Whoa, that's a lot of photos of spoons, hah.

I definitely get a worse effect from eating bread (historically, I don't anymore) than I have from eating table sugar (say in coffee or sprinkled on strawberries, neither of which I do anymore, either).

And... is sugar bad?

I can think of tastier options for consuming that much sugar, but only on my cheat days! -Kristie

Wrong. Table sugar is 50% fructose. Does bread starch break down to 50% fructose? Fructose and glucose are metabolized quite differently. The former only in the liver if I understand correctly.

What about bread made from sprouted grains -- e.g., Ezekiel Bread?  I understand there's still gluten in it, but this particular bread actually has a short, easily understandable ingredient list -- seems far better than the highly processed "whole wheat" bread out there.  Any thoughts?

Bread does not equal sugar. This is a too simplistic Doc, and you know it.

Of course we all know that bread starch does indeed break down as glucose in the body, but there is so much more to bread than just that. Of all people, in the entire blogosphere, I would expect this post from you the least. You know ALL about wheat and bread. You post more on wheat than any other blogger. Yet you say bread equals sugar. I know what you mean, for sure. I get it, but I would like to suggest to you that sometimes people seriously take you word for word, especially when you have a large following of daily readers that know you're a Doctor and maybe don't understand the differences. Then they are gonna run out and tell their friends and family that eating bread is just like eating sugar.

As another commenter mentioned, sugar is half fructose, and although the fructose is mostly bound to the glucose, some of it still definitely goes into your liver. A huge sugar overload is going to have drastically different effects on metabolism as a huge bread overload. Neither are good for you in any way. The bread comes with all kinds of problems that the sugar doesn't have. I'm not sure which is worse, but they're not equal to each other.

I think I just spurted out a bunch of insulin looking at those pics. ; )

Wow, take a chill-pill folks.

It states in the very first sentence that he is speaking in terms of carbohydrate content.

I don't believe for a second that the good doc's readers only read the headline and then run off making nutritional recommendations to their friends and family.

Thanks for another great post.

Thanks, Cary.

It never ceases to amaze that talking about food is like insulting your mother: virtual fist fights inevitably break out.

I was lumping wheat bread and gluten-free bread together. That is indeed misleading, because wheat-containing bread is far WORSE than sugar. The point I was trying to make, perhaps awkwardly, was that both wheat bread and gluten-free bread are, in effect, large carbohydrate loads. And I didn't insult your mother.

Although 2 slices of bread are generally equivalent to 30 g carbohydrate (although some are less and some are more), they are not necessarily equal to 6 tsp of sugar/2 tbsp of sugar.  The carbohydrate in bread is not all sugar.  Bread, especially whole grain bread has fiber which is an indigestible carbohydrate.  2 slices of whole grain bread have 4g of fiber generally, which you will not find in table sugar.  Additionally, this fiber helps to slow down the absorption of the carbohydrate or sugar in the bread.  Therefore, plain table sugar (just glucose + fructose) is far more easily digested than 2 slices of whole grain bread.  Therefore, from the pov that whole grain bread is not 100% composed of sugar nor is it digested in the same manner as sugar (in terms of their glycemic index/how long it takes for the sugar to enter the bloodstream), it seems incorrect to say that 2 slices of whole grain bread= 6 tsp of sugar.  I understand the logic of your reasoning in the sense that all digestible carbohydrate eventually breaks down into glucose, however, fiber (found in whole grain bread) does not and therefore its erroneous to say that they are equivalent to each other and may be misleading to individuals reading this article.

Was there no point to this post but to keep the blog going and selling stuff?  What is going on here?

What was that you said about my mother?

Did you look at a table of glycemic indexes? Most bread, including whole wheat bread, has approximately the same glycemic index as table sugar.

Reduced/absence of fructose makes the bread less toxic, but I'm guessing this post was written from the perspective of the resulting insulin response - in which case, referring to six teaspoons of sugar is accurate for comparison purposes.

I watched Nurse Jackie this week (or maybe last week?) and the head nurse was 'educating' overweight children.  She named a bunch of candy bars/candies and asked what they all had in common.  A child responded "Sugar?".  "Correct!" she replied.  She then told them that when she wants a snack, she eats "These" - then holds up a box of raisins.  Oh, and the children were all holding apples.

you've covered this general concept in many of your other posts about bread and/or wheat in general. everybody knows that bread is carb heavy. but a carb is a carb is a carb is simply not true. besides that, i think the nasty ingredients in most gluten free breads are far worse than the carbohydrate content of the starch.

We are just blind to many other foods when trying to avoid sugar to save us from diabetes.I think we must consult a specialist to formulate our diet which would be healthy and accurate.

If only it were true that "everyone" knows that bread is carb-heavy, or that starches convert to sugar, or even that fruits are carbs! I asked my brother to tell me what he eats in a typical day. "I don't eat a lot of carbs... For breakfast, two breakfast tacos on flour tortillas and a Sprite, for lunch I just eat an apple and another Sprite, and dinner is maybe chicken-fried [breaded] steak and some cornbread, or maybe mashed potatoes." I asked him if he thought soft drinks don't have carbs, and he said he thought clear sodas "don't count"--just colas have carbs. To say nothing of the flour, potatoes, corn, or fruit.

That's a more typical (mis)understanding of carbs than we want to think. And that's why I dont mind reading posts like this.

There are many ways to skin a cat, as the saying goes.  I, for one, appreciate Dr Davis attempts to get the message across by putting it out there in many different ways and using different analogies.  You never know which description will hit home with someone or at least make him stop and think.

Many times I've come across exactly what Annabel describes - so many people lack even a basic understanding of which foods are carbohydrate-rich.  I was astounded when my husband mentioned that he'd always thought fruits were not carbs (and he's a scientist!).   To him, carbs are starches, only - bread, pasta, maybe potatoes, etc...

I used to eat a lot of bread.  Now, none.  I don't have a problem passing up ordinary, store-bought, mass-produced loaves, but when I'm in a deli or restaurant with quality breads -- well, that's harder.  Still, I know I will get a lot hungrier a lot sooner if I eat the bread than if I don't, and so I don't.  It seems paradoxical that eating more food makes you hungrier sooner; knowing that is the key.

Doctor Davis:  It would be helpful to see a post of how you would construct a daily diet for heart health that minimizes the carbs.  There seems to be a full range of low carb alternatives ranging from Atkins like to Rosedale(high fat), etc.  Thanks,

When I first started following Dr. Davis and the TYP eating guidelines, I had a hard time giving up wheat - hell it's in everything!!!  Plus it's a hard addiction to break.  

Now that I'm wheat free thanks to Dr. Davis' recommendations you couldn't pay me any amount of money to go back.

The debate over glucose vs. fructose is interesting but the only thing that's really important is how I feel.

-s-

I used to be a wheat addict but no anymore.  I've had one wheat product in the last 6 months and since then have lost 30 pounds.  I've done nothing different in my diet or exercise program - just ditched the wheat.  The weight dropped off easily.  Dr. Davis rocks!!!

That is messed up
fresh apples are better for children.  All of us.  Everyone.

But, raisins are a better alternative to candy/packedged/processed food...even organic.  or hydroponic.  I say kids.  Eat the apple.

I stumbled across this blog quite a while ago and remain a casual reader of it.  What attracted my attention is how eliminating wheat was what I needed to do to get rid of my belly.  I have been sorely disappointed!  I am a 60 yo female, 5'7", weigh 132, small frame, have always been thin but started gaining weight around midsection in my 50s.  One year ago I gave up my daily glass of wine, and 8 months ago eliminated wheat from my diet.  That was hard!  I agree that I feel better and the hunger is not as intense, but I have long zero weight.  I walk briskly, as briskly as my bad knees allow (former jogger) every morning.  I eat fruit, yogurt and nuts for breakfast, a bowl of raw veggies for lunch (no dressing) and some protein and more veggies for dinner.  Will I ever lose this 5 to 7 pounds around my middle?  Thank you for letting me vent!

Marianne, you're still running on carbs instead of dietary fat. Most fruit and yogurt and sugar bombs. And without dressing or other fat, you won't absorb the vitamins A, D, E or K in your vegetables. Eliminating wheat is great--and I admire your dedication--but I don't see much fat or protein in your diet. Try adding a boiled egg or two and some dressing to your salad for lunch, some fatty fish or other fatty meat and buttered veg for dinner, and leftovers for breakfast. Give it a two-week trial.

I agree with Lori...not enough fat and protein, too many carbs.

You might enjoy reading Dr.(s) Eades book, "The 6 Week Cure For The Middle Aged Middle."  You should be able to get rid of those 5-7 pounds in a couple of weeks.  At your age, it may be mostly visceral fat, not subcutaneous fat, and visceral fat is far more worrisome to your overall health because it's connected to inflammation.

Joe

Another thing: various studies and a lot of anecdotal evidence have shown that aerobic exercise is ineffective for losing weight. IME, it's just as overrated for weight loss as whole grains are for health. Weight training is better for improving your physique and possibly improving insulin resistance. The Eadeses also wrote a book, along with Fred Hahn, called Slow Burn; Dr. Davis has some posts on this.

That doesn't give us any information about metabolic effects of the food.

Don't eat fruit.  Use some caffeine creme.  Have a cheat day.
When things get confusing, you have to log everything - you will be surprised, thats for sure.

Yes, that seems to be truth. I would go for high intensity training as fast twitch muscles drain glucose much faster then slow twitch muscle, plus, its much more doable given the modern time constraints.

There is a problem tho  - high probability for injury, with any type of exercise. Injury equals to even more sedentary life then before exercise.

In Marrianes case, I guess, however, that lots of effort needs to be devoted to solving menopausal hormonal disturbances which promote weight gain. This is, to my knowledge done with concentrating to food quality rather then quantity.  Supplementation is essential.

Lori, I don't think even weight training will rid her of her "middle-aged middle." Only a proper diet can do that (and pretty quickly, too), especially if it's all visceral fat, as is likely.

Weight training will give her a stronger mid-section, of course, but it'll mostly remain hidden under the fat.

Joe

Agreed--weight training won't get rid of fat, but it'll make you generally firmer.

One thing I really like about Fred Hahn's weight training method is that it's easy on the joints. In the doorknob squats, for instance, your feet are a little in front of your knees and you hold a door knob for support, making for a challenging exercise that doesn't hurt your knees.

Still, I don't think she could do enough ab work to get rid of her "middle-aged middle," which she claims is her remaining objective.

That's going to require a special diet, like the one the Eades recommend, for example.

By the way, the best ab workout, in my opinion, is sprinting. Spend a little less time walking or jogging, and a little more time sprinting (provided you're already in relatively good shape). I'm about to enter my 8th decade, and I'm still sprinting.

Works for me.

Joe

I disagree that wheat is worse than sugar, generally.  

Sure it's worse for celiacs, and others with gluten intolerance.  And sure it will raise worse than the equal "net carbs" of sugar since starch is a glucose polymer.

But sugar is half fructose which is a LOT of fructose.  And fructose is very bad for fatty liver, for diabetes, for triglycerdies, for adiposity, for everything...

On the other hand, this is sort of like arguing whether arsenic or cyanide is worse... doesn't really matter.

Hi, Jpatti--

This is a confusing issue. It is the reason why I wrote Wheat Belly that will be hitting bookstore shelves in early September, 2011.

I believe that, once you hear the entire rationale, you will agree that, not only is wheat worse than sugar, it is the most incredibly bad thing ever created by modern genetics and agribusiness and is responsible for more disease and suffering than any war ever waged.

I'm looking forward to your book.  I had heavy whole wheat bread (plus butter and jam) for breakfast for years thinking I was being health conscious (mostly because it was fibrous enough that I didn't snack till lunch).   How wrong I was!  Now that I've gotten educated on the metabolism of carbohydrates plus the dangers in wheat, I realize how unhealthy that was.

How much would one need to take to achieve this?

Mercury interferes with 5'-deiodinase and is often an under-appreciated factor.

I live in Hawaii where I believe there exists a subtle thyroid or metabolic down regulation as an adaptive compensation for the constant warm ambient temperature.
Cold adaption is known to enhance metabolism to keep warm.  The body seems to either be in a phase of maintaining body warmth, warming up by enhancing metabolism  [brown fat, shivering] or tending to cool down by down regulating metabolism to be more able to dissipate heat, not overheating.   This concept is supported by the extreme cold sensitivity seen when the temperature drops below 70 degrees F.

"The tough part: Finding a prescriber for your T3."

My doctor refuses to do anything since my TSH level is "normal" despite the additional symptoms I've told her... says I'm being hypochondriac, yet has no problems prescribing statins and other useless and expensive drugs that I don't need..

So, what does you do if your doc won't prescribe or even test correctly, and other local docs are not accepting any more patients, and it particularly doesn't matter who you go to anyway, as you have no insurance?

Hi Dr. Davis! About iodine:

What do you think about Ray Peat's comment? ( http://www.thyroid-info.com/articles/ray-peat.htm )

"Mary Shomon: Do you think the majority of people with hypothyroidism get too much or too little iodine? Should people with hypothyroidism add more iodine, like kelp, seaweeds, etc.?

Dr. Ray Peat: 30 years ago, it was found that people in the US were getting about ten times more iodine than they needed. In the mountains of Mexico and in the Andes, and in a few other remote places, iodine deficiency still exists. Kelp and other sources of excess iodine can suppress the thyroid, so they definitely shouldn't be used to treat hypothyroidism."

Strange guy... If I understand what he's writing, he tells that all the PUFA (fish oil also) is toxic, that we shouldn't consume protein containing much tryptophan and cysteine and that high serotonin causes problems... And that fructose isn't bad.

He keeps telling strange things but usually with very long reference lists... Strange o_O

Is there an OTC T3 supplement? Would the product Atomidine work?
As Always - Thank you!

Dr. Davis,

Does kelp help boost thyroid?  I would love to find a doctor like you in my neck of the woods.

Thanks for a great blog,
Tonya

I remain undecided on what the ideal dose of iodine should be. While I am personally "experimenting" with a 12,500 microgram per day preparation, I generally suggest 500-1000 mcg per day. I suggest kelp because it provides a mixture of iodine forms.

For T3, the dose depends on your level, sensitivity, and perhaps your level of reverse T3. I usually have people start 10-12.5 mcg per day, since this is how it comes. Alternatively, T3 can be part of an Armour or Naturethroid type preparation, now that they are back on the market.

Concerning the appropriate level of T3 supplementation, my own endocrinologist, Dr. Kenneth Blanchard, has more experience with T3 than almost any other physician I'd imagine (that's one of the reasons I chose him). I'd suggest to Dr. Davis and anyone else interested to read his book if you have not already done so:

http://www.amazon.com/What-Your-Doctor-About-Hypothyroidism/dp/0446690619/ref=sr_1_1?ie=UTF8&s=books&qid=1272227891&sr=8-1

In his book, he suggests what most doctors using T3 would consider a very low dose: approximately 2% of the hypothyroid patient's T4 dose (by contrast, Armour Thyroid contains, I believe, more like 20% T3). Since then, he has concluded from experience with how patients feel that the optimal dose tends be even lower, approximately 1.5% of the T4 dose. But he says it does seem to vary quite a bit from person to person.

He generally uses compounded, time-release thyroid extract (Armour), or sometimes synthetic T3, formulated to provide the desired T3 dose. He has found most people do better using the extract, presumably because of T2 and/or other compounds present.

He has a new book coming out soon which will explain his methods in greater detail after treating thousands of hypothyroid patients with combined T4/T3 therapy.

By the way, I recently started experimenting with seaweed consumption and have been able to reduce my T4 dose by >30%, which is apparently highly unusual. I am now (with the help of a holistic physician) experimenting with pharmaceutical iodine supplements (Iodoral, 12.5 mg per day) to see if further progress can be made. Dr. Guy Abraham and a few other doctors who believe in high dose iodine supplementation often use even higher doses, 50 mg or more, but only with regular lab monitoring, most importantly a 24 hour urine iodine loading test.

My organic Egg-land's Best Eggs list "iodine" 40% per egg. I was very surprised to see this since most eggs don't mention iodine. I love eggs (unfortunately have no access to free running eggs but switch among the organic ones) and easily eat 2 a day - sometimes more. Do you consider this another good and safe alternative source?

Is there a list of docs who would be willing to prescribe T3? I think Dr. Blanchard is in my area, but from my understanding, he does not take insurance, so the cost is prohibitive.

My hubby is using a OTC dessicated thyroid supplement as a replacement, since his tests are in "normal" range but his body temp is very low (96) and he gains weight easily on the slightest bit of carbs.  So we decided to try it, given all we've heard.  It has really made a difference in him, he has energy when he used to be sluggish, and his weight holds steady when he takes it. Does this have the "T3" you are referring to?

I started 5 micrograms synthetic T3 about a month ago.  My hypo symptoms are slightly better, but I am disappointed. I expected more improvement.

I was experimenting with iodine drops prior to starting T3. I titrated up from 500 micrograms to 12 milligrams/day over 2 months and then ordered Iodoral. I decided not take it due to the new T3 prescription as I did not want to start 2 new therapies at once. Do you think I should start Iodoral now or wait longer?

I recently read on STTM [http://www.stopthethyroidmadness.com/ferritin/] that ferretin levels should be greater than 50 for adequate T4 -> T3 conversion. My level was 11 (considered normal by the lab). I am considering an iron supplement for 3 months.

Yeah, a friend of mine saw Dr. Blanchard.. did not have much luck with him. He's too conservative.

I have struggled with weight loss since my 20's
T3 sounds great to aid in  weight loss.
I would be interested to hear what people think about optimizing thyroid with lower insulin levels.
since low carb diet=low insulin diet
How about discussing Metformin for insulin control for a synergistic effect for weight loss. There is some interesting research using this med in non diabetics.

People can check out the doctor finder feature upon Armour's website, if they are seeking a doctor who may prescribe T3.

Once concern I have regarding supplementing T3 regards longevity, as animal (and some human) studies show lower T3 in the elderly = longer lifespan.

I'm curious if Is there any longterm longevity data in people who supplement T3 vs those who don't -- excluding those with definite thyroid disease.

There are many websites and forums dedicated to treating reverse T3 hypothyroid syndrome.  The treatment is T3 only.  There are legal ways to obtain T3 without a prescription and self-treat.  I am currently taking 50mcg per day, and I have seen great improvements in hypothyroid symptoms. I did, by the way, try the traditional route first and was told by different doctors that my thyroid levels were all "normal" despite increasing fatigue and low body temperatures.  Now my temperatures are up to 98.6 average and I feel SO much better.

Anonymous--

Can you tell us more about how you got the T3 without a prescription?

(Remember: This is anonymous. I'm not tracking your IP address or anything.)

Dr. Davis-

I originally found the information about how to treat T3 from two websites that were mentioned in the comments section of Dr. Eades' blog:

www.stopthethyroidmadness.com/
www.thyroid-rt3.com/

There is a forum affiliated with the second website that you can find at the bottom of the page.  If you join this forum, you can find sources for T3.  There is absolutely no cost to joining the forum, and nothing is asked of you.  The moderators are just regular people who have been through the medical maze and come up with a protocol that works for them.  

The focus of this forum is not taking T3 for weight loss, but using it to heal a damaged thyroid.  The ultimate goal for many (myself included) is to restore a normal metabolism and come off of T3.

After moving to Hilo, Hawaii my foot pain episodes occurred more frequently. I learned that lots of people in Hilo had similar symptoms and they told me it was gout. After researching the ailment, I was convinced my painful foot episodes were the result of gout attacks and not due to me being flat footed. Just to be sure, I had a blood test which confirmed that I had high levels of euric acid in my blood.Gout is caused by high levels of euric acid in the blood that forms crystals, usually in or near joints. Feet and hands are the most common place that the crystals form and in my case, they formed next to my big toe making walking nearly impossible. The long thin crystals act like needles and cut into the tissue and bone so that even touching the spot can cause intense pain. Since euric acid is not very soluble in water, it is hard to get the crystals to dissolve. Repeated attacks can cause long term damage to the joints and tissue.

Can 7-keto help this? I have Hashi's, am iodine sensitive - I can't take a multi-vitamin with iodine because it causes my thyroid to swell. My T3 totals are low (102, 109, etc. in a range of 76-181). I'm having an extremely difficult time losing the 22 pounds I put on since this started 2 years ago. I am on synthroid but my doctor won't prescribe any T3. I've read that 7-keto will help but not increase the T3 out of range. I'm too scared to self-treat!

Yeah, finding a prescriber is the hard part. I've talked to a few doctors. Every single one is *totally opposed* to any sort of treatment other than Synthroid and its clones.

I asked a research pathologist friend about your notions re T3, etc. He replies...

"Several problems, although superficially it all makes sense.
1. I likely am incorrect, but T3 is available only as an iv injectable (in UK, Australia). Furthermore, it is short acting, so theoretically you might need more than one injection/day.
2. T4 (thyroxine) or T3 bind to proteins in blood (99%) and only a small amount (<1%) is the free T3, which is the biologically active hormone. The bound and the free form are in equilibrium with each other. So if you take T3 or T4, it will go and bind to proteins (ie, inactive), and only a small constant amount of free hormone is available for action.
3. T4 converts to T3 (via deiodination), so why not take the cheaper T4?
4. T3/T4 therapy might work for a short while, but then your body will become used to it and endogenous hormones will be secreted in lesser amounts, so that the final amount of free hormone available to you will be more or less what you secrete now. This is because of something known as "feedback inhibition", ie high levels of T3/T4 will reduce the secretion of TSH, which will reduce endogenous T3/T4 secretion.
5. You could, of course, overpower the body's feedback inhibition loop, by taking excess amounts of hormones, but then you will stress your heart etc. There is a theory which says everyone is born with a given number of heart beats (similar to the idea that women have a given number of ova), you can use your quota pretty quickly with excess T3. Reduction of weight will occur, but at a price.
6. There is a lot of deiodinase in the body, the only time there is not enough is when someone is sick or has liver disease, but its not a consideration for most people.

So yes, it might prove difficult to find a prescriber..."

As always, I appreciate your blog and its included insights. Thank you!

Hi, David--

I think your research pathologist friend should probably stick to researching pathology.

I take oral T3 as liothyronine, since it was temporarily out of supply as Armour or Naturethroid.

Perhaps he is relying on a textbook copyrighted 1984.

Thank you, Dr Davis

Over the course of a few weeks recently, I read all your posts on this site. You offer a heck of a lot of excellent information. I appreciate that you repeat many topics; e.g., niacin, its attendant flush, and how to deal with it.

I also appreciate that you are on the leading, but not bleeding, edge on health topics. An example: my doctor  bemoaned the sorry state of my D3 level and I was befuddled: "But I ingest 1500IU/day!" She suggested an endocrinologist... and THEN I read your post re tablet D3 vs gel capsule. I corrected my error immediately, and now I cannot wait to re-test my D3 level.

Which brings me to my question. After reading all your posts, I find that you do not collate all your recommendations into one post or FAQ. Such an item would be helpful for all your readers. Which specific lab tests should I, or any reader, request?

And returning to this post, I assume no doctor will prescribe T3 -- without first testing your thyroid levels. Whether high, low, or perfect, what is the appropriate dosage of T3 to achieve the results you indicate?

Thank you!

Anonymous is correct that http://www.thyroid-rt3.com/ is a very good resource.  There is a Yahoo! group associated with that web site for rT3 problems specifically and an associated group for adrenal issues.  

I have an rT3 problem.  I've done very well on 100 mcg T3 per day and no T4 at all.  This was after getting cortisol sorted out and it took several months to titrate to my current dose.  

By temperature, bp and pulse, this is an appropriate dose for me.  And yes, I have lost weight on it, without really trying - as when disabled, weight loss is pretty low on the list of priorities.  I lost 17 lbs the first two months, and have no idea since then as I don't have a scale.  

It's not FOR weight loss.  It certainly helps weight loss, as trying to lose when low on T3 is an uphill battle.  But I don't think it's appropriate to say it's FOR weight loss.  T3 is for treating hypothyroidism... and IMNSHO, no other use is appropriate.

That being said, I have a much looser definition of hypothyroidism than most doctors.  Most people feel best and achieve normal temperatures with FT3 near or just over the top of the range if on both T3 and T4 as with natural thyroid; those on T3 only tend to do best at quite a bit over the FT3 range (you need more T3 when T4 is totally suppressed as when treating rT3).  

Where Anonymous is a bit off is the legality of self-treatment.  It's a fuzzy area.

Self-treatment can be done, as it's legal to import 3 months of medications from an international pharmacy for personal use.  Some of these pharmacies do not require a script, and no one from customs shows up at your house to doublecheck your prescription.  

But I think it's overstating a bit to say it's entirely legal.  It seems the assumption is you're importing stuff you have a script for; that this isn't enforced and self-treatment is possible doesn't mean it's entirely legal.

However, it's certainly not near insurmountable if you don't have a good doctor and don't mind bending the law a bit.

The NTH Yahoo! groups are very good sources of advice for those interested in self-treating.  

But it is not about just ordering some meds, I seriously doubt a moderator on any of the groups would tell you where to get even an aspirin without asking you for your labwork first.  

Hormones are serious stuff and while correcting imbalances is definitely necessary to health,  it's not something you do just to drop a few pounds more easily.

How about discussing Met forming for insulin control for a synergistic effect for weight loss. There is some interesting research using this med in non diabetics.

That T3 is so easy to get a hold of. Ive been taking it w/o a prescription for years for weight loss. Ive gone up to as much as 125mcg a day for 6 weeks of T3 for weight loss, you loose alot of muscle going that high too. I have foud that ramping off very slowly also allows your normal thyroid level to recover faster too. Always remember to "pyrmid" when using this stuff. It allows your body to adapt to it w/o shock and come off easily with no thyroid damage aswell. You wouldnt wanna be using this stuff for life now would you!

Here a little example of how i used it during the 6 weeks for weight loss-

25/25/25/25/25/50/50/50/50/50/75/75/75/75/75/100/100/100/100/100/75/75/75/75/75/50/50/50/50/50/37.5/37.5/37.5/37.5/37.5/25/25/25/25/25/12.5/12.5/

Each margin represents a day. The tabs are dosed at 25mcg each.

Dr. drugs are so easy to get a hold of now a days, a child could order meth over the internet if he knew how. Why do all you "Dr's" fail to realize that? The internet can teach you anything.

Here are a list of sites in which you can order T3. YES with out a prescription, T4 too even if you wanted too..

www.musle-man.com
www.rxhealthdrugs.com
www.spiropenttabs.com
and alot more..

And here are a list of forum boards filled with experienced body builders and trainers who can tell you how to successfully and safely use these hormones and steroids to achieve your goals.

www.elitefitness.com
www.anabolicminds.com
www.bodybuilding.com
and a whole lot more.
-just be sure to go to the sites, type in T3, or anything you wish to know, into the search bar, and you'll have all kinds of threads filled with information, pop up.

Hope i taught you guys all something usefull.

-Dr.knowitall. =)

I will manage my thyroid hormone as it is responsible for weight gain and I want to reduce my weight very soon.

www.iron-dragon.com has t3 also, very reliable.  not too sure on the other site posted here.

Nice tnx for the info...

Expert-Nutrition allows you to understand everything you need to know about nutrition, including recommended dietary intakes and what the science says about nutritional supplements. We aim to make nutrition easy to understand and will ultimately help you to make educated decisions about your diet and your health.
thanks
bodybuilding supplements Australia

I have been taking T3 for over two yrs and there is no weight loss benefits. I was on 120mcg per day and I started to develop heart palpitations and my face looked swollen. I don't think any one should be taking T3 for weight loss because it can also make you Extra hungry when taken with other meds.

İspanyolca Sözlük


Ä°ddaa, Bahis


Snooker


Turkey Travel Guide


Biber Hapı


LW6090


Maurers


Red Pepper Jel


Pepper Time

If Buy phentermine you can acomplish a fast weight loss diet and regain your self worth in no time! i done it after all else failed no ordenery diet worked out for me until i combined it with phentermine!

Hi I am a 28 year old female. I started taking phentermine pill 5/9/2010 and went in at a weight of 248lbs. Went back in on 6/21/10 and lost 8 pounds. It seems to be working very well and I just feel anxious sometimes but overall I have a lot of energy. We shall see when I go in next month and I'm also on a 1200 calorie diet which is working well for me along with exercise

One of the surprising benefits of colon cleansing is that some people experience significant weight loss after treatment. The average human colon weighs approximately four pounds.

I'm a little lost... I have been walking around thinking that I have a bad thyroid with me gaining so much weight (15-20 lbs in the last 15 months)and I have a morning temp of around 96.6 F; and then today I get my test results back:

TSH 0.32
T4 FREE 1.4
(Levels that point for 'Subclinical Hyperthyroididm")
Do I stop taking Kelp supplement?
I was taking between 150-450 mcg per day for about 1 year.

Also found that my A1c was at 5.7% (slightly high)

B12 borderline low

HDL 46 (low)
LDL 139 (high)
TriG 226 (high)

And on top of that my Vitamin D has dropped from 78 last year to 40!!!

What the heck happened? Could this be related to taking synthetic hormones (birth control pill) for 11 years? (Stopped 14 months ago) Or is it just me hitting the big 30??!

Help!

www.alldaychemist.com. No I'm not an employee/owner, but a customer. This is where I get my T3, T4, and that glaucoma medicine that makes your lashes grow.

Becoming healthy should be the number one reason for losing weight - feeling beauty comes naturally after.

I really want to lose weight that is why I am reading this kind of post. I think this post is a very well written post. I love everything that is written in that article.

T3 or any form of Thyroid medicine just for weight loss is highly dangerous. I have been doing this for over a year, starting with T4 and now mixing the two (worried about RT3). Unfortunately I am suffering severe side effects, angina, breathlessness, atrial fibrillation arrhythmia and many other things, i am too scared to come off them but I have and am doing my body alot of damage, which could be fatal (I should never had started). My advise is to only take the hormones via a doctor and only if you suffer from hypo.  

Anon

I have taken both Clen, Anavar and T-3. I have seen moderate results with clen, extreme muscle mass gain with anavar, and the most leaning out and weight loss with the t-3. My only concern was that it took 4-5 months taking t-3 to lose 15 pounds and I was taking what I thought was the maximum. How can I lose 20 lbs of fat in 2-3 months and still maintain muscle? Should I switch to anavar from clen when I notice muscle loss?

Last post above by a 31 year old female that works out, eats right and wants to go from about 20% body fat down to 10% by April/May. I use to be a fitness model and have been off t-3 now for about a year, but still cycle clen. I hear alldaychemist is a good site.

I was under the impression that t4 gets converted to t3 what at the liver or cellular level? if your insulin resistant (or suffering from what some term the famine feast cycle from a history of reduced caloire diets or poor quality diets) you not converting to t3 or are t3 resistant you can be leptin resistance and insulin resistant you can be thyroid resistant to.


I would think one would need to get at the root of the problem, rather than treat the symptom, it could be caused by some chronic nutritional deficiency, regardless of cause, as long as your on the famine feast cycle (look it up) you will not lose weight permanently. nor cure metabolic syndrome or low thyroid that has no known cause.

there is a strong genetic compeonent I think some call it the thrifty gene, I call it the survival instinct myself which encompases more than just energy in and out.it encompases all metabolism, reactions to enviromental changes mental and physical adaptations and what not.

and I wouldn't be surprised if the real culprit for hypo or hyper thyroid for those not suffering a weight problem or metabolic synrdome is due to malnuturtion as well like vita d, cal, vita k, a, magnesium and other minerals defiencies.

these control the immune system dont they? maybe the genetic component is that your unable to absorb them as well and need to over compensate via taking in excess via foods.

but then I wonder about how nutritious our food really is. sure maybe the toxic enviroment may play a role like increasing the nutrient needs of the body in order to detoxify them. but I don't believe they directly cause a problem. everyone has these toxins in ther bodies in usa, but not everyone suffers health problems from it.

could be their genetic and nutritional status that determines that. but the only thing I know who takes t3 are those who suffer wilsons syndrome, stress induced reduction tha doesn't resolve itself after the stressor has past.

and then they only take it for a short time to get the body back into balance not as a weight loss tool.

Can you use T3 for weight loss w/o losing muscle?  I have a prescription for 10 mcg a day that I haven't been taking, so I can start ramping up a bit.

This is nice post thanks a lot for this great post keep posting and updating the blog.....


Smith ALan

I am on t-3/t-4 therapy for hypothyroidsim.   T-3 was added a month ago and although I feel better than I have in the past 3 years, I have had NO WEIGHTLOSS!!!  I am an active female and eat well, I bike 15 miles daily.  Confused as to why I am not seeing any results....

I was just diagnosed with hypothyroidism. My TSH was 5.4. Which is high on both the old and new scale. I weigh 384 lbs., do not sleep well, have swollen legs, and am sluggish and tired. I can loose weight when I eat right and exercise. My blood pressure and sugar are normal. I am also going for a sleep test for sleep apnea next week. Also just for info I had a ct scan just before my blood test and they did give me the contrast, (iodine). My doctor put me on t4,  25mcg per day. (levo) At the beginning of the year I started a diet and lost 50lbs in about 6 months. Then kinda got off the wagon and gained all my weight back. I was in the hospital a couple years ago and the doctors told me my sodium & potasium was really really low. Also I have access to cynomel. I am afraid to start the t4. And have some questions:
1. Is 5.4 that high for TSH? 2. What could have caused this to be so high? From everything I read it looks to me like 5.4 is very high. Why then would my doctor only put me on 25mcg? Everything I read says most people are on 75 to 125 mcg per day and their TSH is much lower than mine. 3. Should I ask my doctor to prescribe t3 also? If he will not should I start my own that I have access to? If so I would start very low dose say around 12.5 mcg along with my 25mcg of t4. 4. Could the ct scan caused my TSH to be high? Could having low sodium and potasium cause my TSH to be high? 5. Should I have another test done? Also have my t3 & t4 levels checked this time? He did not do those test the first time. I am afraid because I cannot gain any more weight! I am maxed out! My body cannot take any more. And just five pounds would be really bad. I do not want to take the t4 alone if there is any chance that I might gain additional weight. 6. One more question, is there anyway I can get my thyroid back to normal with out taking a bunch of medication? Like eating right, exercising, loosing weight. Or is the high TSH causing the weight gain? Because my diet is terrible.

Thank you.















9

Hi, Robert--

Iodine is the only way to restore thyroid function; since you got iodine-containing x-ray dye recently, it seems unlikely that iodine deficiency is at the root of it.

My personal view is that very few people should take T4 without T3--people feel better, are happier, lose weight much more effectively. The problem: the endocrinology and primary care community will fight you tooth and nail. This may sound cynical, but I attribute this to the fact that much thyroid "education" comes from the sexy sales rep who was hawking Synthroid.

Your T4 dose is low because it is wise to start gradually, else you can get hyperthyroid symptoms. Your TSH, by the way, is indeed in the hypothyroid range, sufficient to account for substantial health problems, including weight gain and heart disease.

Jenny i have found an offshore supplier from turkey of T3 (Tri-lodothyronine)  & T4 (thyroxine) i personally have bought T3 & T4 and it is Amazing, the medication manufacturer is Bitiron which are notorious for quality, Bitiron combines both T3 & T4 into one 62.5mcg (Microgram) pill, yielding 50mcg of T4 and 12.5mcg of T3, each box of 100 pill are $22, i have personally bought it and recieved within 10 days and shipping is free, they deliver through USPS and accept paypal payments for a more secure peace of mind, they also sell T3 alone, T4 is generally much weaker than T3 so usually people wont consider it for weigh loss, but what many dont know is that T4 serves as a shuttle for T3...A Normal male will intake 50mcg of T3 up to 100mcg of T3 anymore can cause hyperthyroidism which isnt healthy, i estimate a female should never excede 50mcg of T3, so taking 2 daily will yield 100mcg of T4 and 25mcg of T3 which i believe is a healthy dose for a female, when you take this medication you should always do a pyramid cycle this is where you start off with half a tab, after a week increase to one tab, after 2 weeks increase to 1.5 tabs and after 2 weeks increase to 2 tabs, and keep it steady at that rate for a while then down to 1.5 tabs for 2 weeks and 1 tab for 2 weeks then half a tab for 1 week, i suggest yout take Iodine and L-Tyrosine (Amino Acid) pill after you are finished to help the body naturally produce natural Thyroid hormones once again, NEVER stop taking the pill in the middle of the regiment and NEVER skip a dose.. please do further research to learn more about Thyroid hormone control and its weight loss benefits before doing any regiment.
(this is the website to get the T3 & T4) http://www.anabolix.eu/
or Contact the supplier directly at this email:
anabolicsteroid@hotmail.com
Please tell them Eliu Quesada Reffered you to their service, good luck and best wishes in your weight loss journey

T3 is an excellent supplement for weight loss.  I have used this in a prescription capacity and had great results.  Some sites sell this as a "research chemical".  I have a blog that discusses research chemicals however we do not sell them.  

Great article on T3 for weight loss.  You are actually the first result on Google for that term.  That is how I found you...

Thanks

Dr Davis,
1)  My thyroid was radiated twice due to Graves disease 15 years ago.  Since my thyroid is no longer functioning, would there be any benefit to taking iodine along with my synthroid and T3?  
And
2) With the Graves disease, I developed thyroid eye disease, pretibia myxedema and Acropachy. Will taking T3 effect or aggravate those conditions?

Thank you,
Lisa

Dr. Davis, I envy your patients!  I'm a post meno-hell 56 year old female who, until five years ago, has always been thin; underweight according to all height-weight charts.  Over the last 4-5 years I've gone from 110 lbs. to nearly 150!  I've always been able to cut back on intake and weight would fall off; now a normal for me day's intake is a chicken breast or fish fillet/day and a cup of hot chocolate at bedtime (skim milk).  Sure, I realize that as we age we tend to gain weight but this is way over the top and unhealthy.  I've also been suffering from virtually all hypo symptoms except no difficulty conceiving and problem periods (for obvious reasons).  I've been unemployed for years and have no health insurance so obtaining medical care is virtually impossible.  Around 2 years ago I went to a low cost clinic; they said my thyroid numbers were within normal ranges but didn't give me the numbers.  They did send my cholesterol number, OVER 300, with instructions about diet and exercise.  Not exactly news, duh.  When the lbs. really began coming I began walking/jogging 2-3 miles/day, zero weight loss.  I'm sick of freezing feet!  I was stumped about why the corners of my eyebrows have disappeared until I began researching hypo.  I've been on nearly antidepressant known to man.  I finally located a free clinic last spring.  The first Dr. I saw ordered lab work and said if it wasn't definitive he would refer me to an endo.  Drs. at the clinic rotate once/year.  When I returned I saw a different Dr.  He insisted my lab work was normal but, to shut me up, he put me on 25 mcg. of Levo.  After 3 days I felt great but it wore off within two weeks.  I returned to the clinic, the next Dr. said I'm definitely hypo and increased my dosage to 50 mcg.  He wanted to titer me up to 125.  Awesome... I thought.  No change, I was still symptomatic.  After a couple months I increased it to 75.  Despite my raging symptoms the next Dr. decreased it because my TSH was very low.  He's a resident and will be a regular at the clinic until he's finished with his residency.  And, on each visit my weight has steadily increased.  The next time I went in, my most recent visit, my weight had increased at an alarming rate.  He told me to run 6 miles/day.  When I was his age I did run, I had young knees!  I'm sick of the blame the patient game.  At the rate I'm gaining weight this woman, who has always been the skinny one, is going to weigh 200 lbs.  UNACCEPTABLE.  Clearly I'm the only person concerned about my health.  I've scrimped and saved money when possible and ordered some T3 online last week.  I'd rather die than be yet another morbidly obese American at risk for Type II diabetes.  I'm sick of freezing year round.  As I type my feet are so cold they're almost numb.  I'm scheduled to return to the clinic in a few weeks.  They never give me my numbers but this time I'll DEMAND them.  I didn't learn until November that my lab work from April did, indeed, indicate that I'm hypo.  Most patients at the clinic are poor, unsophisticated, uneducated people who don't challenge the Drs.  I'm poor too but I'm a well-informed law school graduate with top-notch research skills.  Yes, lawyers lose jobs too, age discrimination is pervasive.  I don't anticipate having begun taking my self-prescribed cytomel before my upcoming appointment.  Hope springs eternal that if I do benefit from it I will eventually be able to convince one of the rotating, overall apathetic, Drs. to prescribe it.  Ordering online will quickly become financially prohibitive if it really does help.  A little cooperation from the medical professionals sure would be helpful.

I forgot.  I've suffered from constipation since entering my 20's.  Bad pins and needles in hands and legs; arthritis since my 20's that has become much worse over the years.  Insomnia, physicians have been throwing antidepressants at me for decades.  I've been told I have a "low normal" body temp since I was a kid.  My mom was diagnosed with hypo last year at age 82 after developing an enormous goiter.  Her Dr. said she's probably been hypo for decades even though it never showed up in her labs.  The list of why I need proper treatment soon is infinite.

Wendy, I read your post and I saw myself because I share both your symptoms and your experience. I gained 50 pounds in one year and cannot get it off, although people remark that I don't eat much and they don't understand why I am 184 lbs. I am fatigued all the time, I have difficulty losing weight, I have difficulty concentrating, and yes, I have cold feet (I have to wear socks to bed in the SUMMER). I have been trying to get multiple doctors to recognize that there is something wrong with my thyroid since 2007. I have been tested so often I feel like a pin cushion, and they always tell me my numbers are normal. I ordered copies of all my lab results and I can see that the numbers are going up, and I can feel that my symptoms are getting worse. I am a biochemistry student who would like to go to medical school eventually, and I cannot afford to keep listening to doctors tell me that the problem is not my thyroid when I know that it is. I was laid off from my job and spent a large chunk of my savings on an endocrinologist who insisted that my symptoms were due to a sensitivity to wheat, although I had been tested for 100 different allergens and the results all came back negative! I could not afford to continue paying him to not give me what I asked him for, which was a 1 month trial on thyroid medication. So I did it myself. I researched online, ordered T3, and gave myself a pyramid dosing schedule. I made sure I was aware of the side effects so that I would be able to recognize when to lower my dose. About a week or two after I started T3, I felt like my old self again. I had energy, I was losing weight, and I could concentrate. When I stopped taking the T3, all of my sympoms came back and I immediately put the weight I lost back on.I have been to 3 doctors since I completed my self-administered T3 trial, and I have specifically told them that the medication made me feel better, but they told me that it was because it would make anyone feel better because, as my last doctor told me, "it's like speed." However, my own research has indicated that if you are taking a dose that is unhealthy for your body, it tends to give you headaches and heart palpitations. So obviously my body responded favorably to the T3 since I did not experience those side effects. You should go to the website that the anonymous poster listed called thyroid-RT3.com to see how to pyramid dose and you should try it and see if you feel better. Then you can go back to those doctors and tell them that the T3 made you feel better and you would like to try that. Hopefully, you will get farther than I have. I am going back on T3 on my own. I would have liked to have it monitored by a medical professional but I refuse to live the rest of my life feeling like this. Right now I'm just trying to decide how long to cycle on the T3 and how long to cycle off without making my thyroid worse.

Lisa, this is way too late but....

what a lot of nutritionists don't seem to realize is that the whole body uses iodine, not just thyroid tissue!  it is the opinion of many TRUE specialists that the RDA is way too low, also.  so unless you're a seaweed fanatic, supplementing iodine is probably a good thing -- but make sure you balance it with selenium -- the two work as a team, and people who have had problems with iodine are frequently selenium-deficient.

good luck!

However, you can easily and now cheaply check your blood sugar. Because blood sugar parallels small LDL, checking blood sugar can provide insight into how you respond to various foods and know whether glucose/small LDL have been triggered.

What's your opinion of the study showing that vitamin D levels above the low end of the normal range were associated with elevated CRP levels?

Correct Spelling:  Myocardial Infarction

Er, Joke, sweetie..

HH

What an extremely informative article.

In 2000 I had cardiac bypass after multiple failed stents. In 2003 I thought I was dying. I was short of breath and had pitting edema and many other health problems. My doctor told me I was probably reblocking and suggested a cardiac cath.

I did not know about a connection between wheat and the heart but I did find a connection between my peripheral neuropathy and gluten. Up to the time I stopped gluten, I was carefully following the AHA dietary guidelines for a healthy heart. I even followed the Ornish diet for about a year. All I did was get sicker and sicker.  Dropping my favorite food(wheat) and all gluten was what made the big difference in my health. My PN is no longer painful or progressing. I also had complete resolution many other symptoms including the pitting edema and  shortness of breath. It has been over 8 years and my heart is still doing great.

Of course there are other factors to consider which Dr. Davis addresses on his websites. Vitamin D, blood sugar, thyroid to name a few. I am a work in progress.

Dr. Davis
I am not trying to say you are wrong, Quite the opposite, I think you are on the right track with your program.  But, have you had enough people in your program long enough to make a statistically significant sample?  I am sure there are more people in the world who don't follow your program than do.  That alone would make it more likely for the non-followers to have a heart attack.

MI (myocardial infarction), usually a sequel of ischemia,  is often preceded by episode(s) of angina. In many resilient people the angina event offers the heart a chance to deploy inherent plasticity in what is called "pre-conditioning". Many  who have angina episodes 1-3 days before suffering a full on MI  seemingly paradoxically recover with less serious subsequent arrhythmia ,and for the next 1-5 years have lower susceptibility for in hospital dying (statistically).

"Pre-conditioning" is a likely explanation for Doc's preventative MI protocol for many middle-age & up adults. Ischemia (felt as angina)causes a heart cell mitochondrial response, and also surface of that cell response. This involves channels & potassium with the same name in those respective membranes, but depending on which part is involved the level of reaction differs. And of course, there are isoform variations of this potassium ion channel that responds to ATP molecules (K-ATP).

Mitochondrial K-ATP (mtKatp) is only discussed here. Ischemia results in some heart muscle cell not being able to sustain ATP output. In healthy heart cells it is  normal levels of ATP that keep the channel mtKatp closed. Healthy mitochondria don't ideally let in too much K because it makes them osmoticly swell inside, among other side effects.

Potassium flooding into a mitochondria from a channel mtKatp opening up does several  significant things. One is keeping detrimental calcium (Ca++) from getting into the cardiac cell which is being forced to deal with a ischemic event. Otherwise Ca++  instigates unwanted pore openings in that mitochondria's membrane; letting the inside/outside balance of that mitochondria & the cytosol interact detrimentally.

In other words a significant up-stream "pre-conditioning" benefit is from mtKatp channel opening in response to when that heart muscle cell is unfortunately suddenly challenged by ischemia. Doc tries to prevent high blood sugar (hyper-glycemia) like in metabolic syndrome & t ype II diabetes because hyper-glycemia itself opens mtKatp channels; but this is at the wrong time.

Meaning the hyper-glycemic individual, despite having mtKatp channels quite open, has lost a large part of their potential heart cell plasticity (ie: recovery despite ischemia) because they can't turn on their  crucial natural "conditioned" response to ischemia . They lose an important preventative mode; since, for them,  the protective "pre-conditioning" dynamic can't flip "on" into action because it wasn't  kept primed in the "off" position. When young this doesn't usually matter because time hasn't set them up for ischemia yet.

Dear Dr. Davis,
Many people have confusion about who to believe on this issue like myself.  I have followed the low carb, no wheat diet for over a year.  HDL went up to 58 from 42.  I am a big fan of yours and convert to this lifestyle. The confusion happens like this:  I shared your book and forum with our family doctor, and told him about the results I had.  He seemed interested.  I saw him a few weeks later at a social event and his responses were this.
1. LDL size is insignificant.  If he sees a patient with elevated cholesterol with pattern A LDL, he will still put them on a statin to stop Plaque progression, he sees it as insurance.
2.   He says they are proven to stop plaque progression.
3.  A person gets enough vitamin d from diet and walking to their mailbox everyday.
4.  The only thing that matters to him is reducing total LDL to 50 or below for at risk patients.
5.  If you have heart disease, than there is no need for a heart scan, because we already know you have heart disease.

I think many people read your forum, get excited to hear about your approach, and then go talk to their primary care physician and get shot down on it.  It can be confusing and discouraging to say the least.

Conan,
That's the standard lingo fed down the medical pipeline. I've heard all of those as well. Plus this one; "there is nothing we can do to lower LP(a), so there is no since in testing for it".

I've wanted to ask you to write about dairy and the heart since my heart attack, and now that you're done with Wheat Belly.   I talked with people years ago about your blog and about gluten-free (to no avail), and now they're telling ME about your book like it's a new discovery (how soon they forget!).  Funny.  

I was dx celiac 2-06 at the almost age of 46.  I'm obese and initially gained 22 lbs going gluten free because I turned to Yoplait yogurt when I didn't know what to eat (+ learning to substitute SAD diet with gf SAD diet).  I learned about insulin via Jenny's Bloodsugar101 blog, and I've whittled away at changing my diet ever since.  So many bloggers have changed my life, and I'm so grateful because I'm getting some QUALITY of life I never knew before.  

I was almost Paleo with a lot of cheating, and I continued having dairy until last year when I had a heart attack at age 49 after running my first 5K (trying to get healthy and lose weight).  

I won't go into the history of why, but I was not taking my usual omega3 supplement.  I was supplementing with 5-HTP (100mg) along with other neuro support based on urine testing from ND/MD because I was still a bit depressed (how would I know?  I've only known depression, and I thought most of my depression abated going gf).   While most of my symptoms abated going gluten-free, I was and am still trying to overcome fibromyalgia.   Fibro: lack of energy.  Muscle fatigue.  Actually, for years I had a-fib on and off.  Sometimes it was my thyroid (I have Hashimoto's, and it was in range at the time of the MI, though they didn't do a panel of labs), most of the time it wasn't.  

The year before my MI I went to cardiologist and I told him when I ate dairy (I'd gone from Yoplait full of rBGH at- the-time & sugar, to organic Greek full-fat plain) I had palpitations.  "Is it the calcium?" I asked.  "No, but here's an Rx for statins, hmm, though they'll exacerbate your fibro... How about some beta-blockers?"  I said I'd look into it (throwing the script into the trash).   I wore the Holter monitor and took EKGs, etc.  End of appt and relationship.  I continued to try to research online the best I could.

The day before my first 5k, I was in a weird place emotionally - anxious.  I ate and couldn't fill myself.  I had 3,200 calories where I usually eat between 1,500-1,800.  I considered it "carb loading" before the race even though I never researched what that really meant (too busy researching everything else).  Here's my food log for the day before the MI:

Bfast: Stonyfield cream on top plain full fat yogurt w/strawberries, blueberries, banana, flax meal, Member's Mark gf Spinach Asiago sausage.
Lunch: Stonyfield gf English muffin, 3.25oz gf deli turkey, 8g butter.
Dinner:  2 Amy's gf cheese enchilada dinners, 2 mangoes
Snacks:  46g (unpopped) organic popcorn & 1 stick butter, 1 banana, 20g sunflower seeds, decaf coffee w/15g heavy whip cream.  I was about a month into going caffeine-free.
Processed carbs:  148g, Fruit/other carbs: 154g Total:  302g
Fat:  184g
Protein: 101g
Fiber: 39g

My cholesterol at the time of MI:  
TC: 206  
Tri’s: 74  
HDL: 49  
LDL: 142
A1C: 5.5 which translates to an avg bg 111
BG: 118 (I'd been doing morning fasting tests, and it was hovering around 100, and I knew that wasn't good - hence the 5k.  I'd been walking for years though I was struggling to be consistent w/energy to exercise, something not uncommon w/fibro sufferers.)  
BP: 150/82
hsCRP: 3 (down from 6 which was down from 11 or 12 ~a year before)
Heterozygous for Factor V Lieden discovered when I had a Boston Heart Lab cholesterol study ~a year before.  
It was May, overcast, and not overly hot outside, more like the mid-60s - ideal even.

Thyroid lab early May:  TSH .7
Vitamin D:  tba. I have to look it up, but I have a history of tracking it and supplementing; it has been above 40 for years at least.  It's currently 65.

I had one cup of water before the race.  After the race I ate a banana and 4 c water (+ water provided via Dixie cups along the route which were a pittance).  I was red faced and hot.  I drove home to take a long, HOT magnesium bath, and went to bed due to fatigue.  I don't remember if I drank more water, or much more than that.  I was actually having the heart attack that night, but at the time I didn't realize it.  I awakened around 5 a.m. from a long, unfit sleep, even though EXHAUSTED.  I tried to eat a sweet potato for bfast but had anxiety - I had a bite or so, but kept putting the fork to my mouth and down to the plate.  I had a hard time catching my breath.  My left arm felt like a blood pressure cuff was stuck on inflate.  I called doctor neighbor who didn't answer, then called out-of-state husband who told me to take an aspirin.  I hadn't thought of it.  Oh dear - I had to find a gf aspirin, which I luckily had some expired gf baby aspirin, and took one.  In 20 minutes it was lessening my arm pain.  

I got to the ER, and THEN had to navigate the health care system as to what gluten was.  They thought I was crazy to worry if they're high dose aspirin or sublingual nitro had gluten - this, from two nurses with "IBS" ... the cardiologist has a regimen of drugs to give prior to the heart cath and I had them looking into the gluten ... the hospital DID have a gf menu (wonders!), but got the order wrong a few times and had to redo the meals.  I'm so glad I had my wits about me.  I lost two pounds in the hospital eating strictly Paleo. ;0)

A few months prior to this, I'd seen a hematologist to figure out my mysterious leg pains.  Most of my fibro pain went away with gf diet change, trying to balance my hormones, TRYING to get more sleep, exercise, etc.  But I couldn't shake the pain in my largest muscles.  I'd read about rhabdomyolysis and asked him to do a CK test as a base for when I wasn't in pain.  Sure enough, it was normal.   Whenever I'd try to jog hard I'd get horrible pain in my legs which took about 5-6 days to recover.  There were a few times I exercised so hard they seized up, esp the day after and it was all I could do to get to the bathroom - sitting was an ordeal!   It wasn't normal for as long as I'd been exercising, to have this pain.  I know people who run and never have pain, so it bothered me I had this and couldn't push harder.  

Sure enough after the 5k my quads were killing me.  The ER checked my CK, CK-MB, and troponin.  All were elevated.  When I brought up my theory about fibro and CK to the cardiologist he said everyone's CK goes up after exercise.   What am I to think?  Am I naive?  My heart cath was clear.  I was given marching orders to followup with my GP.  He told me to take a baby aspirin daily, but I'm trying to heal a leaky gut and don't do that.  I have taken fish oil again non-stop though.  

I read about dysautonomia, rhabdo/dehydration, hypoglycemia, and electrolyte imbalance.  I can't help but think my lack of energy had something to do with my heart attack.   I contacted a neurologist who said he didn't believe in fibro, and then tested/probed my muscles (they were responsive).  

Then I heard a podcast between Dr. Rosedale by Jimmy Moore.  Dr. Rosedale said (my words) that saturated fat covers your cell and energy can't get in (you need a balance of fats for cell membrane integrity).  Well, I'd been unbalanced.  I took a special, new blood test* and found my body reacts to dairy fat like gluten (which is hard on the adrenals therefore pushing cortisol? - my thoughts).  

I quit dairy completely and my daily, constant nagging quad/ham leg pain went away, I sleep better, my palpitations went away, my depression got, yet again, better, AND I lost 25 lbs EASILY (which is not something to which I'm accustomed).  

FWIW, I am very lactose TOLERANT.   When you hear about giving up dairy in the celiac community, it's often because a person is lactose intolerant not because of other food intolerance symptoms.   I was stubborn in giving up dairy because I was dependent on the negative drug-like effect it had on me.  I STILL crave it now and then, too.  You don't realize it until you give it up completely: not 90%, not 99%, but 100%.

I am just now trying a boot camp and have better exercise tolerance; my pain is still more exaggerated but I recover in time to exercise again in two days.  

Thanks for letting me share my story, and I appreciate all that you contribute to the awareness of heart health.  I've been a reader since 2006.

I don't think wheat is that bad. If you have been eating a lot of white flour products then you can become gluten sensitive. But, if you use sprouted wheat bread and find out about wheat grass juice, you can have awesome health. I think it is the GMO wheat to watch out for the most.

oops, forgot:
* Cyrex Labs Array 4 for Cross-Reactive Foods, info here:  http://bit.ly/thedrxreactivitypdf or www.thedr.com (Gluten World tab).

I responded to "milk butyrophilin" which is a milk fat protein.  Upon Googling around, I find it's associated with Multiple Sclerosis (http://bit.ly/ze5xOI).  I have enough autoimmune diseases, and will continue on my happy Paleo path.

Sorry, one more thing:  I am a slow caffeine metabolizer which apparently makes me more prone to heart attack:  http://bit.ly/zbc8L0 (even though I'd been off caffeine for a month or so, I thought it was interesting).

Gluten is gluten, whether it is in white flour or whole wheat or several other grains like barley.  Ask anyone who is gluten sensitive or a full blown celiac - and I know several,  any gluten will make them very sick.  It is a protein that their body cannot digest.  And it doesn't matter whether it is from GMO wheat or not.

Hi Dotslady,
For seratonin's (5HT) 16 different receptors to work they have to take routes that are paths which result in an increase in Calcium (Ca++) in that cell interior (cytoplasm).  Seratonin is an amine molecule. In humans there are 9 different trans-glut-aminase enzymes that when turned on by Ca++ binding  can also process the amine seratonin.

"Seraton-ylation" is the result of action by trans-glut-aminase enzymes causing seratonin metabolites that then interact with other cellular processes. Thus "seraton-ylation" of fibronectin results in more smooth muscle cells being produced & in another relevant instance induces platelets to put out proteins that foster coagulation.

2007 Japan  researcher  Miyazaki, et.al. (J Cardiovasc Pharmacol 2007 Apr;49(4):221-227) blocked seratonin & relieved symptoms of peripheral artery disease (PAD). Leg pains you suffer may be  PAD endothelial dysfunction from too much Ca++ influx into muscle cell's cytosol. And your 5HTP (precusor of seratonin) supplementation could be contra.-indicated.

Dairy has tryptophan & the calcium needed to process it into seratonin; yet your doctor told you dairy's calcium content was not the problem. Your depression bio-chemistry suggests altered seratonin metabolism. One's genetic variants of seratonin routing pathways are a jumble of factors, including particulars of calcium (ie: calcium channels in that cell's membrane & the site of stored Ca++ already inside that cell ); all modulated by seratonin reception peculiarities.

Your blood pressure of 150/82  may be due to "seraton-ylation" of fibronectin proliferating too many arterial cells (hyper-plasia) leading to stiffer blood vessel making for more tension (hyper-tension) as lcse ideal  contraction/rebound.(for geeks: 5HT2a receptor & transglutaminase induce serotonylation of a GTPase RhoA affecting proteasome's down of GTPase in a way that upregulates Akt thereby engendering proliferation of arterial smooth muscle cells resulting in diminished contraction capacity). Breathing problem you described is also precisely researched as  part of the "seraton-nylation" sequel involving trans-glutaminase using seratonin as an amine, not a hormone.

Normally people with elevated seratonin in circulation have a natural protective response whereby the number of seratonin receptors perched waiting in the cell membrane is reduced. But your vascular smooth muscle cells actually seem over receptive to seratonin & you've been innocently topping up with 100mg 5HTP daily (how long?) .

I think you will find a hailstorm of opposition to that notion, jhail.

I would invite you to read my book, Wheat Belly, that exposes modern wheat for the fraud it is.

Wow, Dots.

A revealing story. I'm glad you found your answer . . . despite your doctors.

Yes, dairy is a big problem for select people. I pick on wheat because it is a HUGE problem. But, for some, dairy can be a substantial second.

Yes, it is, Conan.

I can tell you that your doctor is reading the commentary and editorials in the medical journals and what we call "throwaways," the low-grade magazines that physicians are sent that are really thin disguises for advertising. It means he is not reading the primary literature, nor gaining an experience, nor is he thinking. He is simply regurgitating the superficial thinking of those who write these pieces. These pieces tend to be CYA with a slant towards drugs.

We are making progress, but it is painfully slow!

Informally, Teresa, there are approximately 1000 patients in the office who follow the diet, about 300 who do not. (The rest have non-coronary syndromes that are not relevant.) This was not a comparison to a population outside the office.

Hi, Anne-

Yes, but you have come a long way, much on your own intelligence, strength of character, and persistence!

No.

I meant myocardial "infraction."

It was a joke.

Even if you're lactose intolerant, milk in the US and Europe contains mainly A1 casein, while milk in Africa and Asia contains A2 casein. If anyone can't live without dairy, they should try to make sure they get it from an A2 cow such as a Guernsey.
More info: http://www.betacasein.org/?p=heart-disease

@ Might,
I noticed that people differ by how much they need to eat milk products. I don't  particularly care about anything made out of milk with the exception of butter and heavy cream for my coffee, even cheese (I eat it anyway because I keep buying it for other family members, but I would always choose some deli meat over a cheese) Does it mean their preference may depend on which path their serotonin takes? Some people actually crave such tasteless things like cottage cheese and plain yogurt.  It feels like there is some physiological difference besides taste preference..

Al- epic as usual. thanks so much for your posts. I don't have the background to truly comprehend much of what you say but I do love reading it. And it does help in an over-all general knowledge kind of way.
Doc- Thanks again for taking the time. It's tragic that too many of us (myself included) don't find out about this stuff until AFTER we've been stented OR WORSE. I only got here by innocently trying to find out about possible side effects for the 80mg/day of lipitor  they put me on no questions asked or answered. I'm still pissed about the quality of care I get from any cardiology related people I've seen. Yet I'm still afraid to  not take my meds.

In reply to the above comments - I'm aware that people who are gluten sensitive should stay away from all gluten products. However, for the rest of us, it's best to try to choose whole grain products. I have a friend who was a food science major, who told me that people become gluten sensitive from having eaten too many white flour products in their life. But, I know people who are gluten sensitive who can have sprouted grain breads and sprouted grain drinks. Everyone should avoid the GMO products though.

Hi GalinaL,
Others here have pointed out eating dairy give us a caseo-morph (ie: opiate like molecule) & this engenders an opiate brain response; so probably one's  real time response of contentment from eating dairy.  Then too dairy's tryptophan/calcium combo producing a bit of extra seratonin in popular legend is supposed to be how warm milk relaxes some into sleep.
"Seraton-ylation" is less about seratonin in a nerve synapse.  It is  how different  tissue cells' internal processing is modified after interaction with the unique amine characteristics of seratonin  (as opposed to any neuro-endocrine functions of seratonin). Your idea of dairy lovers sounds more like a conditioned response anticipating caseo-morphs; much like Doc says modern wheat can condition some people's neuro-physiology to crave wheat.

Hi jp,
Depression is unfortunately common after MI (myocardial infarction); which you may know from fellow patients or first hand. Long term ( not short duration use) of anti-depressant drug SSRI (selective seratonin re-uptake inhibitors) is associated with less MI fatatlity. First this was assumed to be due to SSRIs side effect of  reducing platelets (ie: thinner blood circulating) but 2011 published research disproved that mechanistic linear explanation.

The "Baltimore ECA Follow-up Study" (1981-1994) noted a higher incidence of heart disease for the depressed and those notably sad beyond +/- 2 weeks straight. Curiously, the depression link was more of a significant  factor for younger women followed up on. And most statistical reports concur that those with continual depression after an MI show an increased rate of fatality.

Seems there is an interplay between one's  "seraton-ylation" ( seratonin amine metabolism) quirks in the heart muscle cells (or other tissues) and the useable seratonin neuro-endocrine metabolism in the brain cells. I have a simplified explanation for this paradox (SSRI= good; yet seraton-ylation = risky) ; but nuances aren't detailed here & I may (!) be mistaken.

In true depression seratonin isn't performing normally in nerve synapses (ie: seratonin plucked back from the synapse action site too fast, precisely what re-uptake inhibitors slow down) so there is no need to contribute so many seratonin molecules to building up a reserve pool of seratonin for nerves to have ready to put into action (ie: pool always full enough since seratonin just pulled back in right away; or seratonin rarely even leaves pool to action site). This under-functioning leaves the depressed individual without the normal programming prioritizing seratonin  for nerves. In a sense their seratonin  may be more readily programmed to be used in non-nerve situations (ex: seraton-ylation leading to excess calcium in heart cell) in that individual.

The prolonged use of drug SSRI (ie: keeps seratonin lingering in the nerve synapse) indirectly favors seratonin getting put into the back-up nerve seratonin pool. The nerve cells in due time  register  they can/need to top up with seratonin. This is a variation of  "use it , or lose it" - and the individual re-programs to "fill" the nerve seratonin pool  with an accompanying down-shift of  some of the less important "seraton-ylation" farther away from the brain.

Unfortunately, not everyone's genetics will be able to re-organzize to prioritize nerve dynamic. Some might be stuck favoring  "seraton-ylation" in vascular smooth muscle cells, no matter how long the SSRI make the nerve seratonin pools ideal to orientate seratonin programs around.

Thank you.

Mighty-Al,
this is the 1st time i heard that angina as "pre-conditioning" of MI hence improving the survival/recovery rate!
your other comment equally awesome
thanks!

Hi PHK,
Pre-conditioning phenomena can be from other triggers other than occlusion of heart (ischemia). In ischemia the heart cell(s) affected tries to cope in quick time by instigating  the 1st stage(s) of pre-conditioning. This last for up to 3 hours. (The dynamics other than mitochondria Potassium, mtKatp, are quite convoluted.)

Then there is a delayed 2nd stage while that cell tries to switch over to put out the altered proteins that will act to limit any damage (minimize extent of infarct). This requires enough time for  that cell nucleus to get working on new program of suitable proteins ; the cell nucleus can preventatively shut down for hours without that cell dying.

Ideally after 12 hours the last stage of  pre-conditioning kicks  into gear and that gives cardio-protection for up to 3-4 days. This span of  protection corresponds to statistic of hospitalized myocardial infarction (MI) patients who had episode of angina 1-3 prior showing better prognosis.
Once the 2nd (late) of pre-conditioning in effect a lot of the benefit is from greater mitochondrial anti-oxidant levels up and running. This MnSOD keeps nitric oxide (NO) from being depleted by interactions with the reactive oxygen (ROS) on the loose as the heart cell tries to get back to using oxygen inside that cell normally.

ACE inhibitor drugs & dietary providers of that same inhibition (ex: mycelial/fungal fermented soy bean ACE inhibiting hydrolized by-products like miso and japanese "touchi"- black soy bean  enbedded in aspergillus  oryzae +/- 1 year) afford protection from infarct damage via molecular action just like 2nd stage pre-conditioning does. They do this by acting on the bradykinin molecules a challenged heart puts out; and then downstream there is more MnSOD available to take on the ROS load in order to not waste NO in reactions with those ROS.  

Exercise benefit to the heart is partly because it increases mitochondrial MnSOD; creating a predisposition for late stage pre-conditioning. One of the paradox of exercise is that it induces more inflammation molecules. The cytokines TNF-alpha & IL-1B acting in synergy (not stand alone drivers) induce cascades downstream that make muscles put out more MnSOD.

"Warm-up Angina" is a long recognized phenomena which is akin to an exercise ischemia. The push from one's resting heart wave and subsequent time recuperating  are suggested to be a version of  early stage pre-conditioning. This conditions one so that there is more time before same amount of exercise would drive you to hit an ischemia challenge; and also one would have to get hit by a greater degree of oxygen drop to trigger any ischemia challenge. The plasticity of the heart gets trained.

Another cause of post MI depression was pointed out to me by a friend who was familiar with the drugs prescribed after an MI.  One of the most common is a beta blocker which is designed to lower blood pressure and slow down the heart (I believe I got that right), so that the heart can heal.  One of the side effects (which nobody mentioned when prescribing the drugs) is that they make you feel physically lethargic due to the decrease in heart rate which can then lead to a perception of being depressed (rather than the type of serotonin related depression AL was talking about) because you don't feel like doing your usual level of activity, you may not even feel like getting off the couch - and you may not even realize why!  The lack of information about what to expect and the side effects of all the various drugs used was astounding.

Permit me to revisit Dotslady's myocardial infarction (MI, heart attack):
marathon over & by 5 a.m. she  suspects an MI. Thus, after  usual interlude of 12 hours any 1st phase of pre-conditioning did not manifest enough (any?) 2nd phase pre-conditioning to prevent her hospitalization for MI.
She had labored breathing after 12 hours instead. Pulmonary artery smooth muscle has the enzyme trans-glut-aminase II in between it's elastin & collagen "cables" layers.
The pulmonary artery cells' seraton-ylation (via trans-glut-aminase II) make for a version of  contraction (calcium influx & possibly cyto-skeletal filament actin alters). The increased resistance forced her pulmonary artery to struggle (labor) just to keep up with the base line need for oxygenated blood by the brain & vital organs.
Nitric oxide (NO) is capable of influencing the trans-glut-aminase enzyme and even keeps less amount of that enzyme being  deployed. But without the 2nd phase of pre-condtioning's MnSOD too much NO is busy being wasted interacting with ROS. And considering how Prozac (fluoxetine, traditionally used as a brain SSRI seratonin tweaker) inhibits trans-glut-aminase II enzyme we can see how an appropriate doseage of it (ie: enough fluoxetine drug to infuse relevant tissue cells other than the brain) helps in panic/anxiety to relieve breathing. Prozac blunts the ability of seraton-ylation to go forward in the pulmonary artery by an additional independant avenue than how it is otherwise acting in the brain.
Looks like Dotslady's dys-functional seratonin (ex: depression) hard wiring apparently did let some pulmonary artery seraton-ylation go forward after 12 hours. And then elsewhere seraton-ylation seems to have progressively gotten worse in some cardiac artery smooth muscle cells adding to the occlusion afflicting (attack) her heart muscle myocyte cells.
She is even a young, doctor guided & low-carb exerciser. Which suggests to me that seratonin quirks in some individuals can unfortunately over-ride the ability to get into play the 2nd phase of pre-conditioning.

Dr. Davis gave succinct MI advice (above) : "...supplement iodine and correct any thyroid dysfunction...." Just in case anyone misses that connection to my layman comments  I'll specify the relevance.
Low thyroid has (for decades) been clinically  associated with depression & Doc  is very concerned with adult onset hypo-thyroid. Examples of Prozac (fluoxetine) were given because drugs illustrate the seratonin factor.
My references to SSRI anti-depressant drugs  do not negate Doc's protocol for preventing MI.  Part of his clinical success may be how protocol limits adverse seraton-ylation.

Might,
awesome! thanks!
pam

Hi Might o'chroni AL:  
I appreciate your response, and I understood a lot of it.  I will reread it to understand more as time goes on.  FYI: the date of the heart attack was May 16, 2010.  

I had to look up my notes on how long I took the 5-HTP.  I took a formulary supplement: Travacor by Neuroscience (http://bit.ly/zhayn2), which I understand from my MD/ND had 100mg of 5-HTP for about 5 months.  

When I took my first dose it alleviated my leg pains(yay!), but I had side effect of a piercing headache in the back of my cerebellum area for a few hours while awakening, and in the morning.  However, after that few hours of pain, I was jubilant because I felt a sense of contentment I'd never felt before.  MD/ND told me to cease the supplement for a week, then titrate the dose to prevent the headaches.  I learned serotonin is also in your cerebellum, and even your eyes.  When I titrated the dose I never got back the lack of leg pain, nor the sense of contentment.

Anyway, I continued taking them, and by the time I had the heart attack, I was up to 2 pills.  By May 10, I'd added L-tryptophan (Jarrow, 500mg) for about 3 weeks with no effect, so I stopped that, and then added 50mg 5-HTP.  I noted I slept somewhat better.  That was for about 6 days before the heart attack.  I made no note of it, but I may have even tried taking 2-50mg 5-HTP for a few nights trying to sleep better.  

All the while, all I had to do was give up dairy.  At your suggestion, I've looked into PAD, but can't imagine it as I associate it with calf pain.  I will bring it up with my doctor nonetheless.  Thank you again for your response.  

Dr. Davis:

I agree.

If that were true, would babies have celiac disease?  Or is that because their parents ate too much gluten?  

Having an HLA-DQ gene predisposes a person to autoimmune disease.  Even then there are people without the genes we KNOW about for celiac in particular, HLA-DQ2 and HLA-DQ8, who don't tolerate gluten.  Up to 80% of the population has at least one HLA gene according to Dr. Fine of www.enterolab.com.   Approx. 30% of people of European descent have celiac genes in particular.  Autoimmune disease is triggered by stress (psychological or physical, chronic or sudden), virus, surgery, or pregnancy (which are all stresses to the body).  It's also triggered by eating gluten - whole grain or otherwise.  I wonder if you have the gene, or have stress in your life.

Hi Dotslady,
Your 5HTP supplement link shows it includes taurine. Taurine is pretty basic - yet your genetics seem to challenge a few basics.
Since  published in 1997 "Taurine Depletion, a novel mechanism for cardioprotection from ischemia" (see AJP-Heart, Oct. 1997; vol.273, No,4:H1956-H1961) has  influenced  research (2001 example is http://jpet.aspetjournals.org/content/298/3/1167.full).
Anyway, you took 5-HTP supplement with added in taurine. Taurine can accumulate in a heart cell  myocyte provoking unwanted conditions.
Beta-alanine molecule (which can not build up residually in a cell) is the crucially protective end-product from the Meditteranean Diet's high % of poly-amines per calorie of food volume ingested. Ignobly named, spermine, spermidine & putrescene are key poly-amines that we mammals can process into  Beta-alanine, which is what  counter-acts excess taurine in cells & thus protects heart muscle (ie: why Med Diet is heart healthy despite the dietician "No-No" items eaten) .

I got it!

Dr Davis:

I've been supplementing with Vitamin D3 for the last couple of years since a test revealed a level of 31 ng/dL. I'm now at 48 ng/dL. However I saw this recent finding that is of concern to me:

American Journal of Cardiology
Volume 109, Issue 2 , Pages 226-230, 15 January 2012
Relation Between Serum 25-Hydroxyvitamin D and C-Reactive Protein in Asymptomatic Adults (From the Continuous National Health and Nutrition Examination Survey 2001 to 2006)

"In conclusion, from this cohort of asymptomatic adults, independent of traditional cardiovascular risk factors, we observed a statistically significant inverse relation between 25(OH)D at levels <21 ng/ml and CRP. We found that 25(OH)D at a level ≥21 ng/ml is associated with an increase in serum CRP. It is possible that the role of vitamin D supplementation to reduce inflammation is beneficial only among those with a lower serum 25(OH)D."

http://www.ajconline.org/article/S0002-9149%2811%2902748-2/abstract

Runner2012,

The references for that article might give you some more helpful information. I thought these were good for adding more perspective to the study and its conclusions;

Michos ED, Streeten EA, Ryan KA, Rampersaud E, Peyser PA, Bielak LF, et al. Serum 25-hydroxyvitamin D levels are not associated with subclinical vascular disease or C-reactive protein in the old order Amish . Calcif Tissue Int . 2009;84:195–202;

Pittas AG , Harris SS , Stark PC , Dawson-Hughes B . The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults . Diabetes Care . 2007;30:980–986;

Jorde R , Sneve M , Torjesen PA , Figenschau Y , Gøransson LG , Omdal R . No effect of supplementation with cholecalciferol on cytokines and markers of inflammation in overweight and obese subjects . Cytokines . 2010;50:175–180.

This was a flawed study with only so much potential to extract conclusions. The design of the study makes it hypothesis-generating, at best.

Your doctor isn''t current. You are better informed than he is.
I''d find a new doctor.

Dear Dr. Williams,

An update:  I figured out my fibro pain source:  I'm amine intolerant (histamine and likely tyramine - I'm working on an elimination diet).  I was on to something about the dairy, but it's more about fermented dairy, i.e. yogurt.  If you look at the diet journal I shared from the day before my heart attack, it was full of histamine:  yogurt, strawberries, blueberries, banana, sausage, deli turkey, frozen meals w/cheese and spicy tomato/enchilada sauce, mangoes (I know now if I have two that it's one too many), sunflower seeds.  Histamine levels fluctuate w/dose ingested and what the body can clear/process.  There's no testing in the USA that I know of for the enzymes responsible for clearing histamine (DAO and NMNT), hence the next best Rx: elimination diet.  My recent serum histamine and tryptase level was in normal lab range, but as I know from gluten intolerance this is not reason to not try diet.  I have joggled three days in a row 6.5 miles and without pain!   I asked my cardiologist at my annual checkup if histamine could have caused my heart attack.  He said he hadn't heard of it.  I know there are histamine receptors on the heart.  Yes, I've tried anti-histamines (don't work), and I've used with SOME affect a product called Histame.  Like with celiac disease I didn't have the "usual" GI symptoms.  My symptom would have been migraines .. in my LEGS (not my head); and I have two distinct pains - 1) hamstring aching and sometimes the striated muscles feel like taught piano strings, and 2) aching like a pushed and pulsating bruise above my left knee.  The more histamine I ingest the pain grows to the right leg (the hamstring pain always seems to start in the right hams).  Fermented foods cause the bruise-type ache above the knees; palpitations, and ankle edema (exacerbated by stress - always starts in the left leg and the more histamine I ingest it moves then also to the right ankle).  Too strenuous exercise is a stress btw.  Emotional stress also causes left ankle edema.  Could exercise stress, food allergy stress, emotional stress cause my heart attack?  I think so for me anyway.  I would REALLY appreciate your cardiologist thoughts about this as it affects 1-5% of the population (like celiac/gluten intolerance), and they don't know.  Since we have mast cells all over our body, everyone's symptoms are different.   Typical symptoms for histamine intolerance involve the GI or migraine/headaches, but until I read something about palpitations I never considered it.   DAO enzyme is made within a healthy intestinal mucosa.  I remember having these symptoms the year my Hashimoto's was dx in 1996 and attributing it to hypothyroidism.   I recently had a repeat Cyrex Labs Array 2 Leaky Gut test to assess my healing.  My first test I was still leaky, and this year it's mostly within normal limits.   I'm healing with gluten/grain/dairy/egg white/corn/legume/mostly nightshade  free diet (I have recently reintroduced potatoes, unfortunately that also includes chips!).  I'm experimenting w/elimination diet.   The crux of this?  Gluten damaged my gut and my health steadily went downhill.  I'm on the mend and excited for the first time since my celiac dx in 2006.  Thanks - have been reading your book - it's a great book!

edit to correct:  the second histamine enzyme acronym is HNMT not HMNT as written above.  It stands for Histamine N-methyltransferase (I've also read it as HMT).  DAO is diamine oxidase.  http://bit.ly/daohistamine

[...] Myocardial infraction | Track Your Plaque BlogJan 15, 2012 … 44 Responses to Myocardial infraction … I meant myocardial “infraction.” …. I’ve wanted to ask you to write about dairy and the heart since my … [...]

I'm not planning to see my doctor again until I reverse my plaque growth.  My first round of talks with him was not encouraging as he only believes statin drugs can be of help.  Ironically my doctor's age is similar to mine and he also told me he has a similar amount of plaque.  My plan is simply to see him again once I control or reverse my plaque growth and tell him there no reason why he couldn't do the same thing too.

Interesting.  Recently, my primary care physician and I had a long talk about causing regression of heart disease.  (Imagine that - my doctor actually spent more than 30 minutes talking to me about medicine.)  He took the time to pull out various articles and texts about heart disease and explain the underlying causes.  He noted that his goal for his patients was to move their heart scan score backwards.  His primary tools for doing so are (1) EBT; (2) blood tests using VAP; and (3) medication (primarily statins mixed with niacin); and (4) repeat EBT.  He noted that very few of his patients had regression of their calcium scores but that many of his patients had calcium score increases in the 0 to 10% annual range.  Most interesting to me is that my doctor also has coronary calcification and is a diabetic.  He mentioned that his own calcium score had decreased in the past year by about 3%.  So obviously he must be doing something right, at least for himself.  

We spoke about Vitamin D3.  He is a proponent of supplementing D3 when the levels are below 30 ng/mL.  He also tested for homocysteine levels and then emailed me to to take a B multi-supplement based on a high homocysteine score saying that it may have benefits both for heart disease and stroke prevention.

He had not heard of TYP but I would bet that he would be quite open to this approach as he says his goal is "preventive cardiology."  What materials would you suggest I provide him for my next office visit?

-Russ

We just had a woman reverse her heart disease through diet: congestive heart failure, hypertrophic cardiomyopathy.  Her doctor initially put her on a low fat, high carb diet and she got worse.  She ran into a cardiologist on a plane trip who advised low carb.  She went back onto a low carb diet (she'd been on one previously) and the results of her last echo cardiogram say the damage to her heart is negligible.  Her doctor was formerly skeptical of low carb diets but is now on one and has dropped 20 pounds herself.

So yeah!  She's pretty convinced heart disease is reversible!

And to confirm her results, the day after she found out a study came out about insulin resistance and cardiomyopathy.  Insulin-Resistant Cardiomyopathy, Clinical Evidence, Mechanisms, and Treatment Options.
http://content.onlinejacc.org/cgi/content/abstract/51/2/93

Sadly the study doesn't mention changing your diet to treat it....

Interesting!

Can you tell us who your doctor is? I'd like to contact him myself and congratulate him on trying to achieve regression/reversal. He is truly exceptional.

In the meantime, just let him know that the Track Your Plaque program is all about trying to gain control over your heart scan score. We might be able to improve his results dramatically just by adding a few bits of wisdom.

Thanks, Nancy.

That's an interesting turnaround.

Also, perhaps a curious reflection of how motivations can differ between doctor and patient nowadays. You want to save your life, your doctor often wants to save money (i.e., insurance money).

Dr. Davis - I sent a message to your aol account with my doctor's details.  I would be very curious to learn of his reaction to the TYP program.  I suspect he'll be receptive to your approach.

-Russ

Of course it can be reversed!   I have done it myself although I cannot prove it now.   I used to experience some mild angina pain in my early fourties, and frequent episodes of rapid heart beat every few months.  It all went away about 6 months on a ketogenic diet, on which I have stayed permanently on, to this day. It never reoccured and my stamina has gone back up to roughly the same level I had in my twenties (I am 51).   It was 8 years ago.

Best regards to all, this is really exceptional blog. Keep up your good work,

Stan (Heretic)

I won't add to the survey as I haven't asked, but the mantra from the British Heart Foundation down to the doctor is prevention or management. Nowhere in their literature have I seen any mention of reversing heart disease.

Cannot be

Interesting... my mother was put on a statin about a year and a half ago due to "hypercholesterolemia" (dx of course by a basic lipid panel).  Around the same time she was also put on thyroid medication.  Her LDL dropped and we all assumed it was the statin...

Low carb diets can influence T3 by lowering it. Certain beta blockers can inhibit 5'-deiodinase too.

What do you think about studies like this one:
http://www.reuters.com/article/healthNews/idUSTRE55B67D20090612

Where they theorize that low thyroid function may be linked to longevity? I believe that has been found in certain species of rodents too and low metabolic rates for elephants (as the article researchers comment on).

I'm not saying everyone should go around being hypothyroid, but am curious what your thoughts are. Perhaps lowered thyroid function is a part of aging?

Stephan Whole Health Source Omega-6 Linoleic Acid Suppresses Thyroid Signaling considers in this blog, the ways omega 6 may be influencing thyroid function.

I'm still wrestling with my pcp over my thyroid. I'm back on Armour 90mgs but my tsh is 5.6, which is needs to be lower, as you say 1.0.  My dr keeps telling me she doesn't want to increase the rx because she's afraid I will get atrial fibrillation. She doesn't test for anything else but tsh

Currently, my morning temps are 96.3, I have trouble losing weight and my LDL is just at the upper range of normal and my LP(a)is 34. I'm not taking statins and am following all of the heartscan blog diet/supplement recommendations. I want to get my LDL down, lower my LPa and regulate my thyroid. Is it risky to take more Armour to lower my tsh?  I am taking 220mcgs of iodine should I increase that?

Jan

I'm a little confused about the iodine thing. I Googled around and found several studies implying that iodine supplementation can increase incidences of hypothyroidism.

Here and here are two of the studies I saw. In the referenced-by section of the last one is an interesting study where excess iodine was found to be the root of goiter and thyroid troubles in some Peace Corps workers in West Africa.

I started googling more specifically and found more sites that warned about iodine-induced hypothyroidism, but the majority stated the opposite (that iodine can help hypothyroidism).

I'm not trying to contradict or anything, but I was wondering if you were aware, that's all. I mean, imagine the result if someone on the AAD (with all the prepackaged food) felt hypothyroid symptoms, and was told by a doctor to increase iodine intake, when they really had more than enough intake already...

Perhaps you've already taken this into account. If you have the time I'd like to know your thoughts on it.

skids--

Time for a new doctor, one who will listen to reason.

Anon with question about iodine. Please put "iodine" into the Heart Scan Blog site specific search and you will find the several discussions we've had about this important issue.

There is no question: We need iodine for health and many--not all--people are deficient.

I have read in a number of places that iodine can worsen Hashimoto's, although Dr. Davis feels it won't. Maybe he is right too, but he has never explained why high dose iodine is typically stated in various thyroid articles as something to avoid if you have an  autoimmune disease (besides potentially causing a hyper flare).

The mechanism for worsening Hashimoto's would be:  iodine increases thyroid hormones, which in turns increases thyroid antibodies, which  then slowly kills off your thyroid quicker. Typically synthetic T4 or armour is used for hashimoto's, which can result in lowered antibodies (usually). I know of two studies where low-dose T4 decreased inflammation + antibodies in Hashi people too.

I don't doubt that supplementing iodine if you are deficient is a good thing. But I am  not sure if large doses are a good idea if you have an autoimmune issue going on.

Anon read:
Iodine: Deficiency and Therapeutic Considerations
http://www.thorne.com/media/Iodine13-2.pdf

The paper makes a compelling case that iodine is not necessarily the culprit. The hypothyroidism & life span data has me still worried, though. But that's nothing new.

From a purely CVD perspective T3 & T4 look like an interesting target...

Nameless--

I said nothing about Hashimoto's. I am talking about people in general. Perhaps you noticed that I am not sitting in front of you providing personal information!

You are correct: If you are in the throes of active Hashimoto's thyroiditis, you should not take iodine, no more than a raging fire requires more kindling.

Let me restate: Iodine is--in the general population-- a necessary trace mineral. Humans cannot live without it.

Dr. Davis,

I didn't mean to infer that you should provide detailed info here, or were even mentioning hashimoto's at the moment.

I just know it came up in past iodine threads, and the autoimmune issues weren't really spoken about in detail then. Since someone here asked about it, I thought I'd make a comment. People sometimes don't get fully tested if they have a thyroid issue (actually based on how doctors treat thyroid people, I'd say most don't get proper testing). I just had a concern that if someone has an autoimmune thyroid issue, excess iodine could be a rather bad thing. So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses.

"So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses."

This is definitely true, but in reality, in conventionally practiced medicine,  it hardly ever happens.  I have been treated for hypothyroidism with T4 (and sometimes T3) for more than three years.  For almost 15 years my thyroid function has been tested, initially with just TSH, then with TSH and total T4, then finally the past few years with free T4 and free T3 tests.  Only my new doctor ever tested for thyroid antibodies.

And autoimmune hypothyroidism usually presents quite differently from plain hypothyroidism - with stops and starts to the symptoms, or even periods of hyperthyroidism.

Dr Davis
Re your comment on what stops T4 to T3 conversion.

Adequate selenium is required to form thyroid hormone and with the increasing amounts of heavy metals (which are selenium antagonists,)we all are absorbing, selenium levels are dropping.

"Selenium is a cofactor for 5’-deiodinase, the enzyme required to convert T4 to T3. A low 24 hour urinary selenium level likely correlates with overall selenium deficiency and decreased tissue availability of T3 due to decreased conversion of T4 to T3."

Rocky Mountain Analytical Lab Report.
www.rmalab.com/index.php?id=16

"Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one."

Statins? (grins)

Agreed, if there's something we could avoid to prevent this it would majorly benefit all those poor folks whose doctors refuse to treat hypothyroid. Who are legion.

Anyone interested in the topic of iodine supplementation and who wants lots of detail ought to read Dr. Guy Abraham.

http://www.optimox.com/pics/Iodine/opt_Research_I.shtml

Will answer any conceivable question you thought you had.

I was going to post a response to your question:

"(Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)"

But it looks like LiveRock already posted 1/2 of what I was going to post and that is that selenium is needed to convert T4 to T3.

The other 1/2 of the problem of T4 to T3 inhibition is Vitamin D. My dad (family physician) said that the 5'deiodinase enzyme is a D dependent enzyme. Crank up the D and add selenium and see if the conversion problem still exists.

He almost always puts patients on iodine PLUS selenium (no more than 400 mg) as well as several of the B vitamins (riboflavin, etc) for thyroid management.

Have you read Dr. Brownsteins book, "Iodine: Why you need it, why you can't live without it?" it's a fantastic read.

Thanks so much for this post.  It's always so interesting to me to read up on iodine in relation to thyroid health.  I have Hashimoto's myself and know that there's so much controversy surrounding iodine... I don't know quite what to believe just yet.  Either way, thank you for your explanations about thyroid levels and cholesterol and treatment. The thyroid and liver are connected in a very powerful way that often gets overlooked.

Thank you!

Liz

Great post!thanks for sharing.now i know that low carb diets can influence T3 by lowering it,try to put some thyroid medication by thyroid kits.

What about fluoride? I've read that it affects the thyroid. Is there a mechanism by which it might affect the conversion of T4 to T3?

I have just joined the Track Your Placque Site.  I take fish oil daily, 3200 EPA/1600 DHA.  At this dose my AA/EPA score is 2.14.  When I had LDL electrophoesis done, my pattern was A pattern and I was not on the fish oil at that time.  I am wondering whether it would be better to have an NMR test or a VAP test, or both?

Hi,
In general, I prefer the NMR. However, the electrophoretic test you already had should provide more information than just breaking your LDL pattern down into types "A" or "B". The real numbers to pay attention to are the LDL subclasses III and IV. Add up those numbers to determine how much small LDL you really have (in percent). Anything more than 10% we regard as sigificant.

Is there any reduction in triglycerides from taking flax seed or other non-EPA/DHA sources of omega-3s?

Thank you.  The report is broken down into the various LDL subclasses.  This information is helpful.

Mike-
No, unfortunately not. Only fish oil exerts the sort of triglyceride and lipoprotein correcting effects that we need.

Dr., what do you think of Krill oil? Is it better than "regular" fish oil?

We've actually had a fairly extensive conversation on this question on the Track Your Plaque Forum. Fish oil is tried and true, and the advantages of krill oil--purportedly containing less pesticide residues (no less mercury since fish oil does not contain mercury) and virtually pure DHA--are not fully worked out. However, if you choose to give it a try, let us know what kind of results you get.