I think your are on to something, Dr. David. Every winter I get sad and depressed. After starting my omega-3 supplements, I noticed that I started feeling "better". I know that's very subjective. We set our clocks backwards 1 hour in a few days. I guess I will get a chance to test the "happy factor" of fish oil soon!

FYI, Laval is in Quebec, but Guelph is in Ontario (albeit both Canada). Perhaps you'd edit the post.
  --  Rob McVey, Markham, Ont.

Just to make it clear, the Univesity of Guelph is located in Ontario.

I live in a high-rise apartment building where many of the residents are grouchy old ladies.

Should I sneak fish oil into their food?

Or should I move into a building with lots of happy old Inuits?

I always enjoy and learn so much from you blog. Thank you.
I have tried taking omega 3 fish oil capsules but they give me acid stomach and fish burps. Any solution to these problems? I have tried the enteric coated ones too.

I am not surprised at this data.  When I began taking adequate fish oil (7gm EPA+DHA) I noticed an improved mood, memory, and ability to organize my activities.

Rob and Haggus--

Thanks for the correction.

Hi, Jim--

Perhaps throw a fish oil party for the ladies!

Of course, then you read of a new study discounting fish oil benefits for heart failure and you're left scratching your head:

http://www.sciencedaily.com/releases/2009/09/090929203024.htm

Deb,

You are experiencing the effects of "cheap" fish oil that has a lot of other stuff in it besides Omega-3. I tried Walmart's Nature Made stuff and it made me feel sick. Now I am take Omapure 4x a day (one capsule each time) and I do not feel the same "fishy" burps.

Deb-

Try lemon-flavored liquid form of EPA/DHA. Go with a high quality brand like Carlson, which a lot of us use.

One tsp gives you 800EPA+500DHA (1300 total), and it actually tastes pretty good (it's not cod-liver oil).

Buy it online, such as from i-Herb as an example:

http://www.iherb.com/The-Very-Finest-Fish-Oil-Lemon-Flavor-16-8-fl-oz-500-ml/2796?at=0

You won't have to swallow all those softgels, which used to bother me.  Also, a good quality distilled fish oil should not cause gastro distress, etc.

Rich

They have done Omega 3 depression studies. I believe they found EPA more important than DHA for improving depression scores. A lot of the 'mood' fish oil supplements tend to be EPA heavy too.

I think they theorize that EPA helps the brain function, while DHA is primarily for structure (hence why it's important for children/babies).

I think this is an important study, but I have to wonder if low omega-3 might also indicate difficult in fiding adequate food, which would clearly be stressful.  It's a chicken and egg argument so to speak.  Without verying that total nutrition other than omega-3 was adequate, I'm no sure a real conclusion can be made.

The question would be is it the Omega 3's or the fact that those who eat carbs get more depressed?

I've battled depression on and off for most of my life.  Meds help.  Fish oil and lots of vitamin D help even more.  I increase my intake of both whenever my exposure to sunlight is limited (including when the summer heat keeps me indoors a lot.)

So what would be the typical EPA+DHA daily dose (not the oil) to reach these heights of happiness...or plasma levels?

Another recent report from Laval University suggests that highly purified ethyl-eicosapentaenoic acid (E-EPA) may relieve psychological distress in middle-aged women.
The daily dosage was about 1gram.
http://www.ajcn.org/cgi/content/abstract/89/2/641
E-EPA is a very popular omega-3 supplement in Europe and Japan.

In response to several comments--

Taken in the context of other studies, this study simply adds to the notion that omega-3 intake is associated with mood status.

While omega-3 plasma levels may also serve as a surrogate for other phenomena, such as vitamin D intake (also rich in fish, though not fish oil), the experience as a whole do indeed show a strong relationship between omega-3 levels and depression/mood/"psychological distress."

I'm skeptical of this study.  Look, I expect that, eventually, research will show a strong relationship between mood and LC ω-3.  But this study ain't it.

First off, this is an observational study.  When observational studies turn up order-of-magnitude differences, they point to cause-and-effect relationships.  But when they turn up relationships that barely pass the statistical significance test (p ~ .05) they are more likely measuring the shared influence of some other cause.

And what might this cause be?  Well, the authors point out (a) seafood consumption varies upwards with wealth and income.  (b) Happiness varies upwards with wealth and income. (c) They really would have liked to have controlled for wealth and income but they couldn't because the Inuits wouldn't fill out the wealth and income portion of the questionnaire.  

So their study was underpowered to measure one of the most obvious non-physiological explanations of the (weak) correlation they found.

This study would have us believe (a) Inuits have much higher ω-3 levels that other Quebec citizens.  (b) The suicide rate among Inuit in 1987–1994 was 6.5 times higher than in the rest of Québec, and the rate in the younger age group (15–
24 years) was 20 times higher. (!!) (c) ω-3 is associated with better mood.

Something is pretty discordant there.

I'll wait for an intervention study.

Hi, Red-

That's right.

This study, taken in isolation, proves nothing. It only adds to the other observations that suggest that omega-3 may exert an effect on ADHD, bipolar illness, depression, etc.

The fact that there appears to be concordance across different populations, though with differing frequencies of depession, is the argument of importance.

Hi, Red-

That's right.

This study, taken in isolation, proves nothing. It only adds to the other observations that suggest that omega-3 may exert an effect on ADHD, bipolar illness, depression, etc.

The fact that there appears to be concordance across different populations, though with differing frequencies of depession, is the argument of importance.

Fish oil makes me depressed and nauseous and tired . I do not  know what all the fuss is about.

I use a supposedly good type too, Carlson's.

A group from Laval University and University of Guelph, both in Canada, examined the relationship of plasma EPA + DHA levels and measures of psychological distress. This group had previously shown that Inuits older than 50 years had twice the plasma omega-3 levels (11.5%) compared to those younger than 50 years (6.5%), reflecting the shift away from the traditional diet.

Omega-3 is geally great. Improves memory , I'm loosing pounds and I don't feel hungry or depressed (and when I'm depressed I eat soooo much!).  I prefer flax oil of flax seed as a sourse of omega-3.  My body seems to reject fish oil and I think it's not for nothing. The mercury pollution won't do any good.

Thank you for your efforts on topics like this! It's just not right that supposed experts are pushing this wheat and cereal garbage. Thankfully my wife has tapped in to some really good almond and coconut flour recipes recently, I don't miss wheat at all!

In other words, Doug is among the 5-10% of people who have most of the features of the so-called "metabolic syndrome", but don't look the part. They usually (though not always) have a modest excess of visceral abdominal fat. While some people have to be 100 lbs overweight before they express these patterns, someone like Doug could do it with minimal excess weight, sometimes as little as 5-10 lbs.

Doctor Davis, for those of us who aren't inclined to bake our own bread, but who still like sandwiches, are there any commercially available breads (or bread substitutes) that you would recommend?

Jim Purdy
The 50 Best Health Blogs

Did you check your blood sugar at 2 hours? There are times when my BG spike is later than 1 hour.

Very interested in hearing about everyone's experience.

Interesting, but assuming that the einkorn bread contained the same amount of carbohydrate as conventional bread (if it contained less, then this effect is hardly magical) then one would expect a similar effect on blood sugars ultimately. Perhaps einkorn bread simply left you with higher blood sugars at three hours?

What do you think of displacing wheat in favor of coconut? The following text is a blurb for a cookbook (of all things!)...

"Are you allergic to wheat or sensitive to gluten? Perhaps you avoid wheat because you are concerned about your weight and need to cut down on carbohydrates. If so, the solution for you is coconut flour.

"Coconut flour is a delicious, healthy alternative to wheat. It is high in fiber, low in digestible carbohydrate, and a good source of protein. It contains no gluten so it is ideal for those with celiac disease.

"Coconut flour can be used to make a variety of delicious baked goods, snacks, desserts, and main dishes. It is the only flour used in most of the recipes in this book. These recipes are so delicious that you won't be able to tell that they aren't made with wheat. If you like foods such as German chocolate cake, apple pie, blueberry muffins, cheese crackers, and chicken pot pie, but don't want the wheat; you will love the recipes in this book! These recipes are designed with your health in mind. Every recipe is completely free of wheat, gluten, soy, trans fats, and artificial sweeteners. Coconut is naturally low in carbohydrate and recipes include both regular and reduced sugar versions. Coconut flour pres many health benefits. It can improve digestion, help regulate blood sugar, protect against diabetes, help prevent heart disease and cancer, and aid in weight loss."

Dr. Davis,

Unfortunately, all your test showed is that the einkorn digests more slowly than the other wheat. You might have seen the same result with a sourdough white bread.

A more reliable test would have tested at 1.5 and 2 hours, but because you have normal insulin production you would have to have measured insulin to see what was really happening.

All carb would have eventually been digested, and it takes the same amount of insulin to process it. While it's good to avoid blood sugar spikes if a person is insulin resistant the einkorn will provoke a large though slower insulin release.

This is the problem with the whole idea of the glycemic index. If the problem is insulin, the SPEED with which it is secreted really is a red herring.

What about the blood sugar level after 2 hr? 3? 4? Could it be that, like pasta, the einkorn bread gives a steady medium-high blood sugar for 3-4 hours, while normal wheat gives a spike yet quickly falls down to base level?

In my opinion, the AGE threshold is ketosis. In ketosis and there's little to no AGE production, out of ketosis and there is AGE production. Then there's the bit about ketones directly stimulating junk protein aka AGEs recycling and it becomes obvious what the threshold really is.

Excellent points about the delayed blood sugar response with einkorn.

Yes, indeed. It would have to generate a longer blood glucose curve, as DM suggests, it is still a carbohydrate, though I did not specifically test this.

David--

I wasn't aware of using coconut flour in place of wheat flour. Interesting!

Have you tried it?

I'm with Jenny about the insulin thing. If we only know BG numbers, we still don't know whether it's because there's more carbs in einkorn or if it digests more slowly or something else. We must know how much insulin it takes to bring BG to those numbers.

Incidentally, ketosis (and therefore AGE production and clearing) is also a function of how much insulin is flowing, not a function of how much blood glucose there is. So I guess you'll have to measure insulin to know what's what.

No, I have yet to try coconut flour. In an odd moment of serendipity, I received a scanned copy of the cookbook concurrent with your post.

Odd, because for some health reason I do not recall (not allergy, though) I had strayed away from coconut everything. But things change.

So I will share the cookbook with my wife, and request, nicely, we try a recipe or two. We attempt to go wheat-free this week, so I will wait out this test before trying, and then report back.

PS: I receive the results of my lab tests this afternoon. I sure hope the many changes I put into place several months ago on your suggestions changed my numbers for the better!

coconut flour/fiber isn't truly low in carbs, it has 8 grams carbs/ 2 Tablespoon sized serving. 5 grams of that is fiber, which according to some carb-counters, isn't counted as a true carb.

also coconut flour bread tastes absolutely nothing like wheat bread.  i dont think i could convince a wheat lover that coconut flour bread was the way to go.

Reminds me of Dr. Bernstein, when testing his blood sugar after eating various brands of crackers. He did find one that did not spike blood sugar levels - GG Scandinavian Crispbread, made from unprocessed wheat bran. I tried them and liken it to eating a wood shingle (ok, I imagine that is exactly what a wood shingle would taste like). He tries substituting it as bread in a couple of recipes. This struck me as almost sad; our craving and addiction to starch/sugar is mind blowing.

Dear Dr Davis,

Since you are experimenting, would you consider the option of making your own regular wheat bread the way you made the eikorn bread?

Ready-milled whole wheat flour bought from a store differs dramaticlly from freshly milled flour, both enzymatically and in fatty acid quality. Only with freshly milled flour one has a chance to digest non-degraded Pufas (present in all grains).

Regards,
LeenaS

Very interesting. I wonder if they both had the same caloric density. If eikorn has lower calories it would show a lower glucose response. I wonder what your reaction to something like a sweet potato is. I stay away from grains as they don't agree will with me.

About coconut flour, I have used it before for making pancakes. I really like it but I LOVE coconut in general, someone who doesn't like coconut might feel differently about it. An advantage to other nut flours is that it's low in O6.

The Many Uses of Coconut Flour:

http://www.marksdailyapple.com/coconut-flour/

Yeast needs sugar to work properly--just a little sugar or honey would have made the bread rise much better. No sense using yeast if there's no sugar for it to eat.

Coconut flour is okay for brownies, bar cookies, and pancakes.  It would never yield an edible bread.  Gluten-free baked goods are unsatisfactory, IMO.  They have a somewhat crumbly texture, not spongy like wheat.  I have tried coconut, almond, and other gluten-free flours, including grain-based ones sold commercially.  Nothing can replace the spongy texture that wheat gives baked goods.  Save for the occasional bar cookie or pancake made with coconut or almond flour, I've given up eating flour-based products.

Coconut flour is okay for some recipes but functionally speaking it certainly is not a substitute for sandwich bread.

While it is not a grain I still had a weird feeling after eating it. I think it shares the same need as all flour to be fresh milled and used immediately, or fresh milled and then soaked or fermented in some way.

Hi, Leena--

Actually, the whole wheat (not einkorn) bread was made from flour that was freshly ground. I shudder to think what might have happened had it been store-bought flour.

Dr. Davis,

I wonder if you'll try this experiment again, this time with a CGM and periodic draws to find out what your insulin level was.

This experiment, to a more casual reader, provides too much hope (to a person with diabetes) that they can eat bread and still have optimal glucose levels.

Diabetes has been documented in the ancient world it may be that a 'treat' wouldn't harm someone once, but a regular and consistent 'treat' becomes a habit. Poor habits are what precipitate diseases like Type 2 diabetes, yes?

Funny experiment, but as stated by other commenters, it does not say much. And as you have said before yourself: "The best thing is to avoid grain consumption". Some dangers of grains: http://bit.ly/ckgK4E

Dr. Davis, you wrote: “After the conventional wheat, I also felt weird: a little queasy, some acid in the back of my throat, a little spacey. I biked for an hour solid to reduce my blood sugar back to its starting level”

I am very interested to know how biking reduced your blood sugar after one hour. Do you have some ideas as how exercise can actually reduce blood sugar?

In my case, I am pre diabetic and after one hour of intense exercise my blood sugar is very similar to before exercise, above 100's. Nevertheless, after some meals, it could come down to 80’s, how could that be explained?

Best wishes,
Alfredo E.

Where can you buy bread made from freshly ground wheat?!

@Alfredo
I'm prediabetic too and I've discovered a quick and convenient way to lower my BG: I do 50-60 jumping jacks and if it's very high I'll add 20 pushups. It takes about 5 minutes and lowers my BG anywhere from 20 to 40 points in half an hour or so.

The glucose in your body is reduced quickly because anaerobic exercise like that requires a lot of energy and it takes that in the form of glucose. So it's not an artifical lowering of BG like through medication. The body just uses up available glucose more quickly.

Some may worry that such a large BG drop might make them hypoglycemic but I have never had that happen to me even before I was doing this. I'm not on any medication.

Maybe Dr. Davis can elaborate on this a little more. We don't always have time or circumstance to go bike riding to lower our BG and for me this is a convenient alternative.

Dr. Davis-
A friend of mine who is new to GF eating mentioned that her husband's blood pressure has stabilized rather quickly after eliminating wheat. I googled "GF for heart health", and was delighted to discover your blog.    

My family eats grain free, and the only flour I use is coconut flour.  I recommend Bruce Fife's book "Cooking with Coconut Flour" as a jumping off point, because it explains how the properties of coconut flour make it unique to cook and bake with.  You NEED many more eggs than in a traditional bread recipe because that is what gives it a light airy texture, and you also need lots of fats to ensure it is moist.  I really don't do any cakes, cookies, etc because we try and stay low-carb, but the coconut flour has been great for breakfast, because neither my baby or I can eat eggs plain (wish I could, but they make me gag, he does too).  

Coconut Flour Crepes:
Mix
2 eggs
2 TBSP melted butter or coconut oil (if you use coconut oil, the eggs need to be room temp or it will clump up)
Add 2 TBSP of sifted coconut flour and mix again until smooth.  
Finally thin the mixture with about 1/3 cup of water and/or coconut milk
(I use frozen from Asian market, not canned, and dilute it 50/50 with water and a drop of vanilla Stevia)

cook crepes in pan brushed with ample coconut oil.  They are great with just butter.

Dr Davis,

The book Carrie mentions, Cooking with Coconut Flour, is the one I mentioned last week. I have the entire book as a 2Mb pdf file, and am happy to share with anyone interested.

Doctor Davis

i think we are missing a very vital step here that is of fermenting wheat dough (making sourdough wheat). That is THE traditional style of consuming wheat everyday around the world.

The process is neatly captured under subheading Europe:Sourdough Bread.

http://wholehealthsource.blogspot.com/search/label/gluten


That is how entire Indian subcontinent consumes wheat. That is approximately 2 billion people, not counting europe!

I will really look forward to seeing how sourdough wheat plays out in these tests as that is the staple food for the vast majority day in and day out.

Great interview with einkorn wheat producer Etienne Mabille that may interest some of you: http://www.satoriz.fr/les-entretiens/Le-Petit-Epeautre-de-Haute-Provence/article-sat-info-500-5.html (you will have to use an online translation tool if you don't read french)

Hi Dr. Davis,

Interesting post.  I just received my shipment of einkorn today.  I'll be performing a more sophisticated version of your experiment on myself beginning next week and I'll let you know the results.  Just have to get a blood sugar-o-meter first.

Chris

David M Gordon,
is it still possible to get a copy of the coconut flour book?
sue

Tested my wife's BG before she ate a bowl of glutten free cereal 90. 1 hour latter was 308. I sure got her attention!

Okay, I'm feeling sufficiently guilty just reading this.  Yes, I know intellectually about postprandial lipid surges and such... but given that in the real world sometimes we are caught in situations where there isn't a lot of healthy foods available:  By way of instruction, how could the Good Father have salvaged these situations from disaster?  What choices could he have made in these situations which would have been better, healthier (yes, I know about the lunch pail and packing good, healthy foods to take from home, and do it all the time).  But WHAT IF he didn't have the option of bringing his own food to a restaurant or social "fish fry" situation?  What to do then, constructively, besides a heavy dose of guilt?

I understand low carb diets in general, but the way you talk about postprandial blood sugar levels, what can you eat?  

You continuously point out that foods you didn't think would cause high blood sugars do (is it because of the actual food or hidden ingredients like sugar), so what's on your acceptable list?  (in general).  I realize everyone's body will react slightly differently...

Dr. davis,
I always follow your valuable blogs. please keep up the good work. here is the link to the type of meals to cut down on the carbs.checkk it out.
http://www.phlaunt.com/diabetes/18856280.php

My suspicion is that the balsamic vinegar was the culprit. Some brands are extremely sweet because they have added sugar.

Dr. Davis,
What is an acceptable blood glucose level after a meal? What goal do you recommend for your patients?

I don't know about the Life Scan bg monitor but I do know that some monitors are totally inadequate!  Walmart Relion for one.  I have one and can easily do 2 tests within a few seconds of each other and get readings of 180 and 135!!!!  AcuCheck by Aviva which I also have has never given me a multiple reading spread of more that about 5 points, and that is a 3 year old meter.  You don't do yourself any favors by going cheap. It you have a sympathetic doc who will write a scrip you can get meter for free and have a big chunk of test strip cost covered.

You should add this one caveat. Fructose and its various aliases does not raise blood sugar immediately. It will do so eventually when it screws up your liver.

Mike

Regarding the dressing...I learned decades ago in high school biology that vinegar turns to sugar in the blood. Is this true?

Regulars will know I bought a meter after the first appearance of this post. I was regularly over 8.6 = 155 at one hour.
Went to doctor fasting blood glucose 4.9= 88.2 and HbA1c 5.6 = 100.8 which my doctor thought fine.
I pointed out the day before and day after my meter was reported much higher numbers, he suggested a fasting oral glucose tolerance test for which I had to prepare by consuming 175mg carbs daily for 3 days, which I did gaining several lbs.
However 2hr reading 5.8 = 105
My meter reported  11.3 =203.4 at 1 hr but I peaked at 17.3 = 311.4 the following meal.
Inflammation markers and metabolic characteristics of subjects with one-hour plasma glucose levels
this paper suggests that Elevated one hour plasma glucose (1hPG) in people with normal glucose tolerance and pre-DM subjects is associated to subclinical inflammation, high lipid ratios and insulin resistance. Therefore, 1hPG >155 ( = 8.6) could be considered a new 'marker' for cardiovascular risk.
Medscape article on same paper.
One-Hour Plasma Glucose Levels May Be a Marker for Cardiovascular Risk

So as far as my doctor is concerned I've no problems whatsoever. It seems to me absurd that if I followed his advice I'd be a diabetic basket case and the situation would be almost irretrievable before they will take any action.
I've been a bit stricter with the carbs and have followed some other suggestions so have managed to keep 1hr numbers below 6.7 = 120

So if the peak blood glucose is important, then things that lower it are generally good? Foods with a low glycemic index, which are slow release?  Polyphenols like green tea and red wine, which inhibit amylase and reduce the sugar spike?

You have a choice?

To die of heart disease or alzheimers?

http://www.naturalnews.com/028523_Alzheimers_juicing.html

"Those who drank juice three or more times per week experienced a 76 percent reduced risk for Alzheimer's. Those who drank juice once or twice a week experienced a 16 percent reduced risk."

But various polyphenols have been show to also modify glucose levels in some cases?

What you can eat is *based* on postprandial bg.  

My husband can eat 1/6th of a 2-layer chocolate cake.  

I can eat around 20g carb at breakfast, 40g at lunch and dinner, and that requires insulin injections.

We're all different, you have to test yourself: http://www.alt-support-diabetes.org/new.php

After finding your blog, I purchased a blood glucose monitor and have been checking my post-prandial blood sugars 1 and 2 hours after eating a meal.  I am also checking some fasting a.m. blood sugars.

I am obese, though I have lost 49 pounds by reducing overall carb intake and eliminating all grains, sugars and processed foods.  I eat primarily a whole food diet other than a little (.25 oz.) of very dark chocolate a day (85%).

My post-prandial 1 hour are between 90-110 most meals, and 2 hours are almost always below 100.  However, I am noticing that my fasting blood sugars are rising, sometimes above 100.

Should I be concerned?  Is there anything I can be doing differently to reduce the insulin resistance that seems to be developing due to carb restriction?  Total carb intake daily is around 50 grams, including fiber.

Stephanie A.

"He also had a dangerous combination of other risk factors: high triglycerides, a type of fat in the blood, and a low level of HDL, the “good cholesterol” that can help the body get rid of the bad cholesterol that can damage arteries."

I wonder if he was taking fish oil supplements to try to drive down his triglycerides and niacin to prop up his HDL?

I had a 234 score in 2005 and a 419 score in 2007 - if it wasn't for resources like TYP - I wouldn't have pushed my Dr with questions about Vit D and CQ 10 and Fish Oil...  sit waiting for the next scan to see if things are under control (now - small LDL-P 123 nmol/L).

Just think if Tim R had the time to do a bit of research himself and found TYP - but that is what your physicans should be doing for you.... growing... learning... but as an engineer, I know the spectrum of people calling themselves engineers is a large spectrum... so it is with MDs.

Thanks for what you do Dr D.

Dave

Yes. Fish oil alone could have cut his risk of sudden cardiac death by 45%. It would have cost him all of $3 per month.

I have been wondering if the trans-Atlantic flight several days before his death could have had something to do with it...

Dr Davis I just wonder what you think of this Dr. Mehmet(?) Oz who keeps popoing up on television and writing books talking about the same old stuff, low fat, high carbs blah blah blah . . . I think since Mr. Russerts death I've seen him on tv 3 times and NOT ONCE has he mentioned calcium scoring, vitamin D, fish oil . . .

What a tragedy.  All week long I have been asking myself how such a smart man could be so uninformed about his own health?

With all the resources at Mr. Russert's disposal, I would think he could have easily learned more about his condition, and the measures he might have taken to save himself.  [Then too, he might have also come across the Track Your Plaque website... or the book.]  Instead, he was apparently greatly trusting of his internist and cardiologist, and perhaps thought he was receiving optimal medical management... and nothing more could be done?

Beyond that, I wonder about his Vitamin D status, and whether he was dehydrated from the long flight back from Europe?  I also wonder if the emotional stresses (good and bad) of a quick trip to Europe, his son's graduation from college, and having recently placed his beloved father into a care home, on top of what could only be termed a stressful and grueling work life (no matter how much he may have loved it) might have lead his body to the tipping point on that day.   I suppose we are unlikely to have these answers under the circumstances.

R.I.P. Mr. Russert, but shame, shame, shame on your physicians, IMO they really let you down.

Thanks for this truthful blog, an antidote to all the media nonsense and C.Y.A. I have seen in the past few days.

Terri
madcook

My wife has been to Dr. Michael Newman the internist for Tim Russert.  I don't think she is going back.  I had Angioplasty about 10 years ago with stents put in my right and left artery.  Since then I have the thallium stress test every year, take 1500 mg's of niaspan a day, Lipitor, a blood pressure lowering drug, and aspirin.  Both my cardiologist, and my internist state that a heart scan would not do me any good, and my cardiologist stated that the heart scan would simply confuse the issues.  Are they right? Would the heart scan harm me?  If so, how?

In response to the comment by sschein, I'm not sure it's such a great idea to have a thallium stress test every year.  You should probably investigate the possibility of a CT-angiogram.  

I am not a doctor so I don't want you to think I'm defending them, but there's only so much that a doctor can do in the office visit environment.  It's really up to the patient to do the research and decide on what he believes is the best course of treatment for him or herself and then try to bring the doctor around to his point.  In my own case I refuse to have a thallium stress test and have finally decided to have a 320 slice CT-angiogram when I go to Boston next month.  My cardiologist may not agree that it's the choice he'd choose, but he's going along with it.  Quite simply they don't have the time to convince the patient one way or the other.  We really don't know all the details about Tim Russert's care.  If he had his own private physician who tended only to him or who was consulted extensively I'd probably expect better.  As just one patient (admittedly a famous one) I'm not sure how much you can expect from a doctor.  If he suggests a stress test or an angiogram and you think better of the idea, it's up to the patient to chart his own course.

Andy (the164club) TYP member

Tim Russert and George Carlin

Two beloved American celebrities have succumbed to heart disease before their time.  The national response has been disappointment in a medical system that could allow this to happen.  What could have been done differently to save the lives of both Tim and George, to avoid this fatal outcome?

To read more...Saving Tim Russert and George Carlin by Jeffrey Dach MD


Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood FL 33021
my web site

A simple calculation from known information in 1998 clearly, obviously, and inarguably predicted his death. Recall that heart scan scores of 1000 or greater are associated with annual--ANNUAL--risk for heart attack and death of 20-25% if no preventive action is taken. The meager prevention efforts taken by Mr. Russert's doctors did indeed reduce risk modestly, but it did not eliminate risk.