Doc, what's your thoughts about oats as a wheat supplement? From what I've read, oats don't have the insulin effect of wheat, and have a positive effect on heart health.

I think you mean as a wheat replacement? Yes, it is indeed a great replacement, along with flaxseed. Both exert effects on reducing both LDL and small LDL, opposite that of wheat.

I think it is a pretty easy explanation, wheat contains starches that cause a release of insulin.  Insulin is a powerful hormone that makes you hungry.  Gary Taubes book cites studies where insulin was injected directly into mice and guess what?  The mice eat like pigs.  Then the dropping blood sugar makes you hungry again.  

Ever notice how you get hungrier when you start eating?  That's the first release of insulin and it whets the appetite.  The next release of insulin is slower and bigger (if you're eating lots of carbs).

One of the nicest parts of a low carb diet is you get rid of all these cravings and crazy hunger because insulin is released much more normally.

Barley is a darned good grain also.  More antioxidants than blueberries!

Yes, I agree.

This is absolutely true for me.  I was a victim of the '80s lowfat diet craze - doc told me I was obese, gave me the Standard American Diet and said to watch my fat (I'm not a big meat eater, didn't like mayo ... couldn't figure out where my fat was coming from!  maybe the fries - I will admit I liked fries).  I looked to the USDA food pyramid and to increase my fiber for the constipation I was experiencing.  Bread with 3 grams of fiber wasn't good enough; I turned to Kashi cereals for 11 years.  My constipation turned to steattorrhea and a celiac disease diagnosis!  *No gut pains!*  My PCP sent me to the  gastroenterologist for a colonscopy because my ferritin was a 5 (20 is low range).  Good thing I googled around and asked him to do an endoscopy or I'd be a zombie by now.

My symptoms were depression & anxiety, eczema, GERD, hypothyroidism, mild dizziness, tripping, Alzheimer's-like memory problems, insomnia, heart palpitations, fibromyalgia, worsening eyesight, mild cardiomyopathy, to name a few.

After six months gluten-free, I asked my gastroenterologist about feeling full early ... he said he didn't know what I was talking about!  *shrug*  

But *I* knew -- it was the gluten/starches!  My satiety level has totally changed, and for the first time in my life I feel NORMAL!  

Most of the above symptoms have resolved themselves, except the heart palpitations... Any suggestions?  (Doc seems to only look at thyroid:  Synthroid just reduced again to 100mcg from 175 mcg last year, but I’m still having them, esp w/low bp 96/59)   (I'm losing weight eating no white foods.)

Just heard the tail end of a Gary Taubes interview on XM radio and he mentioned something about low bp and heart ... hmmm.

My life changed when I cut not only all wheat, but all grains from my diet.

For the first time in my life, I was no longer hungry -no hunger pangs between meals; no overwhelming desire to snack.  Now I eat at mealtimes without even thinking about food in between.

I've dropped 70 pounds, effortlessly, come off high blood pressure meds and control my blood sugar without medication.

I don't know whether it was just the elimination of grain, especially wheat, or whether it was a combination of grain elimnation along with a number of other changes, but I do know that mere reduction of grain consumption still left me hungry.  It wasn't until I elimnated it that the overwhelming redution in appetite kicked in.

As a former wheat-addicted vegetarian, who thought she was eating healthily according to all the expert advice out there at the time, I can only shake my head at how mistaken I was.

I've been reading your blog for some time, and eliminating wheat sounds like a great thing...but what do you eat? I'm hypothyroid and have been told to avoid soy products because it interferes with the absorption of thyroid meds. I'm lactose intolerant, so I'm avoiding dairy as much as possible (I miss cheese!), and I've recently been given a diagnosis of IBS. My MD said to avoid raw vegetables and fruits. That leaves eggs, lunch meant, and almonds for protein. Cooked vegetables are very difficult to include in my daily diet when the majority of my meals must be transported. I am at a loss as to where to even begin...and I already eat too much rice because that's one of the things I can consume without discomfort. Needless to say, I am gaining weight... What does someone in my predicament eat to control hunger?

While I have no doubt some are sensitive to wheat, personally I think it's the total carbs in any given meal that regulates appetite. For me, an piece of fruit increases my appetite just as much, if not more than a piece of bread!

Wow. Tough predicament.

I won't pretend to have a full solution but some thoughts:

1) Many lactose intolerant people can handle yogurt and cottage cheese, often some cheese.

2) You've just got to bit the bullet and cook your vegetables. If vegetables are the number one most important food in your diet, you simply need to find a solution.

3) Nuts-lots! Seeds, too, like sunflower and pumpkin.

4) Low-glycemic index grains like oats, barley, and flaxseed (ground). Perhaps Ezekiel bread might be a compromise worth trying.

5) More oils.

6) Rice should be wild.

7) Squashes

8) Avocados-transportable, too.

9) Do you and your doctor feel that ALL raw vegetables trigger IBS symptoms? In my experience, it's just selected vegetables.

No doubt about it. You've got it tougher than most.

dotslady--

Re: palpitations. Have you addressed the omega-3 and magnesium issues? There may also be real issues to consider by your doctor, e.g., your potassium level and blood pressure control. Underappreciated high blood pressure issues can trigger palpitations. In my experience, this is very common.

I'm betting the doctor told nyn to cook her veggies, and avoid soy, because many are goitrogenic (work to make thyroid hormone unusuable).  I think any of the veggies in the brassica family are like broccoli, brussel sprouts.  I know turnips are (I love raw turnips), and soy is too.

If you've got refrigeration and a microwave handy, bringing your meals is pretty easy.  I used to bring all kinds of things to work that would probably work for you.  One of my favorites is a big salad with meat, nuts and a simple olive oil and rice vinegar dressing.  Cooking veggies shouldn't be a problem reheating them in the microwave.  I tend to use lots of frozen veggies and just microwave them and drizzle butter or EVOO on them.

I follow the Paleo diet pretty closely.  It eliminates all grains, legumes, and dairy products.  My autoimmune diseases are much, much better now too.

nancy m & all, thank you for the suggestions. I will look into more cooked veggies. I hate cooking, and am very unhappy with this new way of eating and lifestyle. I am trying to plan ahead, and this site has really helped me. I'm trying to get past the denial stage and move on with things. I wish there was a list of things to eat, like a meal plan, somewhere. I am still looking. Great advice here.

hi nyn -- i've never heard that you have to avoid certain foods when you are taking Synthroid -- you do need to avoid taking calcium and other minerals being co-adminstered at the same time as the Synthroid. Calcium (or magnesium or other cation minerals bind Synthroid and inactive the drug). A recent study showed that taking thyroid replacement medications at bedtime on an empty stomach has the most optimal effects and absorption. so i tell patients to take Levothroid or synthroid when they brush their teeth at night (assuming they brush daily) and at least 1-2 hrs AFTER any dairy, milk, ice cream, multivitamins (esp containing minerals), TUMS, antacids, etc.  I don't see a food interaction otherwise with thyroid medications.
I hope your doc is aware that the new AACE Hypothyroid guidelines is to shoot for TSH between 0.2 and 3.0.  Many labs still have 5.5 as the 'normal' upper limit.  This is no longer correct.  So, if your TSH is greater than 3.0, you are likely still suffering from hypothryoid signs and symptoms. getting corrected (meaning, more medication) will get the TSH down to optimal goal < 3.0 and will prevent complications related to hypothyroidism (ie, high BP, insulin resistance, dyslipidemia, PALPITATIONS, feeling plain crappy, wt gain and even osteoporosis!)  i hope that helps!  IBS is tough -- my husband has it too -- developed when he commuted 1h each way to see me during pharmacy school!  aint stress bad bad bad!!!  once you get IBS you never get rid of it... good news, it can be improved...
sugar-free metamucil (or other fiber source -- take 1-2 scoops with a VERY LARGE glass of water daily) is the cornerstone treatment (it works for most people I know) along with stress REDUCTION! go to a day spa weekly and get yourself a therapeutic massage (*doctor's orders!*  *ha haaa* no kidding!  good luck!!

(of course i hope you followed DR. D's advice on getting checked out for your baseline vitamin 25(OH)D test?  Hashimoto's hypothyroidism is autoimmune and therefore can be associated with hypovitaminosis D, ie, inadequate Vitamin D stores in the body.  get your sunlight/ supplements if you need it!! I'm deficient myself... and in denial...  but i'm so grateful I came across this blog to even become aware of this epidemic)

Dr. D - Re: magnesium and potassium, last check they were in range.  I wanted to get baselines before trying supplements, so I just got my vit D checked also (not sure he did correct test, but D3 was 20, D2 was 10 = 30 and he said it was fine!).  I haven't been taking omega-3s, so will start and let you know how it goes!  Thanks for your help.  I appreciate everything you write!

nyn - another thought re: IBS.  Could be a symptom of celiac disease at worst, gluten sensitivities at least.  Maybe giving up gluten grains will help repair your villi/gut(if indeed that's a problem) and allow fresh veggies, etc. at a later time once healed.   Have you done an elimination diet and rotated foods before?

Healing time varies depending on severity of villi damage.  Consider researching celiac symptoms & websites, maybe read about the Specific Carbohydrate Diet by Elaine Gottschall(google)?  Read:  Gluten-Free Living for Dummies by Danna Korn before changing your diet.  Consider if you want a celiac diagnosis on your health or life insurance records ...

I'm an incurable yoga addict now(nothing special... just 'gym' *translation... 'FREE'* yoga!) but i've done some research and the benefits are huge. it's been around forever > hundreds of years and there must be a reason...

benefits:
1. reduction in stress/cortisol and improved relaxation (cortisol is 'toxic' injuring brain cells, increasing visceral fat in the abdom cavity which clogs arteries to the heart, liver and other organs, and increases glucose and therefore inflammation/free radicals)
2. many poses  'massage' internal endocrine glands including the adrenals, parathyroid and THYROID tissue (which help remove stagnant toxins and improve internal circulation)
3. has helped me to make the magnficient realization that all things are connected in life (whether we like it or not, ie friends-foes, black-white, ying-yang, et cetera) -- just like how all the organs and limbs and the mind are uniquely linked in our own bodies. when one thing is injured/hurt/malignant, it goes and affects e-v-e-r-y-t-h-i-n-g else. For instance I had a recent shoulder injury, and now if I don't do the appropriate exercises to maintain its strength, I unfortunately get referred pain and tension to my neck and back.
4. all the tendons, ligaments and small muscles in the back need to be exercised and kept strong in order to support the back. yoga helps to accomplish this otherwise the back cannot do what it needs to do effortlessly and painlessly.  MUCH LIKE THE AMAZING COMMUNITY HERE -- we all support each other and keep our bodies, minds, and spirit STRONG. I'm so grateful to Dr. D for all his advice, accessibilty and ever endeavoring persistence to improve our greater health. May you ALWAYS be blessed. (and that your house doesn't get TP'd when more truths are exposed). Keep up the excellent work! THANK YOU, G

Thanks for the kind comments, G.

I agree with you about the yoga. Having tried it over the years and doing it on occasion with my wife, I believe that you are absolutely right.

Bring on the TP!

heartscanblog.blogspot.com is very informative. The article is very professionally written. I enjoy reading heartscanblog.blogspot.com every day.

I have been wheat free for 2 and 1/2 months, and have to agree 110% on the hunger factor.  Thanks for getting the word out there.  It has made me wonder if companies know this and use it in their favor? Also if this is one of the big triggers in the US weight problem?  And how sad if people don't know this, that they think they simply have no will, when it is really the wheat.  We have also noticed that it is difficult to find cat or dog food (dry) without wheat in it!   Our outdoor cats are constantly hungry, even though it seems like they have more than enough food, I wish we could find a wheat free cat food, and see if they eat less.  Thanks again for the article.

But if you want to seize control over appetite, elimination--not reduction--but elimination of wheat, as well as other processed carbohydrates, can really change the way you approach food. (Interestingly, The Wheat Foods Council estimates that the average American eats 144 lbs of wheat flour per year; they argue that it should be increased 210 lbs per year!)

Dr Davis,

I am not a doctor by profession but an engineer. I am really frustrated in trying to get to the bottom of things in the medical field. It is quite vexing when I cant decide if something is a safe practice or not. Would you please help me (and perhaps many other) understand how I can take oil-based Vitamin D without worrying about Vitamin A levels as well? Should I worry about taking Cod Liver Oil based preparations with questionable manufacturing practices which seems to include filtering to remove the Vitamin D and then adding synthetic form at the end?

If you could get into some details, it would be very helpful.

Regards,

Anonymous, you could take fish oil instead of cod liver oil for the omega-3 and take vitamin D as D3 in softgel form.

Vitamin A can be supplemented by providing its precursors like alpha-carotene, astaxanthin, beta-carotene, cryptoxanthin, lutein, lycopene, and zeaxanthin. Supplying precursors will let your body decide how much vitamin A to make out of it. Supplying preformed retinol bypasses the body's control systems.

Cannell et al recommended an D:A ratio of about 6:1 in IU terms ("Cod Liver Oil, Vitamin A Toxicity, Frequent Respiratory Infections, and the Vitamin D Deficiency Epidemic", a commentary piece in Annals of Otology, Rhinology & Laryngology 117(11):864-870, on page 866, third paragraph).

Maybe it's best to avoid retinol and make sure you get enough A precursors.

StephenB

The yam based forms of Estrogen have a much better safety profile than the others on the market. In fact,the worst reaction I've ever had to a hormone was to a supposedly "bioidentical" estrogens from a compounding pharmacy.

The problem with anabolic steroids apply to bioidentical testosterone supplements too. Too much testosterone is bad for your body.

Does this mean that Benecol is not good to use in lowering cholesterol?

The bit that I find most disturbing in this post is the bit on sterols. Many authorities advise us to use phytosterols or stanols to lower cholesterol. I did find one article on PubMed a while ago (but can't refind it now) suggesting that, since the structure of phytosterols is similar to cholesterol, using them to replace cholesterol shouldn't just be assumed to be a safe thing to do. Do you have any more data or links on this issue?

I came across this post by Dr Michael Holick whom I respect, and naturally all readers here respect your findings from the front line in Milwaukee. There appear to be some differences in interpretation.
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Vitamin D2 vs. D3
Vitamindhealth.org
Posted by mfholick on November 27, 2008 under Vitamin D |  
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Vitamin D2 and Vitamin D3 Are They Equally Potent?

During the past several years, there have been two studies Trang et al, (Am J Clin Nutr 68:854-858, 1998); and Armas et al, (J Clin Endocrinol Metab 89:5387-91; 2004) that have raised questions about whether vitamin D2, which is found in some supplements, used in some fortified foods and is the pharmaceutical form of vitamin D that doctors prescribe for their patients, is as effective as vitamin D3 in maintaining a person’s vitamin D status, i.e., blood level of 25-hydroxyvitamin D.  Trang et al 1998 gave healthy adults 4,000 IU of vitamin D2 or 4,000 IU of vitamin D3 in alcohol for two weeks.   A comparison of the blood levels of 25-hydroxyvitamin D after two weeks revealed that there was approximately a 50% difference in the group receiving vitamin D3 (being approximately 50% higher) than the vitamin D2 group.  This implied that vitamin D3 was more effective than vitamin D2 in maintaining circulating blood levels of 25-hydroxyvitamin D.  Armas et al 2004 gave a single 50,000 IU dose of either vitamin D2 or 50,000 IU dose of vitamin D3 to healthy volunteers during the summer and observed that the group who received vitamin D2 had a more rapid drop in their circulating blood levels of 25-hydroxyvitamin D.  They also observed that the group that received vitamin D2 had a more rapid drop in their blood levels of 25-hydroxyvitamin D3 compared to the placebo group suggesting that vitamin D2 was not only less effective than vitamin D3 in maintaining circulating levels of 25-hydroxyvitamin D, but also that vitamin D2 increased the destruction of vitamin D3.

Based on these observations, physicians, health care professionals and patients have made an effort to find vitamin D supplements that contain vitamin D3.  However, in the United States, only vitamin D2 is available as a pharmaceutical preparation, and, thus, patients who are vitamin D deficient and treated by their physicians receive vitamin D2.  I treat vitamin D deficiency with 50,000 IU of vitamin D2 once a week for eight weeks.  To prevent vitamin D deficiency from recurring, I then put the patient on 50,000 IU of vitamin D2 every two weeks forever.  From my experience of over 100 patients on this regime for up to six years, their blood levels are sustained above 30 ng/ml which is considered to be the vitamin D sufficient range.  On average, the blood level was between 40-50 ng/ml.  Furthermore, an evaluation of their blood calcium, a measure of whether ingesting vitamin D2 at these levels, had caused any toxicity did not change.  Therefore, this regime was effective in maintaining my patients’ vitamin D status without causing any untoward toxicity.

To determine whether vitamin D2 was as effective as vitamin D3 in maintaining circulating blood levels of 25-hydroxyvitamin D, a study was conducted whereby healthy adults received either 1,000 IU of vitamin D2 or 1,000 IU of vitamin D3 in a capsule once a day in the winter for 11 weeks.  In addition, one group received a placebo capsule and one group received a capsule that contained 500 IU of vitamin D2 and 500 IU of vitamin D3 daily for 11 weeks.  Blood levels of both 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 were determined by state of the art method using liquid chromatography tandem mass spectroscopy.  Holick et al, (Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D, J Clin Endocrinol Metab  93:677-681, 2008;) reported that the blood levels of 25-hydroxvitamin D rose to the same degree in the healthy adults who took either 1,000 IU of vitamin D2 a day or 1,000 IU of vitamin D3 a day for 11 weeks.  The group that received vitamin D2 also had their blood level of 25-hydroxyvitamin D3 measured.  There was no significant drop in the blood level of 25-hydroxyvitamin D3.  To determine whether the mixture of vitamin D2 with vitamin D3 would alter the blood levels of 25-hydroxyvitamin D, the adults who received 500 units of vitamin D2 with 500 units of vitamin D3 also raised their total blood levels of 25-hydroxyvitamin D3 in an almost an identical manner as the adults who received 1,000 IU of vitamin D2 or 1,000 IU of vitamin D3 a day for 11 weeks.  The authors concluded that ingesting 1,000 IU of vitamin D2 or 1,000 IU of vitamin D3 a day during the winter (at a time when sun exposure had no influence on blood levels of 25-hydroxyvitamin D) that both vitamin D2 and vitamin D3 were equally effective in maintaining the blood levels of 25-hydroxyvitamin D.  Furthermore, vitamin D2 did not have a negative influence on serum levels of 25-hydroxyvitamin D3.  Adults who took 500 units of vitamin D2 with 500 units of vitamin D3 had similar increases in their blood levels of 25-hydroxyvitamin D suggesting that vitamin D2 taken with vitamin D3 does not have any negative influence on the metabolism of vitamin D3.  

The authors reviewed in their Conclusion several studies that had previously reported that vitamin D2 was as biologically effective as vitamin D3 in both pregnant women and in healthy adults.  This study confirms these observations and adds to the body of scientific literature demonstrating that at least when healthy adults take 1,000 IU of vitamin D2, they can be assured that it is as effective as taking 1,000 IU of vitamin D3
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Although this a little academic, since I have been perfectly happy with D3 for years, a resolution would be iteresting.
Any chance of an update, or a Holick interview here?
MikeV

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