How to become diabetic in 5 easy steps

If you would like to become diabetic in as short a time as possible, or if you have someone you don't like--ex-spouse, nasty neighbor, cranky mother-in-law--whose health you'd like to booby trap, then here's an easy-to-follow 5-step plan to make you or your target diabetic.


1) Cut your fat and eat healthy, whole grains--Yes, reduce satiety-inducing foods and replace the calories with appetite-increasing foods, such as whole grain bread, that skyrocket blood sugar higher than a candy bar.

2) Consume one or more servings of juice or soda per day--The fructose from the sucrose or high-fructose corn syrup will grow visceral fat and cultivate resistance to insulin.

3) Follow the Institute of Medicine's advice on vitamin D--Take no more than 600 units vitamin D per day. This will allow abnormal levels of insulin resistance to persist, driving up blood sugar, grow visceral fat, and allow abnormal inflammatory phenomena to persist.

4) Have a bowl of oatmeal or oat cereal every morning--Because oat products skyrocket blood sugar, the repeated high sugars will damage the pancreatic beta cells ("glucose toxicity"), eventually impairing pancreatic insulin production. (Entice your target even further: "Would you like a little honey with your oatmeal?") To make your diabetes-creating breakfast concoction even more effective, make the oatmeal using bottled water. Many popular bottled waters, like Coca Cola's Dasani or Pepsi's Aquafina, are filtered waters. This means they are devoid of magnesium, a mineral important for regulating insulin responses.

5) Take a diuretic (like hydrochlorothiazide, or HCTZ) or beta blocker (like metoprolol or atenolol) for blood pressure--Likelihood of diabetes increases 30% with these common blood pressure agents.

There you have it! Perhaps we should assemble a convenient do-it-yourself-at-home diabetes kit to help, complete with several servings of whole grain bread, a big bottle of cranberry juice, some 600 unit vitamin D tablets, a container of Irish oatmeal, and some nice bottled water.

Comments (35) -

  • Anonymous

    1/14/2011 12:26:58 PM |

    When someone dies suspiciously, and someone else benefits, (e.g. big insurance payoff) that "someone" is the first suspect.
    But not if you've been known to promote a heart healthy diet for the deceased...

    Jeanne

  • Anonymous

    1/14/2011 12:44:34 PM |

    You've recommended oat bran in the past for other reasons. Is cooked oat bran a suitable breakfast food?

  • Matt Stone

    1/14/2011 1:16:59 PM |

    This list is way off.  To become a type 2 the most important things that you do are:

    1) Get insufficient sleep
    2) Subject yourself to maximal levels of stress
    3) Do insane amounts of endurance exercise punctuated by long periods of total sedantarism
    4) Eat a low-carb diet punctuated by repeated bouts of carbohydrate bingeing, or a low-fat diet punctuated by bouts of high-fat bingeing
    5) And most importantly, cycle your weight up and down by restricting calories followed by bingeing followed by restricting calories followed by bingeing

    Those are the most effective ways to increase visceral fat, although the soda does help.  You got that one right at least.  Off to eat oatmeal for breakfast and have my blood glucose spike all the way to a ghastly 80 mg/dl afterward.

  • Anonymous

    1/14/2011 1:55:46 PM |

    Dasani has minerals added back in.

  • allison

    1/14/2011 3:23:27 PM |

    I hope the Good Doctor is including saturated fat in his tongue-in-cheek recommendation.

  • Dream_Puppy

    1/14/2011 4:37:37 PM |

    I have eat low carb, am thin, lift weights and do HIIT but have high blood pressure due to genetics (140/100)- I take 12mg of atenolol a day....is there anything else you would recommend to do instead? I have to take something : /

  • Eric

    1/14/2011 5:45:17 PM |

    I've been following Dr. Davis' advise to improve heart health as I'm 34 years old and dealing with calcification of my aorta and chronic hypertension.

    In 2 weeks without grain and oatmeal and taking D3+K2 w/ Fish Oil and my BP has been normal 128/54 and I've already lost 4lbs.

    Some of us follow the advise to save our lives and not over eat the oatmeal to get the pretty beach muscles.

    Thanks Dr. Davis

  • vic

    1/14/2011 5:51:29 PM |

    New to the blog.. the only thing that  I'm a bit surprised about is the no grain thing.

    Aren't whole grains good for insoluble fiber and don't raise your blood sugar like processed (white) flour?   I suppose if you are gluten sensitive you should avoid wheat, but for blood sugar?

    Similarly, doesn't oatmeals' soluble fiber slow down the insulin spike?

    For about 7 years I've been eating the same wheat/oatmeal cereal that has 7g of sugar, 6g of insoluble fiber, and 6g of soluble fiber  (12g of dietary fiber).    I work at a desk so I don't get much (if any) exercise.  

    I don't take supplements (vit. d or otherwise) and drink a soda or two occasionally.  

    I could probably stand to lose a few pounds but I have normal blood sugar levels.  

    Why am I not diabetic if I'm following the 5 easy steps?

  • Nigel Kinbrum

    1/14/2011 6:02:51 PM |

    vic said...
    "New to the blog.." Try reading the blog before posting.

    "Why am I not diabetic if I'm following the 5 easy steps?" Luck? Genes? Who knows?

  • Eric

    1/14/2011 6:10:35 PM |

    Also, Dr. Davis could you expound upon how taking HCTZ and Metropolol affects blood sugar- I currently take both of these to treat (not well) my hypertension?

    Thanks again!

    Eric

  • revelo

    1/14/2011 6:24:47 PM |

    I have a hard time accepting this theory of the pancreas beta cells "wearing out" like the tires on a car because they are asked to produce a little insulin now and then. The problem, IMO, is not asking the pancreas to do what it is designed to do (produce insulin) but rather insulin resistance in the muscles, and that comes from being obese and not exercising. If you maintain a proper weight and get enough exercise to maintain your insulin sensitivity, you shouldn't develop insulin resistance, which means you can eat carbs without problems. When you eat carbs, blood sugar will begin to rise, the pancreas will produce a small amount of insulin, this small amount of insulin will push the blood sugar into the muscles, and blood sugar will stop rising.

    People have been eating wheat and other grains and living long healthy lives, without diabetes, in much of the world. The key is that they don't overeat and they get exercise, and hence they don't develop insulin resistance. The traditional people of Sardinia and Crete, for example, were extraordinarily healthy and long-lived, despite eating a huge amount of wheat products. By contrast, modern Mediterranean peoples are developing diabetes at a phenomenal rate, due to overeating and insufficient exercise.

  • Peter

    1/14/2011 7:01:49 PM |

    Re: oat bran question.  I used to eat tons of oat bran back when Dr. Davis said it was the best cholesterol lower around.  Then I became anemic. Then I read somehere that oat bran blocks iron absorption, so I quit the oat bran, and the anemia went away immediately.  Of course, that might not have been why, you never know.

    Re: the Institute of Medicine didn't say "limit yourself to 600 iu of Vitamin D", that was a minimum not a maximum.

  • Onschedule

    1/14/2011 8:27:51 PM |

    @Peter re Institute of Medicine Vitamin D guidelines

    The chart on the Institute of Medicine's website lists 600 IU/day as the "Recommended Dietary Allowance" and 4000 IU/day as the "Upper Level Intake" for almost all age categories 9 years old and older.

    The way I read this, 600 IU/day is their recommendation, and 4000 IU/day is their upper limit caution. As such, I think Dr. Davis's characterization of 600 IU/day as the Institute of Medicine's recommendation is accurate. While the IoM is not saying "don't intake more than 600 IU/day," they are implying that their 600 IU dietary recommendation is adequate.

  • David

    1/14/2011 10:20:22 PM |

    @Eric- These antihypertensive drugs impair glucose metabolism. See this study here: http://care.diabetesjournals.org/content/31/5/982.long

  • c

    1/15/2011 4:00:42 AM |

    Matt Stone....let see some proof of your 80mg/dl postprandial oatmeal reading....I seriously doubt it.

  • LynP

    1/15/2011 4:32:12 AM |

    I'm obese & still losing (low carb), take Maxzide for lower leg edema.  Every time I stop taking it, I gain 2-3#s (yeah fluid) and get short of breath.  With apnea, I don't need anything else making me anxious about breathing.  Any other diuretics reduce lower leg edema and don't mess with glucose control? I drink low-sodium V8 & eat a lot of parsley to keep my potassium levels in the normal range. Suggestions?  I exercise, take mag citrate, take 15,000 IU D3/day to keep levels 60+, 1500 mg metformin XR/day, 88 mg levothyroxin.

  • revelo

    1/15/2011 5:49:03 AM |

    Per Dr Davis recommendation to test blood sugar (I have no reason to believe I'm diabetic, but I am interested in longevity so I'm following many of his recommendations), I ordered and today received a blood glucose monitoring system. Included in the package was a free sample of a Slim-Fast bar, whose ingredients are as follows:

    sugar, corn syrup, dry roasted peanuts, milk chocolate coating (sugar, partially hydrogenated vegetable oil ...

    Perfect diet for a diabetic, eh?

  • Anton

    1/15/2011 1:56:09 PM |

    Suggesting we stay away from wheat and other cereals is interesting, and following such a diet would certainly a radical departure for a species that has had bread and other grain products as a dietary staple for over 3,000 years.

  • Dr. William Davis

    1/15/2011 3:06:27 PM |

    Several commenters--

    Diuretics and beta blockers (metoprolol, atenolol, etc.) can be replaced in many people by other agents that do not provoke diabetes. However, some people do indeed require these agents for specific problems, e.g., water retention, atrial fibrillation, other abnormal rhythm issues.

    Elimination of wheat on the background of a low-carbohydrate diet is, however, a marvelously effective way to reduce BP (though it requires many months to work).

  • PaleoMom

    1/15/2011 6:57:33 PM |

    @Anton: Mankind, at least SOME of it, has eaten grains for  centuries BUT not nearly in the quantity we eat it in the Western world. When baked into breads, wheat was frequently soaked or sprouted, either on purpose or incidentally through more time in the fields before silage or drier silage, which deactivates the phytates in grains and seeds (and nuts) and makes them more digestible. Bread dough was raised more slowly before fast-acting yeast, giving the moisture in the dough time to do the same with the wheat flour; sourdough serves a similar function today. In some parts of the world today we still see grains treated in what we would consider primitive ways, like soaking and fermenting grains and treating corn with lime - pellagra, anyone? - while we Westerners eat copious amounts of industrially processed grain products without a second thought. This is not the way early agrarian man consumed grains, and not the way most humans did until the last few decades in our evolution.

    What do you suppose man primarily subsisted on for the millennia (not centuries, but millennia!) before becoming agrarian and growing grains? Yep - meat, vegetables, greens, nuts, seeds, and fruits. Maybe the odd serving of grain here and there if enough could be gathered to be mealworthy. Oh, and no dairy, either. It might be suggested that grains themselves are the "radical departure" from a much longer evolutionary background of a very different diet for mankind.

    I would like to know more about the sugar-spiking effect of oats compared to other grains. We do sometimes have them soaked and sprouted first, as porridge or in bread or the odd pancakes, but I've seen my daughter's behavior go crazy on oats before we knew about that practice and that part of this entry rang a bell there. Smile

  • Might-o'chondri-AL

    1/15/2011 7:26:24 PM |

    Oats were a boon crop for the rural Scottish and Irish. The people relished warm belly food in the morning.  

    Then everybody got up and went to perform physical work/chores. They used the glucose for available energy until they were fortunate enough to eat again.

    Moderns get up from the table and lead sedentary lives. Athletes training hard can still get up from breakfast and "feel their oats".

  • Anonymous

    1/15/2011 11:16:03 PM |

    What about oats groats?

  • Helen

    1/16/2011 12:30:37 AM |

    I wrote a long response to this yesterday that didn't go through the system.  Perhaps I'll try again tomorrow.  For now, suffice it to say that I am mildly diabetic and have found, through trial and error, that oatmeal at breakfast does NOT spike my blood sugar.  At one hour it may be 110-135, and at two hours I've had readings from 75 to 100.  (I take no meds.) It does not give me higher readings as the day wears on, either.  This is if I eat very little fat (about 8 grams total) as part of my breakfast.

    After 9 months on a low-carb (about 60 carbs a day, usually) diet, following my diagnosis in May, I found, thanks to dietary changes to address gallbladder trouble, that I am a diabetic whose blood sugars are messed up by fat, not carbs.  

    I respect Dr. Davis' work, but diabetes - high blood glucose and poor glycemic control - is more than one disease.  You can come to the same "diagnosis" through different genetic routes.  The part of your system that is malfunctioning may be very different from the part malfunctioning in the person sitting next to you at the endocrinologist's.  Your best bet is to check your meter after meals.  Many diabetics cannot deal with carbs.  Some cannot deal with fat.

    @ Concerns about anemia: phytic acid in oatmeal, which blocks mineral absorption, is a real concern.  I soak mine overnight with yogurt and buckwheat flour to break down the phytic acid.  I eat gluten-free oatmeal, as I have celiac disease.  

    @ Wearing out the pancreas:  The reality is that chronic high blood sugars (not carbs per se - you have to be hampered in your ability to deal with an influx of glucose to begin with) can and do destroy insulin-producing beta cells in the pancreas, creating a terrible feedback loop and diabetic progression.  People susceptible to diabetes generally have less capacity to produce more and/or larger beta cells in response to greater insulin demands.  This is why most obese people, while not healthy, actually do not develop diabetes, while others can become diabetic when slim.

  • Sandy

    1/16/2011 5:19:13 AM |

    Hi @PaleoMom, in reference to your daughter's behavior after eating the occasional oats, I can totally relate. I have experienced severe brain fog, ADD-like symptoms, and lethargy whenever I've eaten any high carb meal-whether it's whole grain or not.  

    Off the top of my head, I'd suspect 2 things:

    1. Does your brand of oats  specifically say "gluten free?"  There is usually cross-contamination with wheat via containers and equipment.  This is where I would look first. Bob's Red Mill has Gluten Free oats.

    2. It is also possible that your daughter could be particularly sensitive to the effects of carbs. Try adding butter, cream, coconut milk, or some other fat to the oatmeal (+ a dash of cinnamon).

    Hope this helps!

  • Anonymous

    1/17/2011 6:19:43 PM |

    I'd certainly like to read a response to Helen's post. I've never heard of fat driving up BG levels unless it was consumed with plenty of carbs. Helen, can you give personal/specific examples?

  • Helen

    1/18/2011 2:34:32 PM |

    Response to Anonymous, Part I:

    Anonymous -

    I'll give a snapshot here of my evidence, though I can't include everything.

    One point:  It's not the fat that drives up my glucose per se (although I believe it drives up my fasting glucose).  It's that fat impairs my ability either secrete insulin or for my cells to accept glucose, or both.  

    So carbs in the presence of a high-fat diet spike me more, *even small amounts of carbs.*

    First example:  When I had gestational diabetes three years ago, toward the end of my pregnancy, there was a possibility I was developing intrahepatic cholestasis of pregnancy.  I adopted a low-fat diet, which is thought to help mitigate the risks.  I was on insulin and checking my blood sugar about eight times a day.  I found my insulin requirements over the last several weeks of my pregnancy plummeting, until I required none on the day I delivered.

    Although I had had that experience, when I was diagnosed with diabetes last spring, I discounted that and adopted a low-carb diet.  I saw no improvements in my glucose control.  From May to November, I saw my A1C drop from only 6.4 to 6.0, despite increased exercise, a 25-pound weight loss (I'd been only 10 pounds over my ideal weight range at diagnosis), and watching carbs very carefully.  In contrast, my father-in-law saw a drop in his A1C from 11 to 5.7 basically just taking Metformin!  (I think he's particularly lucky.)  Metformin didn't work for me.

    Second example:  I have a log of a day on which I'd had a fasting glucose of 126, had a breakfast of cottage cheese with olive oil, consuming about 7 g carbs total, and ended up with my glucose spiking to 183 at 1/2 hour, with it coming down to 148 at one hour and 122 at two.

  • Helen

    1/18/2011 2:35:18 PM |

    Response to Anonymous, Part II:

    In the interest of full disclosure, I found something similar happened yesterday, when I checked my glucose a little earlier than at one hour.  It went up to about 183, but then came down to 110 by 90 minutes or so post-prandial.  But I'd eaten at least 60 grams of carbohydrates.  

    I think that my glucose may be spiking higher at 30 minutes, but is pretty darn good at 1 hour pp, whether I'm on a low-fat diet or a low-carb diet.  The difference may be that it comes down faster and goes and stays lower on low-fat.  For a few days I was on an almost no-fat diet (though I heard that was actually bad for my gallbladder and stopped).  I had trouble keeping my blood glucose UP.  That's when I saw two-hour readings of 75 after a hearty bowl of oatmeal.  My readings aren't as wonderful now that I'm eating low-fat, not no fat, but they're still much better than high-fat.  I'm certain that on average, it's  at least a 10 point difference, possibly 15.  And I no longer have to live with the insanity of having ever more vanishing quantities of carbs spike me.  

    I'm not and have never been an anti-fat person.  When I was diagnosed I had been following a WAPF-type diet, was gluten-free and nearly grain-free, trending toward Paleo.  I'd been telling everyone I knew not to be afraid of fat, especially saturated fat.  The irony!

    Jenny Ruhl at Blood Sugar 101/Diabetes Update has heard of others like me, though she says it's quite rare.

    Peter at Hyperlipid hypothesized that there may be people like me, since there are some rodents that respond to fat this way.  As you probably know, he's pro-fat, but open-minded.  

    I do think I have something other than a "typical" Type II diabetes. I had a genetic test for monogenic glucokinase-deficient diabetes (MODY 2), but didn't have that.  My insurance is not going to pay for another specialized test.  I'm not sure what I'd ask to be tested for, anyway.

  • Dana Seilhan

    1/22/2011 12:07:32 AM |

    According to the Weston A. Price Foundation, oats are the grain with the highest phytate content.  Eating them without proper preparation not only spikes your blood sugar but chelates the minerals your body needs to stave off diabetes before you've even had a chance to absorb them.

    If you follow the typical "healthy" advice to cut fats out of your diet, you'll eat the oatmeal made with water instead of milk or cream, exacerbating the problem.

    Studiously ignoring Matt's claim about low-carb diets.  Eating low-carb for part of the year and higher-carb for part of the year would approximate the prehistoric European experience of having mostly meats available for food in the winter but lots of plant foods in the summer.  Amazing that type 2 diabetes in particular has never been a problem in Europe up to modern times, despite their long history (post-agricultural revolution) with famines.

    Anyone following a low-fat diet is at increased risk of diabetes because they lack the fat-soluble vitamins and the minerals necessary to sustain endocrine health.  Why anyone still endorses low-fat as healthy for, well, anyone really is beyond my comprehension.  If you can tolerate a higher carb intake that's one thing (and if I were you I would favor starchy tubers over grains and beans), but no human being should have to do without dietary fat, and it's unhealthy to attempt it.  Even people who are missing their gallbladders or who suffer from gallstones can eat certain types of fats without too much worry.

  • Gallbladder Gone

    1/22/2011 5:06:59 AM |

    @Dana Seilhan:

    I'm 51 years old, and I just had my gallbladder removed due to rather severe gallstone problems (I tried to avoid the surgery, but it became an emergency, and I had no choice).

    Can you provide links to good materials on what kinds of fats to avoid, and why?  My wife and I eat a moderate low-carb, high protein diet and don't shy away from fats.  

    I'm concerned about long-term health issues, but I've not found good educational materials on the what, how, and why of post-gallbladder removal fat-related health problems, short or long term.

    Thanks for any guidance you can provide.

  • Helen

    1/22/2011 3:09:04 PM |

    @Dana -

    Actually, without a gallbladder, most people don't have to follow a low-fat diet at all.  It's when you have gallstones or a sludgy gallbladder that fat can exacerbate symptoms.  This doesn't mean that it causes gallbladder trouble, but that it causes pain from stimulating gallbladder contractions, which it's supposed to do.  When you have sludge or gallstones in there, though, that can hurt.

    I'm going to work at making sure I have the fat-soluble vitamins I need, and I'm pretty educated about this.  But my experience has shown me that the WAPF and Dr. Davis' points of view, though they may be helpful to many people, unfortunately don't apply to me.  I realize that lot of people who have found that a certain approach works best for them will think it will work for everyone, and that I'm just ignorant, but I've studied this all pretty deeply for a layperson, tried different approaches, and have finally had to follow the evidence of my own glucose meter and other health indicators.  My diabetes couldn't have been caused by a low-fat diet because I'd not been on one until recently.  

    Agreed about properly preparing oatmeal.  

    I think a problem with so much of the health advice I see, whether it's low-fat or pro-fat or low-carb, is that it makes blanket recommendations.  Different people whose physiologies are malfunctioning may have them malfunctioning for different reasons.

    You can find somewhere a "traditional" diet to support just about any claims you want.  I think the common denominators in healthy traditional diets are really not high-fat vs. low-fat, but lack of industrial vegetable oils, refined sugars, and refined carbohydrates.  I do think improperly prepared grains and gluten (however prepared) are nearly universally problematic.

    If you look Stephan Guyenet's Whole Health Source, he has examples of populations on high-carb diets that do not have poor glucose tolerance or elevated incidence of diabetes.  You also have to look at the possibility that traditional peoples had more homogeneous gene pools, and perhaps therefore their diets and genes meshed more than peoples' today.

    They also had less exposure to toxic chemicals in the modern environment, and other factors like social isolation and disrupted circadian rhythms, all of which can wreak havoc with endocrine function.

  • Anonymous

    1/23/2011 10:24:09 PM |

    I eat oatmeal and I only spike to 120 or less, so that doesn't seem too bad to me. I think it's only bad if it spikes too high. Fruit is a problem for me, however. I would imagine if I ate fruit mixed with protein I might be able to handle it.

  • Sophie

    1/29/2011 3:06:01 AM |

    Diabetes is one of the leading cause of death listed on U.S. I am afraid that this will increase if people will not be aware of the factors that leads to diabetes. Information dissemination is a must. People need to be active and learn to know the foods to be avoided as well.

  • jodi

    5/2/2011 6:52:07 PM |

    you may not be diabetic, YET, but you are headed down that path.  give it time.

  • Gary Snow

    7/15/2012 8:07:43 PM |

    Helen..Excessive carbs DID cause my T2 Diabetes..and yes, oatmeal DID spike your BG..9Damage begins at 140) Take it down to less than 30 carbs @ day and you will reap the benefits!

Loading
Why haven't you heard about lipoprotein(a)?

Why haven't you heard about lipoprotein(a)?

Lipoprotein(a), or Lp(a), is the combined product of a low-density lipoprotein (LDL) particle joined with the liver-produced protein, apoprotein(a).

Apoprotein(a)'s characteristics are genetically-determined: If your Mom gave the gene to you, you will have the same type of apoprotein(a) as she did. You will also share her risk for heart disease and stroke.

When apoprotein(a) joins with LDL, the combined Lp(a) particle is among the most aggressive known causes for coronary and carotid plaque. If apoprotein(a) joins with a small LDL, the Lp(a) particle that results is especially aggressive. This is the pattern I see, for instance, in people who have heart attacks or have high heart scan scores in their 40s or 50s.

Lp(a) is not rare. Estimates of incidence vary from population to population. In the population I see, who often come to me because they have positive heart scan scores or existing coronary disease (in other words, a "skewed" or "selected" population), approximately 30% express substantial blood levels of Lp(a).

Then why haven't you heard about Lp(a)? If it is an aggressive, perhaps the MOST aggressive known cause for heart disease and stroke, why isn't Lp(a)featured in news reports, Oprah, or The Health Channel?

Easy: Because the treatments are nutritional and inexpensive.

The expression of Lp(a), despite being a genetically-programmed characteristic, can be modified; it can be reduced. In fact, of the five people who have reduced their coronary calcium (heart scan) score the most in the Track Your Plaque program, four have Lp(a). While sometimes difficult to gain control over, people with Lp(a) represent some of the biggest success stories in the Track Your Plaque program.

Treatments for Lp(a) include (in order of my current preference):

1) High-dose fish oil--We currently use 6000 mg EPA + DHA per day
2) Niacin
3) DHEA
4) Thyroid normalization--especially T3

Hormonal strategies beyond DHEA can exert a small Lp(a)-reducing effect: testosterone for men, estrogens (human, no horse!) for women.

In other words, there is no high-ticket pharmaceutical treatment for Lp(a). All the treatments are either nutritional, like high-dose fish oil, or low-cost generic drugs, like liothyronine (T3) or Armour thyroid.

That is the sad state of affairs in healthcare today: If there is no money to be made by the pharmaceutical industry, then there are no sexy sales representatives to promote a new drug to the gullible practicing physician. Because most education for physicians is provided by the drug industry today, no drug marketing means no awareness of this aggressive cause for heart disease and stroke called Lp(a). (When a drug manufacturer finally releases a prescription agent effective for reducing Lp(a), such as eprotirome, then you'll see TV ads, magazine stories, and TV talk show discussions about the importance of Lp(a). That's how the world works.)

Now you know better.

Comments (26) -

  • Matt Stone

    7/1/2010 4:18:14 PM |

    Ah, thyroid normalization. My favorite. Of course, this has a trickle-down effect on DHEA, estrogen, and testosterone as well. Perhaps Lp(a) is one mechanism by which Broda Barnes was able to prevent heart attacks in his patients?  

    http://180degreehealth.com

  • Anonymous

    7/1/2010 4:39:21 PM |

    Aw darn it. Again health info to be confused about. From Taubes' GCBC I read it was apoB supposed to be the one associated with smaller and denser LDL, "the bad LDL", and I thought apoA was the "large and fluffy" or more benign LDL. I'm pretty sure Dr. Lustig says pretty much the same in his "Sugar, the bitter truth" video. There goes my newly acquired "understanding" out the window again.

  • Anonymous

    7/1/2010 4:42:40 PM |

    The last of the 4 treatments doesnt' seem very specific...

    is "T3" a supplement.. if not, how does one go about normalizing the Thyroid?

  • Mike

    7/1/2010 8:12:19 PM |

    That's a lot of fish oil. I take about 1/5 that amount and would find it irritating to have to increase my intake by a factor of 5.

  • Drs. Cynthia and David

    7/1/2010 9:52:19 PM |

    If the pharma industry could actually come up with drugs that work and don't just chase surrogate markers, I'm sure that would be helpful.  I'm all for nutritional and lifestyle fixes, but this won't work perfectly for everyone all the time, so useful drug therapies would be nice too.

    Anonymous, I think you're confusing LDL pattern A and B ("fluffy" vs dense) with apoA and ApoB (HDL associated vs LDL associated proteins).

    Cynthia

  • Anthony

    7/1/2010 10:20:10 PM |

    Dr. Davis,
    How low do you like to see Lp(a)? I've seen recommendations of below 30mg/dl, below 20, and below 10. Mine is 19. Thanks,

    Anthony

  • Dr. William Davis

    7/2/2010 1:12:23 AM |

    Anthony-

    Excellent question . . . for which there's no solid answer.

    Despite all we know about Lp(a), no endpoint data have been generated. However, I can tell you that using particle count measurements in nmol/L a level of 60 nmol/L works very well. In mg/dl, a measure of weight per volume, it depends on the method of measurement used. If the "normal" range is 30 mg/dl or less, then aiming for around 20 mg/dl has worked well.

  • Anonymous

    7/2/2010 1:32:33 AM |

    I asked my cardiologist about it (heads up preventive cardiology at a major research institution in Texas) and he said:

    "Well, there's not anything we can do about it, so why test it?"

  • Anonymous

    7/2/2010 1:55:40 AM |

    My cardiologist and PCP have never ever discussed this with me even though I brought it up for discussion. I think my PCP didn't know much and ignored it. I desperately need a new cardiologist (I live in the SF bay area). Anybody here love their cardiologist and like to share some details? I will be forever thankful Smile

    TIA

  • Paul

    7/2/2010 6:09:32 AM |

    I found this to be a very interesting post over at the Animal Pharm blog concerning this very subject:
    Auto-Tuning Lp(a): Value of Low Carb, High Sat Fat


    They basically come to a very simple conclusion in controlling Lp(a); eat some damn saturated fat! And stay away from the damn carbs!

    Now, let me get back to making my LDL the plain and fluffy kind... someone pass me the ghee please...

  • Harry

    7/2/2010 2:41:24 PM |

    Anonymous and Drs. Cynthia and David, there are several "A" designated particles that frequently get confused. Dr. Davis is talking about lipoprotein(a), with a lower case "a", which consists of an LDL particle with a particle of apolipoprotein(a) attached to it. This apolipoprotein is also designated by a lower case "a". Lp(a) is very atherogenic, and should be minimized.

    Apolipoprotein A, with an upper case "A", on the other hand, is an atheroprotective particle that is a component of HDL. It comes in several varieties. The most plentiful one is designated Apolipoprotein A-I, or Apo A-I, which is the main particle that participates in reverse cholesterol transport, which is the principal way that HDL protects against atherosclerosis, by removing cholesterol from plaque and transporting it back to the liver for disposal. There are also particles designated Apo A-II and Apo A-IV that are also associated with HDL, but their function is not well understood. All the HDL-associated apo A particles are described with the upper case "A".

    Finally, there is the LDL pattern A, which indicates that the LDL particles are mostly large, whereas LDL pattern B indicates that LDL particles are mostly small. These are usually designated with an upper case "A" and "B", and the A pattern is thought to be less atherogenic than the B pattern.

    It is easy to confuse these "A" types, especially Apo A and Apo a, which are two very different particles, the large A apo is good and the small a apo is bad.

  • Kent

    7/2/2010 3:21:25 PM |

    My LP(a) started a year and a half ago at 198 nmol/L, it is now down to 35 nmol/L. Thanks to Dr, Davis's advice that I followed in the Track Your Plaque book, including 4800mg combined EPA, DHA fish oil and 2000mg Niaspan, etc.

    I also want ot mention though that I have been following the Linus Pauling protocol as well, which I believe has a synergistic effect with the other principles applied.

    An interesting thing happened that is worth mentioning, my LP(a) had been gradually dropping over that period of a year and a half from 198 to 45 nmol/L, then I switched to immediate release niacin and my LP(a) jumped back up to 150 nmol/L. That was the only change I made, so I switched back to Niaspan and that is when it went back down to 35 nmol/L.

    Kent

  • Alfredo E.

    7/2/2010 3:35:40 PM |

    Hi All.The following paragraphs were taken from http://www.drlam.com/opinion/Lp(a).asp

    Lipoprotein A, commonly called Lp(a), is a major independent risk factor for cardiovascular disease. The optimum laboratory level should be under 20 mg/dl and preferably under 14 mg/dl.

    Currently, there is no medicine or drugs that to effectively lower your Lp(a). A high Lp(a) is genetically linked. Fortunately, Mother Nature has provided us a much better non-toxic alternative. It consists of large doses of vitamin C, L-lysine, and L-proline.

    Many conventionally trained physician uses niacin to reduce Lp(a). This does work to a limited extend. Niacin reduces the production of lipoprotein A in the liver, and helps to bring down the lipoprotein A in the blood. This is what most conventional doctors use. However, this approach has its limitations because until the endothelial wall is optimized and cleared, the lipoprotein A level will not be able to reduce significantly. The effects of niacin usually hit a plateau after 6-9 months of therapy. If you are on niacin, make sure the liver enzyme levels are taken periodically to make sure the liver is able to handle the high dose of the niacin.

    This last flower:
    Replacing carbohydrates with proteins ignores the fact that protein, once in the intestinal tract, converts to amino acid. Amino acids increase insulin secretion. It is unclear, however, whether proteins are as potent as carbohydrates in stimulating insulin secretion.

    My comment: Is it possible that protein can produce high insulin secretion? So, what is left for simple humans? No carbs, no protein?

  • Anonymous

    7/2/2010 3:52:13 PM |

    Is the LDL carried in the blood by a protein or has it already been oxidized. I'm trying to understand what form chlorestral is in the blood.

  • David

    7/2/2010 6:17:02 PM |

    Alfredo,

    It's true that protein stimulates insulin, but the key is that it doesn't only stimulate insulin. Glucagon, insulin's counter-regulatory hormone, is also stimulated. Insulin secretion  is undesirable in the context of low glucagon (which is what we have with high carbohydrate intake), but it's not such a big deal when the ratio of the two are more balanced (which is what we have with low-carb protein intake).

    David

  • Jack C

    7/3/2010 12:03:08 AM |

    The VAP cholesterol profile, which gives the distribution of LDL and HDL particle sizes a other information, shows an upper limit of 10 mg/dl for Lp(a)cholesterol.

    In recent tests, my wife had an Lp(a) of 6 while mine was 8. Through no fault of our own I might ad.

  • Dr. William Davis

    7/3/2010 12:13:49 AM |

    HI, Kent--

    Great results!

    You are living proof that Lp(a) can indeed be tamed. It sometimes requires some unusual strategies, but huge reductions are possible . . . and Lipitor is not part of the equation.

    Long-term commitment to the effort is the key.

  • Anonymous

    7/3/2010 1:29:29 AM |

    what kind of doctor shoudl i see to get the right tests done.  I know I have high Lipo(a) from a previous test at Mayo.  They recommended that I take drugs and I declined.  Now I'm realizing I don't have the complete story.  I need to know more than just my lipo(a) is high.

    thanks!
    Linda

  • Anonymous

    7/3/2010 6:04:15 AM |

    Hi
    Are there stats on people with lp(a) that don't develop any plaque?
    Also does the same happen with lp(a) as with ldl? that is that is better to have a higher mg/dl with big paricles than a lower mg/dl with small particles?
    Santiago

  • Hans Keer

    7/3/2010 7:28:36 AM |

    I would say apoprotein(a) is normal phenomenon. What is not normal is the abundance of small dense LDL which apoprotein(a) binds to. So the best way to avoid LP(a), is to avoid the abundance of sugars and starch in the diet. All the other (still costing) treatments for Lp(a) won't be necessary then.

  • jd

    7/3/2010 5:39:38 PM |

    Hi,   I recently had a VAP test done via LEF -- I seem to have some very good numbers and some bad LDL ones.  Any comments would be appreciated.

    all values in mg/dl
    LDL 105
    HDL 71
    VLDL 14
    Total Cholesterol 190
    Triglycerides 51
    LP(a) 4.0
    IDL 3
    HDL2 18
    HDL3  53
    VLDL3 8
    LDL1 PatternA 5.4
    LDL2 PatterA 7.5
    LDL3 PatternB 61.6
    LDL4 PatternB 22.4


    LDL Density pattern = B, flagged abnormal

    Vit D  65.4 ng/ml
    Homocysteine 6.2
    C-Reactive Protein 0.2

    I am 55 yr of age, 6'0", 165 lbs, exercise regularly.

    Heart disease in family, mother's father died of heart attack at 66, other 3 grandparents lived into 90s.  father died leukemia cancer 53, mother living at 80 in good health.  Thanks,   Jim

  • Anonymous

    7/7/2010 4:40:46 PM |

    I use Lugols solution 2% and I have absolutely no idea what dosage I should be using.  I have been using one drop about twice a week, but I would like to have a better idea of proper dosage.  Can you help?

  • James L.

    7/13/2010 9:52:15 PM |

    My cardiologist is treating my high Lp(a) with Niaspan, but even with high doses, it has not had much effect. What do you mean by items 3 and 4 on DHEA and T3? Please be more specific. Thanks.

  • Anonymous

    7/29/2010 9:06:55 PM |

    Could you give some dose for T3 and DHEA that you are recommending?

    Thanks!

  • Anonymous

    8/10/2010 8:38:43 AM |

    "If your Mom gave the gene to you, you will have the same type of apoprotein(a) as she did. "

    Does that mean that high levels of Lp(a) is not inherited from the father?

    Thanks

  • LisaMichelle

    8/24/2011 11:46:03 PM |

    Dear Dr. Davis,

    I'm a 44 yr old female.   I recently had a consultation w/ a cardiologist here in Canada.   I was sent for the consultation because of some strange left jaw and low chest tightness I'd experienced at work the week prior (had been seen then in the ER, normal ECG x 2, normal CXR, normal bloodwork).  Prior to the appt I was told I needed to have fasting bloodwork (so that results were available for the cardiologist to review at my appt).  

    HDL good, LDL good (though at the higher end of the normal range).  Lipoprotein A was 0.55 g/L (which i guess works out to 55 mg/dl which is what the usual unit of measurement is for this one in the U.S.).  The cardiologist told me that all of my bloodwork was normal and that I was very low risk for a heart attack but I requested a copy of my results just to have on file.   I am surprised she didn't mention the elevated Lipoprotein A (normal range for this lab is: 0.00 to 0.33 g/L).   So that got my on my search for info on what exactly Lipoprotein A is, and what it indicates.

    My question is:   I was only told to fast for 12 hours prior to my bloodwork, nothing was said about ensuring I didn't smoke.   Well I did smoke over the 12 hours up until the blood was drawn (even about 30 minutes prior to).   Now I'm reading online that one should not smoke prior to blood being drawn for Lipoprotein A, HDL and LDL, etc.    So could my smoking right up to the time bloodwork done have negatively impacted the results?   Could smoking have made my LDL and Lipoprotein A higher?    Should I have these redone but ensure I don't smoke for 12 hrs prior to blood draw?  (I have a 'quit date' set for next Saturday, so don't worry, I will be quitting).

    Thanks so much,
    Lisa

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