If it is such a dead end, please comment on the angoigrams and PET scans in Dr. Caldwell Esselstyns 2007 book Reversing and Preventing Heart Disease.

It seems clear from his research, published in the JAMA, that super low fat, plant base nutrition does in fact work. Clearly your methods seem to be working, but does that mean your methods are the only way?

Do we really need to go low saturated fat?

Hi Dr. Davis:

I have been a follower of your blog for a number of years now.  It ha been an inspiration as i have fought to regain my health over the past 9 years.

After suffering a mild MI in 2002 and being diagnosed as diabetic, I was placed on the standard allopathic protocol of statins, Ace inhibitors/beta blockers and low-fat diet. Needless to say, they didn't help me.  I did manage to lose weight, but blood sugar and blood pressure remained problematic.

In 2005, I realized from doing extensive research on sites such as yours that eliminating all refined carbs, sugars and trans fats was the key to my success. I have lost 180 pounds and maintain a weight of 165 lbs. with a height of 6' 1". I am 53 years old, and definitely feel younger than I was in my 30's.

I supplement with fish oil and DHA, vitamin D and a number of other nutrients to provide a baseline of building blocks to help my cells regenerate and avoid chronic disease. Eliminating wheat is the most significant element in regaining my health and dramatically lowering risk form a second heart attack.

I would enjoy discussing my journey, and thank you for all your dedicated work.

Any updated information on heartscans in people who've already had a bypass, a 4x bypass?  Would a scan yield any useful info?

I am new to your website, and I am interested in it. I once weighed 800 pounds, and am now down to 215 pounds. You can check my website for more information. www.justinwilloughby.com

Hi, John--

Fabulous results!
Could you provide contact info here: http://typ.trackyourplaque.com/contact.aspx
I appreciate your help on this. It will make a fascinating story!

Hi, Justin--

Incredible!
However, I am looking for stories in which elimination of wheat was the principal strategy. Is this what you did to lose the 600 lbs (!!!)?

All I get is "500 Internal Server Error" when try to comment.

Web site server is no good at all ... previous thread rejected my comments more than twice on several days, so I tried this thread and post came right through.
Doc - you are not getting your moneys worth despite your page looking pretty .

Just went back to previous thread to try and post since see 2 above went through and got the same "server error"  boot a couple of minutes after my 2 above. Something not working right here.

Sorry, Might. Still working out glitches.
I will discuss with IT people.

Dr. Davis
I have been batling weight for my whole life and by the age of 45 I weighted 290 lbs and was a heavy drinker until I quited drinking and started exercising with a low fat mid protein and high carb diet and due to the fact that I stoped drinking I started to loose weight also as the weight droped I exerciced more till the point that I started to train for a half Ironman there is where the fat lost stoped and I plateaued at 230 lbs and no matter how hard I trained I couldnt lose more and aproaching the half Ironman I even gained weight so shortly after finishing the race my coach sugested me to visit your blog and sent me the link of your post on wheat belly,
that was like the turning poin of my life and shortly I was following your advices and trying to live a more primal life and practically becoming a caveman the results I lost 60 more pounds and gained a vitality like I have never experienced today after 6 more half Ironman races and 1 full Ironman I try to live wheat free and visit regularly your blog not to mention that I follow most of your blog roll!!!
Everytime that I find myself eating wheat I feel terrible my inmune function suffers and I almost get sick I say almost as I haven't get sick in almost 2 yers that I have been following a mostly primal life and as I feel a sickness coming I just get back to being wheat free and low carb all around!!

Very good, have a healthy future, a reasonable mix of vegetables, will be able to give us a healthy body. Thank you to share

Well all best in this post is the image of Obesity!

Dr. Davis,

157 one hour after eating is NOT the diabetic range by any standard.

To be considered diabetic a person must go over 200 mg/dl.

The data collected by Dr. Christensen's CGMS studies suggest that 160 at one hour is the top of the normal range if the blood sugar drops back in the next hour.

That 157 is "prediabetic" though the term is a misnomer because most people with "prediabetic" blood sugars will NEVER become diabetic since they lack the necessary genetic flaws that produce true diabetes.

I mention this not to discourage people from lowering their carb intake and blood sugar--that's a very good tack to take, but because I hear from hundreds of people who obsess about being diabetic when they are not some of whom end up spending a lot of unnecessary money on doctor appointments that produce nothing useful.

The latest research suggests that keeping blood sugar under 155 mg/dl at all times will control the blood sugar related component of heart disease. But to diagnose even "pre-diabetes" you have to look at the 2 hour reading. It is the inability to reduce a spike within 2 hours that appears to be associated with most diabetic complications.

When do you recommend taking postprandial glucose measurements?  45 mintues, 1 hour, 2 hours?  And are they timed from the start of the meal, or the end of the meal?

For those of us who do not eat wheat, avoid grains, and restrict sugar intake, it is important to know that the pancreas gets used to dispensing a certain (lower) amount of insulin. Therefore, if you decide to test postprandial glucose after eating a meal with significantly more carbohydrate/sugar, be aware that you will likely get scary-high readings. When preparing for an oral glucose tolerance test, a patient is normally told "do not restrict carbs" or "eat a normal diet" during the week preceding the test in order to allow the pancreas to adjust its phase 1 insulin response. (when they say "normal diet" they are sadly not referring to *our* normal).

Following Dr. Davis's life-saving advice, I have been wheat-free since last August and avoid grains, and restrict sugar intake. The first time I tested my postprandial glucose after an uncharacteristic meal, I was convinced I had become diabetic. (meal was corn chips, rice, beans, chicken fajitas, and a large margarita). After several consecutive days of eating higher-carb, the same meal generated significantly lower postprandial glucose. (Of course I knew before testing that this meal was a *bad* choice for me).

Using postprandial glucose levels as Dr. Davis recommends to discover which foods cause your blood glucose to spike (and hence trigger small-dense LDL) is wonderful advice. I have learned that I do not tolerate oat bran! Just be careful not to self-diagnose diabetes based on high readings resulting from uncharacteristic meals. I know Dr. Davis has never recommended this - I only mention it because I really scared myself the first time I measured postprandial sugar, and have since discovered that at least two of my "low-carb" friends had the same experience...

Do you measure one hour after eating?

When you say your patient was at 157 mg/dl postpranial, do you mean right after eating?  Or are you talking about a 2 hour test?  What's the time frame for measuring?  And if you don't do OGTT, how do you control how many grams of carbohydrate you're giving the patient?  Does the load matter?

If coronary risk is increased by 50% at a glucose level of only 126 postprandial, then there is no hope of a heart-healthy diet that takes any form other than Low-Carb or Paleo.  I challenge anyone out there to show me someone who can eat an entire bagel, an apple and coffee (likely sweetened for most people) and maintain postprandial glucose of 100.  Totally impossible.

Postprandial glucose is not the problem...it's the food that's the problem.  The glucose is only the symptom.  Cut out the bagels (and all grains for that matter), fruit (except in small amounts), sugar, processed starch, omega-6 oils while keeping carb intake (via whole foods only) to 20% of calories or less and the postprandial glucose will take care of itself given enough time.

Dr. Davis,

I'm curious as to whether genetic predisposition plays a factor in how one's body naturally reacts to sugar.

I happen to have very high LDL cholesterol(220), the vast majority (i think 98%) being very large particles. Yet, I happen to eat a good amount of wheat, juice and fruit, and it doesn't seem to affect my blood sugar or particle size.

Is this typical with some of your patients?

Eating low-carb can give you a bigger glucose spike when you do eat more carbs.  (As onschedule noted.)  There may be more than one dietary pattern that keeps blood glucose in a good range for the non-diabetic among us (though I don't think low-fat is it).

It is possible, as Derek suggested, that the type of carb eaten may be causing some bad change in CVD risk factors (such as grains, sugar, and fruit vs. root vegetables, for instance).  An interesting hypothesis.

Derek S I have been checking my fasting and post prandial glucose for a month and i frequently have 100 or less after a carb heavy meal. It is not impossible!

Regarding Jenny's point
This study
Utility of genetic and non-genetic risk factors in prediction of type 2 diabetes: Whitehall II prospective cohort study. implies Non-genetic variables (age, sex, drug treatment, family history of type 2 diabetes, body mass index, smoking status, high density lipoprotein cholesterol, triglycerides, fasting glucose) are more important, when compared with 20 single nucleotide polymorphisms associated with susceptibility to type 2 diabetes.

The implication is that there is only a small effect of genetic variants influencing susceptibility to type 2 diabetes.

I am certainly not denying the contribution of genes to diabetes incidence.
There is a nice series of talks here Melatonin - Good morning to an unexpected culprit in type 2 diabetes explaining the way one particular genome affects the pancreas to increase the risk of diabetes.
I am certain other genomes have actions that contribute to diabetes incidence in other ways. So while I agree absolutely diabetes is in a genetic disease it is also a result of diet, environment and lifestyle.

  We may not be able to change our genes but knowing the ways in which genes act enables us to modify diet/lifestyle etc to avoid or maybe delay those potential consequences.

Perhaps readers will also like to read Nutrigenomics and Hypertension Dr BG's take on the way Food = MEDICINE and Controls Genetic Machinery

On a low-carb diet, my post-prandial blood glucose level is always 90 or less.

Several weeks ago, when I donated blood, my blood sugar measured 63 after losing a pint of blood.  Wierd thing is that I felt fine, no shakiness, hunger, or any other symptom of low blood sugar.

There is a down side to eating low-carb though.  Even a moderate amount of sugar sends my blood sugar through the roof.  My blood pressure increases significantly and I turn beet red and feel awful.  

I tell my wife that the secret of not eating sugar is to not eat sugar.

Thank goodness I found you guys and gals. My daughter has been following a low carb diet to control her type 1 diabetes and she ate a handful of chocolate chips and spiked to 375 almost immediately. I didn't realize that eating low carb can make you super sensitive to carbs. Thank-you for providing this important piece of the puzzle for me!

Thanks for discussing this...there are so many going through the same situation of ill health and shocking medical reports and not knowing it is common in the world.

how to measure after eating...
Jignesh.

same question by my how to measure it please reply to it i want to inform this thing to my friend

For this reason, postprandial (not OGTT) glucose checks are becoming an integral part of the Track Your Plaque program. We encourage postprandial blood glucose checks, followed by efforts to reduce postprandial glucose if they are high. More on this in future.

I recently saw an article on veg oil and hexane which eventually led to this blog and others of the same bent, Whole Health Source, www.cholesterol-and-health.com, as a result I completely changed my diet. I now eat only meat, whole milk, heavy cream, fresh vegatables, broccoli, spinach, asparagus, salads with balsamic and olive oil, with yams, carrots, or beets once a day for carbs. I eliminated wheat, breads, cerials, sugars, and coffe. Prior to this diet never abused sugar no sodas, occasional ice cream. About a month into this diet I decided to buy a glucose meter and scared myself to serious anxiety as my fasting numbers range from 129-160. The strange thing is that my postprandial numbers if I walk a little after eating range any where from 87-120 usually. and almost never get past 135. Any thoughts?

No one has yet answered the key question - *when* do you measure your one hour and two hour readings? from the start of a meal? End? Mid-way?

Bloodsugar101 says from the start of a meal, but If you eat and chew slowly - which is sensible - the timing presumably makes BG readings vary quite a lot.

When I sit down to a meal, it is probably 45minutes from first bite of main course to last bite of fruit/cheese afterward.

Second part of my comment above:

Also, my resting heart rate came down to 48 bpm. And I plan to get a new lipid profile done soon. My bP was already 120/80, but maybe it has decreased now.


Pre-diabetes can be reversed with lifestyle modifications. I am not really following a low-carb diet, just a low-calorie, no-junk-food diet. And with only about 45 minutes of exercise on weekdays, it is possible to turn things around.

On Nov 10, 2010, I went for a routine physical checkup while visiting my family in India. I am a lacto-ovo vegatarian. My mother was diagnosed recently with diabetes at 62. I am 40, so I decided to start checking my vitals. My lipids turned out to be (in mg/dL) TC: 170, HDL: 46, LDL: 106; TriGL: 88 and my BMI was 26.2 and resting heart rate 72 beats/minute.

But my Glucose numbers were not so good:

Fasting: 98 mg/dL
2-hr post-prandial OGTT (75g glucose solution): 119 mg/dL

Since they seemed high, I asked the doctor about this, and he brushed it off saying it was in the normal range of 60-100 for fasting, and less than 145 for the 2-hr test. He also said since the lipid profile was good I should not worry about it.

An interesting article caught my eye:

"Extremely short duration high intensity interval training substantially improves insulin action in young healthy males"

http://www.biomedcentral.com/1472-6823/9/3

as did the following study by Dr. Christensen:

http://www.phlaunt.com/diabetes/16422495.php

I did a lot, and I mean a lot, of online research about nutrition, exercise, types of exercise, caloric restriction, glucose toxicity etc. I must have read at least 200-300 papers and/or articles and 10 different books.

I used to eat a lot of refined carbs like chips, bagels etc and lots of diet colas (1 can a day). Being a vegetarian, I decided to do things my own way, since none of the existing diets really suited me.  I adopted the following diet and exercise schedule:

Breakfast: Nutritious Living Hi-lo cereal (low GI low-carb 7g + high protein 12g per serving) along with Soymilk and a sprinkling of walnuts, almonds, pecans, peanuts and chestnuts.

Lunch: 1 Granola bar (140 cals, 19g carbs) + salad (greens including baby spinach leaves, and vegetables like tomatoes, onions, beans, asparagus, peas, artichokes, beets, brussels, cucumbers, lentils etc) with olive oil dressing + one fruit (orange, pear or apple).

Snack: 1 fruit and sugar-less black tea.

Dinner: Two slices of sprouted rye or whole wheat bread, with hummus and some salsa + a few nuts, or mixed vegetable Indian foods (many choices there).

Water: 2-2.5 liters/day

Exercise: mornings after getting up and on empty stomach before breakfast, only on weekdays.

* 15 minute 6.5 mph run on the treadmill to exhaust glycogen stores taking about 225 kCal.

* 15 minutes weight training with dumbbells (lower-body/upper body on alternate days). Only two sets of 10 reps with medium weights (a pair of 20 or 30 pound dumbbells) in a circuit, making for a vigorous workout.

* 10 minutes high-intensity interval training on an exercise bicycle. The pattern being, 2 minute warm-up, 6 10-second, extremely intense, all-out sprints at the beginning of each minute, and then a 3 minute cool-down at moderate intensity. At the end of each sprint, my heart-rate would be around 190 bpm, slightly beyond my theoretical max level (220-40 = 180 bpm).

The result? On Jan 1, 2011, after just 7 weeks of the above routine, my numbers were:

BMI: 22.6
Fasting blood glucose: 77 mg/dL
2-hr post-breakfast (Kellog's raisin bran cereal + nuts + soymilk): 94 mg/dL

I intend to keep going until I get to:

BMI: 21.0
Fasting/2hr-PP: 75/85 mg/dL

Not sure why my two comments above ended up in the reverse order.

To: Anonymous, posting Jan. 29, 2011...
Very good job w/ changing your #'s via diet / exercise. I've made similar changes, & my numbers are also good. I think the challenge will be ongoing consistency & maintenance.
Exercise & diet are both huge.

Hi, my name is vanessa.  What is normal for blood glucose readings?.  I was told that two hour postprandial was okay as long as it wasn't over 180.  Is this correct?.

How much would one need to take to achieve this?

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

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

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

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

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

Hi Dr. Davis! About iodine:

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

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

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

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

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

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

Dr. Davis,

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

Thanks for a great blog,
Tonya

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Anonymous--

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

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

Dr. Davis-

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

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

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

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

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

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

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

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

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

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

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

Hi, David--

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

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

Perhaps he is relying on a textbook copyrighted 1984.

Thank you, Dr Davis

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

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

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

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

Thank you!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Hope i taught you guys all something usefull.

-Dr.knowitall. =)

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

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

Nice tnx for the info...

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

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

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

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

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

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

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

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

B12 borderline low

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

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

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

Help!

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

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

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

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

Anon

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

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

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


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

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

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

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

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

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

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

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

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


Smith ALan

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

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

Thank you.















9

Hi, Robert--

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

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

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

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

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

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

Thanks

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

Thank you,
Lisa

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

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

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

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

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

good luck!

Does this mean we shouldn't be taking calcium supplements? I've been taking 500 mg per day.

Hello Dr Davis, I've read recently that calcium supplements are a bad idea - they increase the risk of cardiovascular disease.

Does dietary calcium have a similar effect? I would value you opinion.

Thanks,

Richard

There is a lot of controversy in Canada currently for a treatment of MS; the opening of blocked or restricted neck veins.  Dr. D, you mentioned dementia, which, to my simple understanding, is either nerve damage or vascular dementia due to a series of small strokes. So my reason for this post is to ask the question; Is the tissue type of veins the same as arteries, and if so, would the same inflammation calcification cycle occur?  If the answer is yes, does that imply vitamin D3 /K2 and wheat elimination has potential for MS sufferers and people trying to avoid vascular dementia in old age?
thanks
Trev (recovering vegetarian)

http://www.cbc.ca/health/story/2010/11/18/multiple-sclerosis-vein-death-costa-rica-mostic.html

Mike and Richard--

I have been advising my patients to take no more than 500 mg calcium per day, given the potential for increased cardiovascular events with higher doses per the studies coming from New Zealand. Also, achieving healthy vitamin D blood levels easily doubles the intestinal absorption of calcium, making supplementation of additional calcium less necessary.

This research was published in 2005.
Any updates on this?

Thanks

Dr. Davis, I hear/read so much about 'inflamation' in the body and 'anti-inflammatory' diets, etc.  So I was wondering if the C-reactive protein test is a reliable way to measure this? If so what is the suggested limit or safe range in YOUR opinion?

Excellent blog! I eat an almost dairy free diet (grass-fed butter is the exception for vitamins K  and A and butyric acid etc and to add fat to overly lean protein)   that includes almonds, filberts, sardines and salmon with bones and greens for calcium. I also eat lots of very dark chocolate/cocoa.  I supplement with vitamin d.  I recently passed a calcium oxalate kidney stone and doc says my dairy free diet is far too rich in oxalates and phytic acid. I have also been plagued with calf and foot cramps. He suggests adding small amounts of cheese or a calcium supplement to block the oxalates.  Despite my magnesium rich diet -- he also says I need a magnesium supplement. It's only been a few days since I've added 2 calcium/mag tablets at night (only contain about 300mg calcium and 180 mag plus additional mag citrate powder in hot water) and my cramps seem to have subsided.  Anyone else get mineral deficiencies eating paleo style with nuts and bones but no supplements?

Anonymous, I take Mg supplements, too. I seem to have a hard time absorbing minerals.

The nuts you're eating contain phytic acid, which blocks mineral absorption. The Weston A. Price Foundation recommends soaking and roasting nuts and seeds to neutralize the phytic acid.

This is more complicated than the notion that high calcium intake=high "calcification" ...

...Blood Ca and its accumulation in soft tissues can increase (from bones) even though less is eaten. Ca metabolism is far more important than magnitude of intake.  It seems that Ca supplementation actually decreases intracellular amounts.

If the diet is acidic, calcium will be used to buffer this acid which will ultimately be excreted through the urine. On the other hand, if the diet is alkaline, then no calcium is needed for this purpose. So the question is, where does this un-needed calcium go?

Maybe an alkaline diet isn't such a good thing after all is all I'm saying.

Anon about MS--

I would be careful about extrapolating the wheat-dementia connection to MS. It would be deeply concerning if there were a connection, but I am not aware of such a connection.

The one truly compelling observation being made in MS is the vitamin D discussion. To my knowledge, that clinical trial is still underway in Toronto.

I too had lots of trouble with kidney stones but no more.  The only change I made was stopping calcium supplements and starting magnesium.  I take 500 mg of mag at bedtime and have not had a kidney stone pain in almost 2 years.

Dr. Davis,

Wondering how you explain the paradox that statins seems to significantly increase coronary calcium, but to lower coronary events?


Thanks,
David

Regarding magnesium supplementation - I've read that most magnesium supplements have little to no bio-availability, making it pointless to take them.  There are some on the market which address this concern and I've seen good reviews of them - but they do cost more.  I've also read at multiple nutrition sites that our foods have less and less magnesium as our soils are very depleted.  But almonds, pepitas and nut butters are good sources, as are some other foods, like black beans.  There are lists online.  I've also read that Epsom salt baths are a good source of magnesium.  So I take ES baths and I've made myself a magnesium skin lotion with ES.  Instructions for doing this can be found online.

Basic Ca phosphate crystal deposition disease: Most pathologic calcifications throughout the body contain mixtures of carbonate-substituted hydroxyapatite and octacalcium phosphate. Because these ultramicroscopic crystals are nonacidic Ca phosphates, the term “basic Ca phosphate” (BCP) is much more precise than “apatite.”

Nutritionally people eat hydroxyapatite not apatite  BCP

I guessing the moral of the story is to eat acidic calcium, calcium citrate or hydroxyapatite not apatite.

I have read that Vitamin K2 is very helpful in getting rid of the Calcium.

Martin Levac also raises a good point. I would think as long as the diet is balanced, then calcium will not stay in the arteries.

It could be that too alkaline diets might cause this problem. In India several very strict vegetarian (not vegan) societies do not eat onions and garlic. Both are very highly alkaline.

While Non-vegetarian societies eat a lot of them. I guess the difference may be due to the acid base theory. The over all diet should be very slightly alkaline to be best.

This ACID/BASE diet argument is a little odd sounding to me but even a quick Google leads to the simple explanation that it is the influence of minerals in the diet on blood pH

"The consumption of animal protein, grain, and high amounts of milk increases the acidity of the body, whereas foods rich in minerals such as green vegetables and fruit increase the alkalinity. Generally, the Western diet induces a chronic, low-grade metabolic acidosis.  This relates to the loss of calcium through excretion in urine.  Here is the link:-
http://jn.nutrition.org/content/136/9/2374.full#BIB7

cool, but is there any link to heart heath?

I see that some readers asked the same question I was thinking related to calcium supplements. For instance, I hear quite a bit how much coral calcium is good for people. I would assume based on what you have said to take no more than 500 mg of that as well per day?

HI, David--

While statins do not have much effect on slowing the progression of coronary calcium, I know of no data suggesting that they increase coronary calcium.


Hi, Pat--

While absorption of magnesium products varies widely, magnesium "salts" like the malate and glycinate are absorbed quite well.

Basicly, calcium concentrated outside a cell has a safe bio-chemical role to perform & magnesium inside that same cell has it's major bio-chemical role. They both have vital cellular functions.

When calcium "lingers" inside a cell it keeps over-stimulating things; building up in there is even worse. This inflammatory mechanism occurs in many tissues, not just blood vessels.


Dietary deficiencies of calcium & magnesium naturally trigger a para-thyroid hormone activation. This hormone signal is for getting more calcium available to the body's tissue cells.

As you get older there is commonly more para-thyroid hormone circulating in your blood. It can form a negative feedback loop with pro-inflammatory factors (like cytokines); as the inflammation keeps calcium inside the cell.

Cause or effect of calcium being where it's not supposed to be may involve a vicious circle. Rare youngsters with coronary calcium would suggest uncommon genetics.

The preceding paragraph to the above-quoted passage is probably also very relevant to this discussion:

"It is not clear how or why the claims for high vitamin D levels started, medical experts say. First there were two studies, which turned out to be incorrect, that said people needed 30 nanograms of vitamin D per milliliter of blood, the upper end of what the committee says is a normal range. They were followed by articles and claims and books saying much higher levels — 40 to 50 nanograms or even higher — were needed."

Can you point us to other studies that point to the efficacy of 30 ng+ concentrations?  

I am not attempting to be adversarial at all to your views -- I have been following them closely following my own research.  But given that I havea  data-driven bent, this report has given me a reason to reconsider, and I would love your guidance.

I doubt anyone needs calcium or magnesium supplementation. Calcium and magnesium are virtually impossible to avoid - I believe they're in every plant food. I'll stick with D3, MK-7 and hormones.

"Less calcium, less plaque to rupture, less risk."
It is well known that ethylesterized omega-3 fatty acids, e.g., E-EPA, stabilize arterial plaques. This explains at least partly how these omega-3´s protect the heart and arteries. See for instance J Atheroscler Thromb. Epub ahead of print 2010 Nov 17

http://www.jstage.jst.go.jp/article/jat/advpub/0/1011160316/_pdf

Minä suosittelen K2-vitam.  Se poistaa kalkkia ja ehkäiseen sen kertymistä verisuoniin !!!

Are all OTC omega 3 products ethylesterized? If not, which ones are?

Wonder what their life span is....

Following the TYP program, my blood pressure (not bad to start - 114/72 was typical) has dropped to Yanomamo levels - 102/60 now being a typical reading.  Vit D, Vit K2, fish oil, low low wheat, krill oil, magnesium and a multi vitamin; weight loss may figure in too.

Don't leave out the other explanation for this: Quoting from Napoleon A. Chagnon. Yanomamo: The Fierce People (Chagnon lived with them).

"The villages can be as small as 40 to 50 people or as large as 300 people, but in all cases there are many more children and babies than there are adults....Life expectancy is short. ...The Yanomamo are still conducting inter-village warfare, a phenomenon that affect all aspects of their social organization, settlement pattern, and daily routines. It is not simply 'ritualistic' war: at least one-fourth of all adult males die violently."

If only the toughest babies survive and if males don't live much past their 30s you won't see all that much high blood pressure.

The fact is American life expectancy--despite our diet--is dramatically better than that of any traditional society studied.

how do they do it??

I'm 56.  I used to have average blood pressure of 140/95 when I was 40.  Ten years ago I dropped grains and dairy and have gradually transitioned to a carnivorous diet.  My blood pressure is now in Yanomamo territory.  

In America it's "normal" for blood pressure to rise with age since it's "normal" to be sick here!

I remember a tv documentary about salt, the sources of salt and use by humans since the early days of human civilizations. The Romans used salt as their currency to pay their soldiers. They also analyze and determined the salt intake of different ethnic groups. The question was also raised as whether salt is needed for human survival.  By this they mean, use of table salt in a shaker, added to our food during cooking. What they found is that this tribes in the Amazon, never use salt or even seen a table salt as we do in the civilized world. Their only source of salt(sodium) is whatever is present, in the game meats, plants and fruits they consume. Also the relative ratio between K and Na is 1:1 ratio or probably, a higher ratio of potassium than sodium.

The foods being consumed in our society, especiaaly processed foods are full of salt, and most among us use a salt shaker every time we eat.

kasing12

Dr. Davis,

Read your blog regularly and I know you dismiss the Ornish diet - however, saw that in his 2007 book, Dr. Ornish claims that he had a heart scan and his score was 0.  Do you find that at all compelling?

Thanks,
David

I lived in a hunter gathering society for 2 years and I was struck by how low stress it was: except for the couple hours a daywhen people were going after food, they hung out and chatted.

I thought you would be interested in this new take on omega-3s in Prevention Magazine: http://health.msn.com/nutrition/articlepage.aspx?cp-documentid=100245164

I wouldn't jump to the conclusion that jungle diets are low-carb. Especially in New Guinea, where an island full of people have historically been very hard on the animal resources, there has been great reliance on starchy tubers and other plant-based carb sources.

Off topic, couldn't find an e-mail address Doc, if you could address the following - maybe of interest to readers.

I had a regular checkup and my ALT was 129 (above normal). I am on no meds. I am a non-drinker. Don't have fatty liver. I take 4000 mg of fish oil daily of house brand - warehouse food store gel tabs. I have read you saying that most fish oil is from fish not on top of the food chain - low mercury. My doc wants to repeat test in two weeks to see if lab screwed up, flukes, etc.

My question is, do you think some cheapo brands of gel tabs could have other impurities that could cause liver problems? Thanks.

Anon--

Re: Dr. Dean Ornish.

I don't believe that an experience of one can prove anything, good nor bad. The Ornish program does indeed work, however, for a small segment of the population, such as people who are apoE4 positive. For the rest of us, a low-fat diet is a destructive diet.

Perhaps the best way to put it is: There are variations in what can be called "ideal" in different physiologic types.

Chris--

While we've not witnessed this effect, it doesn't mean it couldn't happen.

The most common problem with "cheapo" fish oil capsules is breakdown products, otherwise known as rancidity. If it smells excessively fishy, I wouldn't take it.

Hi, Jenny--

No doubt. And there is more infectious disease, as well, not to mention traumatic injury.

But the lessons are drawn from those who survive into later life.

These guys are (recently were?) the last surviving cannibal tribe. Not sure if they're still cannibals or have been lead away from that due to influence from the modern world.

Re: the comment about the Ornish diet and Ornish's 0 reading on the heart scan, it's worth noting that Ornish has been railing against sugar and flour for 30 years, even though it's his anti-fats message that grabs people's attention.

Nathan Pritikin, who did the Ornish diet before Ornish, was said to have arteries like a baby's when he died.

It's worth paying attention to the way Ornish agrees with TYP as well as the way he doesn't,as both diets result in low scores.

Jimmy Moore (livinlavidalocarb.com) and Dean Ornish both scored 0 on their heart scans, even though one eats meat all day long a la Atkins, and the other eats vegetables all day long and never meat, you have to wonder what they have in common.  One thing is they don't eat Oreos (and other stuff made with flour and sugar since it violates the rules in both plans.)  I wonder what else they have in common that led to 0 heart scan scores.

For people new to the importance of omega 3 and it's role in heart disease you may find the useful set of presentations at this link will improve your understanding of how Omega 3 and Omega 6 also works in the brain.

Fundamentals of Omega-3 Fatty Acids: Biochemistry and Health Sheila Innis,

From Day 2 of the conference may I suggest you also Watch the William Lands Presentation

So does the sodium intake actually affect the presuure to make it go to the gigher side?

I absolutely agree...the modern life is a jungle of bad habits.packed foods and easier lifestyle with electronic gadgets.I believe in the old school but can not keep with it all the time.

So now the question is, how would your treatment differ for these two women?

BTW I had thought the NMR/VAP were the lipoprotein equivalent of the HbA1c for blood sugar -- oh well!

Hi Dr Davis

I have just discovered your brilliant site.

I saw on another post that you have some Track you plaque members from other countries. Do you have any idea if the blood tests you recommend are available to patients outside of the States (specifically in the UK or Europe)?

Thanks
Lou

Hi Dr. Davis,

Do you find an earlobe crease to be a reliable determinant of coronary calcium?  I have one and notice you have one as well (on your pic).

Thanks,
Dan

Isn’t it natural for us to believe we are healthy and not suffering from any disease? I had a similar thought process until my physician asked me to get a heart scan done after he found that my basic cardiograms were not perfect. I discovered that there were calcium deposits in my coronary arteries and I was at a serious risk of a heart attack. I was shocked and went ahead with the Cardiologist's suggestion of an advanced diagnostic scan. Though it’s always tough to undergo such experiences, I was not at any kind of discomfort at the Elitehealth.com advanced heart scan facility. I am not an expert in medical appliance and machines but could feel that the equipment was world-class and I was in safe hands. That feeling is really very important for me and that’s how it actually went on. The facilities for Full Body Scan were as good as they can get.

Anony--

Easy. A woman with a zero score might make some efforts to correct her lipid/lipoprotein patterns to less strict endpoints, though she should still supplement vitamin D, iodine, and omega-3 fatty acids. The other woman should follow our Track Your Plaque endpoints if her goal is to stop plaque growth.


Lou--

Sorry, but I am not familiar with the availability of lipoproteins worldwide. I do know that people from outside the U.S. have managed, but it differs in every country. Please let us know if you have any success.

I had a heart scan 7 years ago at  Hopkins, how often should it be done? I didn't have any calcium- I  was 49 at the time but I have high levels of small particle LDL and HDL.

Incidentally they called a week after reporting the results of the heart scan and said I had a bunch of 'spots' on my liver which requires CAT scans and Ultra sounds to further investigate. Turned out to be something rather normal- I forget what they are called- just it involved a bunch of tests during a four week period and a lot of worrying.

Anytime you do a body scan be prepared to find other stuff- which may or may not be a good thing depending on your frame of mind and it you are the type of person who needs to know everything.

C'est la vie

Actually, I can think of at least one scenario where getting a VAP or similar test WOULD be the first step... youth.


I am inelligible for a heart scan because of my age (female under 40), yet I have a strong family hx of heart disease and have already presented with some signs of risk.  IMO, a VAP test would be the best thing for someone under 40 who is concerned about heart disease.

I'm looking at "The New Heart Disease Handbook" by Christopher Cannon MD and Elizabeth Vierck 2009. They mention calcium score and calcium scan a few times. Their wording focuses on the calcium scan being useful in identifying areas of plaque buildup. There are probably only a total of 300 words on the subject all totaled. Sounds like progress slowly inching along.

Wheat bran and any other dry whole grain puts my digestive tract in acid overdrive.

We all have heard of heart attacks. Among women, menopausal women are more prone to heart attacks due to lower levels of estrogen. Some symptoms of female heart attacks are: pressure felt in the chest area, feeling weak, low energy, uncommon symptoms are: nauseous sensation, giddiness, etc. Women often put themselves in the last list because they have many responsibilities, but as soon as any women notice such symptoms, should go for checking.

What you say is true, but the archaeological records tells us that insulin changes immediately after eating cannot be the whole story. Studies of carbohydrate-based cultures in Africa found that several of them were in very good health mostly free of the diseases of civilization despite a heavy carb load. A couple points for full disclosure:

1. The majority of the carbohydrate load came from tubers and plantains, not grains, but grains were a part of the diet.

2. The more carnivorous cultures also studied that avoided carbs were in better health, if slightly.

3. What grains they consumed were ground, soaked and fermented to reduce the amount of phytic acid and other tannins and increase the availability of nutrients.

So I will not be the one who insists that you can eat you're bread. I avoid wheat and rye because of the near-indigestible gluten, but the other grains can be healthy if prepared correctly.

Here's a post from another blogger with medical training that has looked into this quite closely:

http://wholehealthsource.blogspot.com/2009/01/how-to-eat-grains.html

Thank you for explaining this more thoroughly... I have been wondering about the other grains, besides wheat, so this is helpful.
------------
Here's a (true) recent exchange with a high school friend in a Facebook posting:

::K***:: is back on her Diabetic food plan and unplugging the bread machine.

::Friend 1::
that evil gluten!!!!!

::Friend 2: ME::
Evil wheat... and other grains!

::K***::
Whole grains are good for my diabetes, not just in large quantities!
------------
It appears that with doctor or dietician-encouraged brainwashing about grains, and following an American Diabetes Assn. diet (with an occasional falling off the wagon to bake cinnamon rolls and other pastries), this woman is probably doomed to the ravages of this horrible disease.

I'm not trying to be judgmental about this particular person, but rather illustrate how a carb addict can justify their carb addiction, and at the same time think they are actually following a "healthy" diet, cheered on by their well-meaning but uninformed doctors and dieticians.

Yes, like many or most of us, I love carbs... but, due to extensive research (and a strong rebellious streak) I follow most of the TYP guidelines and I mostly eat Paleo now.  It's not always easy, but it's my best chance to avoid diabetes, and the ugly consequences of heart disease.

I feel badly for my friend, but I don't think she wants conversion... rather, an easier way to continue to indulge in carbs via those 'healthy' whole grains.  It's not my job to change the world... I have enough trouble just with ::me::.

madcook

So what is it about wheat that makes it worse than the other grains? Is it the refining or is there something inherently bad about it's chemical structure. Anyone know?

Question for Dr. Davis:

Do you ever use glycated hemoglobin as a way to gauge patient's carb intake?

How useful is it as an indicator, and what would you consider an optimal glycated hemoglobin level?

What about oat bran?  It has a moderately high level of carbohydrates to fiber ratio, 25g carbs to 6g fiber, per 1/2 cup serving. It's just a little better ratio than a 1/2 cup of whole oats (27g:4g).  I'm just curious, because I gave it up a long while ago, is it now safe to say that oat bran is no longer blanketly recommended in the TYP protocol in decreasing LDL cholesterol?

Here's my own personal daily "soluble fiber protocol" (ratio - carbs:fiber):

- 1 tbsp Konsyl psyllium husk (not Metimucil which has sucrose or aspartame) - 2g;9g

- 2 tbsp organic milled flax seed -  4g:4g

- 2 tbsp white chia seeds - 6g:5g

- 3 tbsp organic raw cacao nibs -  10g:9g

I also regularly nibble on raw almonds, pistachios, and walnuts which are rich in fat, protein, and fiber, and contain little carbohydrates.

i did not see any mention of rice, either brown or white.  is it relatively ok?  substantial populations eat large quantities of it with apparently little/no advese effect

Like anonymous, I am also curious about rice. Guam has rampant diabetes and the local diet is big on rice (and red rice, which is flavored with achiote seeds). It seems to me if they focused on taro, which is a root, they would have healthier diets (umm, as long as they eliminated all fried foods, too). Would this be a reasonable assumption?

Six months ago I bought a glucometer and started checking my blood glucose as suggested in Blood Sugar 101 http://www.phlaunt.com/diabetes/ I discovered my blood sugar, although under 100 when fasting, was over 200 after eating. All grains and starchy vegetables cause a dangerous rise in my blood sugar. I have had to limit my fruits to only a couple of bites at a time. A handful of nuts does not raise my blood sugar.

Great advice to check your own after meal blood glucose. Although post prandial blood glucose can become abnormal 10 years or more before the fasting level becomes abnormal, most doctors test fasting levels only. That is one reason why people often have complications of diabetes such as neuropathy and retinopathy by the time they get a diagnosed.

Some of these reactions have a personal component, I wonder if differences in digestive enzymes are to blame. I can eat oatcakes even at breakfast (in sufficiently small quantities) and quinoa without shifting my BG, obviously I have no Phase 1 insulin but sufficient Phase 2 to deal with relatively low GI stuff.

The only thing worse than wheat for me is wheat mixed with other carbs, the BG spike suggests they are converted to glucose in parallel rather than in series. Other grains are doable in sufficiently small quantities but in general I limit them all and prefer other veggies as carb sources except when I need to deliberately adjust my BG

Don't believe it? The prove it to yourself: Go to Walmart and buy an inexpensive glucose meter and check your blood sugar one hour after eating. You can gauge the health of these foods by observing the blood sugar increases. (Small LDL closely parallels blood sugar rises.)