That guy was way ahead of his time.  Doctors were posing for cigarette ads in the '50s.  And who cared if you had "middle-age spread?"  We've just update his benzedrine Rx with Red Bull and triple lattés.  I'm surprised Nitroglycerine wasn't mentioned; my dad took it for his angina.  The winter vacation in the tropics suggestion could have been all about Vitamin D, without knowing it.

The Atlantic Monthly had an essay on the placebo effect that I have never forgotten.  You can read it below.

http://www.theatlantic.com/issues/2000/10/fisher.htm

Interesting... my mother was put on a statin about a year and a half ago due to "hypercholesterolemia" (dx of course by a basic lipid panel).  Around the same time she was also put on thyroid medication.  Her LDL dropped and we all assumed it was the statin...

Low carb diets can influence T3 by lowering it. Certain beta blockers can inhibit 5'-deiodinase too.

What do you think about studies like this one:
http://www.reuters.com/article/healthNews/idUSTRE55B67D20090612

Where they theorize that low thyroid function may be linked to longevity? I believe that has been found in certain species of rodents too and low metabolic rates for elephants (as the article researchers comment on).

I'm not saying everyone should go around being hypothyroid, but am curious what your thoughts are. Perhaps lowered thyroid function is a part of aging?

Stephan Whole Health Source Omega-6 Linoleic Acid Suppresses Thyroid Signaling considers in this blog, the ways omega 6 may be influencing thyroid function.

I'm still wrestling with my pcp over my thyroid. I'm back on Armour 90mgs but my tsh is 5.6, which is needs to be lower, as you say 1.0.  My dr keeps telling me she doesn't want to increase the rx because she's afraid I will get atrial fibrillation. She doesn't test for anything else but tsh

Currently, my morning temps are 96.3, I have trouble losing weight and my LDL is just at the upper range of normal and my LP(a)is 34. I'm not taking statins and am following all of the heartscan blog diet/supplement recommendations. I want to get my LDL down, lower my LPa and regulate my thyroid. Is it risky to take more Armour to lower my tsh?  I am taking 220mcgs of iodine should I increase that?

Jan

I'm a little confused about the iodine thing. I Googled around and found several studies implying that iodine supplementation can increase incidences of hypothyroidism.

Here and here are two of the studies I saw. In the referenced-by section of the last one is an interesting study where excess iodine was found to be the root of goiter and thyroid troubles in some Peace Corps workers in West Africa.

I started googling more specifically and found more sites that warned about iodine-induced hypothyroidism, but the majority stated the opposite (that iodine can help hypothyroidism).

I'm not trying to contradict or anything, but I was wondering if you were aware, that's all. I mean, imagine the result if someone on the AAD (with all the prepackaged food) felt hypothyroid symptoms, and was told by a doctor to increase iodine intake, when they really had more than enough intake already...

Perhaps you've already taken this into account. If you have the time I'd like to know your thoughts on it.

skids--

Time for a new doctor, one who will listen to reason.

Anon with question about iodine. Please put "iodine" into the Heart Scan Blog site specific search and you will find the several discussions we've had about this important issue.

There is no question: We need iodine for health and many--not all--people are deficient.

I have read in a number of places that iodine can worsen Hashimoto's, although Dr. Davis feels it won't. Maybe he is right too, but he has never explained why high dose iodine is typically stated in various thyroid articles as something to avoid if you have an  autoimmune disease (besides potentially causing a hyper flare).

The mechanism for worsening Hashimoto's would be:  iodine increases thyroid hormones, which in turns increases thyroid antibodies, which  then slowly kills off your thyroid quicker. Typically synthetic T4 or armour is used for hashimoto's, which can result in lowered antibodies (usually). I know of two studies where low-dose T4 decreased inflammation + antibodies in Hashi people too.

I don't doubt that supplementing iodine if you are deficient is a good thing. But I am  not sure if large doses are a good idea if you have an autoimmune issue going on.

Anon read:
Iodine: Deficiency and Therapeutic Considerations
http://www.thorne.com/media/Iodine13-2.pdf

The paper makes a compelling case that iodine is not necessarily the culprit. The hypothyroidism & life span data has me still worried, though. But that's nothing new.

From a purely CVD perspective T3 & T4 look like an interesting target...

Nameless--

I said nothing about Hashimoto's. I am talking about people in general. Perhaps you noticed that I am not sitting in front of you providing personal information!

You are correct: If you are in the throes of active Hashimoto's thyroiditis, you should not take iodine, no more than a raging fire requires more kindling.

Let me restate: Iodine is--in the general population-- a necessary trace mineral. Humans cannot live without it.

Dr. Davis,

I didn't mean to infer that you should provide detailed info here, or were even mentioning hashimoto's at the moment.

I just know it came up in past iodine threads, and the autoimmune issues weren't really spoken about in detail then. Since someone here asked about it, I thought I'd make a comment. People sometimes don't get fully tested if they have a thyroid issue (actually based on how doctors treat thyroid people, I'd say most don't get proper testing). I just had a concern that if someone has an autoimmune thyroid issue, excess iodine could be a rather bad thing. So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses.

"So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses."

This is definitely true, but in reality, in conventionally practiced medicine,  it hardly ever happens.  I have been treated for hypothyroidism with T4 (and sometimes T3) for more than three years.  For almost 15 years my thyroid function has been tested, initially with just TSH, then with TSH and total T4, then finally the past few years with free T4 and free T3 tests.  Only my new doctor ever tested for thyroid antibodies.

And autoimmune hypothyroidism usually presents quite differently from plain hypothyroidism - with stops and starts to the symptoms, or even periods of hyperthyroidism.

Dr Davis
Re your comment on what stops T4 to T3 conversion.

Adequate selenium is required to form thyroid hormone and with the increasing amounts of heavy metals (which are selenium antagonists,)we all are absorbing, selenium levels are dropping.

"Selenium is a cofactor for 5’-deiodinase, the enzyme required to convert T4 to T3. A low 24 hour urinary selenium level likely correlates with overall selenium deficiency and decreased tissue availability of T3 due to decreased conversion of T4 to T3."

Rocky Mountain Analytical Lab Report.
www.rmalab.com/index.php?id=16

"Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one."

Statins? (grins)

Agreed, if there's something we could avoid to prevent this it would majorly benefit all those poor folks whose doctors refuse to treat hypothyroid. Who are legion.

Anyone interested in the topic of iodine supplementation and who wants lots of detail ought to read Dr. Guy Abraham.

http://www.optimox.com/pics/Iodine/opt_Research_I.shtml

Will answer any conceivable question you thought you had.

I was going to post a response to your question:

"(Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)"

But it looks like LiveRock already posted 1/2 of what I was going to post and that is that selenium is needed to convert T4 to T3.

The other 1/2 of the problem of T4 to T3 inhibition is Vitamin D. My dad (family physician) said that the 5'deiodinase enzyme is a D dependent enzyme. Crank up the D and add selenium and see if the conversion problem still exists.

He almost always puts patients on iodine PLUS selenium (no more than 400 mg) as well as several of the B vitamins (riboflavin, etc) for thyroid management.

Have you read Dr. Brownsteins book, "Iodine: Why you need it, why you can't live without it?" it's a fantastic read.

Thanks so much for this post.  It's always so interesting to me to read up on iodine in relation to thyroid health.  I have Hashimoto's myself and know that there's so much controversy surrounding iodine... I don't know quite what to believe just yet.  Either way, thank you for your explanations about thyroid levels and cholesterol and treatment. The thyroid and liver are connected in a very powerful way that often gets overlooked.

Thank you!

Liz

Great post!thanks for sharing.now i know that low carb diets can influence T3 by lowering it,try to put some thyroid medication by thyroid kits.

What about fluoride? I've read that it affects the thyroid. Is there a mechanism by which it might affect the conversion of T4 to T3?

What would life be like without CVD deaths?

For a while, the way you describe. But as more people lived into their 80s and 90s the rate of dementia would rise dramatically.

If you visit any dementia facility you will find it is full of normal weight people many of whom are in otherwise "excellent" health--that's what got them to live to 88 or 92.

But once demented, their lives are tragic. Saddest are those who are just demented enough to be totally confused, but not enough that they are oblivious to their condition. All people with moderate dementia  need round the clock care which is not covered by Medicare unless they have no assets. This depletes the savings of humble people who have worked for decades who are left with nothing to leave their children.  Depending on the cause of their dementia people may need full time care for a decade. Once they have no money they are turned over to the warehousing of nursing homes, many of which are horrendous  where those who are still conscious may pray daily for death.

Right now one half of those in the 80-100 age group are demented. The humiliation  dementia inflicts on loved ones is so terrible that anyone who has a relative in this condition (and we have two in our family) will pray that they have enough heart disease to take them out before they go through that long, slow degrading decline.

Many people have unrealistic ideas that they could take care of a loved one with dementia which stem from not having been put face to face with it since the truly demented are usually locked away somewhere.

Note too that though there are attempts to blame dementia on diabetes, I don't buy it. The rate of dementia has climbed with the climb in lifespan though "senile dementia" has always been the fat of a good portion of those who lived to be old-old.

The diabetes diagnosed late in life is part of the gradual failing of their organs and often not the same as diabetes diagnosed in the 40s. It may be associated with dementia but it is far from proven that it is causative.

Beside that, eliminate CVD and the rate of people dying from the prolonged agony of cancer would go up too, because the older people get the more likely they are to develop cancers. Something many people don't know is that chemotherapy administered to older people id prone to cause dementia. It causes mild cognitive problems  in younger people too, but in the old-old it is much more likely to take out their memories.

I'm all for eliminating the kind of CVD that takes people out young, especially since it is so often linked to genetic abnormalities.  But for those in their 70s and beyond, eliminating CVD might simply be to trade one condition for another far worse.

No one lives forever.

It sure doesn't seem like that will happen anytime soon, at least not here... I spent all day calling around to local docs (including cardiologists) and NO ONE had even heard of advanced lipid testing...  I'm ashamed to say that I work for a large hospital system that wants to be "cutting edge" and all about research yet they have no knowledge of basic preventative care in regards to the leading cause of death in our country?!!

Is advanced lipid testing really that advanced?

That is part of my dream, too. But first, people have to have access to correct information, stop being so passive with medical professionals  and then take an active role in establishing and maintaining their own heath.  The real "health" care reform would do everything that you say but would come directly from the people who are receiving so-called medical "care."

Of course, the vested interests will fight this tooth and nail but it would be tough to stop if our population would finally wake up to the way they are being manipulated!

Hi, Jenny--

Thanks for your thoughts.

But I would rather succumb to dementia at age 90 (that I helped delay with vitamin D and other mental-preservation methods) than heart attack at age 59, bypass at age 60, three stents at 63, four more at age 68, living a life of hospital revolving doors. Don't forget about the defibrillator that aborts the ventricular tachycardia that comes from the scar in your left myocardium from the original heart attack.

Millions of people live this way and have not been told that it doesn't have to be this way. That's what I'm talking about.

Lucy--

NOT having advanced lipid testing impairs the identification of the causes of heart disease. It is a big step towards better control over heart disease risk. It identifies treatments that often have nothing to do with more need for medication--that's why your doctors don't know about it.

You probably already know that the bulk of medical "education" does not come from journals or scientific publications, but from the pretty drug representative with dinner invitation in hand waiting in the doctor's waiting room.

Dear Dr Davis,

Your mention of congenital heart disease sufferers made me wonder if you could possibly write a blog about how people with congenital heart disease can improve their heart health please.

Anne

Dr. Davis

I am with you! And to be honest – it is actually horrible WRONG that we are not yet there. We (or at least many people) already know how to escape the dreadful C V and D. Why it is not already implemented in every hospital, doctors’ office, and even in education is scary! But most of it has got to do with a short-term money flow, I would guess.

As boldly as I think we can put most cardiologists out of business I also believe we can eliminate many cancer diseases by natural remedies!

No one has to believe me, but sometimes we are to do ourselves a favor and listen to those who have the degrees to say and act upon statements. What about these well selected and bold statements:

John P. Cook M.D. Ph.D. in his book “The Cardiovascular Cure – How to strengthen your self defense against heart attack and stroke” In his book you can read this: “There is magic within all of us. It comes in the shape of a molecule known as nitric oxide.  A substance so powerful that it can actually protect you from heart attack and stroke.  Best of all your body can make it on its own.  Nitric oxide is your body’s best defense against heart disease.  The body is capable of healing itself.  What you do with the magic is up to you.”

Dr. Louis J. Ignarro; Nobel Prize Laureate in Medicine, 1998; “NO more heart disease – How Nitric Oxide can prevent, even reverse, heart disease and stroke” and you can read this in the book: "You do not have to wait for the rest of the world to see the light--and the drug companies to put new Nitric Oxide-based prescription drugs on the market--in order to take advantage of what Nitric Oxide has to offer.  Even if you have high blood pressure, have suffered a heart attack, or are at high risk...You can beat the odds.  The power to lead an entirely new and healthier life is in your hands.  Carpe Diem--Seize the day!  Start boosting your Nitric Oxide production right now!“

Dr. Jonathan S. Stamler; Professor of Medicine; Duke University Medical Center - "It [Nitric Oxide] does everything, everywhere. You cannot name a major cellular response or physiological effect in which [Nitric Oxide] is not implicated today. It's involved in complex behavioral changes in the brain, airway relaxation, beating of the heart, dilation of blood vessels, regulation of intestinal movement, function of blood cells, the immune system, even how fingers and arms move.“
        
What these gentlemen are talking about is Arginine (arginine transforms into Nitric Oxide once in your body). And Arginine has also been found to: “Improve Memory & Cognitive Functions” (J Physiol Pharmacol 1999), and “May inhibit the division and proliferation of cancer cells” (Br J Surg. 1997)

The list goes on and on… Arginine 5gr or more a day along with Citruline and antioxidants on a daily regularly basis can do all these things and we can at the same time fight cancer and dementia! It is all out there in the nature for us to use!!!

Thanks again for a wonderful blog – if anyone is interested in learning about different product options they can email me (don’t want to advertise anything here – this is about people, not money) Helena.mathis@hotmail.com.

Dr. Davis

I am with you! And to be honest – it is actually horrible WRONG that we are not yet there. We (or at least many people) already know how to escape the dreadful C V and D. Why it is not already implemented in every hospital, doctors’ office, and even in education is scary! But most of it has got to do with a short-term money flow, I would guess.

As boldly as I think we can put most cardiologists out of business I also believe we can eliminate many cancer diseases by natural remedies!

No one has to believe me, but sometimes we are to do ourselves a favor and listen to those who have the degrees to say and act upon statements. What about these well selected and bold statements:

John P. Cook M.D. Ph.D. in his book “The Cardiovascular Cure – How to strengthen your self defense against heart attack and stroke” In his book you can read this: “There is magic within all of us. It comes in the shape of a molecule known as nitric oxide.  A substance so powerful that it can actually protect you from heart attack and stroke.  Best of all your body can make it on its own.  Nitric oxide is your body’s best defense against heart disease.  The body is capable of healing itself.  What you do with the magic is up to you.”

Dr. Louis J. Ignarro; Nobel Prize Laureate in Medicine, 1998; “NO more heart disease – How Nitric Oxide can prevent, even reverse, heart disease and stroke” and you can read this in the book: "You do not have to wait for the rest of the world to see the light--and the drug companies to put new Nitric Oxide-based prescription drugs on the market--in order to take advantage of what Nitric Oxide has to offer.  Even if you have high blood pressure, have suffered a heart attack, or are at high risk...You can beat the odds.  The power to lead an entirely new and healthier life is in your hands.  Carpe Diem--Seize the day!  Start boosting your Nitric Oxide production right now!“

Dr. Jonathan S. Stamler; Professor of Medicine; Duke University Medical Center - "It [Nitric Oxide] does everything, everywhere. You cannot name a major cellular response or physiological effect in which [Nitric Oxide] is not implicated today. It's involved in complex behavioral changes in the brain, airway relaxation, beating of the heart, dilation of blood vessels, regulation of intestinal movement, function of blood cells, the immune system, even how fingers and arms move.“
        
What these gentlemen are talking about is Arginine (arginine transforms into Nitric Oxide once in your body). And Arginine has also been found to: “Improve Memory & Cognitive Functions” (J Physiol Pharmacol 1999), and “May inhibit the division and proliferation of cancer cells” (Br J Surg. 1997)

The list goes on and on… Arginine 5gr or more a day along with Citruline and antioxidants on a daily regularly basis can do all these things and we can at the same time fight cancer and dementia! It is all out there in the nature for us to use!!!

Thanks again for a wonderful blog – if anyone is interested in learning about different product options they can email me (don’t want to advertise anything here – this is about people, not money) Helena.mathis@hotmail.com.

Alzheimer's and heart disease are thought to be connected -- they may both be the result of arterosclerosis.

So a world with fewer CHD victims might not be a world with more dementia patients.

Yes I see both your points. I strongly suspect I am going to die significantly younger than others in my family thanks to the clueless doctors who decided not to diagnose my diabetes, and worse, put me on a high carb low fat diet to "cure" my appalling lipids.

On the one hand going quick of a heart attack while in my prime would be far preferable to what happened to one of my mother's friends: after a quad bypass she gradually declined from being a fit active sociable person to someone who was blind, deaf and incapable but whose heart would NOT stop and give her the release she prayed for. Once you get into that state they can warehouse you for years.

My mom was one who met Jenny's tragic fate.  She did Pritikin and McDougall for years, decades actually.  Though she was a lawyer, played piano and read constantly, Alzheimer's (or a similar dementia) overtook her in her 70s.  She spent several years with caregivers in her home, and then six long years in a deluxe nursing home, burning up all the assets she had saved her entire life.  All we could do was watch.

I believe the low-fat diet she followed wasn't what her brain needed.  She was probably chronically starved for EFAs, especially Omega-3.  But we didn't know what we know now, so we couldn't help.  Of course, I can't know for sure this was the causative factor...maybe this is just my defense mechanism.  But I think Dr. Davis's point is that addressing CVD in no way excludes also addressing dementia.  There's tons of exciting research being done.  Plenty of folks make it to the very end with all their faculties intact.  Why?

Dr. Davis,

What is your opinion on genetic testing and it's potential effect on the treatment of both CVD and (since it's been mentioned in this discussion) dementia?   I know both my ApoE and KIF6, and find it all very fascinating.  I am a 4/3 and a noncarrier for the risky form of KIF6.  I do think there are some potential ethical concerns with genetic testing, but I do see benefits as well.  For instance, supposedly my KIF6 result means that I would likely not benefit from a statin.  So, it's extra leverage in my mind when discussing treatment options with my cardiologist.

"I believe the low-fat diet she followed wasn't what her brain needed. She was probably chronically starved for EFAs, especially Omega-3"

My God, that's an excellent point! Nursing home/hospital food is almost always high carb low fat (and cheap)

Dr. Davis
From what I have learned here and in other like minded blogs (Eads, Stephan, Hyperlipid, BG and others)it seem that the whole metabolic syndrome can be prevented + autoimmune diseases and probably many cancers. This has the potential of really emptying out the hospitals and leaving maily the preventative medicine heroes like yourself and Eads in the front where you belong
I have recently started a blog in Israel, translating to Hebrew some of your (and  the other's) posts. The spreading of ideas resemble sometimes the spread of epidemics. It picks up suddenly so lets be optimistic!
keep up the good work!
Miki Ben Dor http//

Dr. Davis,

Life without CVD is not something that can be dreamed about, but rather something that existed in the recent past.  I have heard stories from MD's who served in the US military during the Korean and Vietnamese wars, and while over there, and in Japan, during those years, were asked by local doctors to call them when the military MD was treating a patient (usually American) for a heart attack or having a heart problem, because they had never or very infrequently seen those kinds of problems in their practices, and wanted to see what it was all about.  So, some parts of the world escaped CVD problems already!

DIB

Hi, DIB--

Excellent point!

I agree: Many lessons are being RE-learned.