Interesting that your warning about nattokinese is FOLLOWED immediately by an advertisement for.... nattokinase extracts!

Actually most nattokinase does not contain vitamin K2.  When nattokinase is extracted from natto, the K2 is separated and sold as another profitable byproduct.

Wait a minute though! Was there any indication that he needed a real blood thinner before his clot? Maybe he was just taking it like a daily aspirin to "thin the blood" not for therapeutic blood anticoagulation. His clot was unfortunate but probably could have occurred with a cardiologist sactioned baby aspirin.

Anon--

He was taking aspirin, as well.

However, aspirin does NOT prevent deep vein thromboses that lead to pulmonary emboli, regardless of dose. Aspirin is a platelet-inhibitor, not a true "blood thinner" that works by way of clotting proteins.

Was he using nattokinase as an excuse not to take his warfarin, or something like that? Otherwise it seems very unlikely that the nattokinase had anything to do with the clot. If anything, I'd worry about nattokinase causing bleeds, not clots.

Curious if you ever recommend pycnogenol in cases where there is a risk of DVT? I believe there is at least one study showing a reduced risk of DVT in those who took pycnogenol.

I'm not saying it's better than anti-coagulants, but it may be better than aspirin.

Real anti-coagulants?  Like the red clover extract coumadin?  Patients on coumadin even with careful control often suffer excessive bleeding or more clots and strokes.    
I guess the point is that clotting control is very difficult and that the number one drug is a natural medicine, herbal extract.

One time, I was at a local vitamin shop when I saw that the supplement I was thinking about buying contained nattokinase.  Having read your blog and knowing what you think of nattokinase, I put the product back on the shelf.  The proprietor of the shop asked me why I did not want that supplement, because in his opinon it was a very good product.  I said that I did not want to take anything with nattokinase in it, and he said, "What do you have against nattokinase?"  I didn't bother to explain myself to him, figuring that I would just be wasting my breath.

What is your opinion about doing higher dose mixed tocopherols, which do work on the clotting cascade. Or garlic and omegas which decrease platelet aggregation. What is your stand on normalizing your vitamin K content and then titrating your dosage of coumadin up to theraputic INR. As far as the nattokinase is concerned, do you like any of that style of enzyme? lumbokinase, serrapeptase. Although they don't have any effect on INR they should have an affect on FDPs

That title is misleading.  People have been known to have near death cardiac events while taking fish oil, vitamin D3, and high dose niacin too.

As well, on rare occasion, people have been known to have a recurrent DVT and/or PE while on warfarin therapy, even with an INR as high as 2.5.  Therefore, does that mean warfarin is an ineffective anticoagulant?  Of course not.

This whole blog is about how we as individuals need to take control of our own health.  That just because we're taking a therapeutic medication or supplement, it does not therefore absolve ourselves from further investing in a life style that is proven to lower risk factors that may cause catastrophic health events.  

I totally agree that some of the marketing claims made concerning nattokinase are inflated and frankly, unbelievable - particularly about its capabilities as a thrombolysis.  And I agree that if your doctor advices that you need heprin or warfarin therapy in order to prevent a catastrophic health event, you certainly need to heed that advice.

But, count me down as someone who has extensively studied this subject and is still open to the possibility that nattokinase may contain some attributes in the prevention of venus thrombosis from a novel approach that needs further clinical investigation.

Dr. Davis,

I wouldn't be so quick to blast nattokinase because of this isolated incident or lack of research.

Nattokinase is a "mild" blood thinner. Taking it once a day will not do more than relieve inflammation and slightly improve a person's circulation.

A person would have to take it every 4 times a day (800 IU) on an empty stomach for if he desires a therapeutic effect. I would be curious if this patient of yours even took 200 IU per day (because a lot of products don't even contain that much).

I have personally witnessed an improvement in circulation after taking nattokinase.

I would like to add one more thing...

I'm sure you have had experience with patients who took 400 IU of vitamin D in tablet form, and did not see any results after six months either. Was it because vitamin D is a worthless supplement, and should not be used?

Sorry, I was misspoke about the dosage. Nattokinase is measured in fibrinolysis units (FU), not IU, and the effective dose ranges anywhere from 2,000-8000 FU per day.

Also, here's actual scientific research (albeit small), not marketing hype, on nattokinase.

http://www.ncbi.nlm.nih.gov/pubmed/19358933

http://www.ncbi.nlm.nih.gov/pubmed/18971533

I've like the taste of natto from the moment I tried it. I am, however, a bit weird. ;)

Dr. Davis -- my question here is, could the nattokinase cause the blood clot (doesn't seem the be the case)?  Are you saying that it didn't matter that he was taking nattokinese because it doesn't reach the bloodstream to clear clots (so he would of had the clot anyway)

Secondly, if he was taking nattokinese that had vitamin K2 <--- is it possible that increases in K2 might cause abnormal blood cloting?

Vitamin K2 does not cause blood clotting any more than topping up your gas tank makes your car go faster.

Whether nattokinase has other effects is not my point. My concern is that people frequently ask if they should treat their DVT or pulmonary embolus with nattokinase. This is a death sentence. It should NOT be used for a such a purpose unless there were a large treatment trial proving equivalence or superiority to existing therapies.

Eric,

High dose mixed tocopherols use the same mechanisms as Wafarin/Coumadin.  They block the reabsorption of vitamin-K in the liver.  Vitamin-K is necessary for the liver to synthesize and release clotting proteins in the blood.  Warfarin/Coumadin is much, much more consistent than tocopherols in maintaining vitamin-K malabsorption and a safely prescribed INR range.  

Titrating a Warfarin/Coumadin dosage never made sense to me. It is not toxic other than causing vitamin-K deficiency. What difference does it make if the dosage is 20 mg or 20 mcg to maintain a therapeutic INR?  Your liver will need to be equally deficient in vitamin-K no matter how you caused the deficiency.

Garlic, ginger, ginkgo, curcumin, n-3, aspirin, N-acetylcysteine, Plavix, and yes tocopherols too all are anti-platelet agents.   They are effective at preventing arterial thrombosis, where anticoagulants have little effect. Conversely, anticoagulants are effective at preventing venous thrombosis, where anti-platelet agents (unfortunately) have little effect.

I'm giving my son nattokinase, one tablet daily and he also takes Vitamin K2. He has not been prescribed blood thinners, only aspirin which I stopped many months ago.
Are you warning of not replacing prescribed blood thinners with natural therapies?
If blood thinners have not been prescribed, is it of benefit to supplement with nattokinase?

Hi Dr. Davis

I was wondering if you could help me with something.

I've been monitoring my blood glucose recently with a basic monitor, and my readings would suggest that I am on the verge of impaired glucose tolerance, but not quite there yet.

I was reading about continuous glucose monitoring systems. I would love to have on if these to more thoroughly monitor my blood glucose, but every model out there requires a prescription to obtain one. I don't understand this, because they are not dangerous in any way.

Do you know of any way a non diabetic can purchase one of these?

Any information you can give me would be greatly appreciated. Thank you.

Rob

Dr. Davis, i am a 45 year old female who recently started taking Lovasa for high triglycerides , i am also on garlic tabs and one baby asprin per day . Is is safe to replace the garlic and asprin with one tab of Natto- K per day and is it safe to take with Lovasa? I am about 20 lbs overweight do not drink or smoke and swim and or walk 3 days per week. i am genetically predisposed to high triglycerides but never had a problem until i gained the weight. Until i get the weight off i am trying a more natural approach. Help!

[...] why you need to think for yourself and question studies. See, “Near-death experience with nattokinase | Track Your Plaque Blog, “Nattokinase supplement medical uses, safety, benefit, side effects,” and “Fight [...]

Acta Haematol. 2010;124(4):218-24. doi: 10.1159/000321518. Epub 2010 Nov 13.

In vivo evaluation method of the effect of nattokinase on carrageenan-induced tail thrombosis in a rat model.
Kamiya S, Hagimori M, Ogasawara M, Arakawa M.
Source
Nagasaki International University, Sasebo, Japan. kamiya@niu.ac.jp

Abstract
Thrombosis is characterized by congenital and acquired procatarxis. Nattokinase inhibits thrombus formation in vitro. However, in vivo evaluation of the therapeutic efficacy of nattokinase against thrombosis remains to be conducted. Subcutaneous nattokinase injections of 1 or 2 mg/ml were administered to the tails of rats. Subsequently, κ-carrageenan was intravenously administered to the tails at 12 h after nattokinase injections. The mean length of the infarcted regions in the tails of rats was significantly shorter in rats administered 2 mg/ml of nattokinase than those in control rats. Nattokinase exhibited significant prophylactic antithrombotic effects. Previously, the in vitro efficacy of nattokinase against thrombosis had been reported; now our study has revealed the in vivo efficacy of nattokinase against thrombosis.

PMID: 21071931

Great article. I especially liked the emphasis on potassium poisoning. This is no joke.

I nearly died from potassium poisoning. I bought 99mg supplements and I once took several a day, along many pounds of potatoes. I then suffered from hyperventilation, muscle cramps, tingling on my extremities, and delirium. I was on a salt restricted diet back then. That was an idiotic move. But I saved myself by adding back salt to my diet.

I don't particularly like potassium supplementation. If I overdosed potassium on potatoes, then potatoes will taste disgusting to me. But if I relied on supplementation, then I might overdose because I can't taste it.

Hope this helps.

on the spot again! any role of GMOs here ?

What about Strontium as part of the drive to reverse established osteoporosis ? Strontium Ranelate is prescribed in the UK as an alternative to Fosamax or Boniva type drugs.

I have osteoporosis but I do not have any coronary atherosclerotic plaque I'm happy to say. I had scan to show my coronary arteries are clear.

I take a high dose vitamin D - current 25(OH)D is 78 ng/ml (195 nmol/L) and do strength training   Can't get vitamin K2 but eat an alkalizing diet with lots of veggies high in K such as kale which, I understand help intestinal bacteria make K2.

I jumped down from my kids trampoline back in 2003 with immense pain.  I thought I had jarred my back but after an x-ray, it turns out I had crushed 3 vertebra. The year before, I had an angiogram after suffering shortness of breath and jaw pains on moderate exercise. Surgeon told me he could not stent because the artery was fully blocked. the good news was it had happened over time so collateral had formed, so no heart attack. My recovery has been more due to self education and action than the medical establishment.

For some time I still had occasional angina, but for the last 18months I have been taking K2 together with VitaminD3, fish oil and Niacin. I have no angina, no muscle aches (ok, maybe that was the statin), bike long distances, kayak, hike....yada yada.

This is what has worked for me.  I sincerely hope people with either low bone density or plaque problems give the K2/D3 route a try.

I sure would LOVE for Dr. Davis
to weigh in on Strontium.  I took
Strontium 680 MG following everything I learned about it and had a nice improvement in my Bone Density.  However, my primary care doc insisted on a strontium level of my blood and of course it was off the wall, and
my doc asked me to discontinue because there have never really been any long term trials on it.  I take D as Dr. Davis suggests, and only half the calcium I used to as he suggests and fish oil etc.  Will add K too!  Kathy

PS  As per Doctor Davis instructions, I too had a heart scan and had
Zero plaque.  I am 61 years old and
have improved from Osteoporosis to
Osteopenia in my bone density, mostly from the strontium.....Kathy

Whenever I see Sally Field's Boniva commericals on TV in which she proclaims, "I thought taking Vitamin D and calcium were enough to stop my bone loss, come to find out, they weren't enough," I can't help but ask (aloud), "yea? How much D were you taking?"

I get embarrassed for her.

Docs in our area (FPs and specialists), while now starting to pay more attention to Vitamin D, still take shots at us for recommending Vitamin D over fosomax, boniva, etc. They feel it's unethical.

We press right on, though.

@ Jessica, I truly want to throw something at the TV when I see her
commercials!  LOL
As "they say"
KNOWLEDGE is POWER!  Kathy

"Coronary atherosclerotic plaque and bone health are intimately interwoven. People who have coronary plaque usually have osteoporosis; people who have osteoporosis usually have coronary plaque. (The association is strongest in females.) The worse the osteoporosis, the greater the quantity of coronary plaque, and vice versa. The two seemingly unconnected conditions share common causes and thereby respond to similar treatments. "


mmmkay you just scared the lving bee--geeez out of me. i have osteoporosis and am only 24 yrs old, recovering anorexic now weight restored

i do have joint bone pain and problms however. i do take D, mag and my K is way over 100% DV eveyday(gimme my greens). not sure where my potassium falls

so is a hih fat high meat diet goodfor osteoporosis or not? i am no very 'schooled' about acid-alkaline stuff

"Coronary atherosclerotic plaque and bone health are intimately interwoven. People who have coronary plaque usually have osteoporosis; people who have osteoporosis usually have coronary plaque. (The association is strongest in females.) The worse the osteoporosis, the greater the quantity of coronary plaque, and vice versa. The two seemingly unconnected conditions share common causes and thereby respond to similar treatments. "


mmmkay you just scared the lving bee--geeez out of me. i have osteoporosis and am only 24 yrs old, recovering anorexic now weight restored

i do have joint bone pain and problms however. i do take D, mag and my K is way over 100% DV eveyday(gimme my greens). not sure where my potassium falls

so is a hih fat high meat diet goodfor osteoporosis or not? i am no very 'schooled' about acid-alkaline stuff

Malpaz, I am so proud of you I can't STAND it!  You go girl!
I've been told once DX'd with Osteoporosis- it will ALWAYS show up in your records, but you CAN reverse it!  Read everything you can get your hands on including everything Dr.
Davis told us here.  Weight training
should be a #1 goal.  It is my
understanding that high fat, ADEQUATE
protein does NOT promote bone loss,
as long as you are eating lots of
non acidic foods too! Make sure you K vitamins, and magnesium and D3
are what Dr. Davis recommends AND
FISH OIL!!!  Kathy

Kathy - I am in my 50s and have osteoporosis. Here in the UK I have been prescribed Strontium Ranelate for over three and a half years now. No side effects and bone density increasing. The company that make it tell me that they are following women prescribed it for over eight years now - so long term studies are done on it.

I have great news!

I belong to an osteoporosis forum, and a large group of us has been committed to reversing our osteoporosis without using drugs. We have compiled all the credible research we could find on reducing bone loss while also forming strong new healthy bone architecture and started our own bone-health programs---much of what Dr. Davis advocates here plus some other protocols such as the Prune Study and osteo-specific exercises.

These programs ARE WORKING! at least 40 of us in just this one year have reversed our bone loss without drugs, and actually made increases in our BMD.  (I had a 10-year documented continual loss of BMD and this year gained 3%!!)

Here is the link to our success stories and the protocols we have been using.  Some are adding strontium citrate, but others  such as myself have had success without the strontium. As Dr. Davis states, achieving optimum D levels played a big part. You will need to click on the Part ! link to read all the back stories--- Part 2 is the current new updated thread just started.
http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/success-stories-w-o-drugs-part-2/

A while back, Dr. Davis advised me to try magnesium for my long-standing arrhythmia, which worked magnificently in stopping it, but also was a big part to reversing my bone loss--magnesium, K2, vitamin D, and calcium all have an intricate relationship in transporting calcium and bone minerals safely and effectively to where they belong instead of in tissues, joints, and heart valves.
Warm regards,  Catherine/Santa Fe

Kathy, you are so correct about reading everything you can get your hands on. I have osteopenia (strong family history) and have been taking Boniva for over two years. I upped my vitamin D, and added 5-10 mgs of Vitamin K2 earlier in the year, along with 400 magnesium and fish oil.

I get a bone scan next week, and am very nervous about it. I am hoping I have improvement so I can get off the Boniva and maintain bone density with the vitamins.

By the way Dr. Davis, I am fairly certain I have a polymophism of my Vitamin D receptor. Do you know if that could play a role? Chris Kessler did an excellent post on it a few weeks ago.
            -Melissa

Catherine, thank you for posting that information, what great news! Would you mind telling me how much K and magnesium you take? Do you take the potassium that Dr. Davis recommends also?
            -Melissa

Melissa don't expect your doc
to tell you to stop taking the Boniva!
My OB/GYN was content to let me die on the stuff it was my primary care
doc that said she wanted me off of it!
(Course she was the same one that
did not want me on the strontium) :-(
Listen to your heart- if your bone
density has improved get off the stuff
and use the new tools your are acquiring!  )  Kathy

Kathy, thanks for the feedback. I'm not sure about my gyn who prescribed it, but my internist did say that if bone density returned to normal, it would be possible to go off. While not horrible, I do have side effects. And then there's possible long term side effects...
           -Melissa

Dr. Davis,

I can't tell you how encouraging this is that YOU TOO are seeing reversal of bone loss with these protocols. As I mentioned in my post above, we are trying to assemble these success stories which are plentiful but spread out all over the internet and not easily accessible in any sort of organized way.

It would be so helpful if you would encourage any of your patients who've had success reversing their bone loss on these protocols to post their stories on the thread I posted above, which is from the National Osteoporosis Foundation's osteo forum---where most osteo patients end up when looking for good info.
I know there are tons of these success stories that are just not getting reported. And regular doctors don't even seem interested in these successes (mine wasn't-but was VERY interested on putting me on  osteo drugs).
Thank God their are a few doctors like yourself who are actually awake at the wheel.
Warm regards, Catherine/Sante Fe

wow kathy, thanks for the encouragement! that means a lot. i will get to reading... i do keep my diet high fat but i am currently stressing about fertility as it has been a LONG while since i have menstruated(6-7 years)

i cant afford a bone scan, hormone tests, thyroid or blood work like i need so i am hoping keeping paleo/primal and lots of adequate food is going to help me. glad to know at least ONE part of this is reversible as i am now left with alot of baggage

Hi, Anne and Kathy--

There are indeed solid data on the use of the trace mineral, strontium, as a means to increase bone density.

However, since my focus is heart disease, this is the one agent I've had no experience using.

If anyone chooses to use strontium, please let come back and let us know how your experience goes.

Catherine from Santa Fe--

Thanks for the links to the osteoporosis forums. It's great to hear others are witnessing similar results!


Luming--

Thanks for highlighting how important it is to be careful with potassium.

In fact, it is wise to occasionally have a potassium and a creatinine level checked to be sure that potassium is not accumulating.

The dose I recommended is very modest. Accumulation is highly unlikely unless kidney disease or some other uncommon conditions are present.

Malpaz you didn't pack those "bags" overnight and you won't unpack them
that fast either.  One day at a time and you will get where you want to go!
Be patient with yourself!   Kathy

Hi Dr. Davis,

Another great post, educating as always--my mother kind of freaked out when I showed her this, but once she realized she's taking everything you've suggested to combat her osteoporosis, she was able to breathe again (LOL)

Here's my slightly off-topic question for you: In your experience in your practice, have you ever seen a patient's problem parathyroid (hypo or hyper) resolve with the addition of vitamin D to his/her diet?  Have you ever had a patient one step away from a parathyroid surgery, only to have the problem clear up when proper vitamin D levels were obtained?  I'm wondering if alot of patients suffer with above normal calcium reading in their blood work because of this?

Thanks again for all you do,
Adam Wilk

Perhaps the fear of potassium poisoning is overblown? One serving of low sodium V-8 contains 800 mg of potassium from potassium chloride.

I've been experimenting with topical magnesium lately (Mg sulfate cream and MgCl2 brine aka magnesium oil). It seems to be working. One thing I've noticed since starting taking magnesium (oral and topical) is about a 50 point drop in total cholesterol from 240 to 190.

You forgot to mention, for those new to this site, that not all vitamin D is the same. They ONLY want D3 (cholecalciferol) gelcaps, not the nearly useless D2 (ergocalciferol) that gets added to milk.

tI have seen jaw necrosis up close and in person and believe me, you do not want it!

No need to have "normal"t bone density to get off Boniva, very few doctors will tell you to stop.  You can just stop whenever you want to!

There is little to no correlation between bone density and fracture rate anyway, it is a scam to sell the drugs.  Quality bone is what you want so alkaline diet and supps as outlined and plenty of weight bearing exercise, esp pumping iron.  No coffee, no sodas, no smoking...t

It should also be noted that calcium supplementation can significantly compete with magnesium in absorption and utilization.

There really should be no reason to supplement calcium if you eat plenty of vegetables, especially the dark green leafy kind, or if dairy is part of your regular diet.

If you find that you need to supplement calcium, try to take it in the middle of the day, and take the magnesium in the morning and at bed time.

@malpaz: You wrote "i do have joint bone pain and problms however. i do take D, mag and my K is way over 100% DV eveyday(gimme my greens)."

The K in greens is K1 and not K2, not the same thing. The Japanese studies were done with the MK4 form of K2 (as used in the Thorne drops or Carlson Labs products).

@ Steven!  What brand of transdermal
magnesium are you using?  I am interested for my husband who I FINALLY convinced to get off statins!
He had a zero heart scan score score and yet his doc
STILL had him on statins!  Thanks!
Kathy

Dr. Davis - I love your blog.  Thank you for providing it for us. I have read the comment regarding carbonation and bone loss several times. I always wondered if it is the carbonation in particular that is the culprit, or the sugars, additives etc. that exist in most soft drinks. There seems to be some confusion regarding this. I love carbonated waters, flavored seltzers with no sugar, artificial or otherwise. Are they included in the carbonated beverages you mention as being detrimental?

Dr. Davis, Denise Minger has published the first part of her analysis of wheat, and it is positively bone-chilling.

You were way, way ahead of the curve on this one!

Wheat Is Murder: The China Study, Wheat, and Heart Disease

Hi, Adam--

I have indeed seen mild hyperparathyroidism (high PTH) improve or resolve entirely with vitamin D supplementation.


Kris-

This applies to all carbonated beverages, since they are all rich in carbonic acid.

Hi Dr. Davis - Wanted to share my story of calcium overdose. Was told to take 2000 vitamin D but my doctor didn't mention to avoid the D+Calcium brands. I took in a lot of calcium for about 2 weeks and then had painful digestive symptoms and off and on paralyzing pain in my right leg and neck. My doctor's RN was the one who figured it out. After I searched online about calcium supplements and found your blog. I read on and  have cut out 75% of carbs from my diet. Feeling great for a month now. Thanks for what you do.

Dr Mercola Finally Starts to Catch on to Gluten Free

http://articles.mercola.com/sites/articles/archive/2010/09/03/media-finally-starts-to-catch-on-to-gluten-free.aspx

My mother took Fosamax for years.  She developed acute myeloid leukemia and her bone marrow was shot.  On reading your latest post, Dr Davis, I've begun to wonder if side effects of the drug could go deeper than the bone.

Nina

Well I've answered my own question with a Google search:

http://www.topix.com/forum/drug/fosamax/TSK1OBBDLMJ0EJSQ9

It never occurred to me that Fosamax could cause such devastation until your comment about jaw disintegration, Dr Davis.

Nina

In today's news is a British study of standard osteoporosis drugs and esophogeal cancers:

http://www.reuters.com/article/idUSTRE6816HF20100902

Nina

I don't believe there is any truth to the concept that an acidifying diet promotes osteoporesis, at least as far as protein intake is concerned (I won't go so far as to defend the drinking of phosphoric acid, i.e., sodas).  Numerous studies have shown that increased calcium excretion in urine (observed on higher protein diets) is not due to calcium loss from bone, but rather due to increased calcium absorption.  See http://www.ncbi.nlm.nih.gov/pubmed/20717017 "Contrary to the supposed detrimental effect of protein, the majority of epidemiological studies have shown that long-term high-protein intake increases bone mineral density and reduces bone fracture incidence. The beneficial effects of protein such as increasing intestinal calcium absorption and circulating IGF-I whereas lowering serum parathyroid hormone sufficiently offset any negative effects of the acid load of protein on bone health."

Cynthia

still waiting for doctors to catch onto vaccine free life after the gluten free diet!

Does plain carbonated water (soda water) have an effect on pH or just carbonated soft drinks?

Hello, I'm from Brazil.
I found your website and wanted to ask, please, for that added the link to my blog for disclosure in order to be partners.
Already added your on my list of partners, ok?
My blog is about technology, science and health: http://www.biomedicinaunip.blogspot.com
Thanks!

Dr. Davis, how can the foods we eat shift our body's pH balance toward net acid?

As I understand it, if our blood strays very far from pH 7.4 ("a slightly net alkaline body pH") we will not be osteopenic. We will be dead.

If I'm remembering my physiology correctly, acidic food may affect our tooth enamel, but once the digested food reaches our blood and tissues, the body is well able to buffer it to a very tight pH range regardless of the pH it may have had in its original form.

Dr Davis,

One of the many sports drink-type beverages in Japan is called Dakara. It contains no sodium, but 180 mg of calcium, 60 mg of magnesium, and 500 mg of potassium per liter.

I took potassium tablets for a while a few years ago but found that, even on a full stomach, they messed with my digestion and I gave them up. As an alternative, do you think this Dakara, maybe a 500 mg bottle a day, might be OK? (It does contain sucralose, which might present other problems, though.)

Any other ways to take potassium?

Osteoporosis is another disease of civilization caused by insulin interference with calcium metabolism.

Whatever else you do, you're pushing a rock uphill unless you kick the carb habit.

Hi, Cynthia--

I believe that you are correct: Protein sources, such as meats, have complex effects beyond acidification. That's why meats consumers have greater bone density because of some bone growth-enhancing effect, e.g., insulin-like growth factor.

I believe that it's the grains that upset the dietary pH apple cart, providing an acid load that must be buffered but lacking the bone density enhancing effects of animal proteins.

Dr Davis,  Didn't really understand your statement about protein.  Should I be limiting my protein intake due to my osteoporosis or not?  

The endocrinologist today told me that she doubts that I can totally reverse my osteoporosis.  She thinks I can make a small reversal.  Do you think it's possible to totally reverse osteo?  Thank you!

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.

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.

Your article is truly informative. Many women today suffer from osteoporosis. I've read some articles about preventing it by taking enough calcium so our bones will get stronger.

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If someone can't get enough magnesium from their diet, then they should change their diet. I just don't think supplemental magnesium is wise if someone has a basically normal diet. Besides, magnesium chelate is not food magnesium. I do think D3 and MK-7 are a good idea for many people.

I am late reading this blog and want to know if taking vitamin K2 would interfer with taking the occassional asprin - 81mg which I do take from time to time but not daily.

I did not see you mention anything about that in your blog.

you said: "Animal products are acidic, vegetables and fruits are alkaline."

Now I have read this for the last 20 years - but have never found any scientific research about it. Maybe you could enlighten me with some links - or facts?

Many thanks - by the way I love your blog - as does my doctor

Good to know what is going to help the body recover and heal.A healthy body is more than a gift of nature and no ones knows it more than the ailing.Vitamins are present in various fruits and vegetable so we must pay attention to what exactly we are eating.

@ Melissa,
I'm really late jumping in here and you may not even check this but I have to tell you this. I have osopenia and NOT one of my doctors ever suggested putting me on any type of meds. I was to supplement with cal, and vit D. The ironically, they also didn't bother to tell me how to take the dosage. I didn't know your body can only absorb 500 mg at a time. I was advised to go to a endocrinologist and did. your doc they put you on it to begin with.I would highly recommend going to an endocrinologist..
Julie

The AlgaeCal Bone Health Program is a natural <a href="http://www.algaecal.com/osteoporosis-treatment.html>osteoporosis treatment</a> that combines all of the above advice.This natural osteoporosis treatment consists of AlgaeCal Plus, Strontium Boost and weight bearing exercise.

AlgaeCal Plus is the world's only plant source calcium and It also includes magnesium, trace minerals, vitamin D3 and vitamin k2. Strontium Boost is a supplement consisting of strontium citrate, learn more about strontium, a powerful bone building mineral.

Would anyone be able to tell me where I can get the vitamins and supplements Dr Davis suggests? I live in the UK and have done an internet search with no success. I have just been diagnosed with osteoporosis and don't like the sound of most of the treatment drugs available.

Nice post about vitamins and minerals . Magnesium oxide is also very good for our body's healthy functionality.

Many of the non distilled forms of Fish oil seem to specify varying amounts of cholesterol contamination , + saturated fat etc.  In the pharmaceutical or distilled types most of the fat content is accounted for by the omega-3 content while in most over the counter types you will find varying amounts of additional fat and cholesterol specified. (Nature Made for example has the following:
Per 2 Softgels: Calories 25 (Calories From Fat 20); Total Fat 2.5 g (Saturated Fat 1 g; Polyunsaturated Fat 1 g; Monounsaturated Fat 0.5 g); Cholesterol 25 mg; Protein 2 g; Fish Oil Concentrate 2400 mg (Omega-3 [EPA] Eicosapentaenoic Acid 360 mg; Omega-3 [DHA] Docosahexaenoic Acid 240 mg); Gelatin (Non-Bovine); Glycerin; Water; Tocopherol.

Will insurers cover Omacor?  I don't know...

If so, I know a number of people who would go get a script today.  The out-of-pocket costs for supplements just aren't in some people's budgets.  But I agree with you, it's a shame the system is designed to support such blatant profit for so few people.

Omacor is a prescription drug and it is covered by my insurance. I pay $90 for a three-month supply, that is four capsules a day for a total of 360 capsule. It is also covered by my flexible spending account, so that saves me about 30% tax. I effectively pay about $63 for three months. So the cost per capsule is about 17.5 cents.

Don't kid yourself:

You may pay $63 for a prescription out of pocket, but you and society pay a far larger price of $240 per month through increased health insurance costs. All of us ultimately bear the higher price. In this instance, all the excess profits go into Omacor's pockets, thanks to the brainwashing of the public and physicians.

Its amazing that Physicians, who lead their life using medicines and treatment protocols which are based on clinical research, discourage the use of the only truely clinically proven, regulated, prescription Omega 3 acid available.  The benefits of this product extend far past its triglyceride lowering effects, which makes it a product that should be considered for positive health as well as disease treatment.  The clinical studies are horrifically expensive, a natural based product is unpatentable, therefore making whomever is willing to put millions of dollars into making sure the clinical background is well tested, take a large risk. Copycat, unproven, dietary supplements (by the way which are monitored by the same people who monitor kit kats and gatoraid)make unsubstantiated claims. Shouldn't the developers and companies of this pharmaceutical product be  repaid, profit, and also be supported enough to continue the clinical research and development of such products.  If only the worlds medications were made up of more natural based solutions I believe we would be much more satisfied and less at risk of side effects from strictly chemically "isolated" molecules.  Omacor (which is now Lovaza) provides a glimpse of what practitioners have been looking for, a natural based prescription medication, effective, clinically proven to lower triglycerides similarly to other available therapies (with less expected drug to drug interactions or adverse events) and controlled so it is easier to recommend and use by health care professionals.  What is the sociatal cost of frequent LFT's, myopathy, rhabdo, Drug to Drug interactions from 145 fenofibrate?  Not the POOLED representation of Adverse events in the PI, that my good Doctor is trickery.  The 48mg might be more innocuous, but the 145mg is still risky and even recently had many other interactions and warnings added.  That is still considered a good drug, effective, possibly safer than the alternative of no treatment, but it does say to mind the "risk benefit ratio" which is thrown to hell when products like Omacor (Lovaza) come to market proven to work without expected side effects.  You might want to rethink how you see the companies and industries that develop the future of medicine.  No one is perfect, nor totally disclosed, however this product is certainly a step in the right direction and should be supported, not stiffled.

Anonymous--

I think you may have missed the point of the post.

I was not bashing Omacor/Lovaza because it is fish oil. I have been using fish oil for years with excellent results, preparations that work wonderfully and cost around $3 per month.

Now, there's a fish oil that costs $130+ per month? Purer? I would like to see side-by-side comparisons; I have seen no such thing. There are over-the-counter, highly purified preparations available without prescription and for less than a tenth of the cost of Omacor/Lovaza.

I agree that fish oil in some form should precede the use of fibrates like Tricor. I rarely use Tricor, even though much of my cardiology practice has evolved into a lipid consulting practice.

I guess my point is specifically, if you support $3 fish oils and their use, will those companies obediently go out and do the clinical studies that you need to feel secure to treat your patients?  Business and price per product does not come cheap.  The studies done, the missed compounds, the intergration into a patented item, the production, and the standards and guidelines all factor into the price of a product.  I just believe it to not only be unfair to recommend that patients use other than the proven product (unless there is no alternative) but also bad business sense.  If there is not loyalty or ethical appreciation to the developers and testers of these pharmaceutical products, who will then develop medicine?  I believe it would be futile to compare regular fish oil to Lovaza, just as it would be futile to compare most other drugs head to head.  The difference between relative/ actual and clinical vs. theraputic significance is very hard to show.  However, the dosing (4per day vs 8 t0 15 of reg fish oil), the purity (excursions from storage parameters render the compound less or ineffective = lack of controled standards)the purity (many manufactures are continuously being warned from FDA about the consistancy of product) and the lack of attributable cause data linking other less pure concentrations to actual clinical outcomes are all reasons that a seasoned medical professional like yourself should support the use of Lovaza instead of Fish oil capsules whenever possible.  I do know there are studies in europe about dosing regimin vs. clinical lipid results.  I would expect that at 8-15 fish pills per day the outcome results would be similar, however more variation and much more fat and omega 6's per pill.  Compliance would be less than optimal, outcome would be less than optimal, and with any alternative prescription that provides confidence in all variable and clinical aspects, this should be commended and supported whenever possible rather than talking about "brainwashing the public and physicians."  I wish someone would figure out that for every product that is developed, tested, and brought to market there are 20 other products that are in some stage of development and fail to be approved.  If EACH drug that comes to market costs approx $1.2 billion dollars (Tufts CSDD 2006), how much do you think is lost with the other 10-20 drugs that fail to gain approval?  Somewhere between 100 and 500 million PER FAILED DRUG!  Multiply that times the 10-20 that failed and you have approximately  6,000,000,000 (6 billion dollars).  With that said, it takes a lot more than just actual production cost to reimburse for past, present, and future research and development, business expenses, and of course profits to keep the company developing key breakthrough products.  All I am saying is that I understand and commend you for using an agressive alternative therapy addition in your patients to increase their health and hopefully life.  I do however believe that there is a blame game in medicine created or exacerbated by insurance companies that leads to finger pointing about medical necessity and cost.  People look towards trimming expenses in all places, however if drugs like Lovaza (not just fish oils) are not appreciatively embraced by practitioners and supported/ recommended whenever possible, there will be no more drugs or better yet, alternative large scale studies done on this kind of unpatentable compound because physicians assume similarities and switch to a compound like Dietary supplements.  Sorry, Ill step down from my soap box now, however this is definitely a sore spot for me.

Do you work for a pharmaceutical manufacturer?

Is it the same sort of economics that allows the founder/CEO of Kos Pharmaceuticals to cash out for $2.3 billion in personal payout, followed by the company raising the price of Niaspan?

The answer, in my view, is not to gouge the public with extravagant drug prices, but to support non-profit-seeking research.

Dear Dr Davis,

I had to comment on this old blog as I am in the UK. Up until yesterday I was buying omega-3 fish oil from my health food shop, an amount to give me 2250 mg per day, that is 1125 mg EPA and  750 mg DHA, and it was costing me in the region of £25 per month. I have a bicuspid aortic valve with moderate stenosis and talking about omega-3 fish oils with my cardiologist he suggested that I be prescribed Omacor instead. The Omacor is courtesy of the NHS and is therefore free for me ! I'm very happy to have got it

I would love to have some studies, though, which show the positive effect of omega-3s on coronary calcification.

Anne

Anne said, "...my cardiologist...suggested that I be prescribed Omacor...The Omacor is courtesy of the NHS and is therefore free for me ! I'm very happy to have got it ".
I left hospital a month ago with a prescription list that included Omacor but when I visited my NHS GP for a repeat prescription I was told that I could buy this item for myself, over-the-counter. :-(

"If I go to Sam's Club the same quantity of omega-3 fatty acids (in three capsules) will cost around $2.50. That's less than 5% of the cost of the prescription form."

Lovaza capsules contain >80% purified EPA and DHA (465 mg and 375 mg, respectively), which are purified from fish oil.  The other oils are fish oils, and could possibly be omega-3s.  You must take at 2-4 for triglyceride lowering (at least one for CV risk reduction in AVD patients).  

I don't know about any specific manufacturers OTC, but I do know that typical products contain 120mg DHA and 180mg EPA per GRAM of capsule. This means that only 30% have been confirmed to be the beneficial oils.  What else is in there?  This is why Lovaza does not have a fishy aftertaste, but OTC ones do.  Also, look how many you would have to take to equal the DHA and EPA in Lovaza.  It is not ANY fish oil, but specifically DHA and EPA that is necessary for CV benefit.

Alpha linoleic acid MUST BE ACTIVATED to give CV benefits, and humans only activate 10% of alpha linoleic acid, so products claiming to have a ton of omega 3s using this compound are giving their values of omega-3s via a technicality (alpha linoleic acid is "technically" an omega-3).  

This is not to mention the whole issue of herbal/supplement companies basically able to put anything in a capsule as long as it isn't harmful, REGARDLESS of what they say it is.  The FDA just doesn't care to watch these companies much.  

Therefore, if I had the money, I would go Lovaza, but I am a cheap @$$ and would rather go with a USP Verified OTC product and take my chances

Why would the NHS only recommend eating fish and prescription fish oil? I don't know, but it smells awfully fishy to me. As soon as an opportunity for profit is built into a treatment, all of a sudden it gains endorsement. Perhaps lobbying by those parties with potential for profit drove the process.

The article didn't mention the doctor's diet, but I'd be willing to bet that it was high-carb/low-fat.

If DR. Wade had done a heart scan instead of the CT angio, what do you suppose his CAC would have been given how serious his condition was at the point of discovery?

Also, given how the story lays out how quickly his stress test -- no echo described -- revealed EKG abnormalities with very little exertion, it boggles my mind that he would be completely asymptomatic.  Wouldn't he have some symptoms?  Chest discomfort?  I'm amazed he didn't.

I agree. It's surprising that no symptoms were present.

His heart scan score was almost certainly in the thousands.

Dr Davis,
I have been reading your Blog for months now and have found it enormously informative.  As I read this post, your use of the words "early detection' stood out.  I would encourage the use of this term because people have a favorable response to it already due to it's use when people are talking or writing about cancer.  CT scans need to get the same "social weight" as mamograms have now.  The battle of ideas is often about how language is used.  "early dectection" is a very powerful phrase.

Excellent point. Thanks, Peter.

One step forward, two steps back.

Chocolate Cheerios are good for the heart. If you don't believe this go here http://www.cheerios.com/ourCereals/ChocolateCheerios/ChocolateCheerios_home.aspx

I had a bowl of bran flakes and checked my blood sugar. 141. Yikes!

I have been down on wheat family of grains for a long time, but for other reasons than the health consequences tied to peak blood sugar elevations [and consequent hypoglycemic phases].  I'm down on the inflammatory oils and the allergy aspects.

Have you investigated HEMP SEED?  It is high in protein and packed with good oils.   How does it rate with your diet suggestions?    Would it be good to run some trials?

CEREAL FACTS This site has some interesting factsheets about the different cereals.

In particular I found this The influence of high vs. low sugar cereal on children’s breakfast consumption shows what kids will eat away from home and provided with sugary cereals or not.
These are the cereals most heavily promoted to kids
and here is their sugar content.

AHA Nutritional Criteria for Certified Foods

"they have blundered big time by pushing low-fat ... it is time to quietly start backpedaling."

They're backpedaling all right, but it's not because they are abandoning the low fat message.  The average consumer is not quite ignorant enough to believe Cocoa Puffs are healthy, and they don't want that 60% that are affected by their check mark to drop.

Just got an AHA solicitation in the mail this week.  Like so many other organizations, they do not act in the best interest of the people they claim to serve.  My money and time are better spent pursuing the more promising preventative practices such as those promoted by TYP.

A colleague eats a Quaker oatmeal square for breakfast every morning.  Among the ingredients listed on the label is partially hydrogenated soybean oil, not enough, apparently, to bump the transfat content above .5 grams, so the nutrition label lists 0 grams of transfat.  No amount of transfat is healthy, yet this product has the AHA seal of approval. I used to eat granola bars when I thought they were healthy.  I read labels and noticed that quite a few use partially hydrogenated oils, including brands that boast of high fiber or Omega 3 content.

Maybe the people at Cocoa Puffs stopped writing checks. Who needs an endorsement when your product contains wheat, sugar and chocolate and is marketed to kids in an I-want-to-be-my-child's-friend mileau?

As if these cereals aren't bad enough...
KFC is selling their fried chicken in Pink "Buckets for the Cure" for Breast Cancer fund raising.
It left me speechless.
I've said it before... we're on our own.

http://www.cnn.com/2010/LIVING/homestyle/04/28/kfc.pink.bucket.campaign/

The site Ted linked to (www.cerealfacts.org) has a list of Top 10 Cereals by Nutrition Score.  None of those top 10 are on the AHA list of heart-healthy cereals.

Scientific American Magazine - April 27, 2010, Title: "Carbs against Cardio: More Evidence that Refined Carbohydrates, not Fats, Threaten the Heart"

Dr Davis,

This question is off the topic. I read your book Track your plaque a month back and had been to AZ heart institute and got my plaque measured.

I am a Type 2 Diabetic for the past 11 years and am actively low carbing (<30g carbs per day) and 100% grain avoiding since May 2008.

My calcium score was 0.

But the staff was not able to say whether the machine they used was EBT/MDCT. They said it is newer than EBT. The machine had GE 64 slice VCT printed on it. Can you confirm if this is the one you are asking people to have it calcium scored?

I live in Phoenix, AZ and had been to AZ Heart Institute (got the information from "Track your plaque" book).

Please let me know if I got calcium score done in a machine in which I am supposed to do.

Thanks for all the help.

Thanks

Venkat

IS VERY GOOD..............................

> I had a bowl of bran flakes and checked my blood sugar. 141. Yikes

It is a great idea to check blood glucose levels after meals, just bear in mind that they can vary rather erratically:

http://healthcorrelator.blogspot.com/2010/05/blood-glucose-variations-in-normal.html

Oats, oats, oats is the common thread of the "survivors." Either the oat industry is doing an excellent coordinated marketing attack or there is something to the claim that oats are good for cardiovascular health.

I don't eat cereal of any kind. Have no desire to. A much healthier choice altogether would be cottage cheese with fruit or just fruit, scrambled eggs or even bacon cooked extra crispy.

There are  thousands of websites which provides information  about  
how is angioplasty done.
But dilseindia is one  of the websites where one can get good info about the  angioplasty.

The question I have, is 60-70 ng/ml enough? Are we being too conservative?

I'm thinking a target of 80 ng/ml might eventually pan out.

There is also Melamed's study showing a sharp increase in mortality above 50ng/ml or so.  Small sample size and residual confounding probably, but worth considering nonetheless.

I wonder if it is really true that Vitamin D production decrease is really a function of aging, rather than a consequence of eating the SAD for so long.

It would be very useful to have a properly conducted study to address this question. Could elimination of gluten, excess fructose, correcting O-6/O-3 imbalance, and other hyperinsulinemia/inflammation sources in even the aged allow large amounts of D3 production?

Progress report:
Over about 5 years I have gradually ramped up vitamin D3. Initially, tablet form. Last 18mo capsule form.
Started noticing cold/virus improvements over entire period.
Finger/prick Lab work: (GrassRootsHealth.com)
Results:
Mar 2009  50ng/dL  prior dose 4000iu 3mo.
Sept2009  60ng/dL  6mo dose   6000iu

Current dose for H1N1 Winter 8000iu. Target: 70-80ng/dL by next fall.
Age 73
Weight 190
Race W.
Sex  M
Meds. Armour Thyroid.
Colds: Only hints lasting two days
early in the season. Otherwise cold/flu/infection free.
Hospitalizations: None.  
Vaccinations none in five years.

Hope some one finds this useful.

In my carefully considered (but not so humble) opinion, if most people would follow Dr Davis's recommendations, most US health care cost and availability problems would disappear in less than a generation, Bill or no Bill.

Mike

Supplements can be of great help in getting rid of free radicals  to our body.  A good source of vitamins and antioxidants to suffice what we lack from food intake.

I take 10,000iu in winter and 5,000iu other seasons.

My last grassroots test: 79 ng/ml.

Age 70

Never get colds or flu but have medium grade prostate cancer.  Doing "watchful waiting".  May get foreign "HIFU" treatment.

The perfect blood range will proove to be that of people wearing little clothing in a sunny climate who are tanned and avoiding being burnt ie 80-100ng/ml. Looking at it through the lens of evolution (since animals can out of the sea and forwards)- it has to be that this is what we will be best adapted too.

I like it! I had the 76ng/ml last month when I checked (first time in my life actually checking).

I have been taking at least 5000 IU every day (liquid) for the past year and a half. But have recently increased it to 11000 IU once or twice a week. I can feel the winter is coming.

Thanks for a much important post as we are getting closer to winter and flu season.

6 months of supplementing with 5000IU D3 gelcaps daily has gotten my D up to a level of 58 (it was 46 after 8 weeks of supplementing)so I'm getting there. I'm just trying to decide if I should bump the dose. It's just trying to establish priorities now that I know I'll be losing my job, my income and my reasonable health insurance sometime in the next few months.

And I was just diagnosed with Hashimoto's disease this WEEK, so now have to contend with getting my thyroid sorted out too. Always some darn thing or another. :-D

Scall0way:
I empathize with you in you situation.
If you require thyroid medication, ask your doctor for for Armour Thyroid.
Continue to follow Dr D's recommendations regarding Vitamin D3, fish oil, iodine.
Consider curcumin/turmeric, quercetin, NSAIDS. Avoid omega 6 etc
Hope you get Hashimoto under control before insurance ends.
Maintain vitamin D3 at all costs. Should help to regulate autoimmunity. Best bang for the healthcare buck.
Good luck!
Mike V
Visit drbganimalpharm.blogspot.com

March 2007 D test was 7 ng/ml, and after supplementing with 8000 units Carlson's D3 per day, my grassrootshealth test is 94.  Yahoo! Going to keep it there as I have had SAD (the seasonal kind and the dietary kind in the past) for over 60 years, and the vitamin D supplementation has helped with the seasonal kind of SAD (along with bright full-spectrum light in the morning and blue blocking glasses at night).

Vitamin D and homeostasis " a homeostatic mechanism keeps the level of vitamin D in our bloodstream within a certain range. When UV-B light is always intense, as in the tropics, the level seems to be 50-75 nmol/L in young adults and progressively lower in older age groups. The more sunlight varies seasonally, the more the body will produce vitamin D in summer in order to maintain at least 50 nmol/L in winter—a level well below the recommended minimum of 75 nmol/L and even further below the 150 nmol/L now being advocated by vitamin-D proponents.

This homeostatic mechanism breaks down if we daily ingest 10,000 IU of vitamin D or more (Vieth, 1999). It seems that the human body has never naturally encountered such intakes, at least not on a continual basis.

In a recent review article, Robins (2009) presents evidence for a second homeostatic mechanism. Even when the level of vitamin D varies in the bloodstream, the second mechanism ensures that these divergent levels will translate into the same concentration of the biologically active 1,25-(OH)2D metabolite."

Dear Dr. Davis,
   Are you still recommending Vitamin D for Aortic Valve Stenosis? Do you have any updates on whether it helps the calcification to regress, as you mentioned in your articles from 2007? I just found out I have a very severe case of this, and your blog is the first place I've seen any hope of improving it other than heart valve replacement. But I also saw that some people say Vitamin D makes it worse! It's so hard to know what to do. So could you let me know how it's going on this since 2007? Have your patients gotten better from the Vitamin D and the calcification regress? At the moment I don't take any Vitamin D at all. Tx very much.

Hi, Valerie-

I am definitely continuing to advise vitamin D normalization for nearly everybody, including those with aortic valve disease.

I now have about 30 people who have normalized vitamin D and have aortic valve disease. The overall trend is a dramatic slowing of deterioration. Vitamin D does NOT cause worsening unless you take it to toxic levels. That is what is causing the confusion: Rat studies in which toxic levels of vitamin D were used to cause aortic valve disease.

Dr. Davis,
Do you know whether D3 supplementation can affect the BU/CR Ratio on a CBC? I read that steroids can cause a rise in BUN and that D3 is considered a steroid?

I finally got my D3 levels up to 57 ng/mL with daily 6,000 IU d3 (from mid September)and also added fish oil a month later. Had blood levels checked end of October and got a flag on the BU/CR ratio of 25.0, lab range 6-22. BUN was 17 and Creatinine was 0.68. No other chemistry components outside normal range.

I should mention that I am also post-menopausal and on HRT - (Divigel transdermal & Prometrium) -- and mildly hypothyroid (Synthroid 50 mcg).

I'm 30yrs old from London, England with naturally tanned skin and have a maternal history of primarily bone and heart problems.
My pre-supplement D value was just 10nmol/L. 5000IU took me to 76nmol/L, whereas 10000IU took me to an acceptable 141nmol/L.
Not only has my PTH decreased but my second ever DEXA scan (I am given them as precaution) showed a 7% increase in bone density even though it was fine before and my cholesterol profile changed to show an increase in HDL and a reduction in cholesterol ratio. Of course particle size isn't measured here but I'm sure vit D isn't dis-servicing me by what I've observed so far.

Dr. Davis,

I've tried 3 different forms of supplemental Vitamin D(dry tabs, gel caps and now liquid ddrops). For some reason I seem to experience slight tightness of chest and shallow breathing after I take any form of vitamin D. The higher the dose, the more pronounced the side effects are and for a longer duration(last weekend I took 4000iu's and it seemed to last for most of the day).

Would you advise I stop supplementation? I was considering taking it before bed so that any minor side effects wouldn't be as noticeable when I sleep.

Mike

Hi, Mo--

Great results. I wished that I'd known about vitamin D at your age.

I'm grateful that we finally have come to appreciate what an extraordinary thing vitamin D is.

Mike-

Once in a while, I'll see somebody with sternal (breastbone) awareness of vitamin D deficiency or replacement, both resulting in pain. While harmless, it can be very frightening.

However, you might still want to consult your doctor about this. Hopefully, he/she understands how important vitamin D replacement is.

Thank you Dr. Davis.

Unfortunately my current physician isn't too receptive to the increasing popularity of Vitamin D these days.

Heike-Bischoff-Ferrari et al. (2008):

http://www.ajcn.org/cgi/content/full/84/1/18/F1


As you can see, over 50 year old white-skinned persons who had higher than 100 nmol/l had _lower_ bone mass density than those about at 100 nmol/l.

I think this should be taken into consideration when determining optimal 25(OH)D levels, don't you think ?

Full text here:
http://www.ajcn.org/cgi/content/full/84/1/18

Dr. Davis, I've been supplementing 10k iu per day for nearly 1 year using a gel cap supplement. I still only managed to achieve a level of 52 ng/ml. Is it safe to take a higher dosage. In your practice have you found this to be common. I have had my gallbladder removed and use nexium for GERDs. Otherwise im healthy 50 year old male. Thanks for taking the time to read.

Hi Dr. Davis:
I had an unnecessary hemithyroidectomy about 5 years ago for a benign goiter after my second pregnancy (both winter pregnancies) and have felt unwell ever since.  I could never find a dose of synthroid that would work well.  I would need a dosage adjustment upwards in the late fall and then in the spring I would feel hyper and need to lower the dose.  This went on for 3 years in a row and I finally asked my Dr. if this could be due to Vitamin D since it's the only seasonal variation that made sense to me.  She of course said that was unlikely.

I did lots of reading on the topic and found that many people that have half a thyroid don't need supplementation, so I asked her if I could try going off the meds to see if my thyroid could make enough hormone on it's own.  Other than being tired and having heavy periods I felt not too bad.  At 3 months I was iron deficient so I started consuming liver once or twice per month for about 3 months and started feeling ill with joint pain, digestive problems, fatigue, insomnia.  It took me another 6 months to figure out that people who have familial hyperlipidemia have a tendency to overdose on levels of vit A that would be fine for most people.  Here's are a few of the papers that finally gave me some answers:
http://www.annals.org/cgi/content/abstract/105/6/877

http://www.ajcn.org/cgi/content/full/71/4/878#R25

And again the symptoms worsened in the fall.  I developed a cold that lasted 4 months!  Finally I insisted my DR. check my vitamin D level and in September it was 72 nmol/L.  She was surprised and put me on 1000 IU of vit D3.  Over the next year I waffled between taking synthroid or Armour and going off it because I felt so awful and didn't know what was wrong.  I think the Vitamin A was confounding the recovery process.  A major breakthrough came a couple of months ago.  I was on the lowest dose of synthroid (in the fall of course), my thyroid function had improved enough over the past 2 years that the lowest dose was enough, and I started taking 5000 IU of vitamin D.  Within 2 weeks, I started having severe hyperthyroid symptoms.  I told my Dr. that I thought the vit D was improving thyroid function and that I wanted to go off the synthroid yet again.  Within 2 weeks the hyper feeling slowly subsided and I am waiting 3 months before having my thyroid levels and vit D checked.  My only remaining symptoms are joint pain (less now than a year ago), mild fatigue, insomnia, and constant hunger despite being on a low carb diet (which made me feel great before the surgery).  My mood is much better and my mental clarity has improved.  Over the past year my TSH off medication has dropped from 12 to 4.  I am hoping that in 3 months or so it will be almost normal.

Here is one of a few papers I found about low levels of Vitamin D following a hemithyroidectomy:
http://content.karger.com/ProdukteDB/produkte.asp?Doi=182696

I had my iodine levels tested and they were found to be normal.  I wonder now if the nodule was cause by low levels of vit D during two winter pregnancies along with a prenatal supplement which was high in Vitamin A relative to Vitamin D in a Vitamin A toxicity susceptible person.  I found a few papers on-line which suggest vit A can be a cause of thyroid goiter.
Thanks for this excellent blog.

How or what may I take to get adequate iodine? Tks.

Hi Bumper:

The best methods of getting iodine are Lugol's iodine, Iodorol, or Kelp.  Salt isn't really a good source, the iodine is volatile and eventually dissipates.  You should have an iodine loading test done to determine if you are in fact iodine deficient.  You can order one on-line yourself, or go to a naturopathic Doctor who can order one.  I hope this helps.

I am so pleased to have found this blog! I was diagnosed with mild arotic valve stenois and afraid there was no treatment approach, until reading about Vitamin D here. I have am taking between 1,000 - 2000 i.u. of D3 per day for reducing fatigue and improving calcium absorption(I also have osteopenia and take Fosomax once a week; am age 59.) Dr. Davis, how much more Vit D can I safely take? I do not know how to to calculate the ng/ml levels that I am reading about here. How would you suggest I get started with this approach?

The only way to tell how much Vitamin D3 supplement you need to take is by a blood test - either via your doctor or take a look at this website www.grassrootshealth.net/ which offers cost price blood tests.

I have put together a summary of current advice on Vitamin D blood levels and guidance on response to supplement intake: www.stargateuk.info/vitamind/Blood_Levels.htm

For a general overview of Vitamin D health benefits take a look at my website: www.stargateuk.info/vitamind

Excellent article

You can find in-depth information at http://www.henrylahore.com/VitD.html.  

Actively creating a wiki where everyone can share vitamin D information.

Okay, I am totally new to the Vitamin D issue.  My sister had a full workup and her dr found that she had very low levels of Vit D (19).  She's always extremely tired.  I have been working out with a personal trainer and decided to go to the dr to get a full physical (I'm also tired often but thought it was because I have a 3yr old).  I specifically asked about Vit D and the dr said they don't normally test it.  I told him I was tired often and he said that was a symptom and ordered blood work.  Well, apparently mine is a little lower than my sister's.  The dr said my Vit D levels should be between 35-100 and mine was 16.  Now, what should I do???  Where should my levels be (I'm almost 40, white, healthy).  Appreciate any help!

This is the most comprehensive info re: vitamin D levels I've found on line. Most posts are 50-70ng/ml and bumping up, but my D Total is 19. My dr's asked me to see her, but can she prescribe anything I haven't already learned: take 1-2000 iu's D, cod-liver oil/more fish & sun? Thx!

I'm concerned that my vitamin d is too high! It's 84.9 ng/ML. I'm a 27 year old female and take 2000 IU per day (along with whatever vitamin d is in two citrical pills). Should I back off? Thoughts?

We also know that a vacation on a Caribbean beach in a bathing suit will increase vitamin D blood levels to the 80-110 ng/ml range without ill-effect (at least in young people who maintain the capacity to activate vitamin D in the skin, a phenomenon that declines as we age).

I did a little digging and found this press release from General Mills on the study: http://www.newswise.com/articles/view/?id=CHOLEST.GNM. It's interesting that the study was carried out at the University of Minnesota. Guess where General Mills is headquartered? Yep, in Minneapolis.

The journal in question, Nutrition in Clinical Care, was published by Tufts University and the Friedman School of Nutrition Science and Policy between 1998 and 2005. The original publisher was Blackwell (Volumes 1–5), and it was then picked up by the International Life Sciences Institute (whose members include Bayer, Cadbury, Coca-Coa, Kellogg's, Kraft, Heinz, McNeil, Mead Johnson, National Starch Food (I love that one), Pfizer ... well you get the picture).

A search on the name of the principal researcher is equally interesting.

A little different comment than what is mentioned on this post, but a cousin was told by her doctor yesterday that she should take vitamin D3, K2, fish oil, and stop eating sugary foods.  This wasn't said for heart health though.  She had a nasty accident when riding a horse and broke several bones.  

I'm going to mail her a get well package, include the mentioned supplements plus throw in some magnesium. Good to see another opened minded doctor prescribing what ever works.  My typical experience has been that doctors don't mentioning supplements.

Wow, Susan! Great info!

I wasn't aware of the "interesting" bloodline of the journal.

Thanks!

Hi Dr. Davis,

You wrote that several studies have shown that oat bran does indeed reduce LDL cholesterol, sometimes as much as 30-50 mg/dl.

Where would I find a good oat bran? Also - isn't oat bran pretty "carby"? I typically have to keep my daily intake of carbs between 40 and 60 grams to avoid gaining weight. Does oat bran fit into a low-carb way of eating?

Thanks in advance for your reply!

Paul

"people can lower their blood cholesterol by an average of 3.8% over six weeks by enjoying 3 cups of cold cereal made with 100% whole grain oats everyday as part of the meals and snacks in a healthy lower-fat diet."

THREE Cups a day?!?! That's a hefty dose! A lot of carbage for a little "benefit". I guess the particle size would completely negate any "benefit"?

When I first started testing my BG in the first few days I discovered that Cheerios would cause my numbers to spike.  The numbers I saw that day are the highest readings I have ever had.  Needless to say that was the last time I ate cheerios.

The sad thing was that based on the advertising I thought that I was doing the right thing by eating cheerios.  Of course I know know better.

Add a diet low in processed food and a good 'lifestyle' (don't smoke, control waist size, manage stress well, some exercise) and you will improve general health and help prevent heart disease.

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I have also seen diabetic effects from Cheerios: rises in blood sugar, exagerration of small LDL, drops in HDL, rises in triglycerides. Yes, it may reduce LDL a small quantity, but so what?

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Good information about Heart. In the modern world many person are suffering from hart problem in very early age for such people it is very nice articles.

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Smith ALan

Thanks for this article.

I can't accept NPR's statement that 25% of firefighters have no health insurance. I think that all permanent public employees everwhere in the US have health insurance. A firefighter's union would certainly secure this benefit.

What about adding P-5-P to the Niacin?

I've heard things about cinnamon lowering Blood sugar, but I'm not convinced.

Thank you for posting this.  I am exercising everyday sometimes twice a day to equal 45-60 minutes and see some help with the glucose level.  My LDLs continue to be around 100 and my Dr. wants to increase the Niacin.  Will that help?  It's a fine line, keep the sugars down and get the LDLs down. I appreciate your blog!

Cinnamon does reduce blood sugar but the effect is minimal, even at higher doses.

About Karl comment, you can add many supplements to niacin to counteract this effect. Chromium, resveratrol, standarized cinnamon, green tea extract... Life Extension has launched a niacin with quercetin for example (but now out of stock).

Would reducing sugary/starchy carbohydrate intake be an effective way to reduce hyperglycaemia?

Thanks for posting Dr. Davis.

Is splitting 1500 mg of Niacin to two 750mg doses,one in morning, one in evening ok?
Or should  the 1500 be taken all at once?

Both times I started Niacin, I developed Gout.
The second time I cut the tablets in half hoping to avoid another bout but still, Gout in a different joint.

It has been my experience that over time (2-3 Months)the Slo-Niacin I use has less effects on raising blood glucose levels like it does at the onset. It is well advised that everyone should get in the exercise regardless of niacin intake.

I took 500mg of Niacin every day to get my HDL up. Plus, there was niacin in my multivitamin. My HDL didn't go up at all. I exercise plenty too. All I got out of it were a few itchy flushes that made my ears feel clogged. I'm going to finish my bottle of Slo-Niacin and try a red yeast rice that was tested by Consumerlab.com.

Regarding splitting the dose of Niacin.  I am pretty sure I have seen a post from Dr.D saying to take all at once.  

I used to split my dose. I thought I was being smart by distributing the Niacin over the day.  My local pharmacist told me not to split the dose because of impacts to Liver function.

I avoid sustained release niacin.

I get around 80 mg niacin per day in a multivitamin and don't want to add extra.

http://www.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=114620

pomegranate...

Despite the patients’ advanced atherosclerosis, ingesting pomegranate juice produced statistically significant reductions in the thickness of their carotid artery walls, which is correlated with decreased risk for heart attack and stroke. After only three months, the average thickness declined by 13%, and after 12 months, the thickness dropped 35% compared to baseline. During this same 12-month period, the average carotid artery thickness of the placebo group increased by 9%.

Thank you so much for posting this!  I have bee na niacin devotee for about 15 years, and wanted to get my LDL back up after a dx of T2D (with Antibodies) ... and having my niacin "taken away" by my internist.  MY Endo put me back on a lower dose of slo-niacin ... exercise is helping but I may need to up my anti-IR meds.

When is the best time to take niacin?

morning or night?

before or after exercise or meals?

We've had best results dosing niacin with dinner or the largest meal of the day.

Dr.Davis

Just asking this again, could you could please help me out.

Is splitting 1500 mg of Niacin to two 750mg doses,one in morning, one in evening ok?
Or should the 1500 be taken all at once?

I had a terrible time with Niacin and insulin resistance.

I tried exercising but to keep my BG down, I would have to exercise 3 or 4 times a DAY, which is simply not feasible.  Oh, and I am a low-caber, too.

I would exercise extreme caution in starting to use this, with any Diabetes. (I am a T1.5).

Dr Davis,

What kind of exercise would you recommend for a Senior lady who is handicapped?  It is difficult for her to do any exercise, so do you know of something she would be able to do while she is taking niacin?  Or, would it be better for her to stop the niacin since exercise is difficult and try other supplements?  Thanks for your help.

Assuming your recommended Slo-niacin...is it better to split your doses up (500 mg morning and 500 mg at night) or take all 1000mg at once? If its better to take all at once is night or morning better?

I love to practice exercise, i think this activity is the best option to keep our total welfare and it is very fun. When we exercise frequently we can notice a change not only in our shape but in our mood too. Actually we can improve our sexual performance. When some cases when the erectil dysfunction present like a problem  to buy viagra is a great alternative, how ever you must to combine it with exercises and a good feed.

While the net effect of niacin remains positive, the provocation of insulin resistance is not such a good thing. Can it be minimized or eliminated?

Taking niacin before vigorous exercise has one benefit for me.  The flusing is minimized or even eliminated.

I've seen different recommendations for dosing frequency.  Three times a day is the "standard" dosing regimen.  However, when I haved switched to three times a day dosing, I have experienced elevated liver enzymes.  I've never had a problem with twice a day dosing.

I am not aware of any data to support 24% risk reduction for MI with the use of Niacin, can you provide citations?

Primary or secondary prevention?

Bob Hansen MD

Cinnamon doesn't lower blood sugar per se.  The apparent mechanism occurring here is a slowing down of carbohydrate absorption in the gut.  The mechanism is believed to involve a class of molecules known as flavonoids, which either reversibly compete for the glucose receptor or have their own receptor on the GLUT 2 (glucose transport 2) protein.  This action only slows down the absorption of carbohydrates, but all (that's 100%) sugar is absorbed into the body.  It is the only thing you intake that is absorbed 100% and it doesn't matter if it's glucose, sucrose, fructose, or a complex carb.  Anywho, not that I want to debate the finer points of carbohydrate biochemistry.  For more on flavonoids and GLUT2 you can look up this paper (Kwon O., Eck P., Chen S., Corpe C., Lee J-h., Kruhlak M., Levine M. (2007) Inhibition of the intestinal glucose transporter GLUT 2 by flavonoids. FASEB Journal 21, 366-77.).