Long time reader, first comment.
Thank you for so freely sharing all the information.

Marc

Thank you for this!  I have had this question for a long time given the number of things I take that "thin the blood."

As a veterinarian I've dispensed fish oil capsules for several years.  Some owners give so many that the dogs smell 'fishy' when seen for routine care.  The owner doesn't smell it since they're with the dog a lot.  The coats are gorgeous, something that doesn't often happen in Wyoming at 7000ft altitude.

Hi, Kevin--

My two Boston terriers jump for their fish oil capsules, two every day!

I'm glad to hear from a veterinarian that the coat sheen is indeed from the fish oil.

Due to an afib episode a couple of years ago, I was taking 20 mg of warfarin per day, plus around 5000 mg of EPA+DHA, and never had bleeding issues.  

My INR was always a stable 2.0.

As I've not had an afib reoccurrence, I've replaced the 20mg coumadin with 325mg aspirin daily, and still take around 5000 mg EPA+DHA.  No bleeding issues with that combo either.

Glad this topic came up.
Over the last 5 years, I've had to periodically eliminate my fish oil intake as I would start to bruise badly. My internist said she has seen this occasionally with fish oil and called it "capillary fragility." I bruise easily anyway, but it would really get bad with fish oil. So there must be some quality in fish oil that influences this.

Then about 6 months ago I started a strong supplement change to help with my low bone density--already taking magnesium and calcium but added:
Boron, K2, silica,pomegrantate juice, and BIG increase in vitamin D.
I also increased omegas to 3,000 a day which I was not able to tolerate before.

It has been over 4 months since I have had ANY bruise---which is just unheard of for me. I usually have 3-4 different bruises on arms/legs. So something in these supplements  strengthened my capillaries I guess, and I can now take high fish oil doses!
Anyone else had a bruising problem with fish oil?

Hi, Catherine--

Fascinating observation!

I'll bet it has something to do with the vitamin D, more than anything else. Vitamin D seems to strengthen structural tissues in bones, muscle, heart valves, and perhaps capillaries and other small blood vessels.

Several years ago I bruised easily for a while and attributed it to taking garlic supplements daily.  I started taking Vit C and the bruising stopped.  I don't think it had to do with fish oil (in my case); I don't think I was taking fish oil at the time.

I too achieve rapid blood thinning when taking 2400mg of EPA/DHA per day. That's only 4 pharmaceutical grade capsules. Even after my vitamin d levels were normalized I still got bruising.

I now take Vitamin K2 (MK-7 natto extract) twice a week and it's allowed me to bump my EPA/DHA up to 3600mg with no ill effects or bruising.

It was either supplement or eat a lot of aged cheese, they both seemed to do the trick in my particular case.

Thank you for sharing this study with us.  It helps clarify whether there is a risk for blood thinning from taking fish oils.  This information may help individuals who are taking blood thinning medications and considering adding fish oils to their daily diet.

Catherine,

Without a doubt, your cessation of bruising was due to vitamin k2. I routinely take nattokinase, large doses of fish oil, curcumin, and other blood thinning agents, and if I don't take vitamin K2, I will begin bruising. (I also take high doses of Vitamin D). When I take K2, I have absolutely no bruising.

Vitamin K2 has many clinical trials showing that it helps endothelium  integrity and elasticity.

Also, grapeseed extract and pine bark extract (specifically oligomeric proanthcyanins) has the same beneficial effect.

Daniel,

That's really interesting! There is a lot of research on K2's effect on strengthening weak bones. Bone fractures go down considerably when high doses of K2 are used (Japan is using K2 as osteoporosis treatment) BUT studies show it needs to be in conjunction with adequate calcium and Vitamin D---they work synergistically for bone strength.  So it makes sense that K2 and D could do the same with strengthening fragile capillaries. I am also taking the M7 natto form.

Dave,

Thanks for sharing your experience with this, you've really confirmed it now for me.  I can't believe I have suffered with this for most of my life with no answers (tried high dose Vit C, grape seed, etc) and now within months on K2, there's no bruising and I can tolerate fish oil. Hope my bones are responding this well!
This blog is so helpful....

Thanks for posting this. The question recently came up in our office. I like your assertion that omega-3s restore the blood to normal and remove abnormal clotting. And to comment on a post above, our dog has a beautifully shiny coat and takes 2 pure EPA capsules each day!

I have enjoyed reading That During nearly 3 years of observation, there was no excess of bleeding events in the group taking fish oil. (In fact, the group not taking fish oil had more bleeding events, though the difference fell short of achieving statistical significance.

I've been drinking fish oil for many year and I don't have any chance in my body people use to said me that but I think it is just a rumor.

I'm also especially gratified that a woman now holds our record. I'm uncertain why, but the ladies have been shy and the men remain the dominant and vocal participants in our program. Speak up, ladies!

I haven't heard of this problem
fish oil supplements. But now we know what to tell them when this sort of concern comes up. Fish oil or Omega-3 is really beneficial to health. It's just important that it comes from clean waters.

What is an appropriate dose of fish oil for someone taking coumadin?

Dr. Davis, when  person is taking Tamoxifen...
(1) is it safe to take vitamin k2 or K1?
(2) will fish oil have a role in preventing blood clots?

Thanks for that.  I still take Lovaza; have been lazy about switching.  I just checked the price my mail-order pharmacy pays and it's $546 per bottle of 120, or just over $1.50 per capsule.  While considerably less than what you quoted, it's still $6 per day and $2185 per year!  I'd no idea.  Plus I take Niaspan for another $900 per year.  I'm switching to OTC for both.  No wonder insurance rates are going up!

It's amazing how much some of these companies will try to scam people with 'pharmacy grade' vitamins. It's easy for me to tell how much fish oil is oxidized by taste and how well it works and the best brand I've found is from trader joe's for 8 bucks a bottle. For stuff like vitamin C the process is so simple it's pretty much literally impossible to have any real difference brand to brand aside from how absorbable it is and again it's easy to tell when pills are not absorbing due to how they feel.

And we wonder why healthcare costs are spiraling out of control in america...

What's sad, is the problem isn't limited to just pharmaceuticals, so many other areas like diagnostic imaging and durable medical goods are so much more expensive than they should be.

Do your part to reduce healthcare costs: Reject the idea that fish oil, niacin, and vitamin D should be costly prescription agents.

Pay for them yourself for SUPERIOR preparations that you can obtain without a prescription. This small effort alone will save us all hundreds of millions of dollars.

Anyone know when Lovaza is going generic? I thought I read that perhaps by end of the year their exclusivity may be up, which should open up cheap prescription alternatives -- and sort of kill Lovaza's profits too.

I use otc niacin at about $3 a bottle, and one of the doctors I work with asked me why I hadn't asked my doc for a prescription for Niaspan.
I just didnt know where to begin.

Jeanne

Wow - I'm so surprised that there are worries about a national health care service in the US such as we have in the UK. Here, Lovaza (Omacor) costs the National Health Service £50 for 100 capsules, ie 50p per capsule !

Of course that's not what patients pay. Patients who are charged prescription charges will pay  Â£7.20 per prescription of 100 capsules, and patients who don't pay prescriptions charges at all (approx 70% of patients), well they don't pay anything for their Lovaza....they have paid in their taxes for it already.

But to me the biggest surprise is that the pharmacutical company that makes Lovaza charges so much less in the UK than it does in the US !

Anne

Another way to save on prescription drugs--pill splitting. Too often the smaller dose costs almost as much as the bigger dose. Getting the bigger pill and cutting it down to smaller doses can save a lot of money.

I'm surprised we don't see scrips for "pharmaceutical-grade water", to wash these down.

pyker, its called "bottled water"

It's not really a problem that pharmacy grade fish oil is ridiculously expensive, as long as it's not illegal to sell cheaper fish oils too.

In Europe, the trend seems to be that supplements are becoming available only in pharmacies, which can then charge extraordinary prices for everything.

I have moderately high triglycerides at 255. My physician gave me a sample bottle of Lovazza to try which has 28 softgels. I have been taking one softgel a day.

I have been looking into OTC fish oil supplements. Some are very diluted and some are very concentrated. Most break down the EPA and DHA content while others don't. I created a spreadsheet that collects the EPA and DHA content of several OTC fish oil supplement. In order to make a fair comparison, I adjusted my serving size for each brand name to give me about the same quantity of the essential fatty acids. The prices range from $0.11 per dosage to $1.76 per dosage.

So once I figured out what's the most cost effective brand to buy now I have to worry and wonder about purity. Am I getting a less refined formula that will have heavy metals, PCBs, and other nasty chemicals? The words "triple distilled" mean nothing to me. I'd like to see "Contains no more than 0.010 PPM of arsenic" or something like that.

The Lovazza might have the advantage here since the FDA probably won't let poisoned fish oil out. I have no idea what my effective price per dosage is with Lovazza since my sample bottle was free. My company takes a decent chunk of my pay for health care and I rarely use it. Maybe it's time I get my money's worth and get some subsidized Lovazza?

"I'm surprised we don't see scrips for "pharmaceutical-grade water", to wash these down."

What, like this?

http://www.marksdailyapple.com/bling-water/

My one month experiment with Lovaza is over. I received a free sample bottle with 28 capsules last month from my physician. The recommended dosage was four a day but he told me to take one. I did that for one month. My triglycerides went down from 255 to 135 with no significant change in diet. My total cholesterol went down from 221 to 177, and it was all LDL. Unfortunately, my HDL levels stayed almost the same.

So do I continue with Lovaza and get a prescription or do I get a high quality OTC like Omapure?

I will see my physician tomorrow.

Decisions, decisions, decisions!

Just want to add that Omacor (European Lovaza) costs £2 per day, while Triple Strength Omega 3 from a reputable company costs 12p per day in comparison, for roughly the same amount of EPA and DHA. You just have to take 6 capsules instead of 4.
My jaw would've dropped if I hadn't been getting my vitamin D!

I can also go to Sam's Club and buy a bottle of their Triple-Strength fish oil with 900 mg omega-3 fatty acids per capsule at $18.99 per bottle of 180 capsules. That comes to 10.5 cents per capsule. That puts the price of fish oil from Sam's Club at 97.6% less cost compared to Lovaza for an equivalent quantity of omega-3 fatty acids.

Why expensive Zetia. Niacin appears to outperform Zetia.

http://www.webmd.com/cholesterol-management/news/20091116/niacin-tops-zetia-in-cutting-artery-plaque

While in this study the expensive Niaspan was used, you can by Slo-Niacin dirt cheap.

http://www.costco.com/Browse/Product.aspx?Prodid=11118583

Why do insurance companies pay for Lovaza? They are usually very picky and Lovaza would seem an obvious "soak" job?

How did it get on approved drug lists?

Dr. Davis,

Your correspondent should tell his brother to ditch the Zetia too. The research makes it clear it does not prevent heart attack and may worsen health. Statins appear to be helpful because of their impact on inflammation, not because they lower LDL cholesterol. Zetia lowers cholesterol in a mechanical way that has no impact on inflammation.

Why is a 44 year old being subjected to open heart surgery? Quacks.

As an internist not categorically opposed to statins (although I agree with starting with nutrition first, which is why I read this blog), there are generic alternatives for this person's brother. If my patients need Western drugs, I start with cheap generics whenever possible. Zetia has dubious benefits of ANY kind, and costs a fortune. And of course Dr. D is right that there are many cheaper sources of fish oil; I usually point my patients in that direction.

I often feel "standard" American-style medical practice is intended to waste as much money as possible. People need to be able to trust their docs to execute plans that are not only based on the research evidence, but are cost effective. There is no culture of cost-effective medicine in this country, because health care was defined by the Americans as a for-profit arena.

"Prescribe unto others as you would have them prescribe unto you."

Lovaza fills a void created by bad government and insurance policy. According to IRS rules, over the counter supplements cannot be covered by many insurance handlers. My work's HSA is like this. Fish oil / omega-3 is technically considered an over the counter supplement. The folk making Lovaza more than understand the benefits of omega-3 and want to sell it to the folks who want their insurance to pay for it. So they made it into a "drug" and sell it as such. It's a brilliant marketing plan and it seems to be working for them. The sad part is that it is working! It shouldn't! Same thing goes with Lovastatin. Why not take a good red yeast rice? Oh well... you pay for what you don't know.

-- Boris

Your post, Dr Davis, seems more a call for better health care, the kind we here in the United Kingdom get under our National Health Service, than a call for different fish oils or different meds.

The NHS does have it's problems, sure, but they're nothing like the problems this person you describe has.

It's ironic that her brother is trying to be a "good" American by paying his bills and not filing bankruptcy.
If only his doctors, insurance companies, and drug mNUFcturers had a similar ethic.  It seems that for them, being a good American is maximizing their income regardless of who they take it from.
Ordinary Americans have been sold this "good" American concept from birth.  It's propaganda.  Far too many special interests have used it to enrich only themselves.

Your brother should not be paying anything for drugs to lower cholesterol.

Cholesterol is not the enemy, nor is saturated fat.

The real enemy is chronic inflammation that comes from several sources but mainly from a high grain diet (too much omega 6).

Please, read http://www.omega-3-fish-oil-wonders.com/good-fats.html

Best wishes,
Alfredoe

I have read with interest the comments concerning Lovaza. I was put on it in 2008. I have tried numerous times to ask GSK through emails & ph calls the calorie make up in the gelcap. No one seems to know! Not the Doctor who put me on it, the pharmacist, or anyone from GSK!!! As a diabetic who has lost 140 lbs, following my diet plan is very important to me. Any suggestions on who can make them give up the big calorie secret?
Thanks,
Beverly

Had this reader not been aware that her brother could take fish oil as a nutritional supplement, he likely would have been denied the benefit of omega-3 fatty acids in slashing the risk for recurrent cardiovascular events. You and I can buy wonderfully safe and effective fish oil as a nutritional supplement, but there won't be a sexy drug representative to sell it, nor an expensive dinner and payment for a trip to Orlando to hear about it.

Beverly,
A rough estimate for the caloric content of each Lovaza capsule would be approximately 8-10 calories.  Since each capsule contains roughly 1 gram of total fat.

In addition, since I have been involved with cardiac CT for now nearly 24 years, the PLC also affords me an opportunity to develop a CT coronary angiography training program for cardiologists and radiologists (www.cardiaccta.us). Together, these new efforts are merely an extension of my interests in prevention, patient care, and teaching.

I had a friend that recently went for a heart scan. He said his score was zero. Is that possible?

I hope the USA can see its way to some sort of national standards for State run medicare. As recent events show, if you have the will, the money will be found.

I live in Ontario, Canada and only had to ask my primary care physician in order to get a CT angiogram (did not know about the Calcium score at the time) It's cost is covered under our social medicine program OHIP.

A new study shows 30% drop in mortality from CD

http://www.theheart.org/article/980589.do

Sure it is.  My score was 0.  That's despite doing quite a bit in direct opposition to the AHA recommended dietary advice:

-no wheat/gluten at all (whole or refined)
-very few, if any grains (whole or refined)
-very low sugar and starch consumption (low carb)
-pastured red meat several times a week (bison, beef, or pork)  with normal ferritin level
-high saturated fat consumption (grassfed butter, coconut oil, home-render lard)
-whole fat dairy (incl raw whole milk and raw milk aged cheese)
-no attempt to artificially increase fiber, though there's probably a fair amount of fiber in the ample fresh non-starchy veggies I consume
-2 to 3 "backyard" eggs cooked in ample butter nearly daily for breakfast

i am 72 years old my calcium score is zero.2 yrs ago i was diagnosed with angina.i took the linus pauling protocol and cured my heart disease.on march 20th 2009 i had a calcium score scan and astounded my cardiologist as my arteries were completely cleared.vitamin c and amino acid is cheap and available. no money in it for doctors.discredited by medical profession.

"Why the "push" towards CT coronary angiograms and not "just" a CT heart scan? Well, I know it's shocking but it's . . . money!"

No, surely not.

Rogers experience brought back an unpleasant near miss CT Angiogram memory of an episode that I had while being in the hospital 5 years ago. I was  brought in with congestive heart failure-EF 20/25,  Now Don't think you are soon to lose a faithful reader, my EF is now 45/50, due to Aranesp injections, that I am doing exceptionally well on.  My anemia is now under fabulous control.
But, I digress, one day while in the hospital a beautiful young lady with long flowing hair wearing a white coat and stethoscope came in to see me and identified her self as the cardiologist assistant. She quickly started to promote me to have an angiogram.  I refused. The hospital cardiologist came to see me and I told him not to send me any more sales reps. (he must have learned this technique from big Pharma with all their beautiful drug sales reps). I never did have that apparently unnecessary needless invasive procedure done.  Guess what?, I lived to tell the story.

One morning last year, I drank way too much strong tea. A few hours later, I had chest pains and tachycardia. I had forgotten about the tea, which with hindsight  was the obvious cause, and I went to an emergency room.

By the time I got there, the pain had gone, and I should never have stepped into the ER waiting room.

As soon as they got their hands on me, they wouldn't let me go, claiming that insurance wouldn't pay if I left against doctors' orders. They quickly ran up any thousands of dollars of expensive tests, all of which came back fine.

They were very unhappy that I refused a coronary artery stent.

My ejection fraction was 65.

Anonymous in Canada,

"A new study shows 30% drop in mortality from CD"

Yes, modern medicine "saves" more people all the time.  

But is the *incidence" of CD dropping? or is medicine just getting better at treatment.  I want to avoid CD, not just be saved from it.

I used to be a strong believer that the US needed a universal medical care system similar to Canada and the UK.  Now that I have had a closer look at the UK's system over the last 14 years (in-laws are there) and have experienced the profound lack of primary prevention under a US HMO system (healthcare rationing), I'm not-so-sure.  

Sure, we are a rich nation and we should be able to afford decent healthcare for everyone.  The current system is for haves and have-nots with the in-betweens really getting pinched.  And furthermore, the haves don't get nearly the quality of care that they pay through the nose for anyway (though many don't realize it).  

But I can't see how turning over the decisions to government is going to be any better than it has been to turn over decisions to HMP insurance companies and accountants.  In fact, it could get worse.  Especially since government has turned into the handmaiden for special interests.  As much as I think it should happen, I have a hard time getting behind the proposals.  Be careful what you wish for, you might get it.

ok fred88, you almost got me excited....until I saw the oral EDTA chelation.... I'm calling BS by association

Fred,

I've heard a mixture of reports on the Pauling protocol with varied success. Can you give a little more detail as to how much vitaming C, L-Lysine, etc. you took per day at what intervals, and the time duration you believe it took for the protocol to do it's job?

Thanks,
Kent

Pauling Protocol in PDF format
take note of this section
The half-life of vitamin C in the bloodstream is 30 minutes.  
Linus Pauling advised taking vitamin C throughout the day in divided doses. The Hickey/Roberts Dynamic Flow theory predicts that taking vitamin C  every four hours will produce the highest sustained blood concentrations. Take more before bedtime.
I use a time release formulation

Heart Disease, Ascorbate, Lysine and Linus Pauling by Jeffrey Dach MD A useful summary here

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

Yes, quality and contamination of fish oil IS important.
I have heard that KRILL oil is superior to fish oil on all fronts. It supposedly has much less contamination than fish oil, better bioavailability (bound to phospholipids) and additional ingredients, i.e. Zeaxanthin (important for retinal health).
Can you comment on this?

Thanks.

"My prediction: High-quality fish oil supplements will match or exceed prescription fish oil."

Not to mention the incredible difference in price... in the patients' favor... and not the pharmaceutical company's bottom line!

madcook

After my sample bottle of Lovaza from my physician was done, I switched over to Trader Joe's brand. It's really cheap at $10 per bottle and the EPA/DHA concentration is 50%. I take about 5 to 6 capsules a day and my last triglyceride in December was 109 (down from 255). I also tried Omapure too but it's pretty expensive. Omapure's advantage over the TJ stuff is that it is independently tested by IFOS. Who knows where TJ's stuff comes from? I tried the Spring Valley (or is it Nature Made) brand from Walmart. Pure nastiness! Stay away from those yellow bottles.

I bet some MBA guy dreamed up Lovaza at a brainstorming session intended to come up with ideas to boost sales in a sagging economy.

Dr. Davis, your EPA/DHA content listings in the post seem to contradict the label on the bottle. The bottle claims 2 capsules contain 1100 mg of EPA and 500 mg of DHA. That would translate to 550 mg of EPA and 250 mg of DHA. What am I missing?

-- Boris

I always suggest opening fish oil capsules once in a while to see if the oil is stinky.  That is the advantage of liquid oils is that you can smell and taste them.  One of my nurses opened a Lovaza capsule and told me it made her gag it was so fishy.  The antioxidant used in Lovaza is hydrogenated soybean oil!!.  One of my patients who is sensitive to soy reacted to Lovaza with a rash.

Dr. Davis,

The following question was somewhat inspired by this post, although it relates more specifically to seafood consumption.

A few months back, I started ordering seafood from Vital Choice. According to the Vital Choice website, their Albacore tuna has 0.05 ppm of methyl mercury and that number falls to 0.03 ppm for their sockeye salmon (which Is what I typically order).

http://www.vitalchoice.com/uploads/Merc%20Comp%204_06.pdf

I often hear a general guideline that 2 servings of non-predatory fish (preferably wild caught and definitely not farm-raised) is generally accepted as safe, or at least minimally risky, and that this is likely a good guideline for everyone, but especially pregnant women and children.

However, when I would place a sizable order, I would find myself serving it at least 2, and often up to 4 times per week. So that would be up to 4 servings of roughly 4-6 ounces of fish during some weeks that I would serve to my wife and for myself.

In your opinion, should we cut back to 2 or fewer servings or are the levels listed by Vital Choice low enough to skirt potential issues?

NOTE: the only seafood I eat is what I purchase from Vital Choice, so that I know the source. While the methylmercury is a focus, I am also curious if this level of consumption is also risky in terms of PCB’s and dioxins. It’s frustrating to realize that there will always be some measure of inherent risk.

My wife and I aren’t eating this in place of supplementing with a purified fish oil supplement, we simply add this to it, so on days when we eat fish we lower our dose a bit and on days we don’t, we bump up that dosage. Our primary reason for consuming it is the delicious taste, along with the “bonuses” of protein, astaxanthin, vitamin D, and omega 3’s that come along for the ride.

On one final note, I am also curious if the selenium content of the seafood is at all protective against methylmercury, particularly at these lower levels found in the Vital Choice fish. I’ve heard selenium has the potential to chelate methylmercury, but I am uncertain if this lessens the risk to any noteworthy degree, that is if I am not misinformed to begin with on this front.

-Rick Bachmann

I'd need a second job to buy either one. Kirkland from Costco is my favorite.

One concern with all over the counter supplements, is that they are not continually tested. The test is applied to one batch of the supplement, perhaps years earlier.

As a result, when random samples are sent to labs contamination is often found in supplements that claim to be free of contaminants.

I don't know if there is better supervision in the case of products sold as pharamceuticals, but I think we have to be very careful in accepting purity claims from any company operating in the Wild West unregulated supplement market. The track record when these products are spot checked is terrible.

Another question that (I think) is yet to be answered is if DHA enriched fish oil is more effective than normal DHA/EPA fish oil at improving a person's omega-3 index.

Another option is to eat sardines whole - approx. 1.6 g of omega-3 per 100 g - about 2 sardines, according to my estimation:

http://healthcorrelator.blogspot.com/search/label/recipe

These are wild-caught sardines, not the canned ones.

Your promotion of PharmaNutrients' Cardio is quite shocking. The price for 15 capsules is $29.95. That's $2/capsule - not far from $4/capsule of Lovaza. Surely you must remember your own post "Lovaza rip-off"?
http://heartscanblog.blogspot.com/2008/12/lovaza-rip-off.html

Ren-

While I think that krill oil is a fascinating product that we have used, I feel that the manufacturer's over-the-top marketing has clouded its real value. It is absurd to propose that krill oil be used as a replacement for fish oil until we have 1) confident data on omega-3 RBC levels, and 2) outcome data.

In other words, fish oil has been shown to dramatically reduce cardiovascular risk. Krill doesn't yet enjoy this advantage. While it might be true, it is premature to make claims to that effect.

HI, Rick--

Sorry, but I've not heard about this argument that selenium counteracts the mercury in fish. That seems a bit of a stretch.

Any idea where this came from?

Hi, Jenny-

Sorry, but I've got to disagree with you on this one.

Take a look, for instance, at the two analyses by Consumer Lab (www.consumerlab.com). 77 fish oil products tested; 2 flunked due to oxidative byproducts. None flunked due to mercury, dioxin, PCBs, or related compounds. This has held true in Consumer Report and several other analyses.

Frankly, I wouldn't be caught dead taking Lovaza, because I care too much about healthcare costs. Why stick it to other people when I can buy fish oil for a lot less?

@ Dr. William Davis
Any idea where this came from?
Most recent
Dietary selenium protects against selected signs of aging and methylmercury exposure.

Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions Dariush Mozaffarian Free full text online summary of the evidence.

Jenny, I've seen you bashing supplements before.  Do you have any references for your claims?

Biotivia is going to launch a 100% vegetarian Omega 3 about which says has teh greatest EPA DHA levels around, also with resveratrol, green tea or sesame lignans. I would prefer Omega 3 in one supplement and resveratrol in others, not together because children pregnants..shouldnt possible take resveratrol. But I am so intriguing with a vegetarian Omega 3 with high levels of EPA DHA, arent you?

I strongly agree that Lovaza is a rip-off.

But unfortunately, the brand it's being compared to (PharmaNutrients) is a rip-off too. Once upon a time you were mentioning the benefits of Costco brand fish oil, or cheaper alternatives. $30/bottle isn't really cheap, when anyone can go to iHerb and get much better deals.

Jarrow Formulas, EPA-DHA Balance, 630mg/Gel -- $13 for 120 softgels. Or 240 softgels for $23.

PharmaNutrients vitamin D is another ripoff. $20 for 120 gels, 2000IU. I can get 120 gels of 5000IU for around $8 at iHerb (Now brand).

I question why you decided to choose PharmaNutrients as a partner, when they are clearly so overpriced.

Do any of you have any experience with Vectomega, a phospholipid coated salmon oil?

Hi, Dr. Trumbower--

Only limited experience. Because it has omega-6 added to the preparation, I have been avoiding it.  I can't imagine why they do it. Also, the astaxanthin added makes the capsule appear orange, making it difficult to judge its oxidative status.

The good doctor here gives lots of free advice that runs counter to the big bucks pockets of the drug and insurance industry. So far his advice hasn't failed me yet. My lipid profiles have greatly improved since I started reading this blog. If Dr. Davis wants to partner up with a premium brand of omega-3 then that is OK by me. Nothing comes free and this is one way we can all say thank you and support this blog.

http://online.wsj.com/article/SB10001424052748704107204575039590838522222.html

Is there anything fish oil can't do?

How about as an engine oil additive. Could prevent those gummy deposits.

http://online.wsj.com/article/SB10001424052748704107204575039590838522222.html

Wish we could get Dr Oz and Dr Davis together somehow...... see the following from the RealAge website where Dr Oz is suggesting animal fat are bad and grains are good...again

source http://www.realage.com/tips/live-longer-with-this-protein

"The red-meat and processed-meat eaters also had a higher risk of dying from cancer or heart disease. Why? Researchers aren't exactly sure. Could be the preservatives in processed meats. Could be the artery-clogging fats found in beef and bacon. Or it could be that both red- and processed-meat eaters consume less body-friendly foods like whole grains, fruit, and veggies. In fact, other research shows that vegetarians fare best when it comes to heart disease mortality."

The last line is interesting.
Trevor

I often hear a general guideline that 2 servings of non-predatory fish (preferably wild caught and definitely not farm-raised) is generally accepted as safe, or at least minimally risky, and that this is likely a good guideline for everyone, but especially pregnant women and children.

I also take OMAPURE.  It's almost as pure as LOVAZA (70% vs. 84%) but is tested by third party IFOS and has no PCBs and mercury.  I wish OMAPURE was cheaper but it is still less than Sears Fish Oil and much much less than the rip off Lovaza!  Lovaza is such a joke - should be exposed on 60 minutes.

This Pharmatrend Cardio Formula is ALMOST as concentrated as Lovaza.  Lovaza is about $150 for 120 capsules (a 1 month supply for a the FDA approved 4g/day dose for triglyceride reduction).  The Pharmatrend is $30 + shipping for a 15 capsule package!  That's almost a 4 day supply for triglyceride reduction.  So, it's $30 x 7.5 for a month supply.  That's $225/month!  However you slice it, it's actually less expensive to go with the prescription.  If you are covered by insurance, you will only come out of pocket at around $30-$40 per month for the FDA approved prescription.  Don't let "supplement" make you think it's better or less expensive

Lovaza is an ethyl ester of EPA not the actual EPA itself. It also includes DHA. However, the ester is supposed to significantly lower blood pressure and cholesterol far more than just plain old normal omega 3.

Gilles, just out of curiosity, do you consider me a “priest” of this “new religion of health data as the solution to all/most healthcare problems”? If not, what are you talking about? You read a lot more than I do but I don’t recall hearing anyone suggest that.

What really upsets me is that physician only supplement companies with high quality supplements and processing standards that meet or exceed GSK's are NOT allowed to make the claim that Omega 3's helps lower triglycerides. Simply because the FDA has not evaluated their product. Really?

The FDA is a joke. They approve unsafe drugs based on studies given to them from drug companies. Since the FDA does not require them to provide all of their research, drug companies are allowed to show them their studies that had positive results with little side effects, leaving out the incriminating studies. Some drugs are "fast tracked" through the approval process are then later pulled from the market due to a high number of deaths and side effects. If you think that the FDA protects us...think again.

Also note, that a majority of studies are only done on men. Women are excluded due to the risk of pregnancy and drugs are NOT tested on pregnant women in a lab. They use animals for this. While we are biologically similar to rats, we are NOT the same. But nevertheless there are many "approved" drugs that are deemed safe for pregnant women and are only restricted later after clinical usage has shown to cause birth defects.

When a drug is removed from the market everyone is upset at the drug companies. I say, stop blaming the drug companies for being what they are and are expected to be. How about we start blaming the FDA?! Let's hold them accountable for their actions. Suing the drug companies it ineffective. No, they don't want to lose money but let's face it...they don't won't go bankrupt and often settle. People need to wake up...just because something is FDA approved, does NOT make it safe!

Sorry to rant...but this really irks me.

Yes, i agree fish are high protein, but for the fish oil supplement, we should have to take care about the quality and contamination.

After read this post I think that fish oil is better to take as supplement because as I think that fish oil is more beneficial and also good for health. It is also gives prevention against many of decease.

I have read a few of the Article on your website now, and I really like your style of blogging.

You guys are all missing the point entirely. As can easily be seen from the commercial, Lovaza is manufactured in the future from a lab at the bottom of the ocean.  It requires a prescription because it must be shipped from the future to the present, which you can imagine is quite expensive (and dangerous).  The FDA regulates this process of transporting the drug through time.  The dietary supplement formulations of fish oil are actually smuggled through the time rift by rebels similar to those depicted in the Mad Max movies, starring Mel Gibson, thus explaining their cheaper price tag.

Fish oil supplements and liquid fish oil have been suggested by doctors for lowering triglyceride levels, but people who are allergic to fish should not take fish oil supplements.

@ safe supplements
I used to be allergic to fish.
I couldn't eat fish 2 days running because if I did I'd have a severe sore throat.
I found raising my anti-inflammatory status with omega 3, vitamin d and magnesium has eliminated my tendency to get allergic reactions to fish or anything else. So now I don't get hay fever either. It's now been some years since I last used an anti histamine.
Some fish allergic people may find Krill oil is less likely to cause a reaction but be aware some Krill oil capsules also contain fish oil.
There are also omega 3 formulations from algal-docosahexaenoic acid: effects on triglyceride levels and other cardiovascular risk factors. that you may want to consider but they are a lot more expensive when considering the amounts required to be effective.

Fish oil without doubt is highly beneficial, make sure you take the purest form available in the market.

Cardio passed all tests for peroxides, PCBs, dioxin, furans, dioxin-like PCBs, and heavy metals (arsenic, cadmium, lead, mercury) using criteria at least 60% more stringent than European Commission (EC) standards (EC standard <2 picograms/gm for dioxins and furans, PharmaNutrients <1 picograms/gm; EC standard <10 picograms/gm for dioxin-like PCBs, PharmaNutrients <3 picograms/gm). PCBs levels in particular are less than 0.009 ppm, 90% below the industry-wide purity standard of 0.09 ppm. Likewise, mercury is >90% lower than European Commission standards.

for years the fish oil products that we bought in vitamins stores contained a statement that " The FDA has not evaluated these statments". all of a sudden lovaza comes on the scene & its nowe okay. they say lovaza is purified. This raises the question that the FDA either is lying to us now or they were letting us be pisioned before. which one is it? the FDA in the most corrupt agency of the federal government. ask yourself this question. did you ever hear of restless leg syndrome until the FDA approve a prescription medication for it? if the drug companies pay the right people they can get anything approved.

I have been using fish oil supplements for years and so far I am very satisfied on its performance. Lovaza is very new to me. I am still looking for more info about it. This article will help he clarify everything.

I take EPA Xtra from Nordic Naturals

Two Serving:

EPA 1060 mg
DHA 274 mg

Cost Less than $30 per 60 capsule bottle. Just do your own research on quality and efficacy.

Lots of info to take in....I see the pros and cons written before me. but just tell me this!

"i could buy purity products sealogix pharmacuetical grade fish oil ---- 1.8g EPA & .9g DHA per teaspoon.

or..........

Loveza comes in at 1.8g EPA and 1.5g DHA per 4, 1 gram capsules

which one?

Fish oil is also a healthy alternative apart from the usual vitamins being used.

fish oil supplements for me. It's proven to our family because of its very rich benefits gives to our health condition such as Eases Depression, Lowers Cholesterol, Eliminates Joint Pain and so much more!

I definitely believe in the benefits of fish oil supplements.

I admire the valuable information you offer in your articles. I will bookmark your blog and have my children check up here often. I am quite sure they will learn lots of new stuff here than anybody else!

Nice information, valuable and excellent design, as share good stuff with good ideas and concepts.

They are useful. They have been known to support overall health, boost immune system, promotes healthy brain function and others.

vitamins canada

I dont know why everyone thinks lovaza is a rip off.  My prescription plan covers it and I pay less than $10 per/month and despite what some people on here have been saying, nothing, NOTHING, has anywhere near the EPA/DHA as lovaza....almost 3600MG daily dose

Hi everyone
           I started on Lovaza about a month ago, my doctor feeling this is a last resort to lowering my triglycerides as all other meds left me with with severe muscle soreness when using them. I've been reading as far back as I can go on this particular subject w/ using Lovaza and I'm confused. I have a couple of questions...1, is Lovaza a safe product with as much natural ingredient as possible? 2, or is it an artificial made product?

GSK made the financial investment to have the studies done.  What's stopping the supplement companies?  To answer your question, yes I did hear of retless leg syndrome before the FDA approved a prescription medicine for it.  I understand people's frustration with big pharma and the FDA and if you dislike them you are free not to utilize any FDA approved pharmaceuticals.

What a way to sell your supplements. Your a good hustler Doctor.

You haven't researched very much then. And it's not 3600 per 4 pill dose it's 3,360. Big difference.

Your an idiot if you need to ask "what's stopping the supplement companies from making the financial investment to have studies done. What supplement company has the money a pharm company has. Do you have any idea what a good study cost? I guess not.

Dude, stop reading the Health Ranger and Mercola. when you get cancer you'll be begging the Pharm company for there FDA approved drugs.

Hey Doc.,
Ok I have a question Doc. what fish oil brand do YOU say we should take? I got on here just to see what the diff. was between the two because our doc. said we should take Lovaza. I find it a little interesting that she said to take it along with our reg fish oil we've been taking...

I have 280 triglycerides I was prescribed Lovaza, but  my insurance denied it, my doctor told me to take  over the counter fish oil. I am undecided and confused I need help. Which brand and its purity etc

Sometimes I think that the RDAs only apply to the current high refined carb, nutrient depleting diet most americans eat.  

This is just more proof that the current calcium "requirements" are overstated and probably intended to market dairy products or calcium fortified processed foods.

I always thought the recommendations for supplementing with calcium were probably wrong.  I've heard that Americans eat more calcium-rich foods and supplement with more calcium than other Western countries, but yet suffer from the highest amount of osteoporosis/osteopenia.  

This wouldn't surprise me, given the importance of having the right amounts of calcium, Vitamin D, and Vitamin K2.  I've seen other doctors/researchers recommend that Vitamin D always be taken in connection with sufficient intake of Vitamin K2 to help prevent hypercalcemia.  I do not supplement with calcium, but I do supplement with D3 and K2 and have had no problems

Dr. Davis is wheat a bad idea because of the phosphates which demineralize bones ? If so then lentils and peas and beans would be quite high in phosphates too? would the recommendation be to lower their consumption as well?

Thanks.!

Calcium as a supplement is one of the toughest to assimilate in the body- I can't see how an accurate number can be assessed as too much (or too little)

I wonder how much calcium is in Gerolsteiner Water.  Dr. Davis has recommended this in the past, but probably for the magnesium content.

1) It would seem that anyone speaking of vitamin D, is being a little misleading as we should most likely be talking about D-2 or D-3. Or never talking about D-2 and always about D-3 as it is the more bio-active.
2) Increase K-2 to take care of the D-3 / calcium problem.
3) Blood tests to keep track of all three of them.

Would supplementing with vitamin K2 help alleviate the problem of too much calcium in the blood? It's function is to redirect blood calcium to the bones. Or is the jury still out on this?

This is a point also made in the current posting of "Diabetes Update"

Apparently alot of people are reporting issues with vitamin d supplementation. You may have hit the nail on the head, Dr Davis. Here is a website that has over 200 comments from people experiencing issues.
http://ctheblog.cforyourself.com/2008/12/overdosing-on-vitamin-d-side-effects.html

Steve

Since I ran into just this problem (and blogged about it elsewhere) I want to add this:  You don't have to be supplementing with pills to run into this problem.

If you are eating a classic low carb diet and eating cheese rather than meat for much of your protein your calcium intake can get high pretty fast.

Are you familiar with Dr. Cordain's work on Acid/Base balance?
http://thepaleodiet.com/nutritional_tools/acid.shtml

http://www.ncbi.nlm.nih.gov/pubmed/19113911

Men don't need more than 626 mg/day calcium, and women with D > 20 ng/ml don't need more than 566 mg/day.

We usually recommend that individuals stop taking a calcium supplement once they've reached the target D level (70-90 ng/mL).

We always draw a serum calcium with a 25(OH) level.

Detected several cancers in our patients this way (hypercalcemic prior to starting D supplementation).

Also, I'm about 8 months pregnant with our first child and you think cardiology is behind the times with Vitamin D, try OB! They're living in the dark ages.

Fortunately my OB is more versed than most and the fact that I take 10,000 IU daily doesn't make him too uncomfortable (obviously not since he didn't offer to check my D level...I had to ask for it).

I'm also taking 500 mg QD of elemental magnesium (no preeclampsia for me) and (when I remember), 12.5 mg of Iodoral/week (I worry about taking it everyday due to potential for "heavy metal dumping" since I wasn't routinely taking it prior to pregnancy).

I still take a pre-natal, but I worry more about not taking the other supplements more than i worry about missing a dose of the pre-natal.

Thanks for all you continue to do in healthcare!

Thank you so much for the advice I will try having an supplement calcium, to preserve bone health and reduce blood pressure for my own good.

mjd

interesting. So does this mean that those areas where the calcium levels in drinking water are high : "hard" or "temporary hard", are areas where high vitamin D could work against residents trying to maintain healthy arteries?

Trevor

I'm 37 and have been taking 6,000 i.u. of vitamin D per day for the last several months.  I started urinating blood last night and have a CT scan in a few days to see the likely cause of it all - kidney stones.

My Dad also had them. I think the vitamin D may have contributed in bringing this about.

Coincidently, I'd started taking Tums (rich in calcium) every now and then for heartburn about a month or two ago.  

Timely post doc!

Dear Dr Davis,

Please can you quote the links to the studies you mention in this blog. I have both osteoporosis and a heart valve defect (bicuspid aortic valve) and calcification is being deposited on the aortic valve. My levels of 25(OH)D range from 60 to 100 ng/ml. I have my bone profile tested every time I have my 25(OH)D tested and so far my serum calcium levels have been in the normal range but your post worries me considerably.

Anne

I would agree that we probably need no dairy based calcium at all, since it is only necessary at birth through mother's milk.
Even so, I do like my dairy products in moderation so that's all I take - no additional calcium supplements; and my blood calcium level and bone density has benefited from just D on top.

@ Scott
How much calcium is in Gerolsteiner Water.
Calcium (Ca2+)  348.00 mg/l
Magnesium (Mg2+)  108.00 mg/l

How Much Calcium Is in Your Drinking Water? This paper goes into more detail. The above water has 50% more calcium than in any mentioned in this paper.

@ Anne
Got Calcium? Welcome to the Calcium-Alkali Syndrome.Restoring extracellular blood volume, increasing GFR and calcium excretion, and discontinuing calcium supplementation provide best treatment.

while current blood levels of D3 may appear to be inadequate, there is no science to demonstrate what the higher levels shuld be.  While a blood level of 60 coming from the sun may be wonderful, there are no studies, let alone ones of any duration, that show that supplementing with large doses of D3 to get to a 60 level do not pose any negative health consequences.  As we have learned with other vitamin supplementation, more is not always better; adverse consequences can arise, and there is not always a way to detect them such as blood calcium levels.  Caution should be the watchword.

Dr Davis, what is your opinion of the supplement MSM? Does vitamin D have an effect on this also?

Steve

Dr. Davis,

Magnesium competes with calcium absorption, and therefore is crucial to keeping calcium levels at bay.

I noticed that a study this week found a correlation between very high vitamin D levels and increased risk of pancreatic cancer.
http://media-newswire.com/release_1121308.html

I too had trouble with kidney stones untill I began supplementing with magnesium.  I take 600mg of various forms of mag and no longer have any problems with kidney stones.  I also take 6000 units of D3 and 180 of K2.  I have not had my serum calcium checked but don't eat too much dairy.

What about high phytic acid foods like the raw almonds and cocoa advocated here?  Don't those contain as much or more calcium binding phytic acid as wheat?  I eat very low carb and no dairy products whatsoever.  My indulgences have been raw hazelnuts and cocoa -- now I'm wondering if this has been damaging in some way.  My understanding is that serum calcium represents only 1% of body's calcium and that an ionized calcium test is more accurate.  My doc drew blood today to re-check my vitamin d status but would not check mineral status.

Different take on the calcium for me.  When I develop a faint, "fluttery", tachycardia (up to about 142 for a 63-year-old, and I feel absolutely horrible) I take about 500 mg of calcium citrate with about 1000 mg of vitamin C (for absorption of the calcium) and the heart beat gets stronger and the rate comes down.  Sometimes I have to repeat.  I found only one internet reference to this phenomenon below:

http://www.ithyroid.com/ca_and_mg.htm

I do not have access to health care as I am one of the working poor.  Perhaps you can comment, Dr. Davis.  Thanks, Catherine

Hi, Jessica--

I think that you and your group are managing the calcium/vit D issue the right way.

Unfortunately, some people are wrongly interpreting this to mean that vitamin D causes hypercalcemia. It simply means that calcium is unnecessary when D is restored.

Jenny--

Thanks for the clarification.

Thankfully, your situation is the exception. Most people maintain normal calcium levels even while consuming dairy and other calcium-rich foods.

Several responders here make the point about magnesium, which I agree with. Have you addressed magnesium? Magnesium deficiency is exceptionally common, since it has been taken out of most drinking water.

I noticed that a study this week found a correlation between very high vitamin D levels and increased risk of pancreatic cancer.

Cited are NOT very high levels! The claim is higher rates of pancreatic cancers with >100 nmol/ml - which translates into 40 ng/ml, a level considerably lower than the one recommended here by Dr. Davis (~60-70 ng/ml if I remember correctly). Another claim is NO difference in rates of several other cancers across a large range of 25(OH)D concentrations.

Peter's comment above led me to read the newswire report referred to.

This study was trying to establish any epidemiological association of increased levels of Vit D with reduced incidences of various cancers. No such associations were observed. Rather in the case of pancreatic cancer only, it was observed that when the  level of Vitamin D was GREATER than 100 nmol per litre, there was higher incidence of this disease. Another way of looking at this observation is that at levels below 100 nmol per litre there was no association of pancreatic cancer with levels of Vit D LOWER than 100 nmol per litre.

As far as cancers are concerned there is no point in considering Vit D status as long as it below 100 nmol per litre.

This is timely. I just had blood work done recently and my Dr.'s staff ordered the wrong test. Instead of measuring D3, they measured D2 calcitriol. I don't know what to make of the result: 120.8 pg/mL on a scale of 10.0-75.0. It's extremely high.  The last time I had my vitamin D3 tested, it was 59.2 ng/mL on a scale of 32-100.
FWIW, I follow a low carbohydrate Paleo diet and consume very little dairy. I do take a multivitamin 3-5 days per week, but it only provides 300 mg of calcium (along with 210 mg of magnesium). I also take 500 mg of magnesium citrate every evening.
I'd sure like to know what to make of this.

@ LeonRover
The information on pancreatic cancer & vitamin D status comes from Finland

The further from the equator the greater the swing from high to low status. To have a good shower requires tight regulation of both hot and cold water supplies and a reserve store of both hot and cold supply so neither ever runs out.

Vieth explains in this paper.
How to Optimize Vitamin D Supplementation to Prevent Cancer

In the same way fluctuating concentrations of 25(OH)D may also be a problem, Regions at high latitude or with low environmental
ultraviolet light can be associated with the greater risks reported for prostate and pancreatic cancers. At temperate latitudes, higher summertime 25(OH)D levels are followed by sharper declines in 25(OH)D, causing inappropriately low 1-hydroxylase and high 24-hydroxylase, resulting in tissue 1,25(OH)2D below its ideal set-point.
The answer is to keep levels BOTH HIGH and STABLE.
Humans only build a stored reserve of D3 in tissue above 40ng/ml = 100nmol/l. Only around 60ng/ml are there sufficient D3 reserves for lactating mothers to pass to babies in breast milk. At latitude 32 it takes modern women 6400iu/daily/D3 to provide naturally replete vitamin D breast milk.

@  Mike
The half-life of calcitriol is 5–8 hours.
The half-life of calcidiol is 2~3 weeks.
Dr Cannell The Vitamin D Council explains the different roles here

Thanks Ted. That clarifies the role of calcitriol, but I am still wondering why my level measured so high, if even transiently.

I'm anonymous from above who talked about kidney stones and blood in my urine.

I had the CT scan done yesterday. I have stones, one of them a whopping 1.4 cm.  

Be careful people.

(I am a different Catherine than the one above with tachycardia)

For years because I had osteopenia, I was advised to take loads of calcium.  Later they told us to add vitamin D with it.  I am now FULL of calcium deposits all over my body.

A year ago, Dr. Davis advised me to try magnesium for a bad arrhythmia problem, and it not only quickly cured my arrhythmia, insomnia, and RLS, but I have much less grinding sounds and arthritis pain. I was the poster girl for magnesium deficiency and no one except Dr. Davis even mentioned trying it.

I think along with K2, magnesium is of upmost importance to balance the D and calcium. I only take 500 mg a day now since I don't consume dairy, but after this article, I may totally stop supplementing any calcium and let the K2 and magnesium perhaps reduce some of the deposits..

@Mike -- I have the same issue/question.  My 25 OH was 62 but the 125 test was sky high.  My serium calcium was normal.  I wonder if Holick's new book gives detailed info on how to interpret lab tests.  His first book just said that the correcxt test is the 25 OH but didn't explain if there is any danger is a sky high 125.

This is an awesome post. Great post. Thanks for sharing this. Looking forward to read more from you.
Green Tea

Vitamin D3:

NOW Vitamin D softgels supply this key vitamin in a highly-absorbable liquid softgel form. Vitamin D is normally obtained from the diet or produced by the skin from the ultraviolet energy of the sun. However, it is not abundant in food. As more people avoid sun exposure, Vitamin D supplementation becomes even more necessary to ensure that your body receives an adequate supply. Vitamin D3 on discount at NutroVita.com.

For more details please visit:
http://www.nutrovita.com/32760/now-foods/vitamin-d-3-2-000-iu.htm

UK readers need to be aware that estimated shipping cost to UK from Nutrovita = $26.50
whereas
Item cost IHERB= $4.96 + International Airmail = $4.00
If you haven't used IHERB before code WAB666 saves $5.
Remember UK customs apply VAT on orders £18 and above + UK PO charge £8 handling fee so I make orders up to around £17.50 before shipping to avoid that happening.
To use GOOGLE toolbar to convert currency enter
4.96 USD in GBP

Dr. Davis,
Since increasing my Vitamin D, Magesium and Melatonin I suddenly have very brittle, splitting fingernails.  Any idea which if any of these caused this?  Any suggestions?
Thanks

Love your blog!!!!!

Chances are the calcium supplement you are taking now is a rock source of calcium. The label will say "calcium carbonate", which is nothing more than limestone. AlgaeCal Plus contains an organic, plant-sourced calcium form derived from a unique South American marine algae called Algas Calcareasâ„¢.

think one of the greatest hurdles is overcoming misconceptions in the minds of regulators, doctors and patients alike. I just returned from a trip to Germany and colleagues there are amused about America's 3rd World-like medical records situation

I have celiac disease and osteopenia in my spine and no bone loss in my hips. I have a strong family history of osteoporosis as well.

Because my calcium intake is less than or equal to 500 mg I take:

600 mg calcium citrate at two seperate meals

1200 IU's D3

500 mg magnesium citrate

I track using fitday. I'm grain, legume, dairy, sugar and processed food free and follow a paleo type dietary plan.

Is this okay?

I meant:

600 mg calcium citrate in total but dosage is split between two seperate meals.

I've seen research that shows the body produces more MGP and other calcium handling proteins with higher doses of Vitamin D.  You would expect this effect as a evolutionary collaboration with Vitamin D activity.  Higher doses of Vitamin K2 are needed to carboxylate these proteins and make them active.  These proteins are active in various places in the body like the arteries and the kidneys.  I have a theory that taking Vitamin K2 helps prevent kidney stones and maybe gallbladder stones of the calcium type.

Uncarboxylated MGP is actually worse than the fully carboxylated MGP.  Guinea pigs are given cholesterol and high levels of Vitamin D in research to give them artery disease by exceeding their Vitamin K2 levels thus creating low carboxylation levels.

More Vitamin K2 may well be good for those kidney stones.

There is recent and startling Dutch research to the point that Vitamin K2 is specifically used to carboxylate calcium handling proteins that remove calcium from the arteries and promote heart health.  If you are taking extra Vitamin D, the body also generates more of these calcium handling proteins so the need for Vitamin K2 also increases.

I had good experience over six months with taking Vitamin K2 and found my running speed increased by 8% and the itching or other mild, variable sensations in my chest have decreased 98%.  I suspect this is connected to reduction of calcification.  I noticed a reduction in my symptoms after six weeks.

My Vitamin K2 has:
  1300 mcg Vitamin K2, Mk-4
   100 mcg Vitamin K2, MK-7
  1000 mcg Vitamin K (the ordinary stuff)

Reading all these posts I used to think of vitamin D and magnesium and K2 the same a most posters. Intuitively never took calcium, was up to 6000 mg of D3/ day to achieve a level of 43- up from 26.

That said, my serum calcium has trended upward to 10.3. I am now having a few blood tests to check  for hyperparathyroidism!  The foremost parathyroid doc in the USA is Dr. James Norman from Tampa, and his website is very informative and puts a different spin on what I thought I knew of these matters. Parathyroids is ALL he and his 2 colleagues do all day every day. Please give this a look to be fully informed on the matter of Vitamin D supplementation.       www.parathyroid.com
I have no connection, but if I find out I have an adenoma on one of my parathyroids, this is where I will have it removed!
Jeanne ( RN,BSN)

Oops,  meant to add I have also supplemented with 400-800mg of magnesium and 1 Life Extension K2 in addition to the Vitamin D for several years.

Reikime