Dr. Joseph Prendergast and l-arginine

In response to a discussion started by Track Your Plaque Member, Rich, on the Member Forum, I tracked down Dr. Joseph Prendergast, who had posted a video on his unique experiences, both personal and professional, with l-arginine.

Dr. Prendergast describes some of this in a brief webcast. Here, I quote Rich:

“This 90-second video by a Palo Alto physician (internal/endocrine, diabetes specialist) will totally blow your mind.

http://enews.endocrinemetabolic.com/2007/08/16-12-years.html

You will see in the link below that he reversed his personal atherosclerotic disease, diagnosed in abdominal aorta at age 37—completely reversed. He's now much older."

http://www.endocrinemetabolic.com/about/press/larginine.pdf



I contacted Dr. Prendergast to find out more.

Dr. Joseph Predergast is founder of the Endocrine Metabolic Medical Center in Palo Alto, California, focused on providing care for people with diabetes. In addition to the website, he provides Blogs and newsletters, though most of his conversation is about diabetes issues. Dr. Predergast’s website is located at http://www.endocrinemetabolic.com.

I asked Dr. Prendergast several questions about his l-arginine experience. His brief answers are below.



1) What dose of l-arginine have you employed in your patients and why this dose?

The dose is 3 - 6 grams as suggested by the Stanford Cardiovascular Research Department Chairman John Cooke. http://med.stanford.edu/profiles/John_Cooke/

2) I gather that you have preference for specific preparations of l-arginine. Can you say why some preparations seem superior to others in your experience?

I started with pharmaceutical l-arginine from the pharmacy. I gradually began to add components that would augment the power of the l-arginine and have gone through 12–15 different products. I have completely reversed my own very severe atherosclerosis discovered at age 37 and there has been less than 0.05% cardiovascular disease in my endocrine practice in almost 17 years. Both my exams were evaluated with CT technology. I am now using ProArgi9 Plus that includes several anti-aging components and will likely never switch. http://www.synergyworldwide.com/synergycorp/home.aspx

3) Are you employing any other unique practices in your patients to reduce cardiovascular events?

Withdrawing as many prescription drugs as possible.




Interesting. Of course, I also advocate l-arginine as a facilitator of atherosclerotic plaque regression, though I am not as ebullient about its use as Dr. Prendergast.

Instead, I see l-arginine as a method that yields forced normalization of “endothelial dysfunction,” the abnormal constriction and other effects that develop when abnormal lipoproteins and unhealthy food by-products are present in the circulation. Endothelial dysfunction is an inevitable accompaniment of plaque.

However, unlike Dr. Predergast’s experience, despite our use of doses higher than he uses, I have never seen plaque regression just using l-arginine alone. Nonetheless, it’s good to hear that others are seeing at least some positive effects.

By the way, we have also had some positive posts on our Forum about the ProArgi9 product he uses.

Comments (21) -

  • DietKing2

    9/7/2007 5:58:00 PM |

    Dr. Davis,
    Thanks for putting up this information and for bringing this doctor into full view for me--I'm always seeking out better and newer ways to prevent any kind of heart problems from manifesting themselves in the first place!

    This information/news is very exciting and encouraging!

    Thank you again!
    Adam

  • Warren

    9/9/2007 5:08:00 AM |

    Dr. Davis,

    The product Dr. Prendergast endorses is made by a company he works for and is also sold by his clinic, and lists at $97 for a 30-gram supply.  So following Track Your Plaque principles, this would cost almost $200 a month.  Do you think the claimed improvements in this l-arginine product really justify this huge expense?

  • Warren

    9/9/2007 6:55:00 AM |

    I'd like to correct my earlier comment - the product has 30 "servings" that deliver 5 grams of l-arginine each.  In Track Your Plaque, you recommend 5 to 6 grams twice daily, so this would last 15 days.

  • Dr. Davis

    9/9/2007 1:37:00 PM |

    Hi, Warren-

    As often happens, it is difficult to separate marketing from fact.

    I am personally skeptical that this product offers any specific advantage unless they produce specific data to prove it. I hope my questions to Dr. Prendergast do NOT come across as an endorsement. It was simply providing some information from an interesting perspective, in this case dug up by a Track Your Plaque Member.

    For these reasons, one of the tools we're working on is the Track Your Plaque Marketplace, a place on the Track Your Plaque website that will allow both us and you to post your comments, experiences--both good and bad, and sort of WIKI-like collective experience and wisdom. We're also trying to arrange the possibility of free samples for trying some of the products.

    As always, we are not selling the products, but directing people to the places they are available.

  • Rich

    9/10/2007 1:39:00 AM |

    Hi Dr. Davis and Warren:

    FYI, Dr. Cooke of Stanford told me earier this year that he has "backed away" from the arginine endorsements and he wishes to revise his 2002 book on the subject.

    I made another comment in the Advanced Discussion board today about Dr. Prendergast, if anyone is interested.

  • Rich

    9/15/2007 2:21:00 AM |

    Apologies for all the comments:

    I looked at the ingredients in the expensive arginine product that Dr. Prendergast endorses. It has a few extra good things -- that don't justify the price -- but are useful:

    Arginine 5g
    Citrulline - "Proprietary" - I estimate 0.5g
    D3 powder - 2500 IU (may not absorb per Dr. Davis's recommendations on oil-solubility)
    Ribose - "Proprietary" - I estimate 1g -- not enough to do anything
    K2 - 20 mcg (not enough)
    B6, B12, Folic -- small amounts
    Grape stuff - "Proprietary" - maybe 50 mg or so of polyphenols

  • Anonymous

    9/19/2007 3:29:00 AM |

    I'm baffled. After reading your book and researching
    the net on l arginine I sent away for Now Sports l-arginine powder (100% pure free form).
    I just received  it today and on the suggested usage table it states "Do not use if you have established
    coronary artery disease".
    Why would they say that ?
    Love your blog
    Gene Mc

  • Dr. Davis

    9/19/2007 12:08:00 PM |

    Hi, Gene--

    The only reason I know of was a study that suggested heightened risk of death if l-arginine is taken after a heart attack.

    In my view, the study was flawed since it is alone in show this effect, the numbers were small, and the majority of the deaths in the group taking arginine had stopped taking it months earlier when the deaths occurred.

  • Jim

    3/14/2008 3:27:00 PM |

    Hello all, I'm a new blogger here. Let's start off with a bang! The comments about ProArgin9 are fairly amusing, it's basically a hugely-overpriced elemental l-arginine powder with a couple added nutrients one could easily improve upon for a much cheaper price.  Don't believe the ads on this one, the hype is almost as bad as the statin ads.

  • Jim

    3/14/2008 3:37:00 PM |

    This is new blogger "Jim" again. A few additional comments of mine on arginine supplementation in general... The point isn't that arginine in itself will cure all that ails you (in fact, users looking for quick dramatic results with arginine for problems such as male ED will be disappointed), but that it is one fairly inexpensive strategy that can, importantly, improve the arginine:ADMA ratio favorably, which is important for optimal nitric oxide production. If you're not familiar with ADMA, look at some of the clinical studies on this risk factor, and you'll be better able to appreciate some of the logic behind supplemental arginine.

  • Dietrick

    10/12/2008 9:53:00 AM |

    My wife and I have used L-Arginine for years and now work with several scientist to actually measure the effect we felt using it, and have developed our own mix.

    Dr. Allen and Dr. Pendergast are making missleading claims. Dr. Allen is not even a real doctor and neither of them ever provided ANY data to support their missleading claims.

    L-Arginen ONLY works well in the right dosis, attached to a slow carb and mixed with equal amounts of L-Licine and some other ingredients, those I will list on my web site.
    When taken in the right dosis, at the right time, the right way intake of L-Arginine DOES work well. There can be no doubt about it. BUT Synergy World Wide and other companies who got their stuff from Dr. Allen or made something of their own trying to clone hers, failed to do any DOUBLE BLIND STUDIES, not even a small one!
    And the price of $97 is a HUGE RIP OFF.
    At best the stuff ONLY cost about 12 bucks per kilo to make. To sell it in these low dosis and with sucralose  or what ever artificial dioxin based sweetener is criminal!
    DO NOT BUY IT FROM DR. ALLEN OR SYNERGY, if you do you waste your money.
    I and am NOT selling it in the US. I only sell it in Europe. At least for now, untill we have done our own double blind and can verify.

  • Realta

    9/12/2009 9:47:47 AM |

    Hi I am fascinated by this article. I have a friend who recently had a test done by synergy doctor selling proargi9 and guess what it said her blood pressure was normal (she's 58) her heart was perfcet but her arteries were those of 80 yr old female. So she was put on very high and very costly doses of proargi9. Also on the subject of arginine. My daughter took some (not proargi9) arginine in june and ended up in hospital after passing out. Her blood pressure had dropped severely.
    She was also put on drip for dehydration.
    I believe that arginine is banned in canada - any comments??

  • Tommy

    9/14/2009 7:06:40 AM |

    I am a 42 year old male who has been taking a mixture of Pro-Argi9 plus, Mistica and Core Greens for over 6 weeks.
    The reason I started on this is because I am a care-giver for my mother.  She is 75 years old and has suffered a stroke in 2004, followed by a triple by-pass surgery in 2006, has type 2 diabeties and anemia, osteoporsis, arthitis, and had both hip restructuring and replacement surgery as well as a broken wrist in  2008.  I wanted to enable her to recover easier, and I wouldn't give her any more "medicine" to take without trying it myself.  The difference for both of us has been amazing.  Not only has my mother's rehabilitation been quicker than before, she is also benefiting from eyesight improvement and her blood pressure is "perfect" as quoted from her personal physician.
    The effects on myself have been almost as drastict.  I have more energy and feeling better and healthier than when I was 20.
    I have also seen some great results in others including personal friends who have started taking the above on my recommendation.
    I researched the net pretty well before I started and don't take my mother's health lightly.  If you are able to show certified medical data to back up your statements, then I am happy to stop taking it and will let others know the same.

    With regards to the price, the products produced by Synergy Worldwide are the only ones available with the stated ingredients etc that I have been able to source.  I have seen the tablet and capsule forms and believe me, on a cost per recommendended doseage, the Synergy product is far more economical.  
    In any circumstances, with the amount of money I've seen women spend on dying their hair with caustic chemicals, or men put over the bar or into their "wheels", the cost of 30 scoops at Synergy's recommended dosage, equates to $25.00 per week, less than the cost of a week's worth of cappacinos. Very well worth it for my health.

    Regards
    Tom

  • Dusty

    5/24/2010 4:44:39 PM |

    After reviewing the article from Dr. Prendergast I decided to try His Proargi9 Plus having been diagnose with Atherosclerosis about two years ago. I am on no medication but I get angina after long walks.

    I started with one scope per day and increase to two scopes per day. I noticed after 5min I would start feeling angina it would go away after a few minutes. Is this normal? with this product.

  • Anonymous

    5/26/2010 11:56:19 PM |

    I would really like to try l-arginine but wonder if there are any contra-indications if a person is taking plavix???  I am also taking lipitor.  I had a triple by-pass 7 years ago and a stent last November. I am 63 years old and lead a healthy lifestyle (regular exercise & healthy diet & meditation).  My doctors don't know anything about this alternative and cannot advise me much.  Is it safe for me to take this????  Also, Herbal life makes a product (Niteworks).  Do you have an opinion on this product??
    Kristin Ann

  • Peter

    6/3/2010 8:29:24 AM |

    Hi guys,
    I've taken ProArgi9plus for 4 months and feel heaps better. My angina has gone and my thrombisis pain is nearly gone as well.
    I have 2 friends. One has had 4 major heart attacks and a 6 bypass op. The other one has had 5 bypass and 3 heart attacks since plus 5 stents. They wanted to do more bypass ops but he said no.
    Both have spoken to Dr Prendergast and taken as per his instructions. Both have changed dramatically over a period of time. Both look like they did years ago and seem to have their lives back. As for the price... I think it's cheaper then a funeral. I don't fancy looking up through the dirt any time soon.

    Peter
    PS If you 'd like to speak to the guy who had 6 bypass I know he's happily talk to anyone as he feels so good.

  • Peter

    6/3/2010 8:37:07 AM |

    Hi Guys,
    Just to start I have to say I sell ProArgi9.
    The reason I do is because I have 2 friends who both should be dead. One in Western Australia has had 4 major heart attacks and then a 6 bypass op. Ended up in an electric wheelchair. Could hardly walk anymore.
    The other guy is from Sydney Australia and had 5 bypass 8 years ago, several heart attacks since and 4 stents. Finally told him he needed 4 more bypasses.
    Both went on the arginine on high dose after talking to Dr Prendergast. Both are now in amazing health. The Sydney guy has just spent 2 weeks traveling across the US learning more about clinical hypnotherapy.

    The WA guy just a couple of months ago traveled around Aus. I've know the WA guy for 30 years and the other one for approx 20 years so I knew them when they were healthy and also when they were sick.

    Hope this info helps in your decision making.
    Peter

    PS if you'd like to talk to one of them I think I could arrange it.

  • buy jeans

    11/3/2010 9:13:58 PM |

    Dr. Joseph Predergast is founder of the Endocrine Metabolic Medical Center in Palo Alto, California, focused on providing care for people with diabetes.

  • HealthNut2

    3/14/2011 6:57:28 AM |

    Has anyone compared before and after CT Scans after using an L-Arginine/L-Citruline protocol?

  • Donna

    3/19/2011 7:19:34 AM |

    I have been on ProArgi-9 Plus since Dec 30th 2010 and have had some amazing health benefits from it. I am doing 4 scoops a day.
    I had suffered from dizzy feeling for the last 2 years where I felt like I was going to fall out of my chair. That feeling stopped the first day of taking ProArgi-9. I also have not had any hot flashes or restless leg symptoms since taking it.
    I have vascular diease. I have a stint in my left cartoid, my right cartoid is closed. And I have had a balloon angioplasty on my aorta 3times. I am 54 years old female.
    I plan on taking ProArgi-9 for the rest of my life. After all what is your health worth? I will find a way to pay for it. I am worth it. Smile

  • Anonymous

    3/28/2011 3:36:41 AM |

    Further to my comments of my two friends who got better on ProArginine. One has proof from to 2 angio-grams one year apart.

    He makes enormous amounts of ADMA (been tested) and had to take between 30 to 40 grams of pure arginine a day. Thats up to 8 scoops a day. He had 4 stents blocked and had been told he had to have the bypasses or die within a month or two.

    One year later his cardiologist said he may feel well but he still needed the opperation. He had another angio-gram. His blocked stents were totally clear. He can run and play with his grandchildren again for the first time in years.

    My oppinion derived from testing over 200 people using the BPro machine (which is 99.1% as accurate as an angiogram)is that the synthetic versions I.e. cheap arginines do not work anywhere as well as plant derived products.
    Also people taking arginine hcl mostly didn't improve. Some did Smile

    Argine hcl is arginine attached to hydrochloric acid. Many people don't react well to this. Those that do need to take a higher dose to get the same effects as those taking a pure arginine.

    BTW Before using and recommending arginine to my clients I contacted quite a few companies and none of them would tell me how they sourced their arginine and if it was synthetic, soy based or or what. Synergy was the only one who did so. Theirs comes from organically grown tapioca or sugar cane.

    I would never use or recommend soy based products as 90% of the worlds soy is now genetically modified and how do you know if what is being used is GM safe or not.

    Hope this helps anyone trying to decide what to do.

    Get yourself a high grade pure arginine that is plany based.

Loading
Small LDL: Perfect index of carbohydrate intake

Small LDL: Perfect index of carbohydrate intake

Measuring the number of small LDL particles is the best index of carbohydrate intake I know of, better than even blood sugar and triglycerides.

In other words, increase carbohydrate intake and small LDL particles increase. Decrease carbohydrates and small LDL particles decrease.

Why?

Carbohydrates increase small LDL via a multistep process:

First step: Increased fatty acid and apoprotein B production in the liver, which leads to increased VLDL production. (Apoprotein B is the principal protein of VLDL and LDL)

Second step: Greater VLDL availability causes triglyceride-rich VLDL to interact with other particles, namely LDL and HDL, enriching them in triglycerides (via the action of cholesteryl-ester transfer protein, or CETP). Much VLDL is converted to LDL.

Third step: Triglyceride-rich LDL is "remodeled" by enzymes like hepatic lipase, which create small LDL.


Carbohydrates, especially if they contain fructose, also prolong the period of time that triglyceride-rich VLDL particles persist in the blood, allowing more time for VLDL to interact with LDL.

Many people are confused by this. "You mean to tell me that reducing carbohydrates reduces LDL cholesterol?" Yes, absolutely. While the world talks about cutting saturated fats and taking statin drugs, cutting carbohydrates, especially wheat (the most offensive of all), cornstarch, and sugars, is the real key to dropping LDL.

However, the effect will not be fully evident if you just look at the crude conventional calculated (Friedewald) LDL cholesterol. This is because restricting carbohydrates not only reduces small LDL, it also increases LDL particle size. This make the calculated Friedewald go up, or it blunts its decrease. Conventional calculated LDL will therefore either underestimate or even conceal the real LDL-reducing effect.

The reduction in LDL is readily apparent if you look at the superior measures, LDL particle number (by NMR) or apoprotein B. Dramatic reductions will be apparent with a reduction in carbohydrates.

Small LDL therefore serves as a sensitive index of carbohydrate intake, one that responds literally within hours of a change in food choices. Anyone following the crude Friedewald calculated LDL will likely not see this. This includes the thousands of clinical studies that rely on this unreliable measure and come to the conclusion that a low-fat diet reduces LDL cholesterol.

Comments (15) -

  • nitrile exam gloves

    12/8/2009 3:58:05 AM |

    Thanks for the knowledge sharing...it helps to be healthy.

  • x.ds

    12/8/2009 12:02:31 PM |

    Here is a link showing the atherogenicity in mice of different saturated fats in diets with 1% cholesterol. Look at page 1416 of the free full report that can be downloaded here:

    http://www.ncbi.nlm.nih.gov/pubmed/8409772

    On the opposite you can see bread not being atherogenic in baboons here:

    http://www.ajcn.org/cgi/content/abstract/33/8/1869

    By the way you can notice the effect of 0.1% cholesterol at the end of the article = 1 gm cholesterol per kg of food = 5 egg yolks.

    Does it look a lot ? "There is evidence from animal experiments showing that if atherogenic dietary factors are reduced to levels comparable to man's intake, the same vessel changes occur as with higher levels, but more slowly."

    Download the free full report here:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1938976/

    In this report you can also see butter to be highly atherogenic to swine without additional cholesterol to their diet.

  • Bobber

    12/8/2009 5:06:03 PM |

    What about rice?  Does it also increase small LDL particles?

  • Nigel Kinbrum BSc(Hons)Eng

    12/8/2009 6:54:52 PM |

    @x.ds: Humans aren't C57BL/6J mice (susceptible to diet-induced fatty streak lesions), baboons or pigs.

  • Future Primitive

    12/8/2009 7:34:20 PM |

    @x.ds

    The strain of mice in the first study are predisposed to diet-induced obesity, type 2 diabetes, and atherosclerosis.

    Likewise, here's an interesting quote from the last paper based on a porcine model: "Whenever there are three
    animals from the same litter, they are divided equally among the three groups (ie, "control", "butter", & "egg yolk" groups)  In the present experiment, this occurred once. These three pigs had the most aortic atherosclerosis in their respective groups. The control pig with the most atherosclerosis was the brother of the pigs with the most disease fed egg and butter."  

    The group of pigs with the highest rate of atherosclerosis was the egg yolk group - yet at most we see a vanishingly positive relationship, if any, in a large number of human epidemiological studies of moderate egg consumption and heart disease (too many to list here - many are recent and easy to locate, though).  Do we even have grounds to formulate a hypothesis of egg induced atherogenesis based on human observational studies? I don't know, really - though a casual glance suggests, "no".

    Looking forward to reading the other study you pointed us to when I get the time.

  • Anonymous

    12/8/2009 7:42:17 PM |

    x.ds:

    Often times these animal studies don't translate well when applied to humans.

    Also, like Dr. Davis pointed out in his blog, most (LDL) cholesterol lowering research doesn't use advanced lipoprotein testing like NMR so the data is misleading to say the least.

  • Anonymous

    12/8/2009 9:16:54 PM |

    x.ds:

    It would be nice for a change to see experiments on other than herbivorous (mice) or mostly vegetarian animals (both pigs and baboons on the wild).

  • Dr. William Davis

    12/8/2009 11:48:34 PM |

    Bobber--

    While all carbohydrates increase small LDL, the effect of wheat is the most extravagant.

  • Anon X

    12/9/2009 3:18:19 AM |

    I generally agree with those who deny the universal applicability of experimental results in mice and rats to men. However, I do so with this one caveat; there is one fact I cannot deny: Many women are convinced that most men are rats.

  • LynP

    12/9/2009 4:42:51 AM |

    Doc, does this mean that I ca sorta log my particle size by getting my apoB checked in quarterly labs? I'll never be able to convince primary to do the outright particle size test...yet (working on that). Thnx.

  • Anonymous

    12/9/2009 3:08:55 PM |

    I admit I do not understand VLDL-C. What I would really like to find is a simple range scale. Mine shows up VLDL-C..7  Non HDL ..70
    I do not know if that is good or bad. Is there such a chart showing like,  1 good ... 100 bad ??
    LP(a) shows up by itself and I understand that because there is a range showing bad ..over 30.
    Any help understanding appreciated

  • David

    12/10/2009 2:39:45 AM |

    Dr. Davis,

    I honestly think you are doing God's work and have learned to appreciate the value of heart scans through your site.  However, it still bugs me that so many people in Asia can live off of large quantities of white rice with minimal atherosclerosis.  For instance, this study shows that American Whites have much higher atherosclerosis than Japanese despite the Japanese having much higher LDL-cholesterol, blood pressure, fasting glucose, and smoking rates:

    http://ije.oxfordjournals.org/cgi/content/full/34/1/173


    This other study (below) tries to explain this difference based on the Japanese consumption of fish. However, if you look at the data, those Americans who consume the most fish oil consume about as much fish oil as those Japanese that consume the least fish oil, and yet between these comparable groups in terms of fish consumption, the Japanese still have vastly lower atherosclerosis on heart scans.  And the Japanese American group consumes more fish than the White American group and has more coronary calcium.

    http://content.onlinejacc.org/cgi/content/full/52/6/417


    And here is another study showing much lower CAC in Japanese than in Japanese-Hawaiians even after controlling for a bunch of risk factors including fish intake:

    http://aje.oxfordjournals.org/cgi/content/full/166/11/1280


    Although in this other study looking at only at Americans, the incidence of CAC appears to be similar to that in Japanese - so maybe there was something unusual about the US samples in the other studies?

    http://content.onlinejacc.org/cgi/content/full/49/20/2013

  • Anonymous

    12/10/2009 8:23:46 PM |

    Dr. Davis,
    What is your opinion of the LP-Pla2 test for arterial plaque?  If you've used the test, do any elements of your program reduce levels of this enzyme?

  • buy jeans

    11/3/2010 9:44:57 PM |

    However, the effect will not be fully evident if you just look at the crude conventional calculated (Friedewald) LDL cholesterol. This is because restricting carbohydrates not only reduces small LDL, it also increases LDL particle size. This make the calculated Friedewald go up, or it blunts its decrease. Conventional calculated LDL will therefore either underestimate or even conceal the real LDL-reducing effect.

Loading