it is not a precise measure that can be repeated year after year.

It is okay to have a 64-slice CT coronary angiogram. It is NOT okay to have one every year. That's too much radiation. However, a heart scan can be repeated every year, if necessary, to track progression or regression. Once stabilization (zero change) or reduction is achieved, then you're done (unless your life takes a major change, like a 20 lb weight gain).

The tried-and-true CT heart scan is the gold standard--easy, inexpensive, precise, and repeatable. Not true for 64-slice angiograms.

Is your doctor using "leeches"?

What if you went to your doctor for a problem and he/she promptly placed leeches on your body?

Yeccchhhh! Would you go back? I'd bet that you'd run the other way as fast as your bleeding legs could take you. Outdated health practices like "bleeding" are outdated for good reason.

Then why would you allow your doctor to approach your heart disease prevention program by checking cholesterol and then waiting for symptoms to appear? That miserable approach leads to tragedy and death all too often--ask Bill Clinton! He might as well have had leeches!

Don't allow your doctor's ignorance or disinterest impede your prevention program. Get your coronary plaque measured, then attack it from all sides by knowing all causes, hidden and obvious. That's why Track Your Plaque is such an effective program.

I often wonder why more doctors aren't using this unbelievably powerful approach to deal with heart disease. But when I see colleagues implanting stents, defibrillators, and the like for many thousands of dollars per patient, the answers are obvious. Given a choice of a rational, effective program of prevention that pays the doctor a few hundred dollars for his time, versus $2000 to $10,000 for a procedure, you can see that the temptation is irresistible for many physicians.

All in the family--What to do if there's heart disease in your family

What should you do if a close relative of yours is diagnosed with coronary disease?
This question came up recently with a patient of mine. The patient--a strapping, 47 year old businessman who looked the absolute picture of health--was undergoing bypass surgery. Although I'd met him for the purposes of plaque reversal, he was already having symptoms and his stress test was flagrantly abnormal, all discovered after a heart scan score of 765. On the day after the patient's bypass, the patient's brother came to me. Understandably concerned about his own health, he asked what he should do. The answer: get a heart scan.
Measure the disease with the easiest test available. If his heart scan score is zero, great--he's at exceptionally low (near zero) risk for heart attack. A modest program of long-term prevention is all that's necessary. What if his score is like his brother, should he get in line for his bypass? No, absolutely not! But he will need two things: 1) a stress test to ascertain whether or not he's safe (60% likelihood a stress test would be normal), and 2) an effort to determine how the heck he got so much plaque. (We favor lipoprotein testing, of course, for greatest diagnostic certainty.)
Message: Learn from the lessons your own family provides. Don't let this valuable information go to waste.
Do the math: 41.7 pounds per year

Do the math: 41.7 pounds per year

Consumers of wheat take in, on average, 400 calories more per day. Conversely, people who eliminate wheat consume, on average, 400 calories less per day.

400 calories per day multiplied by 365 days per day equals 146,000 additional calories over the course of one year. 146,000 calories over a year equals 41.7 pounds gained per year. Over a decade, that's 417 pounds. Of course, few people actually gain this much weight over 10 years.

But this is the battle most people who follow conventional advice to "cut your fat and eat more healthy whole grains" are fighting, the constant struggle to subdue the appetite-increasing effects of the gliadin protein of wheat, pushing your appetite buttons to consume more . . . and more, and more, fighting to minimize the impact.

So, if you eat "healthy whole grains" and gain "only" 10 pounds this year, that's an incredible success, since it means that you have avoided gaining the additional 31.7 pounds that could have accumulated. It might mean having to skip meals despite your cravings, or exercising longer and harder, or sticking your finger down your throat.

400 additional calories per day times 365 days per year times 300,000,000 people in the U.S. alone . . . that's a lot of dough. Is this entire scenario an accident?

Or, of course, you could avoid the entire situation and kiss wheat goodbye . . . and lose 20, 30, or 130 pounds this year.

Comments (21) -

  • Keenan

    10/14/2011 3:56:07 AM |

    On Sept. 10 I stopped my consumption of wheat containing foods and multi-grain rice crackers. Two weeks later I began having aching elbows which have not bothered me for years. I'm a 65 yr old male, thin with a bit of a 'wheat belly'  which is shrinking but my muscle mass is also shrinking. Have you heard of anyone experiencing changes in joints after stopping wheat and grains?

  • David Klatte

    10/14/2011 10:58:16 AM |

    That math isn't right and it is pretty misleading because a person who ate 400 more calories per day would gain weight up until they reached an equilibrium. It would be better to use something like the Harris Benedict equation to get a sense of how bad that is.

    I did that for a six foot 180 pound male who is 30 years old who is lightly active. Such an individual would maintain their weight at about 2246 calories per day. If they instead consumed 2646 calories per day, you would expect their weight to top off at about 244.7 pounds after some period of time. About a 65 pound gain, so nothing to sneeze at.

  • Dr. William Davis

    10/14/2011 12:48:30 PM |

    Hi, Keenan--

    I've only seen relief from arthritis, not a triggering of arthritis. That's strange.

    Of course, we are all subject to conditions that fall outside of wheat. It will be interesting to see whether this persists.

  • Dr. William Davis

    10/14/2011 12:49:04 PM |

    Thanks, David.

    Yes, this was hardly a scientific analysis, just an argument to graphically illustrate what we are battling.

  • Philippa

    10/14/2011 12:51:54 PM |

    This would be actionable advice across the Atlantic in the UK, where the Health Minister landed himself in a controversy this week by annoucing the Brits need to cut 5 billion calories off their annual diet.
    http://www.dailymail.co.uk/health/article-2048738/Jamie-Oliver-blasts-Andrew-Lansleys-plan-tackle-obesity.html

  • Teresa

    10/14/2011 8:23:30 PM |

    I couldn't post this below about the drug companies.  

    While I agree that a person should not be made to take medications against their will, what am I to do for a patient with a blood pressure of 220/110, on several occasions?  I have had a few.  They refused meds, and also refused to make any diet or lifestyle changes that may have helped.  While I haven't discharged any patients because of this, I do make sure they know the potential consequences of severe hypertension, including death.  Or worse, complete paralysis on one side, requiring total care.  Sometimes it's a matter of lesser evils.

    More of my patients want the  pills, because they are unwilling to do anything else to help their condition, even though I encourage them, and offer referrals for further education.  I hear it's too complicated, or their insurance won't cover it and it's too expensive.  I doubt I could make a living in my community without a prescription pad.  I wish I could!  I'll keep trying.

  • Princess Dieter

    10/14/2011 9:29:06 PM |

    Just a heads up (although you may have already seen it) is that Gillian Riley, the UK expert on food addiction/breaking out of overeating, recommended WHEAT BELLY in her October newsletter. http://www.eatingless.com/archive-newsletters.html#

    I've often recommended Ms. Riley's books--EATING LESS ; BEATING OVEREATING; and WILLPOWER!--to fellow hyperconditioned overeaters.

    Not eating wheat/sugar  sure helps in the "not overeating" dept. Laughing And Gillian is on board with that.

  • Corey

    10/14/2011 9:42:55 PM |

    Love your site doctor, but this is a terribly naive and simplistic approach. Calorie numbers are irrelevant, it's the kind of calories. Yes, I understand that the 400 you mention would most likely be 400 calories of additional carbs, but calories in/calories out don't determine weight now, do they?

    Really shouldn't post anything reinforcing the outdated but still omnipresent "calorie equilibrium" theory (fairy tale is more like it) of weight gain.

    Otherwise, keep up the good work.

  • Rieland Rigg

    10/15/2011 1:30:51 AM |

    I guess that explains pretty clearly why I've been able to lose about 40 lbs so far in 9 months... Smile

  • Ted Hutchinson

    10/15/2011 9:14:49 AM |

    If you live in the Northerm hemisphere Vitamin D levels drop from September through to March unless effective strength supplementation is implemented.
    Also 65yrs old the natural production of the antinociceptive, anti-inflammatory, antibiotic, antioxidants melatonin and vitamin d will have declined (by age 75 only 25% of vit d capacity is possible if sufficient 7-dehydrocholesterol remains in skin) so everyone becomes far more sensitive to pain/inflammation (and infection).  You can replace the missing Vitamin D3, melatonin with at least 5000iu/D3/oil based gelcap and 3mg Time Release melatonin (Also pay strict attention to improving natural melatonin secretion by using Flux getting outdoors midday and total darkness while asleep. ) Search this site for good Vitamin D3 & Melatonin information.

  • Kris

    10/15/2011 12:11:25 PM |

    A few months ago I did an experiment and cut all wheat and sugar out of my diet.

    That is, if it would contain even a trace amount I would not touch it. I managed to follow this approach for two months, I didn't measure my food intake but my body fat dropped quite a lot and I could see much more muscle definition, especially in my abdominal area.

    Personally I think sugar and wheat are the two main contributors to obesity, and I think the "minimum effective dose" for optimal health would be to remove those two ingredients completely. And of course that doesn't allow any room for "cheat meals" like some people think.

  • Dr. William Davis

    10/15/2011 1:25:26 PM |

    Well said, Chris.

    I agree. In particular, I find that no wheat is far better than less wheat. I believe this is mostly due to the appetite-triggering effect of wheat gliadin.

  • Linda

    10/15/2011 1:27:22 PM |

    @Ted
    I am also living in the Northern Hemisphere [Iowa] and do not get nearly as much sunshine as I should.I tend to be a hermit and spend most of my day inside.  Also over 65. I am taking 5000 IU a day of Vit D, gelcaps.
    Without a lot of testing, is there a way to determine if I should take more and, if so, how much. My biggest concern is tightness in the hip area every morning.

  • Dr. William Davis

    10/15/2011 1:28:17 PM |

    Well, Corey, allow me to elaborate on my "terribly naive and simplistic approach."

    This is clearly not a scientific analysis, but a simple effort to illustrate what happens with simple math what could theoretically happen with an additional 400 calories per day intake but ignoring all other factors, such as proportion fat vs. carbohydrates.

    So of course this is simplistic. It just makes the point that the increased calorie consumption triggered by wheat gliadin has potentially huge effects.

  • Dr. William Davis

    10/15/2011 1:44:40 PM |

    Good to have friends in this battle, Princess!

    We are up against the incredible financial and lobbying might of vertically-integrated Agribusiness and Big Food, who have billions of dollars to allocate on lobbying, marketing, and pushing their agenda. We have social media, the internet, and our wits.

  • Dr. William Davis

    10/15/2011 1:46:00 PM |

    Hi, Dr. Teresa--

    That's all you can do: Keep on trying.

    I'm impressed that you DO try, since most of our colleagues pay no mind whatsoever to even considering genuinely effective dietary changes.

  • Dr. William Davis

    10/15/2011 2:16:54 PM |

    Hi, Philippa--

    Let's see: England, population 51 million times 400 calories per day, times 365 days per day, equals 7.446 x 10,000,000,000,000 calories, or several thousand times more than the Health Minister proposes.

    5 billion calories would be child's play.

  • Ted Hutchinson

    10/16/2011 8:41:41 AM |

    I don't think there is any way anyone can accurately predict their 25(OH)D level either from uvb exposure or daily supplement usage. It depends on individual response. The banner graph at GRASSROOTSHEALTH.ORG shows for any regular daily intake the 25(OH)D achieved varies up to 100ng/ml. Taking 5000iu daily D3 only increases your chances of staying around 50ng/ml  but you could be anywhere between 20ng/ml and 120ng/ml without testing you can't know. After you've had a few tests you get to the point where you can predict the result but it's still worth retesting annualy to make sure nothing's changed. You should be able to find a 25(OH)D test for $60.

  • Fat Guy Weight Loss

    10/16/2011 3:11:20 PM |

    I eliminated sugar and wheat from my diet just from the observation that the food did not keep me full as long compared to other foods of same number of calories.  Not only led to weight loss but also eliminated my ocassional GERD as well as frequent stomach discomfort.  Now I have even more reasons to stay off the stuff and now being 95% wheat free (indulge in ocassional small portion of dessert) I no longer crave these foods and feel great.

  • Dr. William Davis

    10/18/2011 12:52:08 AM |

    How about "Skinny Guy Weight Loss"? (I didn't feel right calling you "Fat Guy . . .")

    It's such a simple formula for returning to health. I, personally, experienced relief from the same gastrointestinal effects. With any small indulgence, I am provided a graphic reminder of how it used to be.

    Stay strong. Your body will be grateful!

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