Dr Davis,

Please give us your take on KIF6.  I know that the data in some ways is preliminary.  All that I can seem to find is the 3 JACC articles in 1/08.  2 of them simply show a high prevalence of the arg/trp or arg/arg variant. But the study showing a statistical difference in MI/ Cardiac Death in as little as 30 months comparing 40 pravachol vs 80 lipitor is impressive.  Statins do save lives so they are ok with me.  It is just that the number needed treat/ number needed to harm ratio is too high.  KIF6 has the potential to cut the number needed to treat in half.

Co-incidentally I am about to go off my Crestor (40mg) for a "rest". I need to loose weight (5'7" and 195lb) but when I started my p90x program, I found that those annoying muscle aches in my left arm and right hand were such that I could not do a single pull up.  My Dr. asked that I stay on the higher dose of Crestor and supplement with CoQ10.  I will add CoQ10 to the fish oil, Niacin and vitamin D I am taking.  I'm going to start Vitamin K2 supplementation too (Canada does not allow high dose for some strange reason). But more than anything, recognizing some of the side effects I have read here, I think a break from Crestor is  overdue for me.

there is no shortage of criticism on this blog of statins and they certainly are over prescribed.  the real question is: when and only when should they be tried?  It would be helpful if you posted on this now that you have carefully gone in to some of the negatives of statins, but also, acknowledged their value.

What about women with high cholesterol without (overt) heart disease or a family history of heart disease? Some say that older women with high cholesterol live longer and better. This certainly has been true in my family. The women live to 90's without heart disease, total cholesterols 220-250 LDL certainly higher than the current "normal/optimal" but with high HDL and low triglycerides.

Hey there, Dr. Davis. Where are all the testimonials from people who have no side effects from statins and are doing just fine with lowered LDL levels?

Or does your profit incentive prohibit you from being fair and balanced, just like the pharmaceutical industry.

I dare you to publish this post. Not doing do will reveal your true intentions.

Steve and Bruce--

I am mindful of the fact that representatives of the pharmaceutical industry troll the blogosphere and internet in order to post comments to counter the rapidly growing rejection of the statin franchise. If you work for Pfizer, AstraZeneca, et al, I would kindly ask you to mind your own business.

If you do not, then please recognize that what I say is said because of the overwhelming influence of the drug industry. It is a David vs. Goliath world. The drug industry does not need to be defended. They would willingly take as much of your money and your insurer's money as possible. Their goals have little to do with health, but everything to do with profit.

If you have fallen victim to their brand of Kool Aid, then perhaps it's time for a little reality check.

Yet more scary but interesting stuff!

I was put on lipitor but had a (rare but reported) side effect that in retrospect was BG lowering over and above the reactive hypos I was already suffering

Switched to simvastatin and have been on it ever since, it appears to do exactly what it says on the tin, halves my LDL without affecting the lethal trigs and HDL (diet fixed them)

NOW I'm wondering if my apparent senility attacks are in fact not due to advancing age. In typing this I have already done several letter pair reversals. I actually forgot to make an appointment for my blood tests which ironically I am now going to blame on the statin (grins) I was going to drop them for a month prior to the next tests but maybe I am going to drop them now.

Why? I have also begun getting tinnitus. The trigger factor appeared to be NSAIDS, even ointment was bringing it on. Now I'm getting it even without these.

I suspect statin side effects are still rare compared to the percentage of people who don't get them BUT with an increasing statinised population there's a low percentage of a huge population now reporting in, hence the apparently increased incidence.

DR Davis:
i do not work for big pharma or any medical or health related profession, and am only interested when statins should be prescribed since my NMR results showed high small LDL despite my not eating wheat,using fish oils, taking D3 as you suggest. Since my Doc says statin time, i am only trying to get the best info in light of all negative publicity.
Perhaps you read my comment to fast; it was not advocating them, but asking since you in your post allude to possible cases when it should be used.  Your comment to me is therefore way out of line.

I fall on the side of believing that statins should never be prescribed.  From my understanding, while there's a slight indication that they can reduce cardiovascular events, they DO NOT reduce all-cause mortality.  This strongly suggests that they are mostly ineffective at doing what they're touted to do, and they introduce a new set of problems that can reduce the patients quality and length of life.

The purported benefits of statins, in all cases, can be beaten handily by a change of diet and supplements.

I think your personal practice is a testament to this, and yet you still leave several diet and supplement tactics on-the-table that could improve the results you could achieve. (I base this on reading every entry in your blog, and listening to your podcasts with Jimmy Moore.)

I love that you're well ahead of 99.999% of the other cardiologists.

I would like to know of any situation that you can quickly describe in which a statin makes sense.  I have an open mind about this, and perhaps you can convince me that such cases exist.

Stop press, dropped last night's statin and already the tinnitus is much reduced. It was never bad but was increasing and I thought its prevalence at night was due to quietness of the environment not to the fact I'd just taken the statin.

Now in the past I'd dropped the things for a month on month off trial which is why I am confident there were THEN no noticeable side effects.

SSRI poop-out is a well known phenomenon and the explanation used to be that while they upregulated serotonin, over time they would then downregulate dopamine in some individuals.

Most statin side effects I've heard of seem to be fairly instant, now I'm wondering if there's a similar temporal effect whereby some side effects don't develop for months or even years. This might explain why reports of problems are increasing over time even faster than the population is becoming statinised

Just wanted to report back on the break I have taken from 40mg Crestor.  Although I posted here on March 1st, I was really hesitant to stop since I was off on a business trip and not going to be too careful about diet.

Anyhow, full 10 days without Crestor and I have ZERO arm aches and have no issue doing chin ups (well, I can do some and all without the sharp "broken bone" pain).

I know I'm going to end up back on Statins as I really hate eating meat, but while I am trimming down, I will stay off them for maybe 3 or 4 months then get a blood test before asking the primary care phys for a dose recommendation.

An Appeal for Support and Conformation of MRI Results

My daughter has lived with ALS-like symptoms for almost 3 years. The worst of the symptoms began when her simvastatin was increased to 80mg in 2008.
Her MRIs show LESIONS in the brain stem, specifically in the PONS area of her brain.
Of course, her 4 physicians refuse to believe that a statin is involved. They are all satisfied with the diagnosis of “Ataxia”.

My Appeal is to all those who are/were on statins and have similar brain lesions as shown and documented in MRIs. Please reply here, or contact her father directly: Dr Stephen Arvay, stephenx11@cogeco.ca

What I am advocating is that statins be used carefully, after all efforts at correction of lipid/lipoprotein patterns have been made, with an assessment of true coronary risk (not such nonsense as the Framingham score). A more reasonable application of statin drug prescription would shrink the market from its current $27 billion to a tiny fraction of that.

when taking statins, follow doctors advice, take the drugs according to doctors prescription, the  drug carefully to be safe.

Finlaly! This is just what I was looking for.

Ya learn something new evreyady. It's true I guess!

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I've lost most of my wheat belly by eating as you suggest. But it seems like there is a last little bit that won't go away, plus I have "wheat breasts". Is there a reason these things don't go away quickly (especially the breasts), and is there something else I can do?

Everything sounds right on! except for the low-fat recommendations.  A body needs fat!

ok, but what is the mechanism?

Please explain why wheat is a problem food.  I am not looking for clinical trials, just a plausible theory that I can align with or not.

Although I don't impose the burden of data on you, here are a few references with ample data showing remarkable statistical evidence for benefits to vegetarianism:-

http://www.vegsoc.org/info/health2.html

http://www.vegetarian-nutrition.info/updates/vegetarian_diets_health_benefits.php

As a Dr I am sure you would feel bad not presenting a balanced view.

Yes. Think I'd avoid the manufactured oils too and go for more animal fats. Just as nature intended.

It is so true, I have experienced it my self, I never used to eat sweets an cereals, but bread and pasta, have been my main diet, not any more!I used to think I had such a healthy diet as I never ate sweets and refind stuff!!

"Most people will report that a cloud has been lifted from their brains. Thinking is clearer, you have more energy, you don't poop out in the afternoon, you sleep more deeply, some rashes disappear. You will also notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again."

The above quote describes me so well, after eliminating wheat from my life!

Is Rye as bad as wheat?

I appreciate your point here, but...

I've been strictly wheat-free since the start of the year (I've slipped up a bit when I've forgotten to pack my own soy sauce for a sushi outing, and there's probably been some "stealth wheat" in infrequent restaurant meals...otherwise nada). I have some sort of wheat-related enteropathy that provides a strong incentive to be strict. I do eat some non-wheat grain products, but not every day. My sugar intake is also not perfect, but it's still much improved over any point in 2008.

So I should be looking pretty good about now, right? Well, no. My weight seems to have stabilized down about 5-7lb below my previous stable weight, but any changes from that baseline have been strictly upward (mostly water retention after weight lifting). My waist measurement is unchanged. If there's any legitimate loss (beyond water weight due to the lower carb diet) it hasn't come off there. I'm quite overweight, so this is really a tiny drop in the bucket.

This near-total lack of improvement has been achieved with a schedule of 4+ hours of intense exercise most weeks.

So, anyway. Not asking for help, just commenting that the picture is not necessarily as rosy as you depict.

brown rice, corn, quinoa, amaranth, whole barley, millet - there are a whole range of whole grain alternatives to wheat. wheat just seems to be more addictive that other grains.

thanks for another great post.

Sorry it I've missed this in your other posts... but besides wheat, are there, in your opinion, any safe cereals? I've been almost completely grain/cereal free for a year but am thinking about adding oatmeal to my diet. In your experience, how well do your patients tolerate this? Thanks.

I agree with what you say about wheat. I feel much better when I omit it from my diet.

However, I do have a question. Previous generations ate wheat without having the dire health consequences we have now. Was this due to
1. not eating nearly as much wheat as people do today? or
2. not eating transfats and/or tons of sugar, along with the wheat? or
3. performing hard, physical labor, something most of us don't do?
Or, perhaps a combination of those things, plus other factors I haven't even considered.

Before great grandpa went out to plow the fields, he probably had a breakfast of some kind of meat and/or eggs, biscuits, perhaps gravy, and then he worked really hard for hours. The kids walked to school, maybe several miles, and lunch might have been bread and butter and milk. And when they had recess, they played hard. That generation didn't have obesity and rampant heart disease. If we lived the same way our grandparents and great grandparents lived, might we be able to eat wheat products (not the super-refined junk, but what they had available), without the major health consequences?

Healthy oils and lean proteins? That idea is derived from the Mediterranean idea which is derived from the observations of Ancel Keys, the father of the lipid hypothesis. It's pure speculation.

It's rather contradictory. The lipid hypothesis says carbohydrate is good. Thus, we should eat wheat. Yet here you are telling us wheat is actually bad for us. Tell us to eat healthy oils, i.e. vegetable oils like olive oil and canola oil. But then tell us to eat lean meats, implying there's something bad about animal fat, i.e. saturated fat, and something good about vegetable oils, i.e. polyunsaturated fat omega 3/6/9 (without noting that vegetable oils contain many times the amount of omega 6 contained in animal fat). Ancel Keys' lipid hypothesis is based on those assumptions too.

To cut wheat, yes. But to cut animal fat, where's the justification?

@D: I do think exercise offsets a lot of metabolic derangement. It's part of how hockey players (the young serious ones, not slow moving middle-aged folks like me) can get away with eating shockingly poor diets.

Incidentally, my parents tell me my grandpa had very similar symptoms to mine, before I was old enough to be aware of it myself. I have some sort of intolerance or allergy, though.

reply to D:
One of the problems with modern bread is the speed it's produced at.
Starting in the early 1960's bread production was industrialised using "bread improvers". A loaf can now be turned out in just a couple of hours, whereas back in the past it was a long process. Earlier in the nineteenth century and before, bread had to 'prove' using naturally occurring wild yeasts. The time factor is important because of the somewhat indigestible properties of grain. Phytic acid and enzymes in the grain need to be neutralised with a long exposure to yeasts. This can be achieved also by soaking grains overnight or longer.
Traditional societies prepare their grains this way to make them digestible and to get the full nutritional benefit.
See 'Weston Price Foundation' for information for grain prep.

My experience supports giving wheat up completely, not just cutting down. My chronic joint pain went away--maybe an autoimmune-related phenomenon. Will be interested to see if it affects my serum C-reactive protein.

"You will also notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again."

My mother, and paternal grandmother were both diagnosed with hypoglycemia (low blood sugar), and were instructed to eat many small meals per day to avoid symptoms of hypoglycemia.

I started having the same symptoms during junior high, so my mother taught me to eat many small meals to avoid my shakes, headaches, and light-headedness that happened after 3-4 hours without food (except when I ate really large meals occasionally, then I could last longer without food).

I start following Dr. Davis' blog, and he was blogging about the benefits of fasting from some studies. I commented that I didn't think I could fast because of the hypoglycemia, and he replied to stick it out, and stop the wheat. Coincidentally, I had a borderline H1C at that time.

But instead of sticking it out, I forced myself to not eat until my hypoglycemic signs started, then I ate veggies, meat, or fruit, with a few nuts here and there. I'd eat as little as possible, then wait until the next episode of hypoglycemic symptoms. Oh, I did continue eating rice or potatoes, but smaller servings, and quit sugar during that time.

I started noticing I could go a little longer between meals without hypoglycemic symptoms after about 4 days, and I think it was about 7-10 days off wheat and sugar (but still eating a little rice or potatoes) when I went 16 hours without food, and no hypoglycemic symptoms.

My follow-up HA1C was in the normal range after stretching out my meals, and stopping wheat and sugar.

Does wheat reduction works as well (i.e. eating a slice of bread or 30 grams of pasta or breading your meat instead of eating two big bowls of pasta, a loaf of bread, a slice of pizza, several biscuits and pastries daily) or total removal of wheat from the diet is absolutely required?

I believe that wheat and refined carbs are responsible for the 'muffin-tops' and 'wheat bellies' so many folks are carrying around now.
I work with people who have gluten addiction all the time and when they eat a Whole foods diet free of gluten, dairy, soy, and sugar the weight falls off them quick. And onlike most other diets the weight falls off the belly first, which is an awesome motivator. Also, there aren't the constant cravings of the low fat diet. My dad went on the gluten, dairy, soy and sugar free diet plan and his blood sugar and blood pressure went from borderline diabetic/high blood pressure to optimal ranges in a few weeks. He is off all medications now and full of energy at 66 years old.

Now, if I were trying to sell you something, say, an alternative to wheat, then you should be skeptical. If I tell you that drug or nutritional supplement X is great and you should take it, only to follow it with a sales pitch, you should be skeptical.

I have been low carb for 5 years and cut out wheat from my diet completely. No pasta, no breads of any kind, no breading on my meat, no waffles/pancakes/donuts/etc or any grains at all. I also cut out potatoes and corn.

I dropped down from 190 to 135, a normal weight for my height, and I have kept it off for 4 years. I completely believe that the grains we eat now are so far removed from what they used to be  (due to refining processes, selective breeding to be more tasty, etc) that they have become a slow acting poison.

Thank you for this blog!

I wish there was a law that would prevent quackery such as this from being published and promoted.  "This food is evil".  "That food is evil".  Aside from junk food that is high in fat and/or sugar, specific foods or food groups are not the problem unless you have an allergy.

David says:
"I wish there was a law that would prevent quackery such as this from being published and promoted. “This food is evil”. “That food is evil”. Aside from junk food that is high in fat and/or sugar, specific foods or food groups are not the problem unless you have an allergy."

And I wish there was a law that would prevent the 'ignorant gene' from being passed down from parents to children...

Thank you Dr. Davis for bringing this to light.  It would seem plausible that genetically modified grains have contributed significantly to our modern illnesses...most notably, inflammation, diabetes and the dramatic rise in the incidence of celiac disease.  As grains have been "pushed" into our daily diets since the 1970's (think low fat, whole grain nonsense), T-2 diabetes has increased exponentially!  And while there is no 'one-size-fits-all' DIET, if the USDA Food Pyramid (the definitive guide on how to eat healthy!) was so great with its ongoing drumbeat of  "EAT MORE GRAINS!", then wouldn't we have LESS diabetes...LESS obesity...and wouldn't we all be slim and healthy?  I guess this is the reason why the standard American diet has the acronym: SAD...

Hi, Donna--

Well said!

The status quo has gotten us into a heap of misery, health-wise. I am not willing to accept it!

FYI:  There is no longer a USDA food pyramid with an emphasis on grains on the bottom of the pyramid.
It was replaced by "ChooseMyPlate" in August 2011.  It's not perfect.  One fourth of the plate is for grains.  But I am happy to see that half of the plate is for vegetables and fruits.
http://www.choosemyplate.gov/

Are oats and oat and oat bran also bad for you?

We took all oat products out of the diet a while back, due to its extravagant blood sugar-increasing effect.