Where is this published?

Has anyone investigated the effect of Vitamin K2 on CCS?

Karl--

In the American Journal of Therpeutics 2009 Jul-Aug;16(4):326-32.

For abstract, go to Pubmed and enter "Davis + Rockway" into the search.

Hi, Nigel--

There are no studies in which K2 vs. placebo have been administered, only observations studies in which lower K2 intake has been related to greater risk for cardiovascular events.

Hi Dr. Davis,

Do you have any insight into what separated those that had reversal from that those that had slow and rapid progression?

Thanks,
David

My cardiologist said essentially the very point of your first sentence.  I had pestered my PCP to order a heart scan a month ago.  He relented only by stating that I should then go see a cardiologist.  

The cardio stated that scores can't be decreased unless "they change the software reading the scan."  He further stated, "calcium is calcium; where's it going to go?"  Needless to say, he placed very little value on heart scans but it made for some lively discussion between he and I.

Dr. Davis - I'm 36YO in Australia with a 50% blockage on my LAD (vulnerable plaque). I have 1 tiny spec of calcium on a branch of my LAD so not much of a calcium score. I realise this is a serious problem.
I guess 'track you plaque' would be harder for my with such a low calcium score so I haven't joined up.
I've been using your techniques for 3months now - I'm sugar and carb free and I'm very close to 60/60/60 as you have recommend.
With reference to your most recent posting, what is your experience with Vulnerable Plaque reduction in people with low or no calcium score? Its a bit harder to track I would have thought? PS - TIP for new bloggers - don't take 500mg of Niacin if its the first time your doing it! Ouch.

Wow.

Any general insight as to why this worked so markedly well for some of your patients, less well for others, and not at all for 3?  Obesity?  Tobacco?  Stress? Not taking their meds? Diabetes? Working in a refinery?  Or is It more about choosing the right ancestors?

A major question remains: "Why are some patients NOT responsive to the TYP protocol"?

Is their coronary artery disease being driven by a different cause?

Hi Dr. Davis,
As usual you always provide great information.  I have been following a life style change that features the diet of our ancient ancestors, with great results for the last 12 month.  I use saturated fats exclusively, including MCT and coconut oil, Weight loss 55 pounds, Diabetes type 2 cured (A1c's of 4.7,4.8,and 5.0 all without medication). My doctor stopped all Staten's. I recently received the results of a VAP test 11/16/09.
Some of the pertinent results are:
Tot. LDL-C Direct 154 mg/dl
Tot. HDL-C Direct  63 mg/dl
Tot. TG    Direct  63 mg/dl
Sum Tot. Cholesterol 233
Real-LDL sz. Pat. A large buoyant
Remnant Lipo (IDL+VLDL3) 26
HDL-2(large,buoyant) 18
HDL-3(small, dense)  45
VLDL-3 (remnant lipo)9
Recommendation: Consider lowering LDL-C goal.

Because I am not a doctor, I am having trouble analyzing this VAP test.  I have started a course of Usher Smith 500mg SLO NIACIN.  Any other suggestions?  Is this  enough to  
lower my LDL? I very much value your opinion, any input will be greatly appreciated.  Thanks in advance.
Bill Eisenberg

Paul--

I believe you may be misinterpreting what Track Your Plaque is intended to do. It is NOT  a program to reduce the amount of calcium in the coronary arteries; it is a program that uses the surrogate marker of coronary calcium as a means of reducing plaque.

All the strategies we use in the program still apply, regardless of the proportion of calcium to non-calcified elements.

new book is available when ?

A small portion of our experience was documented this past summer. (I collected and analyzed the data with the help of Rush University nutrition scientist, Dr. Susie Rockway, and statistician, Dr. Mary Kwasny.)

I just started going to a Dr. who specializes in Health and Wellness and he recommended this scan.  It is not covered by insurance.  It costs $350 here in the Detroit area.  Sounds like it's worth it.  
My new doctor actually answers e-mail too.  What is this world coming to?

6 months, 37 lbs. That's pretty good. Immediate feedback is a strong tool for pretty much anything we do. When all we have is a scale, it takes a while for the result to show up. And we're never sure what we did that did it. But when we check blood sugar, we have the result right there and then. Like you said, we know exactly what's the cause and can act on it with total confidence.

No problem with this but for the cost.
At six (one before, one after, more if you're "grazing") sticks a day @.40 usd each test strip, we're spending $72/mo.
This must be lowered somehow.

To Anonymous,

$72 / mo is only possible if you are eating different for different meals for the entire month. This is highly unlikely.

Diabetics or pre-diabetics making dietary adjustments based on an objectively measured parameter, such as this, is genius. (I believe constant blood-sugar monitoring is what led Dr. Bernstein to adopt a low-carb diet.)

But what about someone who's not diabetic...a person prone to hypoglycemic episodes for instance.

Seems such an individual's tendency to "overshoot" insulin output in response to incoming carbohydrates would quickly (too quickly)lower blood-sugar levels...giving the false appearance that all is well. Even though much of that glucose got partitioned into fat cells.

Keep up the good work Doc! I'm a personal trainer who regularly sends low-carb disbelieving physician clients of mine to your site. They can obviously receive this kind of info with a more open-mind from a fellow physician than from me.

I have a very similar story!  I lost 30 lbs in just over two months and this blog and Dr. Davis was the entire reason.  Total cholesterol down over 30% and triglycerides down over 50%.  LDL is much reduced too.  My only concern now is HDL.  It will not move an inch!  Started fish oil, then waited then started vitamin D supplementation.  Waited another couple months and earlier this week I started Niacin.  My HDL actually went down as Dr. Davis said it would while I was losing weight.  Then went right back up to 22 were it's been for years.  Might try wine and dark chocolate in moderation and if ALL ELSE fails I will have to submit to exercise.  My most sincere thanks Dr. Davis and keep posting actual patient experience.  It's very motivating.  Can't wait to read about a patient with a "stuck" HDL marker.

It costs too much money to buy the strips. I know doctors can get give you prescriptions for the strips at lower costs, but that isn't something my doctor would do.Too bad, it sounds interesting.

For those having issues with the cost, ask yourself this: what is my health worth?  This motivational tool is key to losing weight and changing your lifestyle intelligently.

With 25.1% of Americans either diabetic or prediabetic, it's about time we start thoroughly and intelligently educating patients about how to maintain normal blood glucose levels. The reality is most Americans continue to eat an American diet, conclude blood sugar control thru diet to be impossible, and fall into a never-ending cycle of insulin resistance, pessimism, false comfort in high levels, and an exaggerated concern of hypoglycemia which they use to rationalize running around with blood sugars in the 200s. Proper education and a glucometer the two best tools to combat these epidemics, and yet only a tiny percentage of the population really understands the disease process and proper regimen to maintain good glycemic control. And it's no wonder with the ADA telling people who consider themselves "moderately active" (as most overweight, inactive people do) to eat 45 grams of carbs per meal.
Dr. Davis, do you have any suggestions on how to develop a glucose tolerance test patients could perform on themselves at home simply using a fingerstick? Do you think there's value in something as simple as checking a fasting blood sugar, drinking a 20 oz Coke, and then taking fingerstick readings at 1 hour and 2 hours?

What I learned from testing was that brown rice and black beans raise my blood sugar 60 or 70 points, and that if I stayed away from grains, beans, and sugars, my blood sugar doesn't budge.  It didn't take many strips to figure this out, the bigger expense is that rice and beans were way cheaper than fish, meat, and cheese.

Concern for one's health is a straw man, it's usually everyone's concern; however cost IS an arbiter, otherwise we'd all have "Cadillac" health plans. Technology will lower the strip costs, or eliminate them. In the meantime some do without.

It is easy to find a free meter and it will come with at least 10 strips. This is enough to tell you if your blood sugar is spiking after eating. That is what I did and then I was able to convince my doctor that, in spite of my "normal" fasting BG, I needed a prescription for testing supplies as my postprandial blood glucose was spiking over 200.

Once I figured out what foods were causing my blood sugar to go high, and totally eliminated these foods, testing became much less frequent. The only time I test now is if I add in a new food.  I will also test throughout the day every once in a while to be sure my BG is not creeping up even with the low carb lifestyle.

When I started doing this a little over 2 years ago, I lost 15-20 lbs and have remained stable. I no longer have daily episodes of hypoglycemia caused by crashes after a blood sugar spike.

To penny-wise, pound foolish anonymous,

I would tend to bet that the price of strips is kept artificially high and it is not lack of technology that is the problem.  However, think of what you'd spend on a dinner out, a movie, or even a doctor's visit--and a doctor's visit won't give you half of the information about your health that a canister of strips will give you.  Anything a doctor does is a single snapshot in time, not ultimately helpful on a day-to-day basis.  Testing your blood sugar systematically for various foods works if you pay attention to what it tells you and modify your behavior accordingly.

Anonymous,

No, health concern is most definitely not a straw man.  Yes, most people will give lip service to their health being a top priority but words mean little.  If you observe the hierarchy of priorities in that person's life based on their ACTIONS you will usually quickly see the truth of the matter is that health is NOT one of their top priorities.  It is called cognitive dissonance and it is endemic to our society, unfortunately.

If someone is not willing to give up their Starbucks, movies, pricey wines, or any number of other extras in their life in order to obtain something that has tremendous possibilities for improving their health then by their actions they are stating clearly their priorities.  Words mean little at that point except to misdirect, evade or confuse the issue.  The actions tell the tale.

I would end by saying that your statement about health usually being everyone's concern is simply not true...not because most everyone doesn't say it, because they do, but because most everyone doesn't act according to their words.  It has always been true that you can tell a tree by it's fruit.

I also want to point out that the old biblical term for cognitive dissonance is "hypocrisy".  I usually avoid that term nowadays, though, since it cuts too close to the heart of the matter and therefore makes people very uncomfortable if not downright offended.

Thanks, Anne, for making a crucial point: Keep costs low by only assessing a previously untested food or combination of foods.

In other words, if you know that a 3-egg omelette with olive oil and green peppers results in an excellent blood sugar response, don't bother to check it again.

"Stuck" HDL was posted 30 Dec. so this may  still interest some.

The Linosa study gives low HDL as 54% heritable, and low HDL accompanied with concurrent high Triglycerides as 31% heritable.

The Erasmus Ruchpen study classes HDL as 43% heritable; with both sexes having the same HDL and Triglyceride genetic pre-disposition.

The Healthy Twin (Korea) study classes low HDL as 77% heritable and Triglycerides as 46% heritable.

Our individual genetics are probably not from those study pools. However, it has been theorized that the genetic tendency for most Caucasians (like the Korean twins)is to low HDL.

The ratio of Apoliprotein B to Apoliprotein A1 has an inverse effect on HDL. Doc has described to us how he clinically deals with ApoB;  HDL reading might not "move" much but being pro-active is preventative.

@Ensues,

You might try increasing sat fat a little. Coconut oil, butter, lard used in cooking can help drive up HDL. It also drives up total cholesterol, but as a ratio, HDL goes up more.

Metformin can help with weight loss in the Non Diabetic patient. A great addition to the glucose meter

$72 a month is cheaper than weight watchers.

Taking niacin to raise HDL worked for me, but it raised my fasting GLU to over 160. Another dangerous side effect for me is that even a small dose will cause me to fly into a rage with the least provocation.

Wal-mart sells a test kit with 50 test strips for under $20 (side-kick).

This raises a good question: what is the ideal weight for any individual?

Ensues, Here is a post on Inhuman Experiment about  hibiscus tea  increasing HDL and lowering LDL.

Dr. Davis

I had my HbA1C checked while I was eating roughly 60% of my calories from carbohydrate and it was 4.9%. After 3 months on a low-carb diet I had it checked again and it had risen slightly to 5.0%. How could this possibly happen?

@Many...

Thanks for the tips.  I never cease to be amazed by how supportive this community is.  I was a SAD poster child always "trying" to follow government guidelines.  I made a list of all of the "little" changes I made to conform better.  Whole wheat pasta, skim milk, whole wheat bread, no chicken skin etc etc etc.  My damaged metabolism took hit after hit after hit.  My triglycerides were over 1000.  My PCP advised to avoid greasy fried foods.  It's comical (and sad) looking back on it.  My glucose meter has a permanent place in my laptop bag and my weight goes down every week AND my health improves. Thanks again for the suggestions and data.

Ensues

I eat the same foods everyday, so I don't have to test my blood sugar very much. I save money on test strips (I use freestyle lite) and I save money since I buy food in bulk.
I think it's important to not eliminate foods just because they raise blood sugar. It's also the combination of foods that affects the glycemic response. There are ways to eat oats and other potentially high glycemic foods with minimal glycemic response. I don't like elevated sugar, but after trying to live on flax alone, I became too depressed to continue. Flax is ok for 1 meal, but that's it for me. One example. I eat semi-pureed sauerkraut with glucomannan and dulse flakes and I get less glycemic response than with sauerkraut alone.

I forgot to post my other example of food combining. Quick oats can be processed in a food processor for 2-3 minutes and added to nut butters or perhaps even added to eggs and meats, although I've only tried oats with nut butters. If I eat oats alone once daily, I spike to 150. If I eat oats twice daily, I don't go above 120, so it's about previous meals and also the time of day for me.

Though it's bizarre to me that spending money on health isn't widely accepted as being a good investment, there is a fairly easy way to avoid doing so and still get this information.
Why doesn't the good doctor create a central repository that lists various foods/meals and the BG response to them. There must be variation between individuals, but generally speaking, a "bad" food is a bad food. I understand that the point of the process is to rein in recalcitrant patients who need to see what the food is doing, but for those who don't want to spend the money or don't want to do this for another reason, but who do have self-control, we could just share info on which foods cause the biggest response. Presumably they would be grains, sweeteners, high-lactose dairy and fruit eaten on an empty stomach. Meals comprised of mostly meat and green veggies with a serving of carbs (25g or so) should not elicit such a response.

Travis Culp,
The 'Glycemic Index' may be what you are looking for. To see a very good listing and discussion check out www.mendosa.com
At his site there is a link to Excell listing of GI, this is nice as you can reorder it in assending /desending order. There are also  a book.
Ed

My husband was diagnosed as a diabetic and I am prediabetic so I read Dr. Bernstein's book and started testing, testing, testing as suggested. When I went to get the testing strips refilled the pharmacy said I could not get more yet as I was using them too often!  After explaining what I had done and that I did not know I was only allowed to use a certain number of sticks a day (two), they refilled it but I think that is wrong for the insurance companies to restrict that.  I was glad to read the posts that once you know a food combination does not elevate sugars then you don't need to test then.  That helps a lot.  Thanks for all of your input.  It is a big help to me.

Really liked the way you used to help Jack loose his weight. The results are pretty good and appreciable.
Thanks for the post and awaiting to read more.

Is it really possible to get NO increase in BG?

I am using this plan and have stopped testing that a m fasting (which is always elevated, for some reason).
This has made me way less crazy.

So back to my question....
Yesterday my pre breakfast was 70; pp was 96.
Lunch was 92; 102

I seem to always have some increase so when peop say they have none, do they really mean none?

The other question; Is the 1 hr pp enough?
When I was testing 2 hr the reading was always higher.

So, as you can see, there's much less stress involved w 1 hr pp testing...but am I kidding myself?

Jem--

Some people digest and process carbohydrates more slowly, or the mix of foods slows the process.

Find your peak by performing every 30 minute checks, then use that time in future.

Does anyone have any experience with Mulberry Zuccarin for glucose control?  I read an article about it and came back here to find this thread, hoping for some insight.  Just snake oil, or is there something to it?

For people concerned about cost.  I bought a walmart store brand meter for 9.00 and 50 strips is 20.00   This meter/strips is a good brand,  have no trouble with it.  the pharmacist told me she used it personally with no issues.  I don't test every day every meal,  Great price.

Dr. Davis, two things check out this web site http://www.traceminerals.com/research/synx.html it appears to have some good data on Metabolic Syndrome-X:
I would like to share some good data that I have had by following the TYP program, I was diagnosed with type 2 diabetes Feb. 15 and after that I got my second heart scan, over 600 (my age 57) a 43% increase in 18 Mo. Not good needless to say, than I found TYP in march of this year I started slowly following and implementing a TYP plan,
Background
In February I did not feel well and I went to the doctor(2/15) I had lost 12 lbs my % body fat was going up  the muscles in my stomach were sore at times I was so thirsty I could not stand it and my eye site was changing. Needless to say I was diagnosed as a type II diabetic   glucose 344 A1C 11.2, was prescribed new medications for both the diabetic condition( Januvia 100mg 1X per day actoPlus Met 2X per day 15mg 850mg) along with cholesterol ( Advicor 20/1000 ). I started a life style changing program.
Life style changes
Modified eating program- went to a low GI high Vegetable protein including soy no or almost no Fats, eat as much as I want .(needless to say I have changed this plan)
Quit smoking
Increased exercise- walking on treadmill 7%grade 3.75mph from 30 min. to 30 min twice a day
My Medications were changed Advicor 20/1000; Lisinopril-hydrochlorothiazide tablets 10-12.5 mg and a 325mg aspirin
April started on the TYP plan, my Glucose average was way up, my total cholesterol number was 100 but my LDL-P was 1015 and my small LDL-P was 913 along with a HDL-C of 30  went on the TYP program
Had my Vitamin D checked -it was low , had my DHEA checked it was low, had my Magnesium checked it was low, after my discussion with you came off Lisinopril , ( we are seeing were this settles out to pick the right med's) stopped talking all diabetic med's added two other supplements R-ALA , PGX Fiber Blend (instead of oatmeal too many carbs) along with Vit D, Magnesium, DHEA , 15 grams of soy protein Fish oil, healthy Fats, no wheat products, Dark chocolates L-Arginine.   I have had a additional blood test for these items (Vit D magnesium, DHEA) adjusted supplements body fat down to less than 14% WHAT A DIFFERENCE, in the last 11 days  my fasting glucose numbers are between 84 and 103 that’s normal, before they were above 125 solidly Diabetic (since Feb even with diabetic medications) my doctor has never seen this much improvement without medication, on someone that had a 12 week ave of over 340.I do not know who is more anxious to see my next lipid profile me or my doctor  . I'am scheduled in three weeks.
Needless to say i also beleive that very few people can just take one pill and be cured. I hope i'am alive when they do find the magic cure (and i think they will) but right now the TYP plan is the best game in town. Eugene

Thus, the idea that a statin drug to reduce LDL will cure heart disease is completely folly. It does happen--but rarely. I think I've seen it happen twice. Much more commonly, a program that addresses all the causes of coronary plaque yields far superior benefits.

I knoe a lot about the Cholesterol!
LDL particles vary in size and density, and studies have shown that a pattern that has more small dense LDL particles, called Pattern B, equates to a higher risk factor for coronary heart disease!!My grandpa died for this reason, I think that it was terrible!!

Google Hinze Hogendoorn http://tinyurl.com/3t48zhf
17-year-old Dutch undergraduate student Hinze Hogendoorn  has created scientific history with his simple experiments.

is there ever any good news from the food science arena?

Metabolite screening should be done to compare with old standard and apparently is being done to some extent; there will always be someone who reacts adversely to what is innocuous to most people.  Since field agriculture is not free of  problems there will always be need for adaptations.

Japanese daikon root pickle made today has a different degree of physiological benefit  than when made with a traditional old cultivar of smaller sized daikon.  Hinze's rats might have found old fashioned fare more appetizing but they don't have to struggle to produce it like hungry people worldwide must try to do.

*  2006 article "Transgenes has less impact on the transcriptome of wheat grain than conventional breeding"
Plant Biotechnology Journal 4, 369 - 380

* 2006 article "Effect of transgenes on global gene expression in soybean is within the natural range of variation of conventional cultivars"
Journal Agricultural Food Chemistry 56, 3057 - 3067

* 2008 article " Microarray analyses reveal that plant mutagenesis may induce more transcriptomic changes than transgene insertion"
Proceedings National Academy Science USA 105, 3640 - 3645

It's astounding that tests are not done -- are not mandated by law and international treaty -- on hybridized plants prior to the plants being sold for human consumption! One doesn't need to be a bio-chemist to see the danger there.  Of course, I have to wonder what kind of tests should be required.  Some dangers may not be readily apparent.  It could take a human generation or two for the problems to be recognized.  We are lab rats!

Our number one forage crop is in danger of infecting the nation's livestock with an organism that is causing infertility in a large percentage of food animals.

Don Huber Interview - Roundup Ready GMOs - PATHOGEN NEW TO SCIENCE.flv
swirly78777@mypacks.net

The URL to the Don Huber video is:  http://bit.ly/k25NpH

Thanks, MK.

Anyone with even a passing interest in food and food safety absolutely need to view the video link posted by MK Davis (no relationship).

Dr. Huber brings an incredible depth of insight into the glyphosate GMO crop question.

I'm surprised to see stuff about hybrid and GMO plants here.  

I was an avid gardener before I became disabled and very gung-ho about using open-pollinated seeds, mostly heirlooms.   Even though I didn't save seed, I only bought open-pollinated seeds and plants in order to encourage their preservation by seed companies.  No F1 seeds for me, and DEFINITELY no GMO.  

When you look into the history even a little bit, you realize even the so-called heirlooms are all pretty new plants.  

It's been a very short period of time that sweet corn has even existed - corn was always a grain, not a vegetable.  

Similarly, tomatoes used to be much more acidic than modern varieties are.  It used to be safe to can tomatoes in a hot-water bath.  But new tomatoes need to be canned in a pressure canner... or you have to add acid to the recipe to safely do the water-bath thing and avoid botulism.

Also, most people have no idea how much yummier heirlooms are.  Vegetables for factory farming have been bred for things like uniform harvest by machinery, ability to keep in storage, not bruising when shipped across country, etc.  Not for TASTE.  

A Brandywine tomato (my favorite heirloom) tastes NOTHING like what you can buy in a grocery store - because when individuals were doing the breeding, taste was a factor as opposed to  ease of machine harvest and transport and long-term storage.

You can get good seeds from companies that have taken the No-GMO pledge... such as Baker's Creek Heirloom Seeds, Bountiful Gardens, Southern Exposure Seed Exchange, Pinetree Garden Seeds and Seed Savers Exchange.

The largest problem is with corn.  Monsanto corn has a gene that makes the plant resistant to Round-up, their primary pesticide.  Even farmers who intend to raise heirlooms have found their fields pollinated by neighbor's Monsanto corn - and been sued since the gene is patented.  

Farmers that raise heirloom seeds have to raise corn in very isolated spots, and good seed companies test each batch of seed to make sure it's not been infected by the GMO gene.

Almost ALL corn available today is not only not open-pollinated, but not even normal hybrid corn; rather most of it is GMO.  There's a very few sources of things like non-GMO cornmeal and almost no sweet corn.  

Same with soybeans - it's all pretty much GMO.  

IMO, very good reasons to avoid these products in the diet.  I keep a small batch of non-GMO  cornstarch and non-GMO tamari for cooking purposes, but we eat very little corn or soy - and absolutely none of their oils.  Even the non-GMO stuff, corn is very carby, soy causes thyroid issues, and their oils are full of PUFAs. But the small amounts we use in our diet are absolutely non-GMO.

I forget if it's been released yet or not, but there's a GMO alfalfa coming down the pike.  If the gene is as invasive as the corn gene is, soon it'll be hard to find pasture-raised meat and dairy that hasn't been raised on GMO feed.  

The largest problem worldwide is in poor countries, where farmers traditionally saved seed to plant again the next year.  These folks literally cannot afford to buy seeds every year.  When all that is available is patented seed or hybrid seed, they are screwed in terms of being able to raise their own food.  People literally starve due to the geopolitics of GMO seed.

Read up on Monsanto.  They're pretty damned evil.  Probably responsible for more infant deaths than even Nestle.  I personally won't buy products from any company that sells Monsanto products; it's really THAT bad.

Well, I shall stop my rant now.  I've been ranting about this since back when I was in grad school doing recombinant DNA work myself... I'm getting bored with myself.  ;)

I actually stopped by to drop off this link for you, Dr. D: http://www.diabetesincontrol.com/articles/diabetes-news/10953-common-test-predicts-early-death-in-diabetes-

Thanks for the detailed commentary, jpatti. Exceptionally well said.

A return to the simplest forms of farming and plant selection are, I agree, are about the only ways to dodge all the genetic shenanigans provided by agribusiness. Scary stuff.

Now we know who the snesible one is here. Great post!

Thank you! for stating a musing I have expressed for years! Plant breeding starting with Mendel has probably done a whole lot more than soem obscure snippet of gene insertion....not being a proponet here but I agree that a much larger point is missed......but this theme seems to run in a lot of directions in the health world like worrying about "SmartMeters" and their radiation when that cell phone, cordless phone and wireless signals are right there in their face......or how African-American kids in urban environments are asthmatic and all the potential causes make the news  EXCEPT that the notion that that high carb diet they most likely are eating is the main trigger......ditto for all the suffering this population group has later in life.....

thanks for reviving this Mark Twain quote... to book end it  perhaps reviving Parkinson's Law would be appropriate.

Just found your blog from Regina at Weight of the Evidence. Boy, am I glad to read your stuff. You are fair, balanced, and quite in tune with what's going on with the hearts of humanity. I take Coenzyme Q10, 100mgs. twice a day--I was taking it all along so I wasn't that upset when my doctor added Lipitor to my regimen because of a bad family history. And I don't care what the media plasters all over the airwaves down the road (as you indicated in your post as a possibility) I'm sticking with this stuff for peace of mind alone.
Nice to meet you.
Adam Wilk

The biggest thing I found about Ubiquinol is that yes it is up to 8 x more absorbable however, the claim is that the body is skipping a step.  "Regular" ubiquinone is broken down in the body into Ubiquinol which is what the body absorbs.  So if you take Ubiquinol, then your body doesn't need to break anything down to absorb it.  People over the age of 40 have a harder time breaking down and absorbing ubiquinone so Ubiquinol might be better for them.  You are right, most of my information has come from retailers or manufacturer's but they aren't trying to sway people from buying regular CoQ10 because they all still sell it, they are just offering another option for people who don't see any benefits from CoQ10.  Good info on the blog!

Why has QH not been launched in Japan, the home country of the manufacturer?

You cannot assume that any of the CoQ10 research applies to ubiquinol.

Enhanced bioavailability does not necessarily mean enhanced bioactivity. They have to show what their supplement does in a clinical setting.

What is the shelf life stability data for when the ubiquinol oxidizes to ubiquinone.

Marketing shows 8x (Swanson), 62% (Integrative Therapy), 400% (Jarrow), 8x (Life Extension)  What is the truth?

There has been a lot of clinical research on CoQ10. I think most if not all of it has been on ubiquinone. You cannot assume that any of those results are the same for ubiquinol supplements. People use products because they work, or they don't. What does the evidence support?

The clinical study was performed by the manufacturer not a third party.  The results has not been published in a peer-reviewed journal, escaping criticism

Just FYI regarding Sander's comment about which of the many stats to believe...

Keep in mind that a claim of 100% increase is the same as a factor of 2X. That given, 8X is the same as 400%. So, 3 out of the 4 examples of 8X, 62%, 400% and 8X are are equivalent to one another.

I haven't found any information about "Integrative Therapy", though I'd tend to err on the conservative side with regards to most any claim, as it seems they have done.

Todd, here is a link to the claims from Integrative Theraputics http://www.naturalgreens.com/ProdDetail.asp/ProdID/244

Coenzyme Q10 Facts or Fabrications
William V. Judy, Ph.D., Willis W. Stogsdill, M.D., Daniel S. Judy, M.D. and Janet S. Judy, R.N. CRC

CoEnzymeQl0 has been researched for years by scientists around the world, and its importance to the human body and its reported health benefits are widely known. For more than 30 years, people have been taking CoQ10 supplements in its oxidized form, ubquinone. When ubiquinol — the reduced form of CoQ10 — entered the US commercial market, manufacturers claimed that they had discovered a way to make the product stable so it could be used as a food or nutritional supplement in various delivery forms including softgels and free CoQ10 molecules in water and/or lipid based solutions such as liposomes, micelles, or nanoparticles. Several marketers also claimed that ubiquinol was the most bioactive and preferred form of CoQ10 in that 90-95% of the total body CoQ10 was in the form of ubiquinol. The absorption and bioavailability was claimed to be 300% better than of the oxidized (ubiquinone) forms of CoQ10. The information provided to the consumers led to a general feeling or understanding that the oxidized form that had been in the market for three decades was an inferior compound and not the product form the body preferred — and thus consumers should consider switching to the new reduced and "bioactive" product form.
Obviously, this marketing approach, and the claims made, created controversies among and between CoQ10 scientists around the world and the marketing groups. These controversies led to editorials written by a scientist to explain the differences between Ubiquinone and Ubiquinol, and resulted in rebuttals from marketing groups regarding their opinions in the accuracy of the editorials. The opinions in the editorials were from the scientist who discovered CoQ10 in 1957 and from the President of the International Coenzyme Q10 Association. Those opinions in the rebuttal referenced one study on the absorption of Ubiquinone and several papers on the antioxidant capacity of Ubiquinol along with the conversion of one form to the other in response to oxidative or metabolic stress. In evaluating the claims made relative to Ubiquinol, we have judged many to be factual yet not functional. Other claims appear to be mere fabrications to meet marketing needs and confusing many consumers.
The following is a list of claims made by various CoQ10 marketing groups relative to CoQ10, in the oxidized Ubiquinone and the reduced Ubiquinol forms. We have evaluated many of these claims based on scientific FACT or marketing group FABRICATIONS. The areas to be discussed are:
1. The CoQ10 molecule
2. CoQ10 absorption
3. CoQ10 transport
4. Conversion of Ubiquinone to Ubiquinol and vice versa
5. CoQ10 bioavailability
6. Functions of Ubiquinone and Ubiquinol
1. The CoQ1O Molecule
The characteristics of the CoQ10 molecule in many ways control its absorption and thus its bioavailability to the body cells. Ubiquinone (oxidized form) has a molecular weight of 864 Dalton's whereas Ubiquinol (reduced form) has two more hydrogen molecules and forms with the oxygen, a hydroxyl unit on the head of the molecule, thus having an 866 molecular weight. Both forms are highly lipid soluble due to the predominance of the 10 unit isoprene tail. Ubiquinone is bright yellow in color and Ubiquinol is milky white in color. Ubiquinone and Ubiquinol form a redox (Oxidation - Reduction) pair and can be readily converted from one form to the other in the cells, lymph or blood when their respective functions are in demand.
In the cell, CoQ10 is predominantly found in the outside of the mitochondria inner membrane in the Ubiquinol form (90-95%). CoQ10 in man and large animals has 10 isoprene units in its tail (CoQ10), while smaller vertebrates have 9 isoprene units (CoQ9). The body synthesizes Ubiquinone in all living cells. Commercial CoQ10 is manufactured by two different processes: 1) partial synthesis of CoQ9 to CoQ10 and 2) a yeast fermentation extraction process from which CoQ10 is made by a friendly bacterium. CoQ10 has two isomers (Trans and Cis). The trans isomer makes up 99.95 to 100 percent of the CoQ10 in both commercial product types.
                                              The following is a list of claims made about the CoQ10 molecules or crystals.
• CoQ10 is a vitamin like substance produced in all living human body cells. FACT
• CoQ10 is commercially made from sugar beets. FABRICATION CoQ10 is made by a partial synthesis from CoQ9 or by a yeast fermentation extraction process. The microorganisms which make the CoQ10 in the fermentation process could be fed sugar beets.
• Dr Karl Folkers discovered CoQ10 in beef heart Mitochondria in 1957. FABRICATION
Dr. Fred Crane discovered CoQ10 and Dr. Folkers determined its chemical structure.
• CoQ10 is a lipid-soluble molecule. FACT
• Converting or placing lipid-soluble CoQ10 molecules into liposomes, micelles or nanoparticles make CoQ10 molecules soluble in water. FABRICATION
The particles formed are dispersible in water due to the hydrophilic heads of the CoQ10 molecules forming the outer shell of the particles, and usually with the help of some surfactants. The CoQ10 molecule is still lipid-soluble and is absorbed in the body as such.
• Reducing the size of the CoQ10 molecule makes it more water soluble. FACT
Reducing CoQ10 to CoQ 9, 8, 7 by cutting off its lipophilic tail will make it more water-soluble, however it then is no longer CoQ10.
• Making the CoQ10 molecule smaller and thus more water-soluble will allow it to be rapidly absorbed through water filled pores in the absorption cell membrane. FABRICATION
Small lipid soluble molecules with 5-12 carbon atoms can be absorbed passively through water filled pores; however CoQ10 with 54 carbon atoms can not be absorbed through these hydrophilic pores.
• Ubiquinol, the reduced form of CoQ10, is synthesized in the body cells. FABRICATION
The oxidized Ubiquinone form of CoQ10 is synthesized in the body's cells.
• Ubiquinone is yellow in color while Ubiquinol is a milky white color. FACT
• The term hydrophilic means readily dissolved in water, water-soluble, or absorbable. FABRICATION
In fact, water-soluble molecules can be rapidly dissolved in water, however, if they are very large in size, their absorption may be poor. Water-soluble does not always equate or mean high absorption. Some molecules are simply too large to be absorbed well. CoQ10 cannot be converted into a water-soluble molecule.
• All CoQ10 product types must be placed in colored capsules or dark containers because CoQ10 is sensitive to light. FABRICATION Independent laboratory testing has dearly shown that crystal free CoQ10 in clear gelatin softgel capsules or crystalline CoQ10 have less than 1% by weight loss and no significant sensitivity to light. The primary reason for colored softgel capsules is to prevent the consumer from seeing crystals being formed inside the product.
2. CoQ1O Absorption
CoQ10, being a rather large molecule, is absorbed through the absorption cells in the small intestines by a "simple passive facilitated diffusion" process. Passive means that the process does not require energy. Facilitated means that the process requires a lipid molecule to act as a carrier for the CoQ10 molecules. Passive diffusion is down-hill transport and requires a greater CoQ10 concentration in the water phase adjacent to the side of the absorption cell


membrane compared to that inside the cell membrane. To a point, the greater this gradient is, the faster and greater the absorption.
CoQ10 crystals cannot be absorbed. Thus, crystalline compounds must be dissolved to single molecules before absorption. Intestinal absorption occurs on a molecular level; meaning only single molecules can be absorbed. CoQ10 in its crystallized form has poor dissolution within the chyme of the intestines, because its melting point is 10 degrees centigrade above body temperature. Without the addition of a lipid carrier molecule to facillate the absorption of CoQ10, even single molecules are poorly absorbed. This is evidenced by the poor absorption of CoQ10 plain powder: less than 1%.
The following is a list of claims about CoQ10 absorption:
• For crystals of CoQ10 to be absorbed, they have to be dissolved to single molecules. FACT
The body's intestinal absorption cells can not absorb crystals of any type.
• CoQ10 is absorbed through an active transport mechanism like that of sugar. FABRICATION
CoQ10 being a large lipid-soluble molecule, is absorbed by a process called "simple passive facilitated diffusion" through the phospholipid cell membranes, not the active transport process.
• Combining CoQ10 with a sugar will allow the CoQ10 to be absorbed with sugar directly into the blood. FABRICATION
Membrane proteins are involved in the absorption of sugar and sodium via an active transport mechanism. If CoQ10 was absorbed while being bound to sugar, its Cmax (maximum concentration in blood) would peak with sugar in about two hours instead of 5-8 hours as for most lipids.
• CoQ10 is absorbed across the intestinal cells directly into the venous blood. FABRICATION
CoQ10 is absorbed across the intestinal cell membranes into the lymph vessels in the intestinal microvillus, not into the bloodstream.
• The poor dissolution of powder based CoQ10 tablets and lipid filled softgels in simulated gastric juice is a good indicator of poor absorption. FACT
However, since CoQ10 is not soluble in water but is soluble in a lipid, shouldn't the solubility test for lipid soluble molecules be done in a lipid solution?
• Ubiquinol has far greater water solubility and much better absorption into the blood stream than does Ubiquinone. FABRICATION
The addition of two hydrogen ions on the polar head of the Ubuquinol molecule will not make the molecule highly water-soluble or absorbed as a water-soluble molecule.
• Ubiquinol is more water-soluble than Ubiquinone. FACT
When two hydrogen's atoms are added to the polar (water-soluble) head of the CoQ10 molecule, the increased mass will make Ubiquinol slightly more water-soluble than Ubiquinone. However, due to the larger total mass of the nonpolar tail of the molecule, it is still more lipid-soluble than water-soluble.
• Liposomes, micelles and nanoparticle CoQ10 products are absorbed, transported in lymph, blood and to the target body cells as liposomes, micelles or nanoparticles. FABRICATION
The microspheres can not be absorbed. They are simply transport vehicles for ingested CoQ10, to be delivered to the intestinal absorption cells.
• Reduced CoQ10, an antioxidant, remains in the reduced form when ingested and absorbed. FABRICATION
Reduced CoQ10 is highly unstable in the contents of the stomach and is converted to oxidized CoQ10 before absorption.
• The rapid dissolution of a liposome, micelle or nanoparticle CoQ10 products in water is a good indicator of high CoQ10 absorption. FABRICATION
The rapid dissolution of these CoQ10 products types tells that these polar particles (water-soluble microspheres) will disperse rapidly in water. This does not mean that they are better absorbed. Only the CoQ10 molecules are absorbed, not the liposomes, micelles or nanoparticles.
3. CoQ10 Transport
Absorbed nutrients are transported from the intestines by two routes.
Small water-soluble and some small lipid-soluble nutrients, after absorption, enter the capillary blood in the intestinal microvillus and are transported by the blood to the liver. From the liver these small molecules are transported through the hepatic vein to the inferior vena cava, then to the heart and then into systemic circulation.
Large lipid-soluble nutrients such as CoQ10, after absorption, diffuse into the lymph capillary in the intestinal microvillus, and are transported in the lymph through the abdominal and thoracic lymph duct to the subclavian vein and then into the systemic circulation. In the lymph and blood, CoQ10 molecules are predominately in the reduced form and are bound to the low density lipoproteins (LIM.). The delayed peak concentration of CoQ10 in the blood is due to the very slow lymph flow compared to that of blood. The portal venous blood is a delivery system to the liver, but the lymph is not.
The following is a list of claims about CoQ10 transport:
• After CoQ10 absorption, it is transported by the lymph to the liver where it is reduced and bound to phospholipids. FABRICATION The lymph is not a delivery system to the liver.
• CoQ10 is transported from the absorption cells to the venous blood by the lymphatic system. FACT
The lymph is the delivery system for absorbed CoQ10 molecules to the systemic blood. Large animal studies show that CoQ10 peaks in the abdominal lymph duct in 2-3 hours after ingestion where as it peaks in venous blood in 6-8 hours. The reason for the delayed appearance in the venous blood is due to slow lymph flow.
• In the absorption cell, the lymph or the blood oxidized CoQ10 is converted to the reduced form of CoQ10. FACT
Circulating CoQ10 in the blood is 90-95% in the reduced (Ubiquinol) form.
• CoQ10 is rapidly absorbed in the small intestines and is slowly transported by the lymph to the venous blood. FACT
Total lymph flow is about 100 ml/minute whereas blood flow is 5,000 ml/minute.
4. Conversion of Ubiquinol to Ubiquinone and Vice-Versa
Ubiquinone and Ubiquinol, being redox pairs, are easily converted from one form to the other in the body. For example, when exogenous Ubiquinone is absorbed in the intestines it is converted to Ubiquinol in the absorption cells, the lymph, or the blood. Since CoQ10 is not used to produce energy in the lymph system or blood, it is understandable why this conversion takes place to fulfill the need for antioxidant protection in the circulation. On the other hand, in the inner membrane of the mitochondria where energy is made, the oxidized form of CoQ10 (Ubiquinone) is in great demand. Here the reduced Ubiquinol form is rapidly converted to the oxidized Ubiquinone form. In the mitochondria this conversion creates a Q-Cycle. It was once felt by the late Sir Peter Mitchell (Nobel prize, 1978) that the Q-Cycle would maintain the proportion of Ubiquione and Ubiquinol required for energy synthesis available forever. Little did he know at the time of his discovery that with age and disease the body's ability to produce Ubiquinone and to convert it to Ubiquinol would diminish and true CoQ10 deficiencies would be prevalent in an aging society.
The following is a list of claims about CoQ10 conversion:
• CQ10 can be converted from the reduced to oxidized form and vise versa in the body as needed. FACT
This is a unique characteristic of redox pairs.
• CoQ10 in the foods we eat is in the reduced form. FACT & FABRICATION The CoQ10 in fresh uncooked animal protein in is the reduced form. However, when cooked, it is converted to the oxidized form. Even when ingested uncooked (such as sushi or steak tartar), CoQ10 will be converted in the stomach to the oxidized form.
• CoQ10's ability to cycle back and forth between Ubiquinone and Ubiquinol accounts for many of its unique properties. FACT


5. CoQ10 Bioavailability
After absorption, CoQ10 accumulates in the blood and becomes bioavailable to all body cells. Bioavailability reflects absorption but it is not the actual absorption and should not be used as an accurate measure of such, It does, however, give a good estimate of the amount of CoQ10 available as an antioxidant in the blood and that available to the body cells. CoQ10 is accumulated and is stored in the cell membranes and in the membranes of the organelles in the cell.
It has been known for two decades that the bioavailability of the pure crystalline CoQ10 is less than that of liposome, micelle, and dissolved CoQ10 products. The current commercial and scientific issue is the bioavailability of the Ubiquinol form compared to that of the Ubiquinone form of CoQ10.
The following is a list of claims about CoQ10 bioavailability:
• Ubiquinol has a much higher bioavailability then the Ubiquinone used in other commercial CoQ10 supplements. FABRICATION
In fact, the data on ubiquinol state that its bioavailability is 300 percent more than that of the oxidized dry powder products. Most dissolved, liposome, micelle and nanoparticle CoQ10 products claim to have a 260 to 350 percent greater bioavailability than oxidized dry powder CoQ10.
• The two hydroxyl groups on the Ubiquinol compound results in its stronger bonding with water and helps explain why it is so much more bioavailable than Ubiquinone. FACT
This bonding does make Ubiquinol slightly more water soluble than Ubiquinone. However, the molecule is still lipophilic and is absorbed as a lipid.
6. Functions of Ubiquinone and Ubiquinol
Currently CoQ10 has two main functions in the body: it is used for energy production and functions as an antioxidant in the body.
Ubiquinone is a cofactor in the inner membrane of the mitochondria for the synthesis of energy (ATP). Since the body does not store energy (ATP), it must be rapidly produced through an oxidative phosphorlation process. CoQ10 is positioned between NADH and Cyto-Chrome C in the inner membrane and acts as cofactor stimulation to all three mediators to give up electrons to run the electron transport through complexes I-IV in this system. This function is specific to Ubiquinone in that no other molecule can replace Ubiquinone in this process. However, Ubiquinone and Ubiquinol as a redox pair form the Q Cycle in which they act to conserve each other in this process.
Ubiquinol is an antioxidant throughout the body. This is especially true in the cell membranes and those of the cell organelles. In these membranes CoQ10 may well be the primary lipophilic molecule essential for the prevention of lipid peroxidation resulting in cell damage and eventually cell death. Outside the cell and organelle membrane and in the presence of other lipophilic and hydrophilic antioxidants, Ubiquinol may recycle other antioxidants such as vitamin E and C.
The following is a list of claims about the functions of CoQ10
• Ubiquinol protects the body against toxic oxidative reactions. FACT
Yes, but equally beneficial it also recycles Ubiquinone in the synthesis of energy.
• The functions of Ubiquinol in the body are more diverse than those of Ubiquinone. FABRICATION
Ubiquinol functions in the body as an antioxidant and in the recycling of Ubiquinone, Vitamin E and Vitamin C. Ubiquinone, through its synthesis of energy, is involved in all body processes requiring energy: energy synthesis, active transport, membrane and nucleotide stability, synthesis of enzymes, coenzymes, hormones, neuro-transmitter synthesis and reuptake, cillary activity in the upper respiratory systems, all muscle contractile functions, sperm production and motility, deactivation of muscle contraction, pumping action of sweat and other cutaneous glands, etc. In fact, Ubiquinone is possibly the hub around which life processes revolve in the human body.
• Clinical studies with Ubiquinol show it is superior to Ubiquinone. FABRICATION
In fact, Ubiquinol became available in 2006 and to date, no clinical studies in human beings using Ubiquinol have been published in the

peer-reviewed scientific literature. An anti-aging study in genetic mutated mice has been described, but the role of the genetic mutations in these mice as they pertain to CoQ10 conversion are not understood. This is a concern since mice use CoQ9 as an energizer and antioxidant whereas human beings use CoQ10.
• Ubiquinol supplements make Ubiquinone supplements
obsolete. FABRICATION
In fact, hundreds of clinical studies show that Ubiquinone is effective and is still the choice of practicing cardiologists. Ubiquinone and Ubiquinol are rapidly inter-converted back and forth as needed, regardless of which form is ingested.
The existence of CoQ10 in two forms and structures, having two separate but essential functions, and its ability to act as a redox pair to recycle each other as needed is the beauty of this molecule. Although Ubiquinone was discovered first and found to be essential for life, the discovery of Ubiquinol broadened the overall scope of this molecule relative to the health characteristics and benefits to man. Without Ubiquinone life is not possible in that the body can not survive without energy. On the other hand, the life sustaining feature of energy has to be maintained and protected. Since Ubiquinol recycles Ubiquinone, the life cycle is maintained for about 8 decades in man. This would not be possible if it was not for Ubiquinol and other antioxidants. The antioxidants act as part of the host defense system and thus, prevent the toxic by-products (free radicals and super oxides) from the synthesis of energy and all substances produced by the body from rapidly aging all cells and shortening and reducing the quality of life.
CoQ10 as a scientific entity is 50 years old. As a commercial food supplement it has been around for about 37 years. The basic and clinical science is still growing. It is now presented in basic and graduate level text books of the biomedical sciences. Its entry into clinical text and its acceptance in the clinical societies will eventually occur with more well controlled clinical trials. These clinical trials are currently a world wide effort. CoQ10 as a supplemental nutrient to standard clinical therapy is here now. Its use as a stand alone nutrient to insure and maintain normal health characteristics of man is rapidly growing throughout the world. This will continue to grow with continued and more advanced research.
In summary, many aggressive marketing campaigns introducing Ubiquinol have created false and misleading claims that have only generated more confusion about CoQ10.
The apparent lack of superior absorption, instability in the stomach, no clinical efficacy studies and the high cost of Ubiquinol have to be considered when making a decision as to which CoQ10 form should be sourced. Millions of consumers experience its many benefits each day. Ubiquinone and Ubiquinol are redox pairs in that one can be rapidly converted to the other and vice versa in areas where their specific functions are required. Thus, does it really matter which form is taken as a supplement? Yes, it does matter.
First, there is a cost comparison in that consumers still look for the lowest cost and effective products. Since the forms of CoQ10 can be easily converted from one form to another, it makes sense to choose a form that is more affordable. It was previously mentioned that Ubiquinol molecule becomes oxidized in the stomach. Consequently, taking Ubiquinol as a nutrient is essentially the same as taking the more stable and less expensive oxidized form.
Second, regardless of the product type, the most critical aspect of CoQ10 supplementation is absorption. Due to the high cost of CoQ10, an understanding of the best delivery system to maximumize absorption becomes the critical component in an effective and successful CoQ10 supplement. Based on the current CoQ10 research, the consumer's best bet is a CoQ10 product with superior absorption properties because dosage levels can be reduced to attain the same effective blood levels and health benefits.
References available upon request.
About the Author:
Dr. William Judy is a retired Professor of Physiology and Biophysics at the Indiana University School of Medicine and the Founder and President SIBR Research, Inc. SIBR Research, Inc. is a contract research center that conducts clinical trials on natural products for the international community. Dr. Judy has researched Ubiquinone (CoQ10) and used it with patients for over 35 years. His initial work was in collaboration with Dr. Karl Folkers, University of Texas. He was one of the first researchers to run long-term clinical trials, spanning 10 years or longer, on hundreds of cardiac patients, many of whom had been "left to die' by the medical establishment. Dr. Judy's articles, reports and reviews have appeared in multiple publications, and he has traveled the world, lecturing to physicians, health care professionals and scientists about the benefits o f CoQ10 in health maintenance and disease prevention. Dr. Judy can be reached at sibrinc@cs.com.

This works for me, period, really life, honest to goodness works.  I was having muscle cramps quite a bit, and tried 30mg first, not enough, then 100mg, and bingo, maybe one mild cramp in the last year.  Powder or gel, don't know, I used both, and they worked for me.

In our experience, CoQ10 does work. It doesn't work all of the time, perhaps just 80-90% of the time. It does generally require higher doses (100 mg per day, occasionally more). It very clearly must be an oil-based gelcap (just like vitamin D) to work; capsules containing powder do not work.