What's on page 2 of the report that's being concealed from patients?

The graphic display of data and IDL are the most notable omissions.

Off topic:

Hi Dr. Davis. I was wondering if you were considering writing a book?

Sounds to me like a good way to help spread the word - both to average people and MDs - about your heart disease prevention findings.

Track Your Plaque, the book detailing these concepts, is available through Amazon.

Because I wrote it in 2003-2004, there is updated information that is better accessed via the website accompanying this blog, www.trackyourplaque.com.

Hi Dr Davis,

The lipoprofile teleconference was very informative, but I was not able to access it by clicking on the graphic.  Instead I used:

http://www.lipoprofile.com/teleconference/slide.asp?Slide=0&auto=1

Thanks!  kat1

re: book

Thank you, I didn't know it existed. I'll check it out.

Thanks for the excellent post! Bookmarked! Will come back again…

Do you take the 8,000 units *daily*?  I started out with a serum vitamin D level of 12 ng/ml and was prescribed 50,000 units per *week*.  That got me up to 27 ng/ml (which the doctor considered acceptable).  At that point, a different doctor advised me to take 1,000 units a day, but I started taking 2,000 units and have now reached 60 ng/ml.  I was concerned that 2,000 might be excessive, and now that I have reached a good level of serum D, I thought maybe I should cut back to 1,000.  But you take 8,000 daily?

D.S. 8000 daily x 7 days = 56000 weekly, not all that different from 50000 weekly.

Love the post Dr. Davis.
I have NOT been sick in 2+ years... seriously.  I tell people, I don't know if it's the 'low carb primal' meal plan ... or the almost daily exercise ... or the daily D3.  Most likely a combination of all 3.    I take 4-8k daily depending on the season and 'sunlight' exposure.

Thriving!... not just surviving.

Steve

This may be another case of everyone being different. Over the course of three years on 2,000, then 4,000 units a day I got to 48 then 63 ng/ml. When I upped it to 6,000 units I hit exactly 100 ng/ml. When I was at the lower levels I felt fantastic, at 100 I did not.  I recommend frequent testing to see what amount brings you to the ideal level and keeps you there.

Would it be beneficial to take K2 along with D3 just in case ?
Vitamin D boosts calcium availability and I wouldn't want it to finish on wrong places.

Yes, K2, magnesium and zinc should also be taken if you  suspect that your diet might be low in these. I discovered that I do not absorb supplements very well unless they are in liquid form.

DS and Johan--

Be careful: You're confusing cholecalciferol (D3), the human form of vitamin D, with ergocalciferol (D2), the non-human plant or mushroom form.

Vitamin D is a (pro)hormone. Humans should ONLY take the human form, never the plant form. For one thing, 50,000 units of D2 is apprximately equivalent to 15,000 units D3, because it's different. It is inferior.

If a doctor prescribes D2, it's because he has no idea what he/she is doing. There is absolutely NO reason to favor D2 over D3.

Great, Steve!

I've personally been enjoying the same experience.

Absolutely. Checking every 6 months has worked out very well for us.

There are reports that high intake of D3 will cause calcification of arteries and heart valves. The reported levels are over 50-60 ng in the serum D3. So there seems to be s diminishing effect of high D3 intake. Also it seems that taking K2 will mitigate or offset this effect. There are conflicting reports on this though. Any thoughts?
Renfrew

That's true of the plant forms of all the fat-soluble vitamins.  We have been badly misled.

The statistics and study summaries I've read seem to indicate that somewhere between 40 and 50 percent of the population cannot convert beta carotene to vitamin A in large enough amounts for BC to be useful as an A source.  If the respondents in those studies were only healthy people, the total percentage is far higher;  diabetics and hypothyroid people can't make the conversion.  And that's only adults.  Infants and young children can't make the conversion either, which pushes the percentage even higher.  Vitamin A has many tasks it performs in the growing fetus; helping the urinary tract develop is one of those tasks.  The Mayo Clinic tells us on its website that urinary tract defects are the most common class of defects in the United States.  Vitamin A is also important in eye and tooth enamel development, among the many, many other functions it performs.  How many people are walking around with eyeglasses, and how many young children are getting cavities now?

The Rotterdam study showed that vitamin K1 in plants does nothing to mitigate heart disease risk, whereas K2 from animal organs and dairy does.  I have heard from other sources that the K2 in natto (mk-7) does not cross the placenta, telling me it's less important to our health than the K2 from organs and dairy (mk-4 or menatetrenone).  K2/mk-4 is important in insulin sensitivity as well as heart health and bone and tooth strength.  But most experts focus on K1 or on the K2 in natto, to our detriment.

A, D, and K are so vitally important to good physical development and avoiding chronic disease.  The information is out there, in study after study.  If the experts won't admit to it, we need to educate ourselves.

100 ng/ml is too high for anybody.  Dr. Davis probably hits the high end of acceptable.  No wonder you felt bad.

I insist on supplementing three of the four fat-soluble vitamins because I've found out the hard way that the plant precursors of those vitamins DO NOT work well for me.  I suspect my experience is more in the majority than the minority, too.  Here's my regimen:

Vitamin A from fish liver oil (read the label):  8000 IU
Vitamin D3: 5000 IU
Vitamin K2, analog mk-4 (menatetrenone): 1-5 drops of a liquid supplement in MCT oil.  This company suggests taking 15 drops a day, which is over 10,000 of the recommended daily intake, and I see no point in going that high.

If I could afford no other supplements, I always take these.  I suffered from a subclinical (at least according to mainstream medical practice) vitamin A deficiency from 2004 on up to 2007 or 2008 that manifested as reproductive health problems and also birth defects in my daughter.  No one suspected an A shortage as the problem.  I figured it out by happy accident.  I am apparently not a good converter of beta carotene and my daughter paid the price.  I don't like liver, and dairy and eggs are not high enough in the vitamin, so this is what I do.  And this way the vitamins all work together synergistically  and I don't have to worry about toxicity.

Yeah, I know, but I was taking 50,000 units weekly to rectify a profound *deficiency*, not as a maintenance dose.

I don't know if it was D2 or D3 when I was taking 50,000 units per week (by prescription; this was over a year ago), but the 2,000 units (OTC) I now take daily are D3.  If this dose has me maintained at 60 ng/ml, it's amazing how the 8,000 units you (Dr. Davis) take isn't too much.  I guess this goes to show that monitoring is crucial, and there's no one-size-fits-all in supplements.

vit D and sleep apnea
http://www.musclechatroom.com/forum/showthread.php?18736-quot-Vitamin-quot-D-is-a-Hormone.-It-Cures-Sleep-disorders-amp-many-ailments

Long time followers of this blog will recall that Dr Davis has discussed vitamin D and K2-related issues many times here. You can find many answers to your questions by following the search links http://www.trackyourplaque.com/blog/category/vitamin-d and http://www.trackyourplaque.com/blog/category/vitamin-k2. Not all posts will be directly related to this discussion, but you will know what is related and what is not.

I guess Vit D can also be gained freely from the nature.

To Jack K. ... posted here since Server blocked this where belongs.
Hi Jack K.,
You once mentioned being ApoE4 (I think), thus are specially interested; and are in your "prime" dedicated to physical culture. Frankly I have no insight into how modified fasting or limiting snack fuel would let a body builder achieve their goals. (Doc recently stated how hard it was for athletes to restrict quick energy foods, like carbs.)

HDL heritability  in the Dutch ERASMUS study was put at 43% and the study of isolated Italian's from Linosa put HDL heritability at 54% (and for those Italians having both high triglycerides and low HDL that dual heritability was 31%). When one considers the ApoA2 percentage in HDL in relation to the amount of ApoA1 in HDL then that detail is going to involve the copy number of ApoA2 genes the individual has; and what is eaten, but not the type of protein one chooses, because it is more lipids (as fatty acid derivatives) that are involved in key signaling roles.

Doc & others ( ex: WholeHealthSource) tell us saturated fat intake boosts total cholesterol, but more so HDL than LDL; conversely when restrict saturated fat HDL level falls . For those with ApoE4 however Doc repeatedly has mentioned that for them it may be best to decidedly limit fat. In which case triglyceride levels are seemingly something one must work around.

Restricting saturated fat intake sees a decrease in  ApoA1 because without those fatty acid derivatives (lipid signalers) ApoA1 undergoes more breakdown, and in addition there is less ApoA1 secretion (not only does ApoA1 degrade faster than ApoA2 but the kidneys apparently don't excrete ApoA2, like the kidneys do to ApoA1). This is how statistically low HDL is associated with a higher percentage of ApoA2  in it's make up. Yet genetics can conceivably tweak this dynamic because fatty acid derivatives (lipid signalers) have to up-regulate PPAR alpha (subject to genetic variation), which then acts on the ApoA2 gene regulatory  element "J" (subject to genetic variation) before ApoA2 gets made in the liver (& a bit in intestine).

Experimentally when PUFA  made up 40% of total dietary fat intake there was less measurable ApoA1 mRNA & less liver secretion of ApoA1; while if 30% of total dietary fat is mono-saturated & PUFA there is usually no change in amount of ApoA1 mRNA, nor less liver secretion of ApoA1. When diet is classified as low fat and fat only 9% of total calorie intake ApoA1 levels usually decrease; I don't know if this is the fat level Doc advises his ApoE4 patients to try. I am not aware of any relevance of dietary protein to ApoA1 levels; however there is some recent indication that iso-flavone plant phyto-sterols (ex: genisten & daidzein from soy) may alter ApoA1 & ApoA2 levels (in contrast to older studies showing no benefit). I garnish food with a dry palmfull of Japanese black soy  fermented 1 year in Koji, called "Tochi", specially imported from Japan for Japanese restaurants by Miyako Foods  626-962-9633 (no financial interest for me); they also make this into a nice specialty miso - but I do not know how it compares in iso-flavone content to other soy forms.

2011:  Male rhesus monkey's  ApoA1 g/l went up from 2.34 when fed soy stripped of iso-flavones to 2.75 when their soy had iso-flavones; and their ApoA2 g/l went up from 0.20 when fed  iso-flavone free soy to 0.22 when their soy had iso-flavones....Female rhesus monkey's ApoA1 g/l went from 2.19 when fed iso-flavone free soy to 2.75 when fed soy with iso-flavones; and their ApoA2 g/l went up from 0.16 on iso-flavone free soy to 0.19 on soy containing iso-flavones. (As for Lipo-a : that also went down with iso-flavones.) The female 15% boost in HDL (90% of HDL = ApoA1 + ApoA2) being greater than the males is attributed to the fact that some of the males went from pre-puberty to puberty during experiment and there are often sex related variations in HDL; and to be precise the authors stipulate that iso-flavones may not work the same when the subject has either familial hyper-cholesterol or those with ApoE4.

Doc has given those with ApoE4 and low HDL a little appreciated strategy when he exhorts them not to eat oats, potatoes and wheat bread; these are common foods that increase levels of an asymmetrical lipid called lyso-phosphatidyl-choline (lysoPC). Remember that HDL also contains glycero-phospho-lipids; well, inside a cell the enzyme cPLA2 (cytosolic phospholipase A2) spins off phospho-lipids (another fatty acid derivative). And unfortunately it is usually individuals with low HDL tend to have more lysoPC than normal; which is considered pro-atherogenic when the lysoPC is configured in a "bad" molecular form (and yet other "good" lysoPC  configurations carry desirable DHA across the brain blood barrier).

It was shown that eating fatty fish 4-5 times a week decreases the total level of lysoPC, and both lowers the amount of  "bad" lysoPC, while raising the "good" configurations of lysoPC; which is another reason to follow Doc's high fish oil suggestion (inter-daily fatty fish might be a lot of mercury intake). I believe Doc is allowing fish oil and  maybe some fish for his ApoE4 patients. This experiment ruled out saturated fat beneficially influencing those lysoPC  molecular variations because subjects avoided all dairy fat, cream or butter.

The lysoPC that is carried in oxidized LDL molecules negatively affects one's tricky macrophages and also the smooth muscle cells of the artery; lyso-lipids not only invoke signals but can themselves be transformed. Certain lysoPC  yield a lot of  the platelet activating factor (alkyl-acetyphosphatidyl-choline) which contributes to sustaining inflammation, and so sets stage for atherosclerotic plaque. High levels of HDL usually conveniently equates with reduced levels of TNF alpha, a condition resulting in fewer undesirable adhesion proteins on the blood vessel's endothelium;  so, conversely those individuals with ApoE4 related low HDL are statistically prone to more endothelial adhesion proteins, and thus should try to do what they can to keep as much "bad" lysoPC controlled with diet.

Precisely, DS. I've got people who require 20,000 units to achieve this blood level, I've got a rare person who needs none.

The individual variation in need is quite wide. That's why the concept of an RDA for this hormone is, in a word, absurd.

I find that even low doses of vitamin D leave me feeling terrible. I get these weird chest pains and lower back pain as well. It also causes pretty bad breakouts for me. I've tried different preparations and brands but it all ends up leading to the same symptoms. This usually happens after I've accumulated a couple of weeks of supplement usage. I haven't experimented with different dosing strategies yet(weekly, bi-weekly or even monthly). I made sure to supplement with magnesium and K2 as well. It sucks because I really like all of the preventative benefits that D3 has to offer but it just doesn't seem to agree with me.
Mike

Dr. Davis:

Any chance that you'll be writing more about the positive results you're seeing in your clinic from increased doses of vitamin D on aortic insufficiency?

Joe

Since D activates immune function a lot, could it be that you have some chronic infection and effects you are experiencing are because of bacterial endotoxins which are released when bacteria dies ?

Have you done the D test ?

If so, perhaps taking some detox supplement would help like huge doses of Vitamin C, clay, NAC etc...

Sure, good idea. However, the majority of experiences have been in aortic stenosis, not insufficiency, only because I've got about 10 people with stenosis for every 1 with insufficiency--just too uncommon.

Hi, Mike--
Sorry about your struggles. I've seen this once or twice, but I'm not sure about why. You might ask your doctor to at least investigate parathyroid and adrenal status, e.g., PTH, calcium, and salivary cortisols. These might booby trap a vitamin D effort. After all, taking vitamin D should be no more dangerous than getting a nice tan.

Are you suggesting that my reaction could be from some sort of bacterial "die off?"

Interesting. I never really thought about it. I did get my levels checked during the few months I was supplementing and it was only 52ng/ml.

Mike, are you getting enough quality Vitamin A? Vitamin A and D work together. Chris Masterjohn had a post about it on the Weston A. Price website, they have a lot of info there about A and D levels and how they work together. Other people have had reactions to D also and found that they deficient in A, mostly, I think, by evaluating their diet and seeing there were few good sources of A there. Also, older people and some just not so lucky folks don't process beta carotene into vitamin A, it's age and genetics.

It was recommended that I take additional magnesium and vitamin k2 to see if it would make a difference. I've never taken additional vitamin A though because according to the  vitamin d council, additional vitamin A can be toxic.

I have read that Masterjohn article before though.

I just wanted to add my experience on Vit. D3 supplementation.

Two years ago in July I started supplementing 5,000 i.u. Vit. D3 a day.  My sister had been found low, I live relatively the same lifestyle, and thought, "what the heck, I'll start and get my blood tested in late winter next year".  

That next March I had a blood test and found my blood levels to be at a whopping  32 ng/ml.  My doctor said "fine, you're within range" and I thought, "no, that's not fine" and started to take 15,000 i.u. a day.  In March again this year I had a blood draw, and expected to see a very high ng/ml of Vit. D.  My actual result?  It had raised to 45 ng/ml.  I was floored that with that amount, my levels had only raised such a small amount.  

I will add that I am obese.   I just wanted to give you my experience with D3 supplementation in case it helps someone else.  I have now upped my supplementation once more to 20,000 i.u. a day, and if my next blood test is appreciably better, will hold at that level or drop back some.  I will add that I haven't had many if any colds this past year, so even if I have not attained a more optimal level (perhaps I can't due to obesity)  it's still doing me a lot of good.

Oh, I forgot to mention. A friend of mine suggested I try applying liquid vitamin D on my skin and then checking to see if that raises/maintains my blood levels.

I'm thinking about applying 5 to 8k per day to the skin AFTER I shower so that it gets plenty of time to absorb in the skin. Then re-test my levels after a few months to see if it works.

Please let me know what becomes of your experience! We've not tried this specific strategy.

Hi, Jennifer--

Yes, indeed: The individual experiences with vitamin D can vary widely. You may also note that, 3 or so years into the experience, your needs will diminish, sometimes dramatically, with less vit D required to generate the same blood level.

I began experiencing tightness and soreness in my hips and lower back this year. Have been low carbing for over three years, and, except for a short period of stupidity earlier this year, have not consumed any flour products. My multi-vitamin contains only 500 IU of D3, so I am adding this to my daily supplementing. Should I start slowly, 1000 IU a day for a month, and slowly increase? Is D3 toxic? BTW I am in my late 60's, and I do exercise 5-6 days a week as well.

I have read that 20-25ng/ml is optimal.
"Although numerous studies have not
observed any adverse effects of higher
vitamin D status, a few have. Historically,
the main health risks associated with
excessive vitamin D are linked with
abnormal plasma calcium concentrations.
Excessive vitamin D is recognized to
cause hypercalcemia by increasing intestinal
calcium absorption or by increasing
mobilization of bone calcium. Although
hypercalcemia is uncommon with intakes
less than 10 000 IU/d,3 knowledge of
non-calcium-related adverse events is
limited. At least some evidence suggests
that high vitamin D status may be associated
with increased risk of some cancers.
In a large case control study of prostate
cancer in Finland and Norway, both
low (32 ng/mL)
25(OH)D concentrations were reported
to be associated with an increased incidence
of prostate cancer (50% and 70%,
respectively) compared with individuals
with serum 25(OH)D concentrations
between 16 and 24 ng/mL.4 A direct relationship
between higher vitamin D status
and the development of esophageal
carcinoma also has been observed in
Chinese men.5 Interestingly, all the participants,
including those in the highest
quintile, were vitamin D deficient (26.2
ng/mL) with a 3-fold increased risk of
pancreatic cancer compared to individuals
with the lowest baseline status (<12.8
ng/mL). Overall, these studies suggest
there may be an optimum status and that
values below or above may increase risk
of certain types of cancer.
Adverse events associated with high vitamin
D status other than cancer also have
been observed. Recent data from large
epidemiologic studies, including the Third
National Health and Nutrition Examination
Survey (NHANES III) and the Framingham
Heart Study, suggest that a “U-shaped
curve” relationship exists with all-cause
mortality and the incidence of cardiovascular
disease because both low and high
25(OH)D concentrations elevated risk.7,8
In the NHANES III study, higher mortality
risk was observed in participants
with 25(OH)D above 49 ng/mL. In the
Framingham study, the lowest cardiovascular
disease risks were found in
participants with baseline 25(OH)D levels
of 20 to 25 ng/mL but increased with both
lower and higher values,8 thus suggesting
that increased cardiovascular risk occurred
at levels below 30 ng/mL. Furthermore,
the optimal 25(OH)D levels for protection
against cardiovascular disease and certain
types of cancer may differ from those
for bone metabolism or normal parathyroid
hormone physiology."
from 'too much.pdf' in http://is.gd/vT4Ogh Studies from DrGreger collection.

DrGreger has since changed his recommendation from 4000IU to 2000IU/day:
http://www.facebook.com/NutritionFacts.org/posts/193068787424836 yesterday's update

As knowledge marches forward, there will always be differing observations made, some good, some bad, some indifferent.

However, if we weigh the totality of evidence (and I throw in my experience that now amounts to several thousand patients), there has never been any strategy as powerful as vitamin D--except for elimination of wheat in the human diet, the two most spectacular new health strategies I have encountered in my career.

what happened to my post?

I posted 30Aug11 about a concern I have concerning D3 toxicity, but the message disappeared. I have been following for some two years a daily D3 regimen (4000-8000mg) without incident. I recently experienced unusual chest pains over a week and ended up getting a thorough checkup which found no apparent heart problems. However upon disclosing my protracted D3 intake (considered “very high!") it was suggested I suspend D3 for awhile on the off chance D3 toxicity may be the source of my symptoms. I was wondering if anyone else here has had this experience. As I look into this more, I have learned that D3 toxicity is more subtle and prevalent than I had thought, and is not something to be taken lightly. Clearly as Dr Davis has cautioned, adjusting to the right dosage varies from person to person, and given the latent build up of D3 in fat tissue over time, it is not as straight forward getting it right as one might think. In my case the jury is still out.

re previous message: 4000-8000 mg = 4000-8000iu's

I swear by vitamin D3. It helps me avoid asthma flare ups and kick bugs before they can make me wheeze. In the warm months, I make sure to get outside as much as possible as there are other things produced by the sun in addition to Vitamin D, some of which may be important. Then in the winter, I supplement 2-5k ius a day, increasing to 20k ius when sick.

M

Is taking a high dose of Vitamin D3 during pregnancy safe? I know most of the "recommendations" are to take 200 IU, but I have some 5000 IU pills in my cabinet, and am wondering if those would be safe or not. Or should I find a lower dosage pill?

Hi, Melinda--

Sadly, there are next to no data for how to best manage vitamin D and pregnancy. However, common sense would suggest that achieving a desirable blood vitamin D level should not be harmful, else getting a tan while pregnancy would be harmful, too.

A dose of 5000 units typically yields a healthy blood vitamin D level in the majority of females.

Hi Mike & Dr. Davis!

Can you please tell me, has anything worked for you yet? I too do not like the feeling I get on Vit D3 but I am only at 31 and need  to start taking 8,000 a day as well.

Also Doctor Davis can you please please elaborate on these: "parathyroid and adrenal status, e.g., PTH, calcium, and salivary cortisols". and why they would booby trap the Vit D3 efforts? How does someone work around this ang take Vit D3?? I found out yesterday I happen to have a high Reverse T3 and need to go on thyroid meds and also have adrenal issues. As well as low insulin levels. So I might be the one who is getting booby trapped.

Any help appreciated

Thank you!

Hi Mike & Dr. Davis!

Doctor Davis can you please please elaborate on these: "parathyroid and adrenal status, e.g., PTH, calcium, and salivary cortisols". and why they would booby trap the Vit D3 efforts? How does someone work around this ang take Vit D3?? I found out yesterday I happen to have a high Reverse T3 and need to go on thyroid meds and also have adrenal issues. As well as low insulin levels. So I might be the one who is getting booby trapped.
My Vit D3 is only at 31 and have been prescribed 10,000  a day. I really want to start but I have not liked how I have felt in the past on Vit D3.
Any help appreciated

Thank you!

Hi, Rose--

The key here is to find someone who can guide you along while monitoring and interpreting these factors. The greatest difficulty: finding a healthcare practitioner with the knowledge, experience, and interest in doing so.

As crude as it is, you are still best with word of mouth: asking friends and family who has been a helpful advocate with health problems, especially those involving vitamin D.

See below.

Hi Dr. D,
I posted a question on another thread about vitamin D and calcium levels and now I think this thread is more current and probably relevant .
I am being worked up at the moment for a possible parathyroid adenoma. My serum calcium has been trending up for the past few years and is now 10.3 (x2).
  Way back in 2005 I started reading about the benefits of supplementing with D and used 1000iu/day, as well as 400-800 magnesium and Life Extension's K2. Fast forward to 2009 and imagine my surprise at my D levels being 26!  Increased it to 5-6k per day and went to 43.
Dr. James Norman is considered to be the foremost expert on all things parathyroid here in the US , and his website : parathyroid.com.  was very informative for me, but concerned me regarding blanket supplementation of vitamin D.
I respect your opinions greatly and would like your thoughts as to his information.

Thanks!
Reikime (RN)

Hi, Reikime--

I am obviously no authority on parathyroid tumors. Dr. Norman's website is very interesting and makes great sense. I, too, in looking at vitamin D, calcium, and PTH levels have uncovered several parathyroid tumors. It appears to be a lot more common than previously thought.

The only issue I would disagree strongly with is the statement that the ONLY purpose of vitamin D is to increase intestinal absorption of calcium. In fact, among the most exciting areas of research with vitamin D are a new appreciation for the widespread, multi-faceted effects vit D has in multiple, perhaps all, organ systems.

Hi Dr Davis,
It seems that a finnish University is doing a major study on Vitamin D, check this out!

"The FIND will be a randomized, double-blind, placebo-controlled, 5-y supplementation study of the benefits and risks of vitamin D in the primary prevention of CVD and cancer among 18000 men ≥60 y and women ≥65 y. The participants will be randomized to 3 groups with 6000 in each, with daily supplementation of either: 1) 40 µg/d (1600 IU) of vitamin D3, 2) 80 µg/d (3200 IU) of vitamin D3, or 3) placebo. Compliance, use of non-study drugs or supplements, diet, development of endpoints, and CVD and cancer risk factors will be assessed by questionnaires. Blood samples will be collected for assessment of effect modification by baseline 25-hydroxyvitamin D, as well as for future ancillary studies of genetic/biochemical hypotheses."

https://www.uef.fi/nutritionepidemiologists/find2

Looks awesome to me. What do you think? Highest dose arm 80 µg a day for 5 years is more than VITAL.

Hi, Johnny--

Excellent!

In the meantime, the effects I continue to witness are so powerful that I still advocate correcting vitamin D to 60-70 ng/ml.

Hi Doc,

A quick question on vitamin D:
I recently tested at 17 ng/ml for vit d.  (had been supplementing w/ 2000 iu of D3 for 2 weeks previous to that).
The doc is recommending I take 40,000 IU once a week for several months until it stabilizes, and then switching to lower supplementation.

A few questions:
(1)  Obviously this will be D2 not D3 since it's prescribed - just go with it?  I believe I read a study somewhere that showed D2 ended up being as effective as D3 despite being slower.
(2)  Thoughts on taking these large "catchup" doses rather than a more consistent 10,000 IU/day regimen?

My other stats:  Age 31, 160lbs, Total Cholesterol = 204, HDL = 60, Triglycerides around 100.

You are closer to the truth, N, than your doctor. Clearly your doctor is fairly ignorant of the emerging issues with vitamin D.

While dosing can vary, depending on body size, race, genetics, etc., 10,000 units per day of D3 would be a typical effective dose.

I had read that about 20-30 minutes of sunlight daily were required for Vitamin D absorption.    Having already gone through Mohs surgery for a tiny basal cell carcinoma on my nose - and being "melanin challenged" - I have always tried to cover up or stay out of direct sun.  Sun blocks apparently have some questionable compounds in them.  I jog 2 miles every day if its not raining or snowing.  So on a sunny day that's 20-30 minutes of exposure.  Should Vitamin D dosage be varied according to daily sun exposure ?   Self-prescribing dosage of supplements is a real headache for me.  I don't have a clue.   It would sure help if there were affordable food sources of sufficient Vitamin D.   What about dairy ?

While I certainly enjoyed your book and am extremely grateful for your generous sharing in your daily blog, I am very troubled by this blog entry. Over the last day I have been thinking quite a lot about it off and on, and that would be because I have three stents implanted; two Cypher and one Taxus.

Since my dates in the hospital cath lab in early 2004 I have been following along with TYP principles carefully with the hope of being additional plaque neutral or even a bit of regression, but I see from this entry my hopes might be dashed.

Your statement in the blog entry "I've seen this phenomenon several times now", does this mean it happens most always, or sometimes, or occasionally? What is the game plan now for these patients? Do they (or did) have any similarities that might be contributing to their plaque growth (LPa, diabetes, vit. D, BMI, gender, etc), or are their lipoproteins and assays corrected to perfection?

Thanks again for all that you do, your program and willingness to share is unique and very special to many of us. If you could follow up sometime on this situation with a future blog entry or observations, I would be most appreciative.

With concern,

Neil

Neil--
All this means is that the presence of a stent may modify the potential for reversal ONLY IN THE VICINITY OF THE STENT. Other areas, meaning the majority of your other arteries' lengths, are still subject to your control and the benefits of your prevention program.

Keep in mind that this is an experience involving just a handful of patients. To my knowledge, there are no formal published experiences like this to compare to. All patients had their patterns corrected to perfection by Track Your Plaque standards and don't seem to be distinguished by any one single lipoprotein pattern.

My "gut sense" is that the sort of plaque growth that we see around stents and tracked by heart scanning does not carry the same implications that non-stent associated plaque does.

I just found your site recently and have been reading through the posts.  I find it very educational.  Thanks!  

I'm curious.  Were the stents medicated stents (since it is my understanding that they prevent this kind of thing)?

My grandfather, who had a great sense of humor, had heart disease and was a frequent visitor to the cardiologist office.  One day we were sitting in the cardiologist's waiting room and I was reading an article on doctors that get sued for malpractice.  In it was a list of doctors more likely to be sued and those not.  Leading the list of doctors least likely to be sued for malpractice was cardiologist.  I pointed this out and granddads response was, "That's because cardiologists are better at burying their mistakes."

I'm guessing the best way to make cardiologists change their ways is by using the court system - unfortunately.  Just a few weeks ago I encouraged my mom to talk to her long time friend about doing that.  The friend’s father was on a hunting trip when he experienced chest pains.  He was rushed out of the woods to his hospital.  Cardiologists performed tests and everything came back normal.  No measures were taken.  A few weeks later the guy died from a heart attack.  As I told mom, a simple CT scan would have shown he had plaque and needed to immediately take preventive measures.  With all that is known now about detection and prevention it was criminal what was done and not done to that man.

It's sad and unfortunate, but sometimes your hand is forced. I agree: Legal action in selected cases may be necessary to obtain justice and raise public awareness of the magnitude of this wrongful activity.

Dear Dr Davis; I enjoy your column...  my question is this; I lap swim three days a week. I consider it to be a every other day stress test. i can certainly tell rapidly what foods are not good for: Red meat, butter, ice cream, shrimp, those are the biggys. Certainly the other meats that i eat have cholesterol; why dont they bother me? Ive had friends that swim relate the same to me: Beef and dairy is OUT.

Hi Dr. Davis,

Speaking of prevention - at what age should we start thinking about getting a CT Heart Scan? Also, would the scan show if there were heart problems other than plaque build-up?

Thanks!

I'm a 45 yr old female with diabetes, but no history of heart disease in my family even in the other diabetics.  Obviously, I didn't die from my heart attack in May, but...

I went to the ER complaining of recurrent chest pain, got an EKG and blood work, and was sent home with an antacid for my "heartburn."

A couple days later, after vomiting and screaming off-and-on for a couple hours at a time all night, my husband took me back to the ER.  He carefully explained we already *knew* it wasn't a heart attack, but something is really wrong here - he had to speak for me because I could neither walk nor speak when we went to the ER the second time.  

This time, I was transported to another hospital for an emergency angio and subsequent bypass for my so-called "heartburn."  

Pretty amazing that I developed a heart condition requiring two surgeries two days after I didn't have a heart condition, eh?

I remember being really terrified when the surgeon told me there was a 5% chance of dying during the bypass.  She thought I misunderstood, that a 95% chance of living was good, but no... 5% *is* BAD.  I don't normally do things that have a one in twenty chance of killing me!  

It was much later at home learning about heart disease that I discovered I'd had a 50% chance of dying just from the heart attack itself; sudden death is the first symptom in half of the folks with heart disease.  

I'm a very lucky chick that my husband isn't currently suing someone for letting me die.

As the holiday approaches here in the states, I was asked what I am thankful for.  This year, just being alive at all qualifies as something I have profound gratitude for.

You are a survivor of a flawed system. To me, even worse than the mis-diagnosis of the ER, is why wasn't your heart disease diagnosed during the DECADE before your heart attack?

Have you looked at Jenny Ruhl's wonderful Diabetes Update Blog and the associated website? It provides interesting commentary on diabetes, with intelligent nutritional commentary that flies in the face of the idiocy coming from the American Diabetes Association.

Summersam--I wonder if you are just among the people who struggle with digestion of fats, regardless of type.

Paul-Men, 40 and over, women 50 and over, earlier if an outstanding source of risk is present. For other abnormalities seen on heart scans, please refer to my Heart Scan Curiosities posts on this Blog.

can you please comment on the latest study out that says the Ornish diet is best for hesrt disease. I think it ranked south beach and atkins very low. I know Dr. Ornish has a new book out soon "The Spectrum Diet" these findings were presented at the AHA.
Thoughts?

The study I believe you are referring to was a University of Massachusetts rating system, not truly a study. They simply gave grades of presumed health factors, using the so-called "Alternate Healthy Eating Index (AHEI)" that ranks fiber content and other healthy ingredients. It was NOT a real world comparison of diets, nor did it study effects on heart disease. In other words, it was just a speculative discussion.

Dr. Mike Eades blogged about the anti-Atkins poster presentation here:
http://www.proteinpower.com/drmike/2007/11/06/does-the-atkins-diet-damage-blood-vessels/

and here: http://www.proteinpower.com/drmike/2007/11/08/more-on-the-low-carb-study-at-the-aha-meeting/

And I agree, Dr. Davis, Jenny's site and blog (and her previous sites and Usenet posts) are a great resource for diabetics.

I had 2 CABG and have researched like crazy. Conclusions: we still don't know much. Cytokines & etc. from stress can be lethal regardless. 256 slice CT scan is best test but only one machine in USA. VAP combined with LIPOPRINT best blood tests. Antioxidants understudied. Mainstream medicine is mercenary, more concerned with profit that healing.

Hi, Richard--

I'm afraid you are right. However, I do believe that we still do know a fair amount. I would encourage you to read prior Heart Scan Blog posts, along with the www.trackyourplaque.com website. Our philosophy is that heart disease can be halted or reversed in most people (not all). While not perfect, it is the best approach I am aware of. It is certainly better than the "take Lipitor and pray" mentality of conventional, "mercenary," medicine.

Being Irish an' all, my jeans will only allow me to thrive on a few spuds served with lashin's of butter an' onions and o' course sides of bacon and eggs washed down with Whiskey Go Leor, sometimes called The Juice o' the Barley.

Minimal wheat.

It only makes sense that there are vast numbers of people actually addicted to food, not metaphorically, but in the same way people are addicted to drugs and nicotine. A good start would be stop subsidizing this addiction, but since we have a government of the grain farmers, by the grain farmers, and for the grain farmers, that's not likely.

Is wheat induced brain damage reversible, if one goes off wheat say at 50.?

I would bet good money that this post will get more people off wheat than all your posts about wheat and heart disease combined!

You are totally right the devastating effects of wheat and its palls goes from gut to brain http://bit.ly/cAbZry VBR

Dr. Davis

As usual you are SPOT ON. exactly right with the symptoms and age. Just amazing all clinical symptoms described were seen by me in my father from 53 (stumbling and falling) to 58 (requiring help walking) to 60 (epilepsy hallucinations and fears)to 61 (bedridden) to 64 (last year November) death.

Come to think, it was so simple to save him. It is just unreal.

Sprouted wheat however is I believe extremely good for health.

YOU HAVE DEFINITELY MADE YOUR POINT QUITE CLEAR.  NO NO MORE WHEAT.

Does anyone how tequila is made?

No wheat in tequila

Is it time to join the bandwagon? No more drinking, no more smoking, no more wheat? Really, did I just write that? I have to say, I really enjoy my PB&J on whole grain wheat bread, as do my kids.

Eating wheat is like apple pie and July 4th fireworks. How can we possibly do without and find a relatively cheap substitute? Is rice any good or is that a bad carb too?

To eat healthy, is it just you need to eat organic and nonwheat foods and watch your carb-mix?

Does it have to be this complicated? Has anyone written a book with easy to find, cheap/healthy ingredients that is easy to prepare in 30 minutes or less and feeds a family of 4?

Right now, we're basically down to grilled chicken/fish/pork with steamed fresh brocolli/green beans and long-grain rice. That's pretty much all we eat anymore, with the occassional cheeseburger/steak indulgence.

I started Low Dose Naltrexone 2 months ago to help with Autoimmune Disease.  I started at 1.5 and now am at 3.0
I will increase to 4.5 in 2 weeks.

I eliminated grains and dairy 1 month ago.

I have lost 10 pounds.

I could be as simple as the diet changes but I think more is going on.

I have less pain which allows me to sleep through the night.
I have more energy.
I am more active and actually exercising.
I am supplementing Vit. D and getting daily sun exposure (my Vit. D level was 41).
My moods have greatly improved.

Ironically, any time I have been prescribed an opiate pain medication, I have had severe allergic reactions.

As far as the Neuro symptoms, I do have Meniere's complete with dizziness and vertigo.  So far I have not noticed any positive impact but still hopeful.

Thanks Dr. Davis for all your information.

J9

"This results in stumbling, incoordination, incontinence, "

I know you are right on. I was having mild ataxia and stress incontinence. Off gluten for 7 years and balance is better and no stress incontinence.

This also affects dogs. My 12 year old cairn terrier was stumbling, falling over and urinating in her sleep. Got her off grains 2 years ago and she improved immediately.

I can not say it enough times..............  Be healthy, not Paranoid.

Dr. D emphasizes extremes for effect.  Do not fall into either side of the trap. Complacency nor paranoia.  informed decisions are critical for you and your family's well being

Trevor

i'd agree with Trevor as well.

sourdough wheat (traditional preparation) and boiled raw milk go together.

sourdoughing helps breakdown anti nutrients in wheat making the nutrients more bio available. Further Raw milk takes care of the rest by providing necessary enzymes (phystase etc) to digest wheat completely.

pasteurized milk and wheat consumed without sourdoughing give both milk and wheat a bad name and will improve health when stopped simultaneously.

traditional preparations eliminate such problems to a large extent.

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food.  Is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats.
celiac disease symptoms

Sprouting wheat begins the process of breaking down gluten, but it is not a complete process. Same goes for fermenting. Making a suboptimal food less bad for you does not mean that food is now good for you.

As for boiled raw milk, taking raw milk to a boil heats it to an even higher temperature than is done during regular, non-UHT pasteurization, and it keeps it at that high temperature for a much longer time than any commercial pasteurization process. Raw milk that's been pasteurized at home at a higher temperature for a much longer time is not somehow magically superior to commercially pasteurized milk.

I'd personally like to see an experiment on sourdough whole wheat combined with boiled raw milk to see what Dr Davis notes. That should settle it.

Alex share your experience rather than float around in clouds.

Just out of curiosity, I would like to know what is the point of buying something raw (supposedly because "raw" holds more benefits) only to then get it home and cook it. Boiling raw milk, in my estimation, defeats the purpose of consuming raw milk. Boiling kills everything. I buy raw milk weekly and I drink it "raw." That's why I buy it.  
Am I missing something? (serious question).

Anonymous, I don't have acute gluten sensitivity, but I've read enough about gluten sensitivity to know that sprouting and fermentation are not 100% effective at making wheat a tolerable food for people with gluten sensitivity.

Why cling desperately to consumption of a crap quality food when it's so much easier and simpler to just not eat it at all? One personal experience I can draw on is the addictive nature of wheat. I've been addicted to both tobacco and alcohol, but the most addiction-triggering image I can visualize in my mind is a loaf of locally made, crusty Italian bread. I think people cling to wheat consumption because it's addictive, plus it's deeply embedded in human culture.

raw milk is a relatively new fad in usa while india is the highest wheat and milk consumer since hundreds of years. The way they consume raw milk, is, after boiling it and the way they consume whole wheat is after making sourdough.

I personally consume raw milk without boiling but whats important is to understand the effects of consuming wheat and milk traditionally on health viz a viz consuming it in modern style.

Alex wheat is sub optimal as are many other foods. the only complete food is milk, everything else is had in combination with a complementary food.

Wheat is also not easy to avoid while its consumed traditionally  daily in the east, it is everywhere in its modern avatar in the west.

its not a bad idea to figure out wheats' complement and how it works than declare wheat suboptimal and write it off.

I think that more than the problems wheat may cause for some, the problem is the amount of wheat we consume. Consuming the bulk of your calories from wheat (or grain) is a problem, even for those who don't have any existing conditions. Drinking beer all day or more than you should isn't good either but that doesn't mean that a beer here and there or even one per day is a big deal. For an alcoholic one beer is a bad thing but for the average person 1 or 2 isn't. For someone with a problem, wheat is bad; for the average person a little here and there in moderation isn't. There are a lot of things modern man eats that he didn't eat at one time. But then again, there are many things in life in general that modern man does that we didn't do years ago. We will always look to make things easier and in doing so compromise ourselves in some way. The best thing is to be educated enough to make good decisions but not get too carried away in either direction.
Eating store bought chicken and meat tainted and chemically enhanced isn't good either. What does that do to us long term? What about our children. Eat less wheat and grains and avoid one illness but get another from mystery meat. So I guess we can't win no matter what we do. We can't get crazy, we just have to make good decisions.
Middle of the road always seems like a good starting point.

"The most common immune neurological syndrome consequent to wheat consumption is cerebellar ataxia"

Where is the study or other reference that supports this statement? How common is this neurological syndrome in the American general population?

Thank you.

How exactly are the Purkinje cells damaged, and how specific is the effect to gluten/wheat?  What is your source for this?