"Heart disease a growth business"

29. June 2006 William Davis (0)




So announced a Boston newspaper recently, featuring a story about new heart program at a local hospital.

They were announcing how a hospital had entered the cardiovasculare procedure game and how it would boost their bottom line. The article discussed how the hospital administration was anticipating "a surge in patients from the baby boom generation."

To justify this new program, the article quoted an administrator from another hospital: "Cardiovascular issues is [sic] the number one cause people sought treatment at our hospital."

The hospital featured in the story had spent $13.5 million dollars to develop their program.

Do you think they'll make it back?

You bet they will--many times over. Hospitals are businesses, complete with a bottom line, an expectation of profit and an eye towards growth.

The hospitals in the city where I live (Milwaukee, Wisconsin) are, as in Boston and elsewhere, very aggressive--expanding into new territories, hiring new "salesmen" (physicians), all to capture more marketshare and produce more "product" (your coronary angioplasty, stent, bypass surgery, defibrillator, etc.).

The equation for hospital profits is tried and true. Ignore your heart disese risk and you can help your local hospital grow its business. Neglect to get your heart scan and you can help your hospital pay down its debt. Get a heart scan, then do nothing about it, and you may even justify a pay raise for the hospital administrators for record revenue growth and profit.

Hospitals are a growth business because of the failure of most people and their doctors to 1) identify hidden coronary disease (CT heart scan to obtain your heart scan score), then 2) seize control over it (the Track Your Plaque program or, at least, your doctor's guidance along with your efforts at prevention).

Unless you do so, you are highly likely to help your hospital boost its annual goal for procedures.
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Vitamin K2, aspirin, fish oil and blood thinning

Vitamin K2, aspirin, fish oil and blood thinning

27. May 2007 William Davis (12)
An interesting question came up from one of our Track Your Plaque Members on the Forum.

"I am now taking 9 mg of vitamin K1 and 1000 mcg of K2.

Does taking this supplement with this much K1 have a counteracting effect on the thinning/anticlotting properties of aspirin and fish oil that I also take?"


Great question (along with lots of other greater discussions we have on the Forum.)

The answer: Vitamin K should have no effect on the platelet-blocking effects of aspirin or fish oil. The majority of blood clot inhibiting effects of aspirin and fish oil arise from their ability to keep blood platelets from "clumping" (just like the TV commercials for Plavix).

Vitamin K, on the other hand, participates in the liver production of blood clotting factors (like II, VII, IX, and X, among others for you curious ones).

Thus, vitamin K-dependent clotting factors and platelet-blocking are two separate pathways to forming blood clots. Some of us refer to the difference as "red clots" from the vitamin K pathway and "white clots" from the platelet pathway, since they really do have this different physical appearance.

The vitamin K2 conversation, like that about vitamin D, is fascinating for its potential to provide the missing link between the tightly-tied fortunes of bone health and atherosclerosis. Why is someone with a high CT heart scan score far more likely to have osteoporosis? Vitamin D and K2 deficiency may provide the missing link for many people.
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Comments (12) -

  • Anonymous

    5/28/2007 2:23:00 PM |

    Dear Dr. Davis;   thank you so much for your blog...praying you reach many people.

  • Anne

    5/28/2007 8:06:00 PM |

    Is there a test for K2 deficiency? I have both osteoporosis and CAD. I have asked my doctors about vitamin K, but neither could tell me anything about it.

    What is the difference between K1 and K2?

    Great blog. Thank you.

  • Dr. Davis

    5/29/2007 1:25:00 AM |

    Anne--
    I have not yet been able to find a laboratory that makes K2 measurements available. However, it is a safe assumption that, unless you ingest fermented traditional cheeses (not Velveeta, etc.), pate or liver, or natto (blechh!), then there's an excellent chance you are deficient. To my knowledge, there is also no definition of deficiency, even if we were able to obtain a blood value. This will unfold over the next two years as data trickles out and experience accumulates.

  • Cindy

    6/3/2007 1:40:00 AM |

    What is a good dose for Vitamin K? Sine I'm not much of a cheese eater, or liver for that matter, I figure it can't hurt to take a supplement....but have no idea how much to take!

  • Dr. Davis

    6/3/2007 2:51:00 AM |

    The problem is that there is no dose.
    Based on available data, we have been advocating a dose of 1000 mcg (1 mg) per day, though the evidence is, admittedly, slim to support this specific dose. Changes are possible--probable--in future, as the experience develops.

  • BelieveIt

    2/12/2008 2:30:00 AM |

    Vitamin K test available at http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=4131&query=vitamin%20k%20testing&hiword=VITAM%20VITAMER%20VITAMERS%20VITAMI%20VITAMINA%20VITAMINC%20VITAMIND%20VITAMINE%20VITAMINES%20VITAMINIC%20VITAMINK%20VITAMINS%20k%20testing%20vitamin%20

    Differences between K1 & K2 also discussed at http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1152&query=VIT%20K1%20K2&hiword=K1%20K2%20VIT%20

    aCCORDING TO THE ABOVE:  Tufts University tests the vitamin content of foods for the U.S. Department of Agriculture which maintains a database. Not too long ago, new technology allowed a more precise determination of the vitamin K content of food. Using the new technology, Tufts researcher Dr. Sarah Booth discovered that the vitamin K content of most foods is lower than researchers previously thought.

    Green leafy vegetables supply 40-50% of vitamin K for most Americans. Vegetable oils are the next highest source. Hydrogenated oils (margarine, for example) create an unnatural form of K that may actually stop the vitamin from working.

    There are three different types of vitamin K: K1 which is from plants, K2 which is made by bacteria and K3 which is synthetic. Vitamin K3 is generally regarded as toxic because it generates free radicals. This version shows promise in the treatment of cancer. K2 specifically keeps calcium and phosphorus out of the aorta, and reverses the effects of heart-unfriendly diets. The body converts K1 to K2.

    Dosage and precautions

    Vitamin K is not stored in the body, and is therefore nontoxic in high amounts. Forty-five milligrams a day were used in osteoporosis studies without any ill effect. Vitamin K has been approved in Japan for the treatment of osteoporosis since 1995. Several thousand times more than what people are currently getting in their diet has been taken without any toxicity. Dosage depends on an individual's diet, age, whether they are taking drugs, and what stressors are present. Generally, 10 mg/day is recommended.

    If you want to get your vitamin K level tested, request the osteocalcin test. It is much more reliable than coagulation tests. The osteocalcin test measures how much carboxylated osteocalcin you have. Since carboxylation is dependent on vitamin K, this test will give you a good idea of your vitamin K status, and whether or not you're headed for osteoporosis and possibly heart disease.

  • Anonymous

    1/16/2009 11:29:00 PM |

    An article at the Weston Price Foundation suggests that high amounts of vitamin K1 supplementation might not be correct. The author states:

    These results show that our absorption of the vitamin [k1] declines as the amount we consume increases and strengthens the interpretation that we might only be able to absorb about 200 micrograms per day. [of K1 from vegtables] …

    Preliminary evidence indicates that doses of 1000 micrograms per day of supplemental K1 may contribute to periodontal disease,31 suggesting that our bodies' resistance to absorbing this much K1 from vegetables may serve an important purpose.

    www.westonaprice.org/basicnutrition/vitamin-k2.html

  • Anonymous

    4/16/2009 2:49:00 PM |

    My mother-in-law is taking nattokinase for blood clot protection and disolving a clot in her caratoid retinal artery. Would taking K2 with natto kinase interfere with the clot disolving action of nattokinase?

  • Anonymous

    4/16/2009 2:51:00 PM |

    My motherinlaw is taking nattokinase and k2 together. She had a clot in her retinal artery causing some vision loss. Would taking k2 together with nattokinase dimish of help the nattokinase effect of disolving this blood clot?

  • Sal

    7/29/2009 4:52:05 AM |

    Dear Mr Davis

    Iam  lately diagnosed with arterial calcification in my lower limbs. I have no diabetes, no cholestrol issues nor any kidney or blood pressure issues, yeah I do have some anxiety.

    Please tell me whether taking vitamin k2 supplements would help. Also is there a test to find out if I am defecient in vitamink. What is the best supplement I can take.
    Thanks

    Kindest Regards
    Salim Khatri

  • Anonymous

    11/19/2009 2:30:39 AM |

    Actually, aspirin is a vitamin K antagonist. It is sort of silly to take an antagonist AND vitamin K.
    Further, if aspirin effectively blocks the K from working, the aspirin is maybe preventing platelets from clumping, but preventing inappropriate calcium deposition and therefore leading (over a long time) to arteriosclerosis and therefore CVD.
    Vitamin K2 is made by bacteria and found in fermented foods and animal organ meats. These are two food groups that have strong cultural ties, but they are lost as various cultures have blended into the American culture of some pretty heinous foods.
    So eat sausage, sauerkraut, pickles, natto, kimchee, organ meats and avoid pasteurized of the above and this may kill the bacteria that are making the K2.

  • buy jeans

    11/3/2010 10:32:34 PM |

    Vitamin K, on the other hand, participates in the liver production of blood clotting factors (like II, VII, IX, and X, among others for you curious ones).

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Can natural treatments "cure" or "treat" any disease?

Can natural treatments "cure" or "treat" any disease?

30. August 2006 William Davis (0)
According to current FDA policy, the answer is a flat "NO!"

No natural treatment, whether it be fish oil (as a nutritional supplement), l-arginine, vitamin D, magnesium, various flavonoids like theaflavin or resveratrol, can be declared to treat or cure any disease. That's why you see the evasive and vague wording on nutritional supplements, nutraceuticals, and various foods, like "Supports heart health" or "Supports healthy cholesterol". Claiming, for instance, that taking 6000 mg per day of a standard OTC fish will reduce triglycerides and stating so on the label of a supplement is unlawful and prosecutable.

Think what you will of Mr. Kevin Trudeau (author of Natural Cures They Don't Want You to Know About"): visionary, consumer advocate, David vs. the Goliath of the FDA and "Big Pharma", or huckster, scam artist, and one-time felon. But Trudeau got it right on one important issue: The FDA dictates what claims can be made to treat disease. On one of his ubiquitous informercials, Trudeau states:


"...the way the system works today, you have the Food and Drug Administration—the FDA, and you have the drug industry. They really work in tandem. Unfortunately, there’s an unholy alliance there. People don’t know that the majority of commissioners of the FDA, which allegedly regulates the drug industry, and the food industry—Food and Drug Administration, the commissioners of the FDA—the majority of them—go to work directly for the drug companies upon leaving the FDA and are paid millions and millions and millions of dollars. Now in any other format, that would be called bribery; that would be called a conflict of interest; that would be called payoffs. That’s exactly what’s happening right now. So what has occurred is the Food and Drug Administration is really working in tandem with the drug industry to protect their profits. Example: The Food and Drug Administration says that only a drug can diagnose, prevent, or cure any disease."


He goes on to say that

"...the Food and Drug Administration says only a drug--nothing else--can cure, prevent, or diagnose a disease. Therefore the Food and Drug Administration continues to call more and more and more things diseases. Therefore they eliminate all-natural remedies. No one can say what a natural remedy can do if it’s been classified as a disease. So Attention Deficit Disorder is now a disease. Therefore only a drug can cure, prevent, or diagnose it. Cancer is a disease. Acid reflux is now a disease. Obesity is now a disease."

(PLEASE do not construe this as an endorsement of Mr. Trudeau's overall opinions. But I do think he's right on this one point.)

The stated purpose of this restrictive policy is to protect the public. Indeed, in years past before protective legislation, ineffective and even poisonous products were commonly sold as therapeutic treatments. (Remember cocaine and morphine in cold remedies? Lead and other toxic agents were also common.) Unfortunately, a huge gap has emerged as clinical data accumulates that support the efficacy of nutritional treatments and other non-traditional methods to treat or alleviate diseases. Any disease, or anything construed as disease as Trudeau points out, can onlybe treated by a drug.

In the FDA's defense, they have made slow progress in allowing "claims" of benefits for several supplements and food substances, such as the beta-glucan of oat products, soy protein, and most recently barley (for cholesterol reduction). The scrutiny is quite thorough and the wording of the policy is quite specific. Regarding oat products, for instance, the policy states:

"FDA concluded that the beta-glucan soluble fiber of whole oats is the primary component responsible for the total and LDL blood cholesterol-lowering effects of diets that contain these whole oat-containing foods at appropriate levels. This conclusion is based on review of scientific evidence indicating a relationship between the soluble fiber in these whole oat-containing foods and a reduction in the
risk of coronary heart disease.

Food products eligible to bear the health claim include oat bran and rolled oats, such as oatmeal, and whole oat flour...To qualify for the health claim, the whole oat-containing food must provide at least 0.75 grams of soluble fiber per
serving. The amount of soluble fiber needed for an effect on cholesterol levels is about 3 grams per day."

(Source: FDA Talk Paper which can be viewed in its entirety at http://www.fda.gov/bbs/topics/ANSWERS/ANS00782.html.)

In light of the boom in nutritional and non-traditional research that validate or refute efficacy, is such a policy still necessary? Or does it inhibit the open dissemination of information and result in a extraordinary monopolization of health treatment for the drug companies?

This debate will likely rage for the next two or more decades, particularly as drug companies are increasingly viewed as profit-seeking enterprises and more validation is gained by non-drug treatments.

For the moment, don't dismiss a "treatment" because it doesn't come by prescription. But don't reject a drugjust because it is a prescription. We need to strike a healthy, rational balance somewhere in between.
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Is your doctor a hospital employee?

Is your doctor a hospital employee?

21. May 2006 William Davis (0)
There's a disturbing trend that's growing--silently but rapidly.

In Milwaukee, three hospital systems compete for the local health care dollar. To gain more control over revenues and the routing of patients, the hospitals are aggressively hiring physicians to work for them. I've witnessed many of my cardiology colleagues, primary care doctors, and a substantial number of procedural specialists enticed by the offers made by hospital employers.

This phenomenon is not unique to Milwaukee but is being used in many, perhaps most, major cities in the U.S.

This means that physicians are employees of the hospital. That way, employee-physicians are obliged to use only the hospital system that employs them. In the old days, your doctor could use any hospital he/she desired, depending on the quality, location, facilities, etc. Now, many physician-employees are given no choice but to use the hospital that pays their salary.

That by itself is not necessarily bad. But combine salary with incentives for bringing in patients for hospitalization and procedures--that the rub. In other words, physician-employees are incentivized to generate more revenue for the system, just as employees in many other industries.

If you're a salesman for an insurance company, your job is to bring in more business. If you're a worker on an auto production line, you're expected to meet certain quotas. These same principles are now being applied to many physicians.

How does this affect you? Well, if your physician--especially procedure-driven specialists like cardiologists, general surgeons, orthopedists, etc.--is a hospital employee, BEWARE! Do you really need that procedure, or is your doctor suggesting you have a procedure because it will add to his track record?

Prevention? In this model of health care, why bother? It certainly doesn't pay for a hospital to keep you well. Then why should your physician-employee?

Be careful who you're dealing with. If your physician is a hospital-employee, don't bet on getting preventive care. It's more likely you're that just a future source of revenue when it's time for your bypass operation, hip replacement, carotid endarterectomy, etc.

What more powerful argument is there for increased self-empowerment and information for health care consumers?
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