Thank you for writing about this. Thank you for thinking and acting like you do.

Best regards

Dr. Davis: this sentence that ended your blog--"This notion is a remnant of the paternalistic, 'I-know-better-than-you' attitude of the last century of medicine"--brought to mind something I read recently in Angie's List, which apparently in a previous issue had asked readers to rate the care received by their doctors, and reported the ratings in an article. In the next issue Angie's List published the letters of several doctors who wrote in to express their outrage that patients would have the audacity to critique the care they received, since they believe said patients are incapable of accurately evaluating whether they received competent care or not. The attitude conveyed in their letters dripped with contempt for people who in their estimation are too stupid to assess the care they receive. I fear a lot of doctors really do believe they are an elite breed apart, towering over the ignorant rabble. All I can say is that, thanks to you and to Dr. Eades, I am a lot better prepared to assess the care of my own doctor, and counter her assimilated commonplaces about nutrition and heart disease. I wish I had known when my parents were still alive what I know now. I couldn't save them from their doctors, but maybe I can save my husband and myself.

"The 21st century promises a new age."
Taking into mind what ethyl d said: what are the med schools teaching nowadays? Last time I worked in a hospital it was same old, same old. That was eight years ago. The med schools' resistance to change (or not) will make the difference, I think.
And thank you for this blog. It is an invaluable service.

an old joke:

Q: What do you call the guy at the bottom of his medical school class?

A: Doctor.

I'm probably living proof that eating or taking calcium does not cause a high heart scan score.  

For around 18 years I suffered from a crippling gut problem.  During that time I was advised to avoid milk products along with high fiber.  Milk was avoided because of lactose intolerance and another effect I noticed it had on the gut.   Calcium rich vegetables were not eaten in much quantity due to fiber causing my gut problem to become worse and more painful.  Early on I tried taking calcium tablets but they caused a great deal of gut problems too so that was stopped.  

Basically my body was calcium deficient for close to 2 decades.        

It was only after I figured out my gut problem was food related - a food allergy - that I began eating fiber calcium rich foods along with cheese again.  It was also around this time that I had a heart scan.  My score is in the top 90% for my age.  From blood testing it appears my plaque build up came from eating a sugar rich / low fiber diet and not eating too much calcium.

Is there a test for K2 deficiency?

What is the best source of K2?

To my knowledge, no clinically available measure of K2 adequacy is yet available. The best source is arguable, but we're gravitating towards supplements that supply the MK-7 form until the data clarify.

Dr Davis,
Thank you for your comments. You state that supplemental calcium does not cause artery calcification, explaining there are different mechanisms in bone vs. arteries, etc. This may not be the case however.  A recent study has shown that calcium supplementation might very well increase vascular events (e.g. heart attack or stroke) in elderly women. According to the studies lead author the findings were surprising and robust.
ref:
1. Bollard MJ, et al. Vascular events in healthy older women receiving calcium supplementation: randomized controlled trial.
2. Medscape CME/CE 1/24/08
ref: British Med. J. 1/15/2008

These calcium concerns can be added to other studies linking excess calcium (esp. calcium citrate) to small vessel calcification in the brain, and others showing increased aluminum levels when co-ingested with sources of aluminum hydroxide, such as antacids. Also noted here is calcium citrate is up to .25 to 2.5 times more absorbed and bioavailable than calcium carbonate. Then a more prudent dose recommendation becomes necessary. Ours is to limit the dosage below the daily value (DV) for most post-menopausal women. The DV is based mostly from lessor absorbed (esp. on an empty stomach) calcium carbonate studies.  
  In our clinic, the following calcium (citrate, or citrate/malate) supplementation guideline is given to postmenopausal women, and especially important for over age 65.
1. Do not take calcium without vitamin D3 and vitamin K2 (MK-7), unless K is contraindicated because of warfarin / coumadin.
2. Limit dosage to 600 mg per day, as unopposed with or without vitamin D. (e.g. a cal+D supplement)
3. Limit dosage to maximum 1200 mg / day with the co-administration of vitamin D (dosage based on 25(OH)D testing) and vitamin K2 (MK-7a) 50-100 mcg /day.  
4. Limit calcium (citrate)intake to 600-1000 mg / day (even with D+K) if known coronary artery disease is present or coronary calcium score elevated, or smoking.  
5. If elevated coronary calcium score is elevated and the risk for CHD is high, individualize the vitamin K2 (MK7) dose upward as high as 300 mcg/day to attempt to reverse the calcification.
6. Do not take aluminum hydroxide antacids, or any other sources of
AH.
7.Related "bone up" caveats: Recognize that bone loss and CHD often co-exist in the same patient. Hip fracture risk is greatly increased with proton pump inhibitors (e.g. reflux meds). Consider natural alternatives to bisphosphonates and calcium+D only supplements.  e.g. The FOOT Plan (Fully Optimized Osteoporosis Therapy) using strontium citrate, potassium (citrate) alkalization,  vitamin D3/K2, omega-3 EPA/DHA, melatonin, and calcium /magnesium citrate. Far greater and faster bone density results occur in both spine and hip, with healthier bone architecture and geometry. And much healthier for the heart too!  

Mark Swanson, ND
drswanson@drswanson.com

Hello,

I was diagnosed with stage III-C uterine cancer about 4 years ago. A recent CT scan of the abdomen and pelvis revealed atherosclerotic disease. However, the same day I took the scan, I also took a Calcium Scoring test which revealed a good score of zero concerning the heart arteries.

I ordered k2 supplements, but I am leery as to whether it would increase estrogen in my body because K2 is generally derived from fermented soy beans. When I was first diagnosed, one oncologist felt soy was ok, another oncologist plus my gynecologist suggested I steer clear of it. I just wonder what your opinion is on this matter. Also, would the fact the scan picked up atherosclerotic disease indicate it is in an advanced stage? Thank you.

Jackie

Thus, bone health and arterial health do indeed intersect via calcium, but not through calcium supplements. Instead, the control exerted by vitamin D connects the seemingly unconnected processes

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