Thank you for clarifying which test to use.  

I personally find this information very helpful.

My previous testing was done at Berkeley.

How often do you suggest retesting be done?  Yearly or ??

Thank you.

Marilyn

Marilyn--
In the Track Your Plaque program, we advocate lipoprotein testing at the beginning to diagnose the full extent of causes of coronary plaque, and then again when correction is believed to have been achieved. Standard lipids are used in between to assess response. Of course, this is just one way we've used that we've become comfortable with.

The VAP does provide IDL on their profile.

What sort of external validation does NMR have on their methods?

Randox provide a kit which tests for the full lipid profile - a group of tests comprising triglycerides, total cholesterol, HDL and LDL cholesterol. The lipid profile is used, together with other risk factors, to assess a person's risk of cardiovascular disease (CVD).

It is very important to get the balance between the protective HDL and the destructive LDL right in order to reduce the risk of CVD. This can be achieved either through dietary and lifestyle changes or treatment with cholesterol reducing drugs called statins.

All Randox cholesterol tests, including small LDL, are direct enzymatic clearance tests, and as such are highly accurate even in lipaemic samples.

For more information click here http://www.randox.com/lipid%20profile.php

Having done many of all three (though least of VAP), I am partial to Liposcience's NMR. (By the way, I receive no fees from Liposcience to use their test, nor to promote it in any way.)

I know a group of guys that run marathons regularly.  If you asked them why they run, they will tell you there are two reasons; one to prevent heart disease and two to drink beer with out gaining weight.  Special emphasis will be placed on drinking beer.  I was reminded this week of how much the group enjoys their beer when the head of the group CCed me on a letter he wrote to Kroger grocery store pointing out that their Miller beer price is significantly higher priced than Wal-Mart, located just across the street.  If Kroger did not lower the price, well, they might just have to shop elsewhere.  

I'm going to send them this blog and tell them they can stop running blind.  Today there are tests to determine if you have heart disease.  I'd suggest to them to drink red wine instead of beer, but that might be asking too much.

That's great.

Now we can only hope that their doc's know what to do next if any of them have Lp(a) or other "obscure" factors.

When (what age) should one have a heart scan and Lp(a) test done if there are no symptoms? What would be the approximate cost to get the recommended testing done and evaluated?

I am curious as to why you focused on LPa as the likely cause. For example I am a regular runner and my LPa is in the low normal range. Is there something about running that makes LPa abnormalities more likely?

Hi,
I believe that the combination of Lp(a) and marathoners is no more likely than the general population, but it makes for media hype--the apparent contradictions of ultra-fitness and a disease generally associated with poor lifestyle. Lp(a) is, more often than not, the source of the contradiction.

Do you have any advice on a Vitamin C/Lysine regimen? Apparently this combination was recommended (in high doses) by Linus Pauling years ago for cardiac health, particularly in controlling high levels of Lp(a). TIA

John--

I can only tell you that we've tried a number of times only to see no substantial effect.

The concept has the basis in some real--and very interesting science--but the leap from a "test tube" observation to a "cure" for heart disease and cancer is, to say the least, a big one.

Mike--Please see the extensive commentary on these issues on the Track Your Plaque website that this Blog accompanies. You will find an enormous amount of discussion, even in the non-Member, open content section.

What are the health implications of this?

I buy beef hearts for my dogs and have noticed rather large fat deposits on the outside of the heart.  They always seem to be on the top part of the heart!

Hi, Cindy--

I'm not really sure.

This is a really dramatic case. (Unfortunately, I failed to post a normal image next to it.)

I do, however, pity the surgeon who, should this person go to bypass, have to dig through the fat to reach the heart. If only Track Your Plaque became common wisdom and made bypass unnecessary . . .

May I ask, what is the optimal serum range for Vit D.  What do you consider too high and what are the undesirable consequences of too much vitamin D?
Thank you kindly -- fantastic blog !

I wonder- do you have a general rule of thumb for a starting dose based on how much the person weighs? I've found that 1,000 IU per 25 lbs of bodyweight seems to generally get it in the ballpark.

The "1000 units per 25 lbs body weight" that Dr. John Cannell suggests does indeed work well, though there is still great variation among individuals.

For that reason, we aim to maintain blood levels of 25-hydroxy vitamin D of 60-70 ng/ml.

can supplementing with D3 negatively impact TSH thyroid levels, causing TSH to increase? I have seen this stated on another blog.  Suggested remedy was to lower intake of D3.  Thanks.

With daily effort your endurance will continue to increase. In no time at all you will be able to sustain 30 minutes of continued activity. Now as you begin to get into better shape you will be on your way to experiencing fast weight loss.

Great article, I'd never known how vitamin D was related to weight loss until now.

But, with all supplements for weight loss it would need to be combined with exercise for best results

I have the same question as Steve: Can increased D3 affect TSH or thyroid in general. I have hashimotos thyroid autoimmune, and have increased my D3 for osteoporosis reasons, but it seems to be affecting my TSH---need less medication to have same levels of normal TSH.  I read that D is good for autoimmune disease.
Thanks for your response!
Kate

Awesome! really very nice article.

I wanted to take more than 4,000iu because I'm obese (11-17-08 level was 64, 8-3-09 level is 55), but my PCP said not to for fear of kidney problems?  I just upped it to 8,000iu.  We'll see - I sure could use help in the weight loss arena.

Though the levels of vitamin d and weight loss seem to be correlated, is it always true.

Dr. Davis
(Probably not the right forum to post this comment but I just had to send this to you)

Not many weeks ago a colleague of mine (let’s call him Eric) asked me if I knew the difference between D2 and D3 and I told Eric that D2 comes from irradiated mushrooms and D3 comes from the wool. In other words D3 is the same kind of vitamin as humans get from the sun. Humans just don’t get enough and we can’t produce it on our own, like the sheep can. (D3 is natural for humans, D2 is not just like you have said)

After telling Eric this, he asked me how he would know what he is taking and I gave him the medical definitions of them both (D2 = Ergocalciferol; D3 = Cholecaliciferol). Since I was aware of that he had gotten his Vitamin D by prescription I told him “I am 99.9% sure that you are taking D2, but I would be thrilled to find out I am wrong”.

Eric called his pharmacy right away and got the answer I was expecting: Ergocalciferol. When confronting the person Eric was talking to the answer he got back was that Ergocalciferol is the only Vitamin D they are giving out.

A week later, Eric had a new appointment with his doctor and decided to ask him about the D2/D3 issue. The doctor said he knew that there was a difference in them both, but could not say what, not even the basic facts I mentioned above. But the doctor stamped a post-it with what he had sent to the pharmacy just to show Eric… “Vitamin D3; 50,000IU tab” is what the stamp said.

Eric, off course, got confused and was starting to believe that the Pharmacy had made a mistake by giving him Ergocalciferol (D2) since the doctor had given him D3, or at least that is what was stamped on the little note he had.

Today, after getting a refill of his Vitamin D he also got and kept all his paperwork that came along with it. Still in believe about that stamp the doctor had given Eric earlier he asked me to double and triple check that my definition of D2 and D3 was correct. I did, just for my own sanity, and I was still right.

One of the sheets Eric brought me today was the “Patient Education Monograph” sheet stating the drugs and how to use it and so on… The thing the jumped out the most to me was this:

Generic Name: Vitamin D – Oral
Common Brand name(s): Drisdol, Maximum D3
Identification: PA140 Green Oval Capsule

This is the Drug Eric was given: Vitamin D 1.25 MG softgel; Generic name: Ergocalciferol

My researching mind went into high concentration mood and I started to dig. And this is what I found:

The brand name Drisdol is Ergocalciferol (D2), not D3. The Brand name Maximum D3 seems to be hard to find out there in cyber space as a brand name. But the ones I found that was called Maximum D3 seems to be the real stuff, however none of them required a prescription.

When trying to find out through the identification number on the pills (PA140) I now know for sure that Eric is taking Vitamin D2 and not the preferably Vitamin D3. The Brand Name Drisdol had the identification W on one side and D92 on the other, but it is still Ergocalciferol.

The only conclusion I can draw from all this is that the medical industry does not know or care about the difference in D2 and D3 – it is all same to them. And as long as the pharmacies only give out D2 it does not matter what the doctor prescribe anyway.

I knew that people are most likely to be prescribed a D2 pill than to be told to buy over the counter D3. But it was almost heart breaking to see the letter D and number 3 right next to the drug Drisdol as we know is a D2 vitamin. It just didn’t make sense to me that they can be labeled as the same type of medication, when we know it is not!

I love your blog, and I just wanted you to know that I am passing on your information to as many as I can. If you are interesten in seeing any of the documents that I have from this story you can just email me at helena.mathis@hotmail.com

moderator

shouldn't you take helena mathis' email off the blog post ?

This looks interesting.

Good point! I suppose this is true of anything fat-soluble, if you reduce the fat deposit then the concentration will increase?

wow..excelent post, thanks for sharing

thanks for this - with all sorts of info available on the net - this one gives me a greater understanding on vitamin D in relation to my weight loss level. More posts like this

I take calcium with my vitmain D3.  The vitmain D3 I take has olive oil with it.  It is highly advised to take calcium when taking more than 1000 UI daily.  You should get tested for vitamin D3 levels in your blood.  You can get a private lab or do it through a doctor.  I take 1000 UI for every 25 lbs.  I tried taking it a few days that way and I lost 4 lbs in a few days.
You shouldn't take more the recommend amount on the bottle more than a few months.

Thanks Every body for sharing information ....

You really need to consult a doctor if you have any plans to lose weight. Ask for a prescription of the right dosage of Vitamin D and eat nutritious foods as well. Don't forget to exercise too, its helpful.

In my case, I created my own – FatBlasters. It’s essential that you not feel alone, and reaching out to friends (new or old) is typically a smart move. I just heard about PeetTrainer, but didn’t know about it when I began down the road to weight loss. You have to know that others are out there for moral support – they know things that you couldn’t possibly know, and they’ve probably been “in your shoes” at some point in the past (or present). Share stories, laughter, tears, successes, and failures – share them. There are thousands of communities out there, so keep looking until you find the one that fits you.

Nice post on the Vitamin D and weight loss. Overweight is one of the major problem in the world. People do lot of things for losing the weight.

What is suggested here is that if you start out with an inadequate vitamin D level, it’s possible that this might inhibit or impede your ability to lose weight on a reduced caloric diet?

yes my dear friend ,definitely you lose weight on a reduced caloric diet, HCG diet , thanks

There is many more information on this post about how to reduce our weight loss and also there is plenty of information about the functions of vitamin D in weight loss.Office plugin Its really a helpful information to all of us.

This is a common phenomenon with substantial weight loss: lose weight and the need for vitamin D is reduced. The reduction in dose is roughly proportion to the weight lost. Vitamin D should therefore be reassessed with any substantial change in weight of, say, 10 lbs or more, either up or down, because of the influence of fat on vitamin D blood levels.

Vitamin D is good for weight loss.

I am now on a weight loss program and I can say that I am getting a very good result. I never thought that vitamin D can really affect my weight loss program.

Thanks for sharing the importance of vitamin D in loosing the weight. keep posting such a nice post....



Smith ALan

Amen, brother! This is the dirty little secret that proponents of the lipid-hypothesis of CAD continually try to sweep under the rug. Looks like the cat's out of the bag, though, thanks to the internet.

But what can be done about post-meal elevated triglycerides?  Would it be best to avoid fats too, and just eat fruits and vegetables, if one had the will power to do it?

Perhaps we should just give up eating altogether.

I think that worrying about post-meal elevated triglycerides is probably shortening your life more than post-meal elevated triglycerides.

so what does this mean?

"It also remains true if you chronically consume fats."

my understanding is that it is actually in support of normal metabolic functioning for us to "chronically" eat fat. low carb eating, in my lay-person's opinion, means therefore eating good fats (and i am of the un-pc standpoint that saturated animalfats are a-ok) , not just green veggies alone. low-car and low-fat would be no fun! but that's just my 2 cents.

I've had two non-fasting cholesterol tests performed in the last year.  My fasting triglycerides are around 40.  My triglycerides three hours after eating a meal with 10g carbs and 59g of fat were 91.  The time prior to that, they were 79 eight hours after breakfast and three hours after lunch (both were high-fat meals).

Yeah, they go up, but not that much.

So what about the other side of the equation? Decreasing the absorption rate of fat (or spreading it out over more meals) might not help any. But if you can optimize the deposition of fat where it really belongs, in subcutaneous fat tissue-- that is, if fat is deposited in fat tissue where it belongs until needed, at a rate close to the rate at which new dietary fat is absorbed into the bloodstream-- then there shouldn't be a problem.
Interventions that raise HDL generally increase adiponectin. Eating less wheat, beer, fructose, or adding in fish oil, niacin, vitamin d, even being born a woman. And they also associate with less wheat belly.

http://www.springerlink.com/content/dpy09vbc0r8jxnm9/

-----------------------------------
Conclusion/interpretation. These data suggest that adiponectin concentrations are determined by intra-abdominal fat mass, with additional independent effects of age and sex. Adiponectin could link intra-abdominal fat with insulin resistance and an atherogenic lipoprotein profile.
--------------------------------
Maybe they've got cause and effect reversed here? I read a study in mice that were leptin-deficient. Adding extra adiponectin made the mice fatter. So adiponectin is probably not so much a reaction to deposited fat as it is a promoter, maybe a facilitator of proper fat storage.

?

Thanks, interesting post. Just wondering: what about proteins?

So if I eat cheese slices with butter as snacks all day, my triglys will be chronically high and I can get heart problems?

Does this mean that intermittent fasting is very important if you eat low carb/paleo style?

Where Oh Where can I find a Doctor like Doctor Davis in the New Jersey area?

My doc who is a cardiologist referred to by local medicenter when it was found out my Trigs were 235 and Total Cholesterol were 295, LDL 195, HDL 57, promptly put me on 5 mg Crestor to lower trigs and LDL, never discussed diet or anything with me. His office plastered with Pfizer Lipitor posters and Crestor bags given by pharma reps.

Heres the kicker, this was all done with blood work that was NON-FASTING. I had blood drawn an hour after I had eaten eggs and bacon. This was also around halloween time too when I was over indulging on ALOT of Sub sandwiches and bread and lots and lots of candy. I love peanut butter cups. But I know 5 a day is excessive, which was my intake.  Was I getting a DOUBLE Whammy increasing my Trigs?

Since I found this blog, I've been taking my Crestor which I don't want too. But have taken up the no wheat diet and HFC out of my diet that Dr Davis suggests. Dropped 18 pounds in a matter of weeks.

Took my own cholesterol with one of those home machines after 4 weeks of Crestor. Doctor wants to test after 3 months. But my Total Cholesterol was 151, calculated LDL 87, HDL 50 and Trigs 69. I wonder how much was the Crestor doing the change or the change in my diet and 18 pound weight loss?

Sorry for the rambling, but Dr. Davis your blog does give great info and brings peace of mind to me.

Anonymous,

Absolutely not. Having elevated triglycerides immediately after a meal is not a dangerous thing. It's only when they are chronically elevated that you are in danger. Same thing with insulin. Chronically elevated levels are the problem.

Both of these are caused by excessive sugar/carb consumption.

-Bryce Lee

Bookmarked this. Sometimes non-standard due to you after sharing. Positively value my time.

Dr. Davis: a friend of mine recently had triglycerides trending up to 700 and more. I pointed him to your blog, recommended low carbs and fish oil, and after *one month* his TGs are around 200.

Kudos to you.

Interesting series of posts. But keep one thing in mind: Excess blood glucose is converted to palmitic acid by the liver...a saturated fat.

(This fact alone should give the anti-saturated-fat crowd pause...if the body could have evolved to convert glucose to any type of fat, why did it evolve to produce a saturated fat? Can't be too bad for you...)

Anyway, if the body through DNL produces a saturated/healthy fat after only a very brief (and normal) spike in blood glucose - after which the glucose returns to a normal fasting level - then high starch (not fructose) diet appears to be quite healthy. This would answer the question of why a rice-base culture can maintain good health while consuming a diet high in starches...in effect, they are eating a high saturated fat diet.

If they don't eat continuously, allowing their bodies time to eliminate the excess blood glucose and the attendant insulin spike before the DNL triglycerides (palmitic acid) hits their blood stream, then there is no insulin-driven storage of the fats. Instead, they have elevated blood-borne fats that remain available for a consistent energy source of over time, of a type that their body prefers and has evolved to produce.

Can you get the same effect from eating saturated fat in the first place? Yes. But to assume that this is better than the starch-driven approach you have to accept that higher levels of ANY saturated fat in the bloodstream is unhealthy. Which runs counter to the viewpoint of paleo and low-carb eaters.

As Stephen has pointed out, there is no evidence that post-prandial glucose spikes are dangerous to someone with a healthy metabolism (i.e. not a type I or II diabetic). So, if there is no evidence of danger from a post-starch-meal spike, why would your body care where it got its saturated fat? Either dietary or liver-produced, it’s all the same once it is in your blood.

Following the chain of reasoning further, a high-starch diet that leads to DNL production of palmitic acid would be healthier than a high fat diet composed of vegetable oil or other undesirable fats.

We have to be very careful about quickly latching onto bits of "evidence" that confirm our biases. Remain scientific, think it through. The human body is an amazingly complex organism; when we begin to isolate its responses to prove our points, we can start down a path that leads to conclusions that may satisfy our dietary worldview, but are not entirely accurate.

Scott W

Note: If we are being carefully scientific in our approach, we should be careful to distinguish our descriptive terms for non-fat and non-protein calorie sources. "Carbohydrates" is too general. It encompasses fructose, which as a much different effect on the liver than glucose. My discussion above focuses on starches for a reason; they break down to glucose, which the body has evolved to handle efficiently, even in large quantities. It can handle fructose, too, but did not experience it in large quantities prior to modern times. Even using the term "sugar" is inaccurate, since it is half fructose and half glucose. By extension of my discussion above, eating pure glucose powder (dextrose) would be as healthy for a rice-based culture as eating white rice itself. You are simply giving the body the end product of rice digestion (glucose), from which it can produce palmitic acid.

There's no question that postprandial triglyceride-rich lipoproteins are causally related to atherosclerosis, regardless of whether they were fat-driven or carbohydrate-driven.

However, these brief posts are NOT meant to endorse low-fat diets. They are meant to show that a simple low-fat vs. low-carb approach is too simple-minded. There are other aspects of diet that count for substantial effects. Postprandial phenomena are one important class of effects that cannot be fully controlled by just controlling carbohydrate or fat content of the diet.

You still haven't explained why the chart in your previous post (Di Novo Lipo-what?), where normoinsulinemic people have lower DNL on a high-fat diet, is in marked contrast to the chart of Gretchen in the post before that (Gretchen's postprandial diet experiment II) when she was eating high-fat.  From those two posts, it seems that peoples' postprandial triglyceride level is dependent on the amount of insulin they produce (and obviously how sensitive they are to that insulin).  Therefore a high-fat diet is not problematic unless one is also hyperinsulinemic.