Dr. Davis, I agree with you whole-heartedly - especially if you have Celiac disease you should learn to eat a more carb free diet - but I am thankful for the gluten-free junk foods.  My 9 year old has Celiac and gluten free cupcakes and pizzas have truly been a godsend for school pizza parties and birthday cake celebrations.  You can explain until the cows come home to a 9 year old that gluten makes them sick and gluten free spikes their blood sugar - but when they are sitting in the classroom while all the other kids ooh and ahh over pizza and cupcakes that doesn't translate for them.  I wish we could change EVERYONE'S thought process on this junk and their wouldn't be these instances at school....but that's another lifetime.  

I actually just posted about this, this very morning on my blog:  http://i-am-paleo.blogspot.com/2011/06/third-grade-is-done-nooooooo.html

Thanks for our amazing blog!!!

I make really good breakfast muffins from coconut flour using Bruce Fife's book and almond meal also makes treats that come out much better than any of those mixes flooding the stores now. I had to get creative when I found out I was pre-diabetic! Making things from scratch allows you to put good quality ingredients in and doesn't take any more time. I still think these kind of treats shouldn't be the mainstay of your diet, but it is nice to have so you don't feel deprived and have more variety.

So how much carb is too much? I don't really eat grains. If I had the equivalent grams in sweet potato, would that be as bad?

I had taken a look at those gluten free breads to see if there was a doable option for hubby, but the ingredients were horrid, so I ditched the notion.

I've been grain-free for a few months, lower carb (I try to stay between 60 and 120, ideally under 100), and this week my endocrinologist said, "You have now resolved your prediabetes." A1c and glucose were nice. HDL and triglycerides were lovely. LDL was up, but the good kind. She was gonna start the statin talk, and I nixed it, but she wants me to do red yeast rice. I'm considering it..gotta read up on it.

Hubby has a hard time keeping weight ON since he went (mostly) grain free. He was becoming underweight from losing too much, so I added potatoes and rice, and he gives in to corn now and then in small amonts. Otherwise, he dropped sugar, except for the occasional dark chocolate square. (He has a raging sweet tooth, so I'm amazed.) I keep telling folks, you wanna drop weight, ditch the sugar and grains. On a tall guy, it's like liposuction, it drops so fast!

And he doesn't fall asleep on the couch right after dinner anymore. Nor do I. That alone is worth ditching grains. Nudge;wink.

Wish the universe could give me some wonderful, non-damaging toast...I miss toast...but it's not worth the cost....and gluten free breads are just downright scary...

Buy yourself a blood sugar meter, eat the sweet potato, and see what it does to your blood sugar.

Red yeast rice has a naturally-occurring statin--Mevachor is basically a pharmaceutical-grade version of what's in red yeast rice.

Well, if red yeast rice is going to give me the same effects as statins, I'll pass. The muscle pains were horrible, and I lived years with that. And the forgetfulness that had me worrying about dementia. It wasn't until they took me off (liver issues) that I realized how wonderful I felt OFF them. Brain began to be like normal and muscles eventually stopped hurting at the lightest touch. Those things don't like me.

Sometimes when I'm out dancing, I'll have a couple of small gluten-free cookies to help with what feels like falling blood sugar.

I'm guessing that pasta made from beans be an acceptable replacement for grain-pasta? Here's a blog post I learned about them from (the distribution site, nor amazon have label photos like this blog does): http://www.j3nn.net/2011/05/13/mexican-black-bean-spaghetti-gluten-free-grain-free-vegetarian/

I've dehydrated cooked beans before, and it should be super easy to powder them with just a regular blender. One of these days, I'm going to play around with making bean noodles, just to see if it can be done with just water. Of course I'll have to make an egg batch too.

While on beans as replacement for carby foods, many food blogs have been posting "bean brownies", and "bean muffins". I don't recall off hand if beans totally replace flour, or just reduce the flour needed. I suspect each site differs in their ratios. I'd probably grate some zucchini into bean muffins to lighten their texture.

PS: I hope there's seed cracker recipes in your book! Hubby HAS to have crackers with salads and soups.

Here's my version. Junk food eating friends loved them enough to ask for recipe:
Black Bean Brownies

2 1/2 cups black cooked beans
3 medium, very ripe bananas
2 tablespoons ground flaxseed or other
1/3 cup cocoa or carob (adjust to taste)
1-3 teaspoons Baking Powder (potassium version so no sodium)
2  tsp vanilla
3/8 tsp stevia  (or substitute with chopped dates to taste)
=============================================
Put all above and blend in food processor.

Spread in 13 x 9 in baking dish. Bake 350 degrees for 20-25 minutes. Definitely tastes best after chilled in refrigerator. Then cut into squares.
    ===========================================
Single Serving

1/2 cup beans
1 large, very ripe banana
2 tsp ground flax or other (I like cashews)
3 Tbs carob
1 tsp bake pwdr
2/3-1 tsp vanilla
3/8 tsp stevia (or substitute with chopped dates to taste)

For me, beans are out. They spike my blood sugar to unacceptable levels. Also they are not part of my paleo/primal diet because of the lectins. If you do use bean flour, be sure it is well cooked. Some beans are quite toxic uncooked.

Anne and ShottleBop make the crucial point on how to gauge individual sensitivity to carbohydrates: Assess one-hour blood sugar after eating.

This is the only way to immediately assess your tolerance to a specific carbohydrate load. A less immediate method of feedback would be to assess hemoglobin A1c, a reflection of 60+ days prior blood sugar.

Being gluten intolerant myself I get my carbs from rice, potatoes, gluten free pasta or bread made from corn flour, I can also reccoment Qinoa which is a grain from South America that tastes a bit like a mix between rice and cous cous and is completely gluten free and is high in energy. You can have it as a porridge in the morning and you can buy it in most supermarkets.

I love quinoa and am using it in everything.  However, just a correction...quinoa is a seed, not a grain.  Not sure if it's processed different from grains in the system, though.

Dr. Davis,

Excuse me if I missed it, but what dose would you suggest supplementing iodine at?

I've been taking a kelp pill with 150 mc since reading your blog posts about it. I seem to feel perkier, but that might be placebo effect, or spring.

Actually your hairdresser might know a lot more than your pharmacist.Hairdressers do have to study nutrition you know!.

You are saying what I have been saying for years! I am so glad I found your blog! I take at least 5000 IU of Vitamin D3 every day.
More often I meet Doctors and other people whitin the prescription drug industry that questions my motive on taking natural nutrition, and all I do is shake my head and wonder why they are allowed to call themselves doctors. I thought that the most important thing was "First do no harm"...

I would add that the vitamin & supp store clerk's advice needs to be taken with a grain of salt, too, at least until you have learned which clerks to trust.  

At the local stores where I buy my supplements, there are some clerks whose judgement I trust quite a bit when choosing a new supplement or brand, because they have given sound, credible advice in the past, and I know from discussions they have a sound understanding of human nutrition and physiology.  

But there are a few clerks I know to avoid like the plague, because they have too often "dispensed" patently untrue, biased, and  uninformed nutrition and biochemistry advice.   One of them (the one with the huge divots in his cheeks from protein deficiencies) tried to sell me "whole food plant-sourced" Vitamin D, with the argument that whole food sources are always superior (I already knew to take the fish liver D3, not the D2 from rradiated yeast or plant sterols).

I'm glad you keep reminding everyone about choosing the right form of Vitamin D - D3.

"Most pharmacists know virtually nothing about nutritional supplements".... got that right.  I asked about vitamin k2 supplements and why there was a 120mcu restriction in canada.  The pharmacist said he knew only about Vitamin K as injections used for babies....

I don't think you should bash hairdressers as ignorant about nutrition.  Mine has lost around 60 pounds eating low carb and looks great.  I'd take anything he says about nutrition seriously.

Personally, I've yet to meet a good pharmacist in Austria. Most of them are even worse than our mediocre doctors; it's really a shame...

I think I know what you're up to with the sleeping poll! ;.)
Is it?

JAMA. 2008 Dec 24;300(24):2859-66.
Short sleep duration and incident coronary artery calcification.
King CR, Knutson KL, Rathouz PJ, Sidney S, Liu K, Lauderdale DS.

I'd love to see the study results discussed.

Interesting, my fiance's father was recently give Niaspan by his doctor and at a pretty high dose. He had a severe reactions, jitters, heart sped up etc. and quit taking it. The Dr. said that couldn't have been caused by the Niaspan but the pharmacist said it was as he had the same reaction when he was on it.

Great Post, Thanks.

I am a bit curious though as to the difference between Niaspan and Sloniacin. From what I've been told, and correct me if I've been given false information, is that Naispan has a substantially quicker release time than Slonaicin, therefore being easier on the liver, especially at higher doses?

Thanks,
Kent

I have a pretty specific question about the Vitamin D issue....

I have a Vit D deficiency -- first noticed by the endocrinologist that I see for hypothyroidism. She prescribed a supplement over one year ago; and I get it tested every few months. So far, I still have a deficiency - I don't know the exact numbers, but I got the impression it hasn't moved much at all. I usually take a gelcap weekly for about six weeks after the blood test, and then drop back to taking it monthly (per her instructions).

After reading the post you referred to above, I looked into it a bit more and confirmed that she has me on D2 (50k units, I think). So I asked her about this, told her about what I'd read on your website and others, and whether it would be better to switch to D3. She was emphatic that it would not...partly (or entirely?? I can't remember if she had other reasons too) because I already take SO MANY medications that finding a schedule that works for taking them where they all work effectively is already a huge challenge. (Some have to be taken alone, like Synthroid, etc. And I'm on warfarin, which just makes *everything* difficult.)

She insists that she can get Vit D stabilized "eventually" with D2, and that sometimes it just takes awhile. She is an endocrinologist with -- as far as I can tell -- a good reputation locally; so she SHOULD know what she's talking about. But I just don't know; and the ongoing deficiency concerns me a little bit.

What is your opinion? Should I be looking for another endocrinologist? Thanks in advance for any thoughts or guidance.

Hi, Jenny--

After an exhaustive search, I have come to the conclusion that nobody knows the ideal dose of iodine for human health.

However, 500 mcg per day has been working well for us.

H--

Your doctor's attitude is, sadly, representative of the knuckleheaded bias of my colleagues: Prescription = good, non-prescription = bad.

Yet there is no rational reason for this distinction when it comes to D2 vs. D3. D3 = human; D2 = non-human. Which are you?

Kent,

I believe they BOTH release over a 6-8 hour period of time. If Niaspan was released faster, my guess is that it would cause more flushing and that less people would be able to tolerate it.

I myself take Endur-acin which is also released over a 6-8 hour period of time.

i usually order mine from IHERB. the reason being is that the feed backs from the users helps to make a collective decision. the feed backs are exclusive to the actual purchasers through email invitations. still better to study my self along with the feed backs. good price, fast shipping, best customer service and large collection.
As to the iodine Dose, Dr davis, you are absolutely right about the iodine dose that no body knows. we have 5 people in our family. our doses are from lugol's 20mg a day to 650mcg from kelp to one person can only take 150mcg every second day. mostly it is the rapid heart beat and light pain behind the neck is the indication of over dose for me. when i first started taking iodine i have taken up to 50MG a day and it was lugol's. i felt great. but soon after few days i  had to reduce my doze. now i am taking kelp tablets with 650 mcg iodine in it. i am taking these with L-tyrosine 500mg along with vitamins B's. i feel that kelp contains bromine, therefore it helps to balance if it is over dose. i also do not take any vitamins or iodine etc. 2 days in a week, so that the body can not get lazy on this extra supply of vitamins. Iodine also helps to cleanup the body from mercury, bromine, fluoride etc. so it may develop little rash or other signs like too much sweating. i also felt that Norwegian kelp feels better than any other kelp for some reason.
the other thing that i noticed that when starting iodine or thyroid hormones, one may notice loose gum and pain around the hard working side teeth. because iodine and thyroid hormones get rid of extra water from the body. bones become smaller and stronger. to get rid of the temporary discomfort to the teeth and gum, we have used turmeric powder as a mouth wash successfully. leave it in the mouth for a minute or so and it will help big time.

H-

"So far, I still have a deficiency - I don't know the exact numbers, but I got the impression it hasn't moved much at all."

Not at all surprising. D2 is only 1/3 as effective as D3. Taking 50,000 IU of D2 is equivalent to roughly 2,000 IU of D3.

I started with a Vit D 25(OH) level of 26 ng/mL and it took nearly 9 months of 10,000 IU/daily of D3 to get an optimal level (70-90 ng/mL).

If you have any of the NUMEROUS medical conditions that need Vitamin D, then you likely will require more D than the average person...if you're carrying extra weight you'll likely need more than the average person...if you're dark skinned, you'll likely need more than the average person...if you live north of Atlanta, GA, you'll likely require more D than the average person...

With all of these factors, its not at all surprising that you haven't yet achieved a good Vit D level since you've only been taking D2.

Taking D2 instead of D3 is like giving a thirty man in a desert a thimble of water to quench his thirst. He's getting water, right? But, it's not enough to do any good, so whats the point?

Take D3 and take enough to get a good blood level.

D3 is best in power or gelcap form?  Does that mean I'm wasting my money on the tablets I purchased?

Hey Kent,

My primary care physician sent me to a cardiologist at Ottawa heart institute.  I had already started using the "Now" brand Niacin after reading a study from Baylor's lipids online.  I asked about Niaspan as I assumed it was a pharmaceutical grade and more accurately controlled.
The Cardiologist's comment was that the blood work indicated what I was taking was just fine but she had no issues providing a prescription for Niaspan.  My insurance at the time covered the cost.  I changed jobs, the new insurance company would not. I take 2grms at bedtime.  I sometimes get a flush and tingling, which I did with Niaspan too; but who the hell cares, my tg numbers speak to the value of this minor inconvenience
Trevor
Sups= Niacin/K2/D3/fish oil

About 9 weeks back, my 25-Hydroxy Vitamin D levels were found to be dangerously low at 12.2 ng/ml! My situation led me to research, begin a self-directed treatment and create a blog www.gkwellness.wordpress.com to benefit others. I have taken a re-test of Vitamin D and expect the new results soon. Considering that my 6th week supplementation went up to 604,000 IU, it would be most interesting to know my new levels which I shall promptly post on my blog.

Becky,

"D3 is best in power or gelcap form? Does that mean I'm wasting my money on the tablets I purchased?"

To answer you I would say that liquid is always the best. The body can absorb up to 98% when taken by liquid, but it can be as low as 20% when taking by pill. With powder you should always wait until it is compleatley dissolved (20 minutes) or you will loose some vital IU's.

However I would not throw away your pills, but take them until you have no more. Until then I would look for a better alternative.

I take my Vitamin D3 by liquid and I love it.

Good luck!

IME pharmacists have a competence range at least as great as doctors

"If you needed a glucometer one would have been prescribed for you"

"Sounds like you may be diabetic, I'll sell you a meter and you can take the test results to your doctor"

two different pharmacists. I've found much the same with respect to knowledge both of drugs and other supplements. A good one can be an excellent source of useful information, if you can find one.

I'd like to second a previous comment to put into perspective that a range of expertise exists across all members of a particular field, whether that be pharmacy or medicine. I've had plenty of disturbing queries from doctors to my pharmacy, one that comes to mind is from a doctor (over fifty years of age) that needed to know the name of any antibiotic that comes in a cream. You would think that over the course of a career, and access to printed and electronic resources within their practice, they could figure it out on their own. However, does that mean most GPs are woefully out of touch and lacking the continuing education necessary to practice or let along know where to find drug info without resorting to the phonebook for the nearest pharmacy? Of course not, branding an entire profession due to personal bad experiences is the same as saying a treatment is fantastic and bound to work because of hearsay evidence, or that it worked for your friend's friend.

Most doctors I deal with are knowledgeable and I am glad to assist with queries, most pharmacists I find the same. If you are asking a 'shop clerk' for help, that is different from asking a pharmacist. It is like asking the receptionist at your  GP's clinic to check your rash and makes a diagnosis.

AustralianPharma
http://askapharmacist.com.au

CT coronary angiograms yield around $1800-$4000 per test. CT heart scans yield somewhere around $200. Though the scan center support staff might not care too much about the money themselves, their administrators likely make the cost distinctions clear to them.

Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

hello -

there IS a difference between Slo-Niacin and Niapsan.  It has to do with the difference btw Ph-dependent release and non Ph-dependent release.  the Niaspan product has a bile containing element that achieves optimum absorption at targeted GI areas.

also, there are two forms of pharmaceutical grade D2/D3:  brand names drisdol and rocaltral.

any Non-Rx you get on the shelf is not regulated.  take at your own risk.