Vitamin D on Good Morning America

1. February 2007 William Davis (9)

Positive comments about vitamin D made it to a discussion on Good Morning America today about the new and exciting developments in nutrition and "functional foods".

I'm thrilled that the media is conducting these conversations. It sure is making my job easier, not having to persuade patients that taking vitamin D is truly and hugely beneficial for health. I still have to struggle with my colleagues, who tell patients to stop the "poisonous" doses we use.

But I worry that many of the details behind vitamin D don't quite make it to the media conversation. These are crucial, make-it-or-break-it issues, such as:

--Vitamin D must be vitamin D3 or cholecalciferol, not D2 or ergocalciferol. D2 is virtually worthless. Little or none is converted to the active D3, despite the fact that D2 is the form often added to some foods.

--Vitamin D3 supplements must be oil-based capsules, or gelcaps. Tablets are so poorly or erratically absorbed that it's simply not worth the effort. (We get ours from the Vitamin Shoppe.)

--The dose should be sufficient to eliminate the phenemena of deficiency, which is around 50 ng/ml. I take 6000 units per day. Dr. John Cannell of www.vitamindcouncil.com takes 5000 units per day. I give my wife 2000 units per day (she's not as deficient as I was), each of my kids 1000 units per day, except for my 180 lb. 15 year old who takes 2000 units.

I fear that, when people hear that vitamin D packs fabulous effects for health, they will take a 400 unit tablet--nothing will happen. They will not obtain the benefits such as reduction of blood pressure and blood sugar; increased bone density, reduction of arthritis, dramatic reduction in risk for fractures; reduction in risk for colon, prostate, and breast cancer; reduction in risk for multiple sclerosis; reduction in inflammatory processes such as those evidenced by C-reactive protein; and facilitation of reduction of heart scan score.
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Comments (9) -

  • Meredith Curry

    2/1/2007 1:24:00 AM |

    Ooh, that's interesting about D3.  Glad you explained that.  I'm going to check it out right now.  Thanks doc Smile

  • Cindy

    2/2/2007 2:04:00 AM |

    A few months back I read that D2 was what was used in fortifying milk and other foods. Do you know if that's changed?

    Curious what you would recommend for a woman with no known D deficiency? Or should we all get levels done? I have a rather uncooperative doc and it's just not worth trying to get her to order blood work, and I can't afford to get it done without insurance coverage. I currently take 1000iu pills (in oil) 2 one day and 3 the next.

  • Dr. Davis

    2/2/2007 3:06:00 AM |

    Unfortunately, nothing substitutes for a blood level of 25-OH-vitamin D3.

    However, common factors that affect your vitamin D3 requirement include:

    --Body size
    --Skin color--the more dark-skinned you are, the greater your requirement.
    --Sex--Males require more, females less.
    --Geographic location--Extremely important. Northern climate requirements are probably about half that of southern climates in winter.

    If you are unable to obtain a blood level and you are not exposed to substantial sun, then 2000 units per day of an oil-based gelcap would be a reasonable quantity. But please keep in mind that this is an estimate, not a precise prescription.

  • Jim

    2/3/2007 7:07:00 AM |

    The media and many experts either ignore or minimize the fact that all the vitamin D3 a human body can use is processed naturally during just one or two sessions a week in a tanning bed.  

    The UVB from tanning bed lamps is more effective processing vitamin D3 that the Sun in Northern states during the Winter.  

    Moderation is the key. Don't sunburn.  

    One can feel good about looking good and healthy with a tan.

  • David

    2/5/2007 9:53:00 PM |

    Is cod liver oil a good source for vitamin D3 & if so, what dosage? Does the presence of vitamin A complicate things (ie toxicity). TIA

  • Dr. Davis

    2/7/2007 6:15:00 AM |

    Cod liver oil would not be my first choice. Problems: great variation in vitamin D content, saturated fat, and vitamin A.

    In my view, the best way to get vitamin D (when sun is not available) is a vitamin D--only-- supplement. That way you can regulate the amount you need with reasonable precision.

  • David

    2/7/2007 9:01:00 PM |

    Thx for your reply. Saturated fat in cod liver oil? Hmmm ... that's a surprise. I had the impression that it was loaded with omega-3 fats. Hell, what do I know?

  • buy jeans

    11/3/2010 10:17:11 PM |

    They will not obtain the benefits such as reduction of blood pressure and blood sugar; increased bone density, reduction of arthritis, dramatic reduction in risk for fractures; reduction in risk for colon, prostate, and breast cancer; reduction in risk for multiple sclerosis; reduction in inflammatory processes such as those evidenced by C-reactive protein; and facilitation of reduction of heart scan score.

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Heart scan: Standard of care?

Heart scan: Standard of care?

6. January 2011 William Davis (0)
If coronary disease is easy to detect by measuring coronary calcium, shouldn't this represent the standard of care?

In other words, if you've been seeing your doctor and he/she has been monitoring cholesterol levels and, inevitably, talks about statin drugs, then you have a heart attack, unstable angina, or die--yet never knew you had heart disease--isn't this negligence?

Coronary calcium, and thereby coronary atherosclerotic plaque, are markers for the disease itself. Unlike cholesterol, high blood pressure, etc., that represent risk factors for coronary atherosclerotic plaque, coronary calcium is a measure of total plaque: "soft" elements like lipid collections, necrotic tissue, fibrous tissue, as well as "hard" elements like calcium. Because calcium occupies 20% of total atherosclerotic plaque volume, it can be used as an indirect "dipstick" for total plaque.

So why isn't an unexpected heart attack, hospitalization for unstable heart symptions, emergency bypass, etc., not regarded as potential malpractice? These are not benign events, but potentially life-threatening.
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I eliminated wheat . . . and I didn't lose weight!

I eliminated wheat . . . and I didn't lose weight!

19. October 2011 William Davis (33)
Elimination of wheat is a wonderfully effective way to lose weight. Because saying goodbye to wheat means removing the gliadin protein of wheat, the protein degraded to brain-active exorphins that stimulate appetite, calorie consumption is reduced, on average, 400 calories per day. It also means eliminating this source of high blood sugar and high blood insulin and the 90-minutes cycles of highs and lows that cause a cyclic need to eat more at the inevitable low. It means that the high blood sugar and insulin phenomena that trigger accumulation of visceral fat are now turned off. It may possibly also mean that wheat lectins no longer block the leptin receptor, undoing leptin resistance and allowing weight loss to proceed. And weight loss usually results effortlessly and rapidly.

But not always. Why? Why are there people who, even after eliminating this appetite-stimulating, insulin-triggering, leptin-blocking food, still cannot lose weight? Or stall after an initial few pounds?

There are a list of reasons, but here are the biggies:

1) Too many carbohydrates--What if I eliminate wheat but replace those calories with gluten-free breads, muffins, and cookies? Then I've switched one glucose-insulin triggering food for another. This is among the reasons I condemn gluten-free foods made with rice starch, cornstarch, tapioca starch, and potato starch. Or perhaps there's too many potatoes, rices, and oats in your diet. While not as harmful as wheat, they still provoke phenomena that cause weight loss to stall. So cutting carbohydrates may become necessary, e.g., no more than 12-14 grams per meal.

2) Fructose--Fructose has become ubiquitous and has even assumed some healthy-appearing forms. "Organic agave nectar" is, by far, the worst, followed by maple syrup, honey, high-fructose corn syrup, sucrose,and fruit--yes, in that order. They are all sources of fructose that causes insulin resistance, visceral fat accumulation or persistency, prolongation of clearing postprandial (after-meal) lipoproteins that antagonize insulin, and glycation. Lose the fructose sources--as much of it as possible. (Fruit should be eaten in very small portions.) Watch for stealth sources like low-fat salad dressings--you shouldn't be limiting your fat anyway!

3) Thyroid dysfunction--A real biggie. Number one cause to consider for thyroid dysfunction: iodine deficiency. Yes, it's coming back in all its glory, just like the early 20th century before iodized salt made it to market shelves. Now, people are cutting back on iodized salt. Guess what's coming back? Iodine deficiency and even goiters. Yes, goiters, the disfiguring growths on the neck that you thought you'd only see in National Geographic pictures of malnourished native Africans. Number two: Exposure to factors that block the thyroid. This may include wheat, but certainly includes perchlorate residues (synthetic fertilizer residues) on produce, pesticides, herbicides, polyfluorooctanoic acid residues from non-stick cookware, polybrominated diphenyl ethers (flame retardants), and on and on. If you are iodine-deficient, it can even include goitrogenic iodine-blocking foods like broccoli, cauliflower, and soy. Thyroid status therefore needs to be assessed.

4) Cortisol--Not so much excess cortisol as disruptions of circadian rhythm. Cortisol should surge in the morning, part of the process to arouse you from sleep, then decline to lower levels in the evening to allow normal recuperative sleep. But this natural circadian cycling is lost in many people represented, for instance, as a flip-flopping of the pattern with low levels in the morning (with morning fatigue) and high levels at bedtime (with insomnia), which can result in stalled weight loss or weight gain. Cortisol status therefore needs to be assessed, best accomplished with salivary cortisol assessment.

5) Leptin resistance--People who are overweight develop an inappropriate resistance to the hormone, leptin, which can present difficulty in losing weight. This can be a substantial issue and is not always easy to overcome. It might mean assessing leptin levels or it might mean taking some steps to overcome leptin resistance.

Okay, that's a lot. Next: More on how to know when thyroid dysfunction is to blame.
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Comments (33) -

  • Jay

    10/19/2011 2:37:59 AM |

    I tend to gain weight when I work a lot of night shifts at the hospital.  My sleep/wake pattern gets very messed up and I turn to extra carbs to fight off fatigue.  Working rotating shifts must take a toll on health.

  • JO

    10/19/2011 4:06:28 AM |

    Well I am living proof that 4 and 5 exist. Very low carb diet ( 10 g a day ) for 3 months and less than 2kg weight loss. My Leptin is 32 ( norm is 8 here ).

    So how do I sort out Cortisol and Leptin ??

  • Fat Guy Weight Loss

    10/19/2011 5:18:50 AM |

    Surprised to see high-fructose corn syrup so far down on the list....don't really consume any of those but enlighting still.

  • Helena

    10/19/2011 11:31:04 AM |

    Could it be as easy as these people might actually need to cut down on something else instead... I am most often in favor or cutting wheat in diets but if you look at blood type there is actually some grains that are good for some people with a certain blood type. Type A is one of the group that could possibly be seeing nothing when they stop eating wheat and continue to eat other things that is not good for them, such as red meat. Off course there could be other issues too, just what you are saying in your post, but I think it could mention that blood type do play a role in what your body can do with the food you give it...

  • Howard

    10/19/2011 4:03:12 PM |

    I eliminated wheat in 1999. Lost 100 lbs and my arthritis, but stalled out at about 50 lbs over goal.

    I have been "tweaking" lately. I already take an iodine supplement (didn't appear to make any difference, although my low morning body temperature isn't as low).

    I'm guessing that all those trans-fats damaged my metabolism. Or maybe it was a combination of trans fat, HFCS, and wheat.

    My latest experiment for breaking the nearly decade-long stall is IF, combined with Fred-Hahn style slow-burn twice a week. That appears to be working, at least in the short term.

    I am interested in the Leptin resistance idea, and especially in ways to fix it if that is the problem.

  • Howard

    10/19/2011 4:05:18 PM |

    @Helena: "eat other things that is not good for them, such as red meat. "

    Nutritional ignorance abounds. You are confusing red meat with fuzzy gray-green meat. The latter is not good for you, but the former is.

  • Dr. William Davis

    10/19/2011 4:27:09 PM |

    Yes, it does, Jay.

    The sooner you can escape this unnatural sleep-wake pattern, the sooner you can regain better health.

  • Dr. William Davis

    10/19/2011 4:27:44 PM |

    Let's cover in a future post, Jo. There's no quick answer.

  • Dr. William Davis

    10/19/2011 4:29:20 PM |

    Hi, Howard--

    Let's cover the leptin question in future.

    I do love the Slow Burn idea, too, a way to make substantial gains with a minimum of effort.

  • Bertil

    10/19/2011 6:12:25 PM |

    Dr Davis,

    Do you have some references for the term "best" as in "best accomplished with salivary cortisol assessment"?

  • michael

    10/20/2011 2:20:38 AM |

    I  would prefer this comment to be private:

    It seems that maybe excessive alcohol consumption might be a factor in not losing weight after cutting out wheat.  I am wondering why you don't talk  frankly and directly about alcohol consumption when you talk about the patients you have helped.  You do say moderate consumption is  better, but you do not go into any detail about what overcunsumption is and what it does, or what advice you give to those who are drinking too much when you help them.  You have given vivid examples of people whose lives have been saved by the avoidance of wheat, but is that really the whole story?  My guess is that at least 10% of the people who are reading your blog or who have bought your book are drinking alcohol to excess.  What advice would you give that 10% ?  I applaud you for your diligent efforts to help people recover their health, and I would encourage you to consider those people who might still be outside your scope of interest.

  • oc

    10/20/2011 11:51:02 AM |

    Hi Dr. Davis:
    If one has an abnormal salivary cortisol or is leptin resistant, what steps must be undertaken to overcome each of these?  Thanks.

  • Susan

    10/20/2011 1:35:08 PM |

    I have not eaten wheat, (or any grains) for over a year. I do not eat sweets except occasionally fruit like berries. (When peaches were in season last summer I could not resist.) I have been able to stop gaining weight, but losing weight is elusive. I have Hasimoto's disease. My TSH is around 1 with 45 mg Armour Thyroid, but my T3 and T4 are in the lower range of normal. I do take about 750 mcg  iodine, Standard Process Thytrophin PMG (which is supposed to help with the autoimmunity) and a product called Sea Vegetables Plus which has sea vegetables, L-Tyrosine and Bioperine . Are there any other ways to optimize thyroid function?

  • Clark

    10/21/2011 9:27:42 AM |

    I've long eliminated all of what you list from my diet and reaped benefits. I'm very lean but for a very small handle around my mid-section -- I'll call it my 'fruit belly' as fruit is the one indulgence I refuse to give up.

    I live in a region with fresh fruit stands on almost every corner and I eat it aplenty. I think there are a few pleasures in life worth a little weight gain (if it causes any in me at all). And certainly there must be some benefits to a diet full of many different types of fresh fruit.

  • Dr. William Davis

    10/21/2011 2:50:33 PM |

    Hi, Oc--
    Great topics for future discussions!

  • Dr. William Davis

    10/21/2011 2:51:45 PM |

    I hear you, Michael.

    I suppose that I am guilty of not saying the obvious, at times, such as smoking causes heart disease over-consumption of alcohol, e.g., more than 3 drinks per day, is unhealthy for a long list of reasons. Thanks for the reminder.

  • Dr. William Davis

    10/21/2011 2:54:14 PM |

    None that I know about, Susan. In fact, I am skeptical that ANY iof the "thyroid support" supplements available do anything at all.

    Iodine works, no question. Selenium might work in Hashimoto's thyroiditis. Beyond this, I know of nothing that makes the thyroid work better, including tyrosine. Giving your thyroid tyrosine is like putting more gas in your gastank: It won't make the car go any faster.

  • Dr. William Davis

    10/21/2011 2:55:20 PM |

    Just beware of glycation, Clark.

    Gauge glycation by your HbA1c. I regard anything above 5.0% as an undesirable level of glycation.

  • Peter Andrews

    10/21/2011 3:00:56 PM |

    This is a comment about a statement in the first chapter of Wheat Belly but I did not know how where to send it to.

    You have repeated the oft statedidea' that humans share 99% of their genes with chimpanzees. The correct number is closer to 95% if you take into account insertions and deletions. The 99% was an early estimate based on older technology and has been superseded. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC129726/ "Divergence between samples of chimpanzee and human DNA sequences is 5%, counting indels"

  • Kenneth

    10/21/2011 3:55:11 PM |

    How big of an effect can borderline hypothyroidism have on lipid profiles? I've been fighting high triglycerides and low HDL (and presumably small LDL) all my life.  Even on a gram of niacin, lots of fish oil and topped up vitamin d, I'm running 300ish on TG and 33-35 HDL. I'm not obese or even overweight by more than perhaps 5 pounds. Even when I'm a fanatic about exercise and low carb, the best I've ever done was 160 TG. As much as I hate the idea, I'm ready to throw in the towel and resort to Tricor and/or a statin. I've been on testosterone replacement for over two years (I'm 41), and I may have my thyroid evaluated as we make adjustments to that. I don't think I'm big-time hypothyroid, but if its running a little slow, can fixing that have a marked impact on lipids?Is whole extract usually/always better than synthroid?

  • MGCC

    10/21/2011 7:24:39 PM |

    Or another possible reason - I had already sharply reduced carbohydrate intake for several months, and hit a stable plateau of just over 250 lbs (tall and muscular guy, but still 30 lbs too fat).  Going off all wheat six weeks ago hasn't helped break below that weight.  I've never been symptomatic for coeliac or other auto-immune reactions from wheat so for me it was just a tightening of my carb intake.  Activity levels pretty high - regular gym work, some running & walking, outdoors for soccer coaching.  But stuck above 250.

  • MGCC

    10/21/2011 7:25:32 PM |

    I admire  your way with words, and I imagine you're a very good looking man as well.

  • MGCC

    10/21/2011 7:26:14 PM |

    Aw shucks.  But lots of people say that.

  • Dr. William Davis

    10/22/2011 12:58:01 PM |

    Hi, Kenneth--

    Thyroid can exert a BIG effect on lipids. The worse the hypothyroidism, the bigger the effect.

    And, if thyroid replacement is necessary, the extracts are nearly always better than T4 alone as Synthroid.

  • Sandra Brigham

    10/22/2011 7:21:56 PM |

    Dr. Davis, I'm one of those who gained doing Archevore (eliminated all grains, legumes, sugar, seed oils but kept whole cream, cheese and butter).. In 10 mths I'd lost inches everywhere but start gaining wt the last couple mths. On your blog you suggested that I might have a thyroid issue. I bought myself a glass thermometer and did basal temp checks 3 mornings in a row at same time before rising - 96.9, 97.1 and 97.1. I understand the normal range is 97.4-98.2.  My average of 97 indicates hypothyroid right? If most people don't see symptom resolutions using thyroid meds, is there any reason for me to get tested?

    I also concurrently gave up all dairy and substituted coconut milk. I am happy to say I am now seeing a wt loss of 1/2 - 1 lb a day this week! I have even been able to up my carbs from VLC (25) to moderate (60-100) with no adverse effects!  While I had given up milk, I really did not think cream, butter or cheese was holding me back. Boy was I wrong! The joint achiness is also now gone!

  • Dr. William Davis

    10/23/2011 11:48:14 PM |

    Hi, Sandra--

    Normal temperature if taken orally immediately upon awakening is 97.3 F. So your temperatures are marginally low. Worth watching over time.

    That's great with the dairy products. While I've included limited dairy products in the diet I advocate, there are undoubtedly people like you with exceptional sensitivities.

  • Henk Poley

    10/25/2011 2:51:50 PM |

    Please make sure you still have a good calcium source. Most western people are very vitamin D deficient, especially during the winter. Which means you don't take up all the calcium from the food. So keep an eye on your 25(OH)D3 level, and calcium intake.

  • Henk Poley

    10/25/2011 3:08:07 PM |

    You should check your 25(OH)D3 and B12 levels to make your sleep more effective: http://www.youtube.com/view_play_list?p=35D93D52577FB34C

    And if you are not a night owl, don't work nightshifts..

  • Tee

    10/28/2011 11:28:43 AM |

    Dr. Davis
    This gentleman, Dr. Kruse, is all the rage at Marks Daily Apple site. I'm curious about your thoughts on his Lipten Reset approach.
    Here is a link to his bog, and his Leptin Prescription.
    http://jackkruse.com/my-leptin-prescription/
    Thank you.

  • Dr. William Davis

    10/29/2011 10:52:00 PM |

    Dr. Kruse's advice is very reasonable. One modest difference: I tend to rely on an even lower carbohydrate intake, e.g., 10-12 grams per meal, while trying to regain control over metabolic distortions.

  • Tee

    10/30/2011 3:41:40 AM |

    Thanks Dr. What are your thoughts on eating 50 gr. of protein within a half hour of waking up?  I'm never hungry till after11 AM.

  • Chris

    5/6/2012 5:33:37 AM |

    Interesting Blog. I've read this far, and I see over and over again one theory that has me a bit baffled, which is fruit. Hi carb to be sure, but the 80/10/10 diet by Dr. Graham suggests that fat is the culprit that drives up blood sugar.  My blood sugar has been very stable on a strict fruit/veggie diet. I'm curious what your take would be with regards to small LDL particles on a strict fruit and veggie regimen?

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Cardiologists out of touch

Cardiologists out of touch

17. June 2006 William Davis (0)
This weekend, I'm fulfilling some responsiblities I have every so often to some of the local hospitals. It gives me a chance to interact with many of my colleagues who are likewise "on call" for the weekend.

I tried to strike up several conversations with colleagues about how they were managing heart disease prevention. I received blank stares, puzzled looks, indifference. One colleague declared that 80 mg of Lipitor is all you need to know.

These same colleagues are the ones scrambling for the heart attack patients in the emergency room, climbing over one another for consultation in the hospital for patients with chest pain and heart failure. They're consumed with expanding the range of procedures they can perform.

Carotid stenting is hot. So is stenting of the leg arteries. Defibrillators have been a financial bonanza. Opportunities abound on how to add these procedures to a cardiologist's abilities.

But heart disease prevention? How about heart disease reversal?

Frankly, I'm embarassed by my colleagues' lack of interest. Imagine we had a cure for breast cancer--not a palliative therapy that just slows the disease down or prolongs life, but actually cures it once and for all. I would hope that all physicians and oncologists would learn how to accomplish this. What if instead they focused on learning new ways to remove breasts, administer new toxic chemotherapies, etc. but ignored the whole idea of cure?

This is what is happening with coronary plaque reversal. The answer is right in front of them, but the vast majority (99%) of cardiologists choose to ignore it. After all, prevention and reversal simply don't pay the bills.

That means that, in 2006, you simply cannot rely on your cardiologist to counsel you on how to achieve regression or reversal of coronary plaque. How about your internist, family physician, or primary care doctor? Well, they're busy doing pneumovax injections, Pap smears, managing knee and hip arthritis, low back pain, diarrhea, headaches, sinus infections and . . yes, dabbling in heart disease prevention.

And, for the most part, doing a miserable job of it. What you generally get echoes the drug manufacturers pitch: Take a statin drug, cut the fat in your diet.

Until the majority of doctors catch on, you're going to have to rely on sources like the Track Your Plaque program for better information.
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Statin drugs for everybody?

Statin drugs for everybody?

17. April 2009 William Davis (10)
Who is better off?

John takes Crestor, 40 mg per day:

LDL cholesterol 60 mg/dl
HDL cholesterol 60 mg/dl
Triglycerides 60 mg/dl
Total cholesterol 132 mg/dl



Or Sam:

LDL cholesterol 60 mg/dl
HDL cholesterol 60 mg/dl
Triglycerides 60 mg/dl
Total cholesterol 132 mg/dl

who obtained these values through vitamin D normalization (to increase HDL); wheat elimination (to reduce triglycerides and LDL); and omega-3 fatty acids (to reduce triglycerides).


Believe the drug industry (motto: If some statin is good, more statin is better!), then John is clearly better off: He has obtained all the "benefits" of statin drugs. They refer to the "pleiotropic" effects of statin drugs, the presumed benefits that extend outside of cholesterol reduction. The most recent example are the JUPITER data that demonstrated 55% reduction in cardiovascular events in people with increased c-reactive protein (CRP). Media reports now unashamedly gush at the benefits of Crestor to reduce inflammation.

However, on Sam's program, elimination of wheat and vitamin D both exert anti-inflammatory effects on CRP, typically yielding drops of 70-90%--consistently, rapidly, and durably.

So which approach is really better?

In my experience, there is no comparison: Sam is far better off. While John will reduce his cardiovascular risk with a statin drug, he fails to obtain all the other benefits of Sam's broader, more natural program. John will not enjoy the same cancer protection, osteoporosis and arthritis protection, relief from depression and winter "blues," and increased mental and physical performance that Sam will.

If our goal is dramatic correction of cholesterol patterns and reduction of cardiovascular risk, for many, many people statin drugs are simply not necessary.
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Comments (10) -

  • Joe E O

    4/17/2009 5:59:00 PM |

    The question I have - what happens if you eliminate wheat, add the fish oil, and niacin, normalize vitamin D and still don't hit the TYP target of 60-60-60? What's the thought process for deciding to take a statin???

  • Jenny

    4/17/2009 6:16:00 PM |

    Dr. Davis,

    Have you checked this out yet. It looks like something worth considering. I've heard some very interesting things lately about new microbes being found in association with diseases not considered infectious until now. The association of enterovirus with Type 1 and Type 2 diabetes also points to the inflammation potentially being nonautoimmune in nature and raises the question of whether Vitamin D is downregulated as part of the body's attempt to fight invasion.

    Since the studies I've found show raising Vitamin D does NOT have a positive impact on diabetes, though Vitamin D is low in diabetes, this is a serious concern.

    If we are eliminating inflammation but not organisms causing inflammation, long term the results may not be so good.

  • Anonymous

    4/17/2009 6:50:00 PM |

    A total cholesterol of 132 can be quite unhealthy considering that all cause mortality in the lowest quartile of total cholesterol is twice the death rate in the upper quartile of total cholesterol.  A paleo diet would produce more optimum cholesterol numbers (no grains, etc, as recommend here) but that diet varies by latitude with more carbs the closer to the equator one lives with total cholesterol varying accordingly.

  • Scott Miller

    4/17/2009 9:26:00 PM |

    Additionally, dig a little deeper and Sam likely has a much better LP(a) value than John.  He's probably sick fewer times during the year, and he's risk of getting cancer is half that of John's.

    Oh, and Sam probably has less bodyfat as a nice healthy side effect of wheat reduction.

  • Anonymous

    4/18/2009 4:16:00 AM |

    My HDL was suck at 38 since 2002. I went to 40mgs crestor mid 2008. I put myself on 2 grms of niacin, this fixed the perpetually high trigs, and the 40gms crestor crushed the LDL

    Then I found this blog and went on vitamin D.  I already had followed fish oil but not consistently so I fixed that.  After 4 months on Vitamin D, my HDL was up to 50 Smile
    oh...and my LDL dropped too.

    My Dr. told me I was a poster child for Crestor treatment but she allow the change back to 20mgs anyhow.  I did take a month off from crestor to get rid of the muscle/bone aches and pains and have now restarted 20mgs with no problems.

    I am going to spend a few months on 20mg and check the lipid profile, if good, next step is statin free for me.

  • Anne

    4/18/2009 8:59:00 AM |

    I eliminated wheat - and all grains - from my diet nearly three years ago (I eat low carb Paleo). My fish oils give me a total of 1680 mg EPA and DHA per day, and my vitamin D levels since last year have varied between 50 ng/ml and 80 ng/ml. However, my lipid profile is not like either John's or Sam's:

    LDL cholesterol 154 mg/dl
    HDL cholesterol 93 mg/dl
    Triglycerides 36 mg/dl
    Total cholesterol 255 mg/dl

    My cardiologist and endocrinologist are happy with my profile because they say the ratios are good, no one is asking me to take a statin. My calcium score is 0.

    I have read too that too low a cholesterol level is just as bad and, maybe worse, than too high !

    Anne

  • Dr. William Davis

    4/18/2009 11:32:00 AM |

    Hi, Jenny--

    Excellent point. Perhaps a topic for a future discussion.

    However, we do witness positive effects on various phenomena associated with diabetes when vitamin D is normalized: reduction in CRP, dramatic increase in HDL, modest reduction in triglycerides and small LDL, and reduction in blood sugar if insulin resistance is present.

    Will vitamin D replacement impact on cardiovascular mortality in diabetics? Uncertain, though I predict it does to a substantial degree.

  • JPB

    4/18/2009 3:55:00 PM |

    Plus John will likely experience some nasty side effects from the statin that Sam will not!

  • homertobias

    4/18/2009 8:00:00 PM |

    Jenny, love your blog, your spirit,and your free questing mind.

    My take on Vitamin D and Diabetes:

    In general, Vitamin D does better at preventing disease than ameliorating it once it exists.  There is soom good Finnish epidemiological evidence that supplementing Vitamin D to levels in the 50's can decrease the incidence of Type 1 diabetes in children.
    Proposed mechanism has to do with the leaky gut hypothesis.  D deficiency leads to impaired intercellular signalling through degredation of tight junctions between cells.  Adjacent intestinal lining cells can't effectively talk to each other. Bacteria, viruses etc "leak" through, The immune system gets overwhelmed, then the immune system notices that pancreatic islet cells look a whole lot like a portion of a proteus or klebsiella bacteria and whammo, you have type 1 diabetes, rheumatoid arthritis, etc.  

    Type 2 diabetes seems to be another story.  Since Vitamin D is often sequestered in fat, lowering serum 25-OH Vitamin D levels, and type 2 diabetics tend to be obese, therein may be part of the association.  

    But no one essentially dies of a Hgb A1c of, say, 6.7.  As you know, it's the sequelae -  the heart attacks, strokes, CHF.  I do recall one recent study on MI, diabetes, and Vitamin D levels.  It may be that D can help prevent the adverse sequelae of type 2 dm with no direct effect on A1c.

  • Jenny

    4/25/2009 1:09:00 PM |

    Dr. Davis,

    I just saw your reply to my earlier question.  The one decent study I've found suggests that dramatically raising Vitamin D has no significant effect on blood sugar.

    My concern is this: when we lower inflammation by raising Vitamin D are we putting out the fire or turning off the smoke alarm.

    Though inflammation clearly raises heart attack risk and lowering it does prevent heart attack, there are many other forms of inflammation that are important because it's a sign we are fighting off invaders that need to be fought off. So if we turn down inflammation we may be promoting microbe-stimulated cancers five years later.

    And if as some evidence suggests, cardiac inflammation stems from bacteria originally associated with gum disease, raising the Vitamin D might lower the inflammation but not bacterial infestation which over time cannot be good for us.

    Is there any evidence that Vitamin D does more than improve the markers like CRP (the smoke alarm) and actually eliminates the disease state?

    So far I am not seeing that in Diabetes.

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The myth of small LDL

The myth of small LDL

28. June 2006 William Davis (1)
Annie's doctor was puzzled.

Despite an HDL cholesterol of 76 mg (spectacular!) and LDL of 82 mg, her CT heart scan showed a score of 135. At age 51, this placed her in the 90th percentile.

Not as bad, perhaps, as her Dad might have had, since he died at age 54 of a heart attack.

So we submitted blood for lipoprotein testing. Surprise! over 90% of all her LDL particles were small. (By NMR, they're called "small". By gel electropheresis, or the Berkeley Lab test, or VAP (Atherotech) technique, they're called "HDL3".)

What gives? Traditional teaching in the lipid world is that if HDL equals or exceeds 40 mg/dl, then small LDL will simply not be present.

Well, as you can see from Annie's experience, this is plain wrong. Yes, there is a graded, population-based effect--the lower your HDL, the greater the likelihood of small LDL. But small LDL is remarkably persistent and prevalent--regardless of your HDL.

We've seen small LDL even with HDLs in the 90's! I call small LDL the "cockroach" of lipids. If you think you have it, you probably do. Getting rid of small LDL requires a specific bug killer. (Track Your Plaque Members: Read Dr. Tara Dall's interview on small LDL.)

Don't let anybody blow off your request for lipoprotein testing just because your HDL is high. That's just not acceptable. Loads can be wrong even with a favorable HDL.
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  • buy jeans

    11/3/2010 12:23:53 PM |

    We've seen small LDL even with HDLs in the 90's! I call small LDL the "cockroach" of lipids. If you think you have it, you probably do. Getting rid of small LDL requires a specific bug killer. (Track Your Plaque Members: Read Dr. Tara Dall's interview on small LDL.)

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