Pill pushers

28. April 2006 William Davis (1)
Have you read the latest cover story from Forbes magazine? It's entitled "Pill Pushers: How the drug industry abandoned science for salesmanship".

It's great reading. (A condensed version is available at the www.forbes.com website: http://www.forbes.com/business/forbes/2006/0508/094a.html. They require you to provide your e-mail address though it's free.)

Drug industry advertising has raised consciousness of all the prescription therapies available for us--that's good. However, they've gone so far overboard trying to squeeze more and more revenues out of drugs that they've cost this country a huge amount in increased health care costs and even lost lives. (Forbes does a great job of summarizing some of these instances.)

Drugs like Lipitor, Crestor, Zocor; diabetes agents; anti-hypertensive agents, etc., that is, medications taken chronically, a huge financial bonanzas for drug companies. Not only do they get $100-200 per month, but they get it month after month after month. That's per drug.

Now not all medications are bad or unnecessary. There are times when they can be truly necessary and beneficial. But don't rely on drug company advertising to tell us when.
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  • Anonymous

    4/30/2006 8:09:00 AM |

    I feel better then I have in Years.

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Butter basics

Butter basics

24. October 2006 William Davis (3)
There’s lot of confusion about butter, margarines, and their substitutes. Butter/margarine substitutes that avoid the negative aspects and provide modest health benefits are available, but I find that people confuse what's what. So here’s a brief primer.


Butter--Avoid it. Plain and simple. Butter is a rich source of saturated fat. Of 11.5 grams total fat per tablespoon, 7.3 grams are saturated. It is not better than margarine, contrary to simple-minded reports from some media sources. Butter raises LDL cholesterol, raises blood pressure, and has been related to various cancers.

Margarine--Not better than butter, arguably worse. Some argue that the trans-fatty acids, or hydrogenated oils, used to solidify vegetable oils to make margarine solid are worse than butter. In addition to the ill-effects of butter, margarine reduces HDL and raises cancer risk, perhaps even more than saturated fats. Hydrogenation yields a very unnatural structure that modifies cellular behavior of the sort that may promote the appearance of cancer cells. More recently, however, some of the major manufacturers, like Blue Bonnet, have produced soft spread products without hydrogenation. These are reasonable substitutes when used sparingly.

Smart Balance--This is a product made with canola oil, a source of monounsaturates (the best oil source after omega-3s), but manufactured without hydrogenation and therefore has no trans-fats. It does have, in my view, a bit too much saturated fat (1.5 gm per tbsp. in the 37% Light Spread; 2.5 gm per tbsp in the 67% regular spread). This is a reasonable product to use in small quantities.

There is also a Smart Balance Omega PLUS product that contains added flaxseed oil and sterol esters. I do not recommend this product because of the sterol content (see below). I also object to the manufacturers who label their products “rich in omega-3s” when they mean linolenic acid (in flaxseed), which is converted to a trivial quantity of omega-3s. Linolenic acid may pose unique benefits of its own, but it should not be listed as an omega-3 source.

Benecol--This is a butter substitute that contains stanol esters, a substance that reduces total and LDL cholesterol. Two tablespoons a day reduces LDL around 20 mg/dl, more or less depending on your starting cholesterol.
There’s a light and regular spread. The light contains 20 calories less per tablespoon but somewhat less monounsaturates, but the same LDL-reducing stanol esters. The manufacturer does hydrogenate the oils, yielding 0.5 mg trans-fats per tablespoon--a small drawback.

Take Control--Similar to Benecol, but made with sterol esters. Take Control also reduces LDL cholesterol. However, data from several high-quality studies from Finland suggest that sterol esters may, in some people, be absorbed into the blood. This is potentially concerning. There is a rare disease called sitosterolemia that results in coronary disease in teenagers and young adults in their 20s from increased absorption of sterol esters. While you can’t acquire this genetic disease, some people have the capacity to absorb sterol esters from their intestines very efficiently. I find it very disturbing and I suggest that you stay away this product and other sterol-containing products like HeartWise orange juice and Smart Balance Omega PLUS until the issue is clarified and safety assured.

Brummel and Brown--A blend of vegetable oils (soybean and partially hydrogenated soybean) with calories and fats reduced by blending in yogurt. This is an okay product. The hydrogenation yields trans-fats below the FDA required declaration limit of 1.0 mg.
There’s also 1.0 mg each of saturated and monounsaturated fats. The calories are relatively low as a consequence of the added yogurt, only 45 calories per tablespoon. This makes the Brummel and Brown a reasonable choice.


Other products are making their way out to supermarkets. Look for the type of oil used. Canola, olive, and flaxseed are the best. Also look for trans-fats and saturated fat content; both should be low, preferably <1.0 mg per tablespoon, ideally none.

The best choice among the above products in my view is Benecol, though it’s also the most expensive. It will yield substantial drops in LDL cholesterol. All the products in our informal tastings taste a lot like butter, or at least as well as we can remember what butter tasted like! The key with all of these products is use in moderation, since they all provide between 45?80 calories per tablespoon.
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Comments (3) -

  • Jack Christopher

    11/4/2009 12:50:18 PM |

    Dr. Davis, could you update this page? I know you fundamentally disagree with it now

  • Anonymous

    10/23/2010 9:50:57 AM |

    I wonder why Provencal French are able to eat so much butter, fats, red meats, etc... oh, that's right. Unlike Americans, they exercise and practice portion control.

    It's sad when the US has to go to such extremes to become healthy, because they eat far too much and far too many processed foods.

    Sad, sad, sad.

  • buy jeans

    11/2/2010 7:31:46 PM |

    Other products are making their way out to supermarkets. Look for the type of oil used. Canola, olive, and flaxseed are the best. Also look for trans-fats and saturated fat content; both should be low, preferably <1.0 mg per tablespoon, ideally none.

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Statin Diary

Statin Diary

1. March 2009 William Davis (17)
Here are a sampling of some of the comments I've received from people taking statin drugs:


Barkeater said:

On Lipitor since 1997, and pretty sure I had no side effects. Hey, I am a man, I don't complain.

Work has gotten real challenging (but they pay me well). At age 52, 2 years ago, I was fed up with working hard, cranky, and wanted to quit. Very low tolerance for frustration. A year ago, I hit a low spot again, but knowing that quitting was not an option, I started pestering my wife about things married people quarrel about other than money. No matter how great she was, every month or so I would get in a complete funk about it. Meanwhile, my brother had an MI, freaking me out, so at my doctor's suggestion I doubled the Lipitor dose (to 40 mg a day), bringing LDL below 100 and total chol. to 162 (40% below what God's original design of me produced). Plus, I ached a lot after exercise with severe "arthritis" in my hip, and these pains took days to go away, and still I got mad every few weeks at my wife and otherwise into a depressed funk (one morning I wrote an essay about suicide, which was much on my mind). Mood swings could be sudden.

She finally asked whether it might be the Lipitor, which I dismissed as very unlikely because I wanted to believe I was controlling my anger and depression better at that point (not really so) and besides everyone knows that statins have very few side effects. But, I did poke around a bit, and saw that kooky internet people seemed to have a lot of statin side effects, including depression. So, I thought I would quit, as an experiment. Like the JUPITER study, the results were so stunning I had to end the experiment in just 48 hours, except unlike JUPTIER, the clear result was that statins are nasty poisins that were ruining my life. I quickly concluded that no statin would again pass my lips. Depression, gone immediately (I am now 45 days off Lipitor). Relationship with wife, great (maybe "saved" is the word). Athletic performance, vastly better (adjusted for my modest natural abilities), with aches reduced vastly. Ability to withstand frustration, zoomed way way up. I feel totally different, and better; I think of my high cholesterol as my friend, protecting my from the abyss.

The other exciting thing is that I was depending on Lipitor to prevent heart disease, but I see now that it was only a raffle in which I had one ticket, with 75 or 100 other ticket holders in the NNT raffle (to prevent a survivable coronary in the next ten years, but not to prevent death -- that is not a prize in this raffle). There are obviously way better things I can do for prevention, at low cost and no negative side effects (plenty of positive ones, though).

I feel ten years younger. I refer to quitting Lipitor as my "miracle cure." I feel a moral obligation to warn others.



Anonymous said:

It was the craziest thing, my elbows felt like they needed to pop but couldn't. I was taking 20mgs of Zocor, and the first couple of months the elbows were fine, but one day I realized they hurt and wouldn't pop. I enjoy tennis and will occasionally shoot baskets with the boys - working elbows are a requirement for both sports. I told my doctor the problem and he said to stop taking Zocor, and after two weeks he will have me try a different statin. Avoiding Zocor brought relief. After a week of being statin free the elbows stopped aching.

I havn't gone back to my doctor to receive a prescription for that new statin. After learning more about heart disease prevention from this site and others, my starting LDL was low to begin with right around 80, and so decided to take a different natural approach to lower my LDL and more importantly for me raise HDL. I cleaned up my diet and began taking nutritional supplements. It worked, today cholesterol levels are great, and I have working elbows.



Tom said:

Two weeks after I started 10mg/day of Lipitor I developed tinnitus. I had never noticed a ringing in my ears before and now all of a sudden it was LOUD. After three months I saw my doctor for a cholesterol retest (it went way down) and complained of the tinnitus. He said he hadn't heard of this side effect, but I told him the web said 2% complain of it. He suggested I go to 5mg/day to see if it helped. I tried this for a few months, then went totally off for a few weeks, and the tinnitus got better, but never went away. I'm still on a 5mg dose after 9 months and I still have tinnitus. My fear is that the damage is done and the tinnitus will never go away.



Veedubmom said:

I got sun sensitivity from taking Simvastatin. Wherever my skin is exposed to the sun, it turns red and starts itching intensely and my skin looks like giant hives. I have to wear long sleeves, gloves, turtlenecks, etc.



Jegan said:

I was on Lipitor, but as a result of a recent study, asked to go on Simvastatin. I too have never suffered tinnitus until taking statins. I perceive it most at night. It sounds either like a pure high pitched white noise, or often like being stuck in an aviary with a million high pitched birds. I did not suffer any pains, but I clearly am more forgetful. I also feel depressed, and really don;t care about anything... Paying bills, family, cleaning, you name it. Also, my rosacea seems to act up a lot more.



Terri SL said:

Statin side effects are, in my personal experience, vastly under-reported. What Dr. in practice takes the time to fill out FDA complaint forms or contacts independent researchers about a pts. side effects? What pt. even knows that they can do so, whether their Dr. wants them to or not? No surprise about that 80% if you've taken statins!

I've personally taken two different statins (Pravachol, Zocor/Vytorin) and developed horrendous muscle aches even while taking CoQ-10 200 mgs. daily in divided dose. I also experienced mental fuzziness, gait instability and near complete GI shutdown, when Dr. doubled statin dosage against my protests. Stop the drug = complete reversal within ~three days!

What seems to be consistent is the dosage of the statin... the higher the dose, or the more potent the statin (Lipitor, Crestor), the greater the chance of adverse side effects. The other consistency is that Drs. out there in practice are not recommending CoQ-10 to their patients on statins, or at least that has been my experience.


Am I advocating that everyone stop their statin drug? No, I am not.

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.

These drugs can be useful but are miserably and tragically overused.
For a discussion of an alternative to statins for LDL cholesterol reduction, see my post, Which is better?
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Comments (17) -

  • homertobias

    3/1/2009 4:06:00 PM |

    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.

  • Anonymous

    3/1/2009 5:56:00 PM |

    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.

  • steve k

    3/1/2009 9:44:00 PM |

    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.

  • Anonymous

    3/2/2009 12:10:00 AM |

    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.

  • Bruce

    3/2/2009 2:24:00 AM |

    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.

  • Dr. William Davis

    3/2/2009 2:44:00 AM |

    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.

  • Trinkwasser

    3/2/2009 2:25:00 PM |

    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.

  • steve

    3/2/2009 2:44:00 PM |

    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.

  • Scott Miller

    3/2/2009 9:49:00 PM |

    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.

  • Trinkwasser

    3/3/2009 12:21:00 PM |

    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

  • Anonymous

    3/14/2009 7:39:00 PM |

    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.

  • drarvay

    8/8/2010 12:24:56 AM |

    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

  • buy jeans

    11/2/2010 7:35:02 PM |

    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.

  • simvastatin side effects

    5/9/2011 1:57:14 AM |

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

  • Maryland

    7/10/2011 3:56:32 AM |

    Finlaly! This is just what I was looking for.

  • Kassi

    7/10/2011 9:37:58 AM |

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

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DHEA and Lp(a)

DHEA and Lp(a)

16. January 2011 William Davis (25)
DHEA supplementation is among my favorite ways to deal with the often-difficult lipoprotein(a), Lp(a).

DHEA is a testosterone-like adrenal hormone that declines with age, such that a typical 70-year old has blood levels around 10% that of a youthful person. DHEA is responsible for physical vigor, strength, libido, and stamina. It also keeps a lid on Lp(a).

While the effect is modest, DHEA is among the most consistent for obtaining reductions in Lp(a). A typical response would be a drop in Lp(a) from 200 nmol/L to 180 nmol/L, or 50 mg/dl to 42 mg/dl--not big responses, but very consistent responses. While there are plenty of non-responders to, say, testosterone (males), DHEA somehow escapes this inconsistency.

Rarely will DHEA be sufficient as a sole treatment for increased Lp(a), however. It is more helpful as an adjunct, e.g., to high-dose fish oil (now our number one strategy for Lp(a) control in the Track Your Plaque program), or niacin.

Because the "usual" 50 mg dose makes a lot of people bossy and aggressive, I now advise people to start with 10 mg. We then increase gradually over time to higher doses, provided the edginess and bossiness don't creep out.

The data documenting the Lp(a)-reducing effect of DHEA are limited, such as this University of Pennsylvania study, but in my real life experience in over 300 people with Lp(a), I can tell you it works.

And don't be scared by the horror stories of 10+ years ago when DHEA was thought to be a "fountain of youth," prompting some to take megadose DHEA of 1000-3000 mg per day. Like any hormone taken in supraphysiologic doses, weird stuff happens. In the case of DHEA, people become hyperaggressive, women grow mustaches and develop deep voices. DHEA doses used for Lp(a) are physiologic doses within the range ordinarily experienced by youthful humans.
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Comments (25) -

  • Anonymous

    1/16/2011 4:39:07 PM |

    I recently had this test as part of my blood work and have a level of 34, which is very low.  My doctor advised just as you have to start low and go slow watching how I feel.

    This along with some other hormone supplementation has helped my overall well being and energy.  I can't remember when I had my last energy crash.  

    As always, Thanks!

  • Mike

    1/16/2011 5:50:53 PM |

    Interesting stuff, Dr Davis, regarding treating Lp(a) w/ DHEA.  

    What are your thoughts on the efficacy of increasing/maintaining natural endogenous secretion via strength training and/or caloric restriction?

    This is something I'm becoming more interested in as I creep closer to 40.

  • Dr. William Davis

    1/16/2011 9:35:42 PM |

    Hi, Mike--

    I should have mentioned that I only suggest DHEA supplementation for these purposes in people age 40 and over.

    Your idea of endogenous enhancement is the preferred, though relatively modest, route in younger people.

    Thanks for reminding me.

  • Hotwife Admin

    1/16/2011 11:48:46 PM |

    I’m very interested in trying DHEA for this very reason. I’m am a 43 year old male in good health but who had very high cholesterol. I am currently using high strength fish oil and niacin along with cutting out most carbs from my diet. I have lost about 7 kilo since doing this and had some great plummets in my cholesterol. Problem is as I live in Australia we cannot get access to DHEA without paying obscene amounts of money via compounding pharmacies and doctor scripts as it’s a class 1 drug that is illegal. I know in the states you can get it as a nutritional supplement but Australia is backwards in this sense. Do you or any readers know of any sympathetic doctors who are interested in male health and would prescribe DHEA? It seems criminal that we cannot access the health benefits of this because of government bureaucracy.
    Cheers from South Australia
    Dave

  • Might-o'chondri-AL

    1/17/2011 12:59:26 AM |

    Young people produce at least 12mg./day of DHEA; when we reach +/- age 30 our production of DHEA normally drops. I am led to believe that decline is +/- 2 mg./d. for every decade of our life past 30.

    So, for an average patient of (say) 50 years supplementing daily with 10 mg. DHEA: the first 4 mg. is serves to "top up" the natural ageing deficit. The remaining 6 mg. is providing a 50% bonus level for the circulatory system to use thwarting Apo(a).

    Sounds relatively safe intake. I'd like to hear if Apo(a)patients, who took it regularly in middle age, would be taking (say) +/- 15 mg. DHEA daily when they are in their 70's.

  • Becky

    1/17/2011 2:07:56 AM |

    I am 58 years old and was recently tested and had levels of 4.510 ng/mL.  What levels do you recommend as targets for someone wishing to treat Lp(a)?

  • Anonymous

    1/17/2011 3:51:24 AM |

    I have long been fascinated with DHEA but I read too many horror stories on Wikipedia and Consumerlabs.com about the dangers. Cancer, lowering of HDL, and aggressiveness are big turn offs. How do we balance these risks with the risk of heart disease?

    -- Boris

  • JC

    1/17/2011 1:30:34 PM |

    http://curezone.com/forums/fm.asp?i=1448411#i

    Problems with DHEA supplementation.

  • ben

    1/17/2011 2:50:08 PM |

    What do you think/know about magnesium oil's effect in raising levels of DHEA? I take oral magnesium in the form of Natural Calm (citrate i think) but three months ago I also started rubbing magnesium oil into my skin. I have read that this type of transdermal magnesium application raises DHEA levels. Any truth there, Dr.? Thanks

  • Anonymous

    1/17/2011 3:17:30 PM |

    What is a good brand name DHEA, and can it be found in less than 50 mg tabs?

    Thank you.

  • Anonymous

    1/17/2011 5:03:23 PM |

    Anonymous,

    I would recommend Life Extension brand of DHEA. I have had excellent results with Life Extension products over the years. They are a little more costly, but I believe the quality is top notch. Unfortunately however, the smallest dose of DHEA that LEF makes is 15mg.

    Here is what Ray Sahelian, M.D. says about DHEA:

    http://www.raysahelian.com/dhea.html

    I myself had low levels of DHEA and low testosterone and I took DHEA (starting at 25mg and going all the way up to 75mg) and while my DHEA levels went up to the upper end of the reference range, my testosterone only increased by 9%-10%. I ended up discontinuing the DHEA because I couldn't get my testosterone levels up sufficiently and I was concerned about possible longer term side effects even though I didn't really experience any of the horror stories you read about online.

    I don't have Lp(a) problems, but if I did, I would consider taking DHEA again in lower doses (15mg-25mg for me) however.

    Hope this helps.

  • Anonymous

    1/18/2011 2:51:56 AM |

    I've been taking the stuff since my mid-30s and found it to be great for general energy, mood and body composition. However, I've never been able to take more than 15 mg a day. That's low for a male, I know, but 25 or more and I get ferocious acne.

  • Maggie

    1/18/2011 5:53:12 AM |

    I was taking 10mg DHEA but have switched to 7-KETO (just 25mg a day at present). I believe that 7-KETO, as a naturally occurring metabolite reduces the risk of DHEA side effects, so was this a good idea?

    (I am a 50-something female.)

  • Dr. William Davis

    1/18/2011 1:21:34 PM |

    Hi, Ben--

    Sorry, no knowledge.

    I did ask one of the manufacturers of topical magnesium preparations (creams, epsom salts) whether they had any data in humans showing effects on magnesium blood levels. They said they had not generated any nor were aware of any.


    Several commenters--

    The "horror stories" surrounding DHEA all refer to the higher, supraphysiologic doses I mentioned, not the low, physiologic replacement doses we use for Lp(a).

    Also, this is about DHEA for Lp(a), not DHEA for youth preservation. Two different perspectives.

  • JC

    1/18/2011 1:39:27 PM |

    Q: I've been feeling really tired for a while now. My doctor checked my DHEA level which was very very low -- less than the level typical for an 80 yr. old woman and I am less than half of that! Could you please suggest some supplements for me? I know that there are DHEA supplements but these aren't available in Canada. Is there something else I can take? Thanks!





    A: I have never been a fan of hormonal substitutes, including glandulars. With hormone replacements there is a great risk of atrophying the glands that normally produce the hormones. There are two reasons for this. One is a feedback mechanism in which if high hormone levels are perceived in the body the gland will be shut down to compensate. Secondly, glands are like muscles and must be worked to be kept healthy. Substituting for the glands makes them weak over time. I have seen some people claim that DHEA does not atrophy glands like other hormones, but rather leaves the adrenals producing the same level of hormones. Of course even if DHEA was not atrophying the glands and was leaving the glands to produce DHEA at the same level then the adrenals would still be producing at a diminished output. Therefore, the DHEA would do nothing to boost adrenal performance.



    DHEA is classified as a weak androgen (male hormone). It is converted in to estrogen and testosterone, but not the balancing progesterone. This may lead to problems of elevated estrogen, including weight gain, thyroid dysfunction, problems with blood sugar, and problems with elevated testosterone, including increased body hair, and loss of scalp hair. There is also a lot of concern about the possibility of causing cancer or promoting existing cancers. There is not enough known about the actual long term effects of this hormone. Many of the studies on DHEA were done on rats, which do not have the same chemistry of humans. And the few human studies I have seen on DHEA were short term studies looking for improvement of certain symptoms, not side effects including the risk of adrenal atrophy. Overall I really think that DHEA supplements should be avoided!


    DHEA is normally thought to decline due to age, though this is not necessarily the case. Primary production of DHEA occurs in the adrenal glands. Therefore adrenal function may directly affect DHEA levels. And the majority of the people are exposed daily to two of the biggest weakening factors for the adrenals, stress and stimulants. Stress can be physical, such as pain, or emotional. And both can be increased by reduced adrenal function since the adrenals produce the anti-inflammatories and anti-stress hormones for the body. Stimulants include caffeine, ephedrine, pseudoephedrine, and nicotine. Various pharmaceuticals can weaken adrenal function. The best known of these are steroids, such as Prednisone. Though anti-seizure medications, antifungals, cold medications, asthma medications, etc. can also cause adrenal weakness.


    In short it is safer and more effective to build up your adrenal glands so they will produce their own DHEA at proper levels, rather than raising levels artificially to abnormally high levels. This is best addressed with vitamin C and pantothenic acid, the most important nutrients for proper adrenal function, and adaptogenic herbs. Adaptogenic herbs get their name from their ability to help people to adapt to stress by improving adrenal function.



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  • xenesis

    1/18/2011 4:08:03 PM |

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  • Anonymous

    1/18/2011 4:51:44 PM |

    At a dose of 50 mg daily, DHEA has not resulted in any decrease of HDL for me.

  • Might-o'chondri-AL

    1/18/2011 7:02:49 PM |

    Adrenal genetic factors will not let everyone respond to "boosting". Of course, the same genetic quirks imply high dose DHEA (de-hydro-epi-andro-sterone)is not wise.

    Worldwide +/- 1:1,000 develop late onset congenital adrenal hyper-plasia; among Hispanics 1.9%, Italians 0.3%, Slavs 1.6%,
    Ashkenazi Jews 3.7% and caucasians generally 0.1%. Hirsutism (face hair) is an easy sign in women; adult acne for both genders.

    A genetic enzyme 21-hydroxylase deficiency is the rate limiting factor in 95% of these cases. Then low amounts of cortisol are made. Signals for more, by cortico-tropins, "whips" the adrenal cortex; trying to get more cortisol output. But, the inability to synthesize cortisol makes all those building blocks go into production of androgens.

    Additionally, there are 12 known genetic mutations of the gluco-dorticoid receptors. These make the body "resistant" to deal with the cortisol in circulation. Without de-activation (receptors a first step) into cortisone the cortisol level stays elevated.

    In this situation both adrenals are, in a sense, overworking for no purpose. Progressively this leads to arterial hyper-tension down the way. So-called gluco-corticoid resistance, as a syndrome, develops in 10% of the elderly.

    Point being that genetics, and the epigenetics of age, are some reasons why not everyone will respond to a "natural" plan. It also explains how different people respond to supplement dose of DHEA.

    Paradoxically, genetics that mean patient can't be made to do what others can backs up Doc Davis' clinical DHEA use. If it is for combating high Lp(a) with small doses of DHEA.

  • Anonymous

    1/19/2011 5:29:09 AM |

    I've never heard of topical magnesium supplements. It's awfully hard to imagine effective delivery of a cation/ionic salt through intact skin. Nor can I see any advantage in trying. Oral Magnesium supplements are readily absorbed and cheap. I'm also skeptical of claims that magnesium would optimize DHEA levels in most people. Magnesium is integral to the function of many enzymes, but unless it's the rate-limiting step in DHEA production and someone has a serious deficiency, I can't imagine how more magnesium would fix the issue. One CAN make a decent pharmacokinetic argument in favor of topical DHEA to minimize first-pass metabolism etc.

  • Onschedule

    1/19/2011 6:41:37 AM |

    There's nothing like a warm bath with Epsom salt... I do believe magnesium is well absorbed through the skin, though I am ignorant of how it compares with oral supplementation. I get the same effects (deep sleep, vivid dreams) as with oral supplementation, only more pronounced with the bath.

  • Kelly A.

    1/20/2011 5:55:41 PM |

    My Lp(a) result was zero when I tested it a few years ago.

    Was this inherited and will it likely always be absent? I can't find much if any info on nonexistent Lp(a).

  • Anonymous

    1/23/2011 10:49:00 PM |

    I take 12.5 mg DHEA twice daily with no side effects - I just feel better. I am sure I was deficient - I plan on testing soon. I'm 43.

  • kris

    2/28/2011 11:59:31 PM |

    i tried 25mg and it drove me nuts. cut it down to 12.5mg and all of the crazy symptoms gone and i feel much better ocer all. wife tried 12.5mg and she felt bad. she cut it down to 6mg and she is fine too. thank you so much Dr. Davis

  • Anonymous

    4/13/2011 10:53:52 AM |

    Thank you for your valuable post.  We have decided to share it with our global physician audience at PhysicianNexus.com:

    http://physiciannexus.com/forum/topics/dhea-and-lpa
    Jaerou Kim
    Team Member
    www.PhysicianNexus.com
    Physicians Comparing Treatments Worldwide

  • kim

    6/4/2011 11:28:12 PM |

    Boris,

    Based on 15 years of study and research, I would say (and truly without sarcasm) for you to stay away from Wikipedia (who get their info from google, FDA and American Medical Assoc) all of which are political agencies who DO NO ACTUAL RESEARCH THEMSELVES, but get their info from pharmacueitcal companies who HATE vitamins and nutritional supplements because they cannot patent them and make any money.

    The horror stories that you have read at those sites are simply opinions of people who took as the gospel media soundbites on reported research and did not search out viable valid resources who study the actual research reports.

    Dr. William Davis (of this site) is actually a very good resource for your valid health information.

    Now stay away from those silly sites you cited and you can Live long and prosper.

    Best of Health To You

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"I can't do it"

"I can't do it"

30. May 2009 William Davis (20)
Anne sat across from me, bent over and sobbing.

"I can't do it. I just can't do it! I cut out the breads and pasta for two days, then I start dreaming about it!

"And my husband is no help. He knows I'm trying to get off the wheat. But then he brings home a bunch of Danish or something. He knows I can't help myself!"

Having asked hundreds of people to completely remove wheat from their diet, I witness 30% of them go through such emotional and physical turmoil, not uncommonly to the point of tears. For about 10-20% of people who try, it is as hard as quitting cigarettes.

Make no mistake about it: For many people, wheat is addictive. It meets all the criteria for an addictive product: People crave it, consuming it creates a desire for more, lacking it triggers a withdrawal phenomenon. If wheat were illegal, there would surely be an active underground trafficking illicit bagels and pretzels.

Withdrawal consists of fatigue and mental fogginess that usually lasts 5-7 days. Just like quitting smoking, wheat withdrawal is harmless but no less profound in severity.

People who lack an addictive relationship with wheat usually have no idea what I'm talking about. To them, wheat is simply a grain, no different than oats.

But wheat addicts immediately know who they are. They are the ones who can't resist the warm dinner rolls served at the Italian restaurant, need to include something made of wheat at every meal, and crave it every 2 hours (matching the cycle of blood sugar peaks and valleys, the "valley" triggering the craving). When they stop the flow of immediately-released glucose that comes from wheat (with blood sugar peaks that occur higher and faster than table sugar), irresistible cravings kick in. Then watch out: They'll bite your hand off if you reach for that roll before they do.

Break the cycle and the body is confused: Where's the sugar? The body is accustomed to receiving a constant flow of easily-digested sugars.

Once the constant influx of sugars ceases, it takes 5-7 days for metabolism to shift towards fat mobilization as a source of energy. But along with fat mobilization comes a shrinking tummy, reducing the characteristic wheat belly.

If you try to quit smoking, you've got "crutches" like nicotine patches and gum, Zyban, Chantix, hypnosis, and group therapy sessions. If you try and quit wheat, what have you got? Nothing, to my knowledge. Nothing but sheer will power to divorce yourself from this enormously destructive, diabetes-causing, small LDL-increasing, inflammation-provoking, and addictive substance.
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Comments (20) -

  • Ghost

    5/30/2009 5:00:26 PM |

    I totally went through that. It took me several tries to quit wheat, and I still mess and have a cookie or a sandwich once every few months-- generally while eating at someone else's house. One thing that helps keep me straight: the ONLY time I get acne anymore is when I eat wheat or chocolate. So now when I think about how much I want a dinner roll, I try to imagine how many spots I will get on my face if I eat it, and ask myself if it's worth it.

    I have read in other sources that wheat, like A1 dairy (from Holstein cows, rather than A2 from Jersey or Guernsey or goats) contains opioid-like molecules, and this is why some people exhibit addictive behaviors in response to them-- and that people who are addicted to wheat also tend to react that way to milk. This certainly matches my own experience.

  • Nancy LC

    5/30/2009 5:15:50 PM |

    When I found out I have a reaction to gluten what I did was repeat to myself "Poison" every time I saw something with wheat (or gluten) in it.  When I smelled it, same thing.  Sometimes I'd use visualizations to imagine it was green and moldering like something poisonous.  It really worked to reprogram me.  I haven't once broken my conditioning and voluntarily ingested gluten, and I don't have the extreme reactions some people do, they can be pretty subtle and take a long time to really make themselves known.

    Maybe it's a technique that other people could find useful.

  • Gretchen

    5/30/2009 6:30:07 PM |

    If it takes a week, maybe you could try some weeklong retreats at which no wheat was available. People would have social support as well as a lack of temptation.

  • Anonymous

    5/30/2009 6:37:44 PM |

    Low Dose Naltrexone might help..

  • thania

    5/30/2009 6:53:33 PM |

    I understand that, I quit smoking 67 days ago, doing low carb, I dont miss as much wheat but rice yes. I have put on 20 lbs low carbing?? I havent ate more that before 1200-1800 cal, depending on the day. But I am a bit depressed dont feel like moving , so less work outs. The heavier I become the less I feel like moving, and I also am having hormonal changes...,
    I feel very unhappy, but dont want to smoke again, this time is for ever.

  • Anne

    5/30/2009 8:21:30 PM |

    I am not the Anne in your post, but I was addicted to wheat. It was my favorite food. I lived on and for breads. Then I discovered I was gluten sensitive and I did go through a withdrawal of about 4 days. After 4 days I noticed my health problems were disappearing. Depression, brain fog and joint pain are 3 of the many symptoms that disappeared. That was 6 yrs ago.  

    Of course giving up gluten does not mean I gave up sugar. I still got my sugar fix with candies and alternative grains. Then I found out my blood sugar was too high so I started eliminating anything that spiked it. I easily lost 20 lbs with low carb eating that got my blood sugar under control.

    Tell Anne that I had dreams about bread in the beginning - they will pass. Now the donuts, breads, cookies and cakes in the stores and at work don't even look good. In fact, I don't like the smell of bread anymore. It takes time, but the cravings do pass.

  • Tom

    5/30/2009 8:49:44 PM |

    I agree, although this leaves open the question of why some people get addicted to things and some people don't (the 10%-20%).

    Meditation and problem-solving seem to be effective cures for all varieties of addiction. Exercise might be used as a substitute for meditation.

  • Lena

    5/30/2009 9:36:50 PM |

    I cut out everything with gluten pretty much immediately once I figured out it made me very ill. That wasn't hard. As for reducing intake of other carbohydrates, I just did that gradually and avoided the desperate cravings. I don't see any particular need to cut down on wheat and refined carbohydrates in one drastic move. Maybe first week, reduce intake by 20%, then another 20% the next week, then in about a month you'll probably be doing fine.

  • Ed

    5/30/2009 10:08:58 PM |

    I've heard "wheat spikes blood sugar more than sucrose" before, and upon reflection, I'm not sure I understand it.

    I assume this is for an equal amount of carbohydrate, ie 100 grams starch (not 100 grams wheat) vs. 100 grams sucrose.

    The problem I see is you're comparing 100 grams of glucose to 50 grams glucose + 50 grams fructose. After looking at it that way, wouldn't you expect your blood *glucose* levels to spike higher with starch than with sugar?

    (Suggesting that sugar is the same as other carbohydrates has become my pet peeve. Technically fructose is a carbohydrate, but the human body processes it totally differently than glucose. It's like saying oleic acid is equivalent to linoleic acid because they're both lipids.)

    Anyway, I have worked grains, sugar and "vegetable" oils out of my diet and my waist just sort of evaporated, while not going hungry -- eating pretty much as much of anything else I want. I would offer moral support for anyone else trying to do the same. Keep at it, the effort is worth the result.

  • Captain Mikee

    5/31/2009 12:06:16 AM |

    Actually, if you are lucky enough to live near a chapter of Food Addicts Anonymous, I think you can get help there. Unfortunately, I do not.

  • Scott W

    5/31/2009 1:45:35 AM |

    I completely agree that wheat is addictive to many and I personally never eat it. However, I'm not sure that your basis for this position, as stated in your posting, passes the credibility test. You have related the addictive capacity of wheat to its starch load, rather than its gluten content.

    If the only reason that wheat is addictive is its starch, then the same position could be taken on potatoes, rice or bananas. But no one ever says they are addicted to boiled potatoes.

    Now, if the patient has a compromised metabolism (type 2 diabetic), then they truly do have a problem with all carbs - not just wheat - and the blood sugar swings that can result.

    However, I think that for a person of normal metabolism (good blood sugar control), it's not the carb content of wheat but its gluten that cause the addiction and other issues.

    Thanks for your ongoing willingness to share your insights from your medical practice.

    Scott W

  • mongander

    5/31/2009 3:25:09 AM |

    In addition to following Dr Davis, I also follow Dr Gabe Mirkin.  So I have compromised and quit wheat, but continue to eat whole intact barley and oats.  Have done well, losing over 60lbs, with the help of exercise.  Haven't had the comprehensive lipid tests nor the heartscan but at age 70, feel good.  Last total cholesterol was 158. Also take niacin, K2, and fish oil.

  • stern

    5/31/2009 4:30:57 PM |

    we need to restrict from carbs since we started with the poisenios wheat ,but we can get along with healthy carbs which is organic whole einkorn sourdough bread ,does any have a tip on how to rise it without yeast please let hear from you

  • Anonymous

    6/3/2009 2:24:54 AM |

    For rising sourdough try Kefir !

  • Shreela

    6/4/2009 12:35:42 PM |

    While waiting for my doctors to diagnose my gut ailment, I thought it sounded like I had a few gluten-intolerance symptoms and was desperate enough to try cutting gluten from my diet to see if I could stop the terrible pain.

    The pain did stop fairly soon after stopping wheat/gluten, so it seemed I had Celiac, so I continued being wheat/gluten free.

    After reading about how difficult it was for people because of the cravings, I searched for gluten free substitutes for baked goods and pasta. They were pretty expensive online, and that's not factoring in shipping prices. So I thought I'd tough it out if I got the cravings.

    I did get them. It was rough for about 2-3 days, then faded a little. Watching TV didn't help either! I decided to try out some local health food places and found one that carried a nice selection of gluten free baking mixes and pasta.

    My husband almost laughed as I fought off tears when I ate gluten-free muffins, after eating NO muffins for at least a month.

    And eating those gluten-substitute baked goods and pasta DID help reduce my cravings! So I'm guessing that once I past the rough first few days, maybe I was craving foods I used to enjoy but could no longer eat.

    Although Dr. Davis warns about gluten-free products still being high-glycemic and spiking blood sugars, I'm still suggesting that if you're not diabetic, and want an easier time going off the wheat, try gluten-free products to see if they offset your cravings, for it might be a combination-craving of both gluten, as well as comfort foods. After a few weeks off the gluten altogether, then wean down the gluten-free products if needed for normalizing blood sugars, weight-loss, and not spending so much on expensive gluten-free products.

    Meanwhile, my gluten-intolerance bloodwork returned negative! It looks like it was IBS triggered by insoluble fibers in whole wheats (and some other foods). But even though I discovered I can tolerate processed flour, I don't eat nearly as much flour/gluten as I did before this experience, since my borderline A1C dropped a lot after being off wheat products.

  • Anonymous

    6/4/2009 12:47:05 PM |

    In response to the sourdough , do you have a recipe using the Kefir? Thanks

  • Trinkwasser

    6/17/2009 12:56:14 PM |

    "If you try to quit smoking, you've got "crutches" like nicotine patches and gum, Zyban, Chantix, hypnosis, and group therapy sessions. If you try and quit wheat, what have you got? Nothing, to my knowledge. Nothing but sheer will power to divorce yourself from this enormously destructive, diabetes-causing, small LDL-increasing, inflammation-provoking, and addictive substance."

    It's worse! With wheat you have friends, relatives, bakeries and especially *mothers*, pushers all

    grrrrr

  • jpatti

    7/24/2009 11:57:04 AM |

    I've done induction to go back to low-carb several times when I'd gotten off track.  For me, it does feel like a withdrawal, and I tend to feel sick 2-3 days if I do it strictly, whereas otherwise I feel crappy for a week.

    I choose a time when my life will be relatively low-stress, roast a whole turkey and buy a bunch of pepperoni for snacking on.  Going meat-only for a few days makes the withdrawal pass faster.  

    After a few days of turkey and pepperoni, I add back in vegetables, then a few days later dairy, then later still, low-sugar fruits.  

    IME, that's fastest way to get through the ickiness.  

    And REMEMBERING the withdrawal is the best way to avoid having to go through it again.

  • Anonymous

    12/26/2009 3:09:37 PM |

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  • hopeful geranium

    5/19/2010 11:27:35 PM |

    Tom, the 10-20% addicts are not the same people for every drug.
    I was junkie, speedfreak, benzo addict, alcoholic, ether sniffer for years (decades). I chain-smoked when high (lucky to be alive smoking on ether) but always went off tobacco when sober - I could never get hooked on cigarretes, never had withdrawals, don't smoke now, but if I chose to once, it would be the only time.
    Apparently 20% of people don't have the tobacco addiction gene. Most don't smoke at all, but I enjoyed changing my consciousness with tobacco while high on other things. 20% of men where I come from are red-green color blind - I wonder if this is connected to the gene for no nicotine addiction.
    Perhaps nicotine, for all its effects, didn't interact with endorphin receptors, and for addicts, there is a link? This is known to be important for determining who gets alcoholism.

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