Slightly off topic, but I'm wondering if you've had patients complain of sleeplessness when they take Vitamin D. I take 1000iu in the morning; if I take more, I can't get to sleep at night.

Congratulations to Eric! That is an incredible improvement in your blood pressure.  And I am very happy for you and your family.  

Thanks Dr. Davis,  for continuing to share these amazing stories.

I've just learned the hard way that HTN in someone young, that has to be treated with multiple meds, can sometimes be caused by a condition called primary aldosteronism.

Eric, if your docs have not tested your plasma aldosterone and plasma renin activity, *please* ask them to.

Blood pressure is related to the relative tension of the blood vessels.  So, how does that relate to the buildup of plaque?

Is it that relaxed cells are less likely to allow plaque to adhere/incorporate?

I have low blood pressure; sometimes 90/60.  However, I don't feel that means my risks of plaque buildup can be ignored or can it?

Thanks for the super kind words Patty- I'm feeling better than I have in a long time!

I'll have to see if my plasma aldosterone and plasma renin have been tested. I know my potassium levels get low, but not sure if it's related to the HCTZ Rx or not. Thanks for the heads up though!

As far as blood pressure and plaque- I was advised that the many years my BP was uncontrolled it caused calcification of my aorta (plaque). Not sure if this is correct, Dr. D would be the expert on this. I am getting my calcium score done on Tuesday, but I know I have calcium build up based on the angiogram images.

Eric, low potassium combined with HTN is often the first indicator of an aldosterone problem. They thought my low K was related to the HCTZ that I took for some 5 years, but it turned out that the other med I was on - Diovan - masked the issue.

Most primary care docs haven't even heard of primary aldosteronism (or they don't remember the five minutes they spent on it in med school) so they don't routinely order the test. Which is a shame, because some of us spend years misdiagnosed with primary HTN when our HTN is really secondary to the aldosterone issue.

That is crazy- during the years I have researched many secondary causes and don't remember even reading about Primary Aldosteronsim.

How did they finally determine it was this and what treatment did you receive for it? Thanks for the info.

Hey Doc
Can you bring us up to speed on K2 supplementation.  I saw your "nasty natto" post from a few years ago about how it might be promising treatment but back then it was still too early to tell.. What have you learned since then? How/when do you prescribe it?  Are there particular brands you recommend?
Thanks for this great blog and for your tenacity in speaking truth to power.

Awesome work and inspiring for many who no doubt also felt as thought they had no option to restore their health.  I meet these people all the time, and many are so frustrated they are no longer taking in new information; but for the ones who will try, transformation awaits.

Hi Eric - regarding primary aldosteronism, I'm only in the first stage of being diagnosed, but here's what I know. The causes are most often an adrenal tumor (in which case they remove the entire gland, at least in the U.S.) or less commonly, a condition known as bilateral hyperplasia, which affects both adrenals. For the latter, they can't do surgery; usually the protocol is spironolactone and a low-salt diet for life. There's also a third possibility, a very rare condition known as GRA that requires meds. I don't know which of these I am yet - I'm waiting for the insurance company to approve further testing.

In over 9 years of unexplained HTN, I hadn't heard of it either despite lots of research (hey, I'm a trained librarian!). I got lucky - in October I changed primary care doctors and the new doc immediately referred me to a specialist. Both recognized the high BP/low K as symptoms of PA. The high aldosterone/low renin was confirmed by a blood test. Next test is a CT scan to see if there is a tumor.

From Wikipedia:

"CRP is a general marker for inflammation and infection, so it can be used as a very rough proxy for heart disease risk. Since many things can cause elevated CRP, this is not a very specific prognostic indicator. Nevertheless, a level above 2.4 mg/l has been associated with a doubled risk of a coronary event compared to levels below 1 mg/l"

also:

"CRP is associated with lipid responses to low-fat and high-polyunsaturated fat diets."

Hopefully, your CRP levels have fallen along with the blood pressure.

Hi, Kurt--

Yes, some people are very sensitive to the effect.

The only way I know to deal with it is to increase dose to the desired level very, very gradually, e.g., additional 1000 units every 3-6 months.

Slightly off topic here too - has anyone info on Hyperalphalipoproteinemia. That is high cholesterol due to high HDL. Does anyone know the figures for a typical lipid profile for a diagnosis of Hyperalphalipoproteinemia ?

Many thanks in advance

I'm just curious what exactly caused Eric's BP to drop in such a short period of time. Obviously, the diet changes and supplementation lead to it, but what did those things do to cause the change?

Dr Davis,
I also would like to know what K2 supplement you recommend nowadays..?

Bean & Gillian-

Dr. Davis advised me on Track Your Plaque that he is recommending 1,000mg/day of K2 that has a mix of short acting MK4 and long acting MK7. He suggested Life Extension "Super K". Hope this helps.

http://www.lef.org/Vitamins-Supplements/Item01224/Super-K-with-Advanced-K2-Complex.html

Davide- I think it was a combination of diet, supplementation and reduced anxiety.

When you have a cardiologist tell you he's never seen something like calcium in an aorta, made my anxiety level sky rocket. Especially when they had no clue how to stop or reverse the build up.

Reading Dr. D's blog and info on Track Your Plaque put control back in my court and that was extremely beneficial to my mental stress.

It's amazing the biological affects the mind can create.

Dr. Davis,

Thank you so much for your blog. After your comment on Atenolol I have been inspired to once and for all conquer my insane hypertension. I have a blog to track my progress. I am doing low carb, real food, exercise and a shitload of supplements.

I'll let you know how it goes.

Hyper-alpha-lipo-proteinemia is an uncommon genetic trait detected mostly(?)among the
Japanese, French Quebequois and South African Boers. One curious
peculiarity is a thick Achilles tendon; another is women with HDL over 70 mg/dl (men's HDL is more confusing if they drink alcohol).

Their cholesterol ester transport protein (CETP)is less active. Instead of HDL being able
to pass cholesterol fractions over to lipoprotein B those esters stay "stuck" in the HDL.

Person's HDL gets large as it fills with re-cyclable cholesterol. This only becomes problematic when their
macrophages become overloaded with LDL it (the macrophage) picked up. Those LDL laden macrophages can, in certain individuals, go on to become the
nefarious foam cells.

In this case, the "full up" HDL can't "snatch" up much LDL from the "filling up" macrophage. Sure, HDL is around, but there's diminished capacity to "unload".
I can't say if (or how) CETP can "break down" in a "normal"
person and cause them to develop
clinical hyper-alpha-lipoproteimenia.

Thanks Might-o'chondri-Al ! Most interesting. My HDL is 116 so am wondering if my 'hypercholesterolemia' is due to Hyperalphalipoproteinemia as my trigs are only 36 but total is high at 333. Trying to find out as much as I can....and there isn't much info around.

@  Might-o'chondri-AL :

Does that mean japanese people could do bad on a high fat- low carb diet?

Hi Tami,
Blog being Doc Davis' I won't presume to give dietary advice.
If you lay out your reasoning maybe readers will try to work  out a good theory with you.

Hi Anne,
My favorite cousin's total cholesterol ran over 300 for years; she's 76 - with  medical "help". I think, in the post before this one's comments thread, Doc Davis gives his office phone for arranging paid consultations (a man asked for it). Free internet advice has it's limitations.

Hi Might-o'chondri-AL,
Unfortunately (or perhaps fortunately !) I live in the United Kingdom so a telephone consult to the US is out, especially as we can't get the same kinds of tests done in the UK that people in the US can get done - believe me I've tried asking for particle size tests and Lp(a) and asked privately, rather than NHS, and still not been able to get them. Ideally I should be able to ask these questions on a UK forum or blog devoted to heart health, but such a forum doesn't exist so I have to rely on the good will of people like you or Dr Davis. If I can get sufficient information to present to my cardiologist then he will do the necessary, I'm absolutely sure of that, I just need a little bit more info !

@ Anne:

I'd suggest looking for a private lab that tests for as many of the tests as Dr Davis recommends. If Claymon Biominis has branches in the UK, they can do most tests, excluding the advanced lipoprotein testing.

In the meantime, join the Track Your Plaque site, it costs very little and has wonderful resources, an almost overwhelming array, in fact!

When you've got your basic tests done, book a cheap flight to the USA and schedule advanced lipoprotein testing, an appt and a heart scan with Dr Davis. That's my plan.

Good luck!

Hi Anonymous,

Private labs in the United Kingdom won't do any of the tests unless a doctor does a bona fide request form. I have private medical care as well as NHS and I cannot get those tests because even though they would be done privately the doc is not prepared to ask for those tests considering them unnecessary.

Medicine is very different in the UK. Patients are unable to self refer to doctors or to private labs for tests. However, once I have just a little more info - I'm not asking for medical advice at all but just info on how Hyperalphalipoproteinemia is diagnosed - to present to my doctor he will be more likely to look into this.

Doing phone consults to the US or even flying out there and seeing a US doc would not go down at all well with a doc here in the UK - they are unlikely to take any consultation or tests I have in the US seriously. I know that's a pain, but medicine is more tightly regulated here.

The internet is great but it has its limitations :-( Sorry for wasting peeps time.

O.K. Anne,
   I don't want to detail how my cousin's life has gone; there is no way to guess it relates to you. If you are young,around 30, you should consider seeking out a medical opinion now; I hear in U.K. you'll get on a waiting list.

You asked for a symptom for a doctor to look into - your HDL reading is it. IF you already had one who said "never mind & go away" try to see a different doctor for your peace of mind. You can not conclude that you have hyperalphalipoproteinemia just because it might explain your data.  
    
High HDL in Japanesse was originally seen as a sign of longevity. So researchers figured more of a good thing should mean it's even better. Then the genetics of hyperalphalipoproteinemia was found - in some, not all.

Yes..I guess I should just go back and ask the doctor to explain the high HDL then and see what he comes up with then...before I start a stain that is !

very helpful: http://itunes.apple.com/pl/app/bloodnote-blood-pressure-control/id493849490?mt=8

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.

And yet if you read a typical article on "gynecomastia" you'll rarely see anything suggesting a problem with feeding plant estrogens (like processed soy foods) and insulin-spiking foods (like wheat and grain products) to growing male babies, children, and adolescents.  Usually the focus on on the remedy.

"Moobs" seem to  a growing phenomenon that rapidly increased with the rise in soy and processed grain consumption during the past 3 decades, though it may also be due to everyone's increased awareness of appearances or the Seinfeld episode with Kramer's invention of a "mansierre" and similar media references.  I was never really aware specifically of the existence of "man-boobs" until the late 1980s and even then, I noticed it mostly on overweight middle-aged and older men  and thought the condition on slim men to be extremely rare (turns out it isn't).  I never heard any slang terms  until just a few years ago and now I regularly hear quite a few names for it.  It seems like the condition is everywhere at every age and weight level now - I don't think I was less observant 25 or 30 years ago.   Even grade school kids are aware of the condition and slang names, though if they eat the school lunches, they'll likely end up with their own set.

Nicely said.

The world we live in is a strange one. Man boobs - moobs - are now so common that they seem to elicit little or no attention. I was at a pool recently with the wife and kids, and moobs were present in abundance. Perhaps we've come to think of them as inevitable, as we seem to think that tooth decay, myopia, diabetes, heart disease, dementia all the other diseases of civilization are inevitable concomitants of being human.

As John Durant recently said over at Hunter-Gatherer, we need a new concept of normal. Disease isn't normal. Health is normal. And we must come to recognize that only when we aren't lean, fit and ready for whatever the world thows us  - when, for instance, moobs begin to sprout on our boys- something has gone very wrong.

So funny but true.  I like to run quite regularly and have some friends into running also.  They love to 'carb up' before a race!!  Yet, they can't figure out how to loose that bit of belly hanging over their belt w/o extreme excercise or calorie restriction.  I've been doing VLC (very low carb) for about 2 years now.  I've got no 'wheat belly' to be found .  Maybe I'll let'em in on my little secret!  Age of these guys are a couple in 40's and one is 60.  So funny, I see them eat their bannana and grape nuts/shredded wheat every morning.  It seems an impossible task to lift the veil that 'FAT is bad for you' montra that's been lied to us the last 30 years.  Keep doing what your doing Dr. Davis.

I eat bananas every day. I eat a lot of fruit. I have 1/2 cup of rolled oats (which I soak overnight with an acid medium) every morning, with ground flax and cottage cheese...been doing it for years. I also have quinoa daily and most weeks brown rice also at dinner which I also soak. Lots of veggies. No bread, no wheat no sugar or anything containing sugar. No processed foods. I don't have a belly and as a matter of fact I have a hard time keeping any weight on. I'm 53 years old 5'10" and currently 169.5 lbs. I don't eat till I'm full and I eat pretty big portions...any more would be ridiculous.  I prefer being around 173 or at least 170 but weight just falls off of me. I'd say I eat moderate carbs.  Every one is different.  I think I eat sensibly and pretty traditional. Eggs, chicken, meat in small portions (3-5 oz) soaked grains in moderation, lots of veggies and fruit, water and raw milk, walnuts and almonds, ground flax, extra vitamin D and fish oil capsules. I exercise a lot and have for the last 30 years or more.

I think the problem is a bit more complicated than just too much wheat.  With age men's testosterone levels decline while estrogen levels go up.  Men in their 50's can have hormone patterns similar to a woman.  And if a man develops BPH, the medications that allow him to get a full night's sleep suppress his testosterone levels while leaving estrogen unchecked.  Being 54 with BPH I worry about gynecomastia.  I used beta-sitosterol as an alternative to alpha reductase inhibitors but recently found articles that say sterols like beta-sitosterol cause the same side effects as Proscar.  My weight now is less than when I was in high school in 1973.   I follow the Sears antiinflammation diet.  

kevin

Is it wheat or the carbs in the wheat that's the villain?  

If it's the wheat, should both soluble and insoluble fiber be avoided?

Also, the poppyseed reference seems kinda random... is there something particular about poppy seeds?

Thanks for the laugh with the post title!

At 260 lbs on my 5'7" frame as of May 13, I had "wheat belly," and lots of it, along with dangerously high LDL, low HDL and high triglycerides, and, ironically, borderline hyperthyroidism at .34 TSH.  That was also around the time I discovered this blog.

Since June 11, I've  been grain-free except for flaxseed; have not had any processed foods; cut down on added salt; have had nothing to drink except water and unsweetended almond milk; have had only lean meats to eat; greatly increased my intake of vegetables (mostly leafy green, i.e., kale, Swiss chard, spinach, red/grean leaf lettuce with some occasional asparagus and broccoli); have had  minimal dairy (maybe 4-8 ounces of cheese per week, at most); and some avocado, and a little fruit.

As of July 21, I'd lost only 18lbs even though my hyperthyroidism is all but confirmed (TSH dropped to .19 as of 7/8 and lots of symptoms have hit).  Since then, I don't feel as if I have dropped an ounce, my clothes feel the same in terms of fit, and of course, I still have plenty of "wheat belly."

Next weigh-in is on Friday, 8/13, when I see my endocrinologist for the 1st time.  How bad is my luck that I can't lose weight quickly on a very low carb diet AND with hyperthyroidism?!

My wife tells me that Playtex is no longer in the bra business.

Oh well. It was the only bra manufacturer that I popped off the tip of my tongue.

Franklin--

Yes, well said. I, too, worry more about our children and the strange dietary legacy we leave.

I constantly have to remind patients, family, and friends that what we hear on TV, radio, read in magazines, etc. is largely driven by industry, easily drowning out the message that we are trying to disseminate.

I have heard of "beer belly" and clearly its occurrence is ubiquitous, but "wheat belly" is something new. Are they the same thing or are we talking about a different condition?

Moobs are *not* a new phenomenon, lol!  Take a look at very old Buddha figurines. . . .
But, *more* for sure.  

But anyone interested needs to look at pollution (air, water, food) and see how much of it is pseudoestrogens.  We are feminizing a whole generation of baby boys.

I appreciate the low carb/preventing insulin release science, but how the heck do people maintain muscle mass on a low carb diet?  Short sets can only be fueled by muscle glycogen, so how does one support their weight training on such a low carb diet?

Dr Davis,
Have you looked into the Primal Blueprint at www.Marksdailyapple,com ?

That lifestyle is pretty much what you're trying to tell us about.

Hi dr davis

Im drinking protein supplements and i dont know that glutamine peptides is from wheat protein.

What can you say about artifial sweetener acesulfame potassium in the ingredients of most whey supplements??

Trey,

go to bodybyscience.net for answers about conserving muscle mass

Jeanne

Hi, Puddle--

Excellent point.

I do believe, however, that high-carbohydrate eating and obesity are typically accompanied by the man boob phenomenon. I rarely see them in slender men who might "just" have exposure to pseudoestrogens.

Dr. Davis, this must be the funniest post you have ever written. My husband thankfully didn't have moobs, but he had wheat belly and "Cheerio" face. One day I gathered up all the "heart healthy" whole wheat bread, Cheerios, Kashi bars and crackers and put them in a big garbage bag for the trashman.

He was not especially pleased, but with the exception of ferreting out a couple of stale Girl Scout cookies late one night (I call this "carbdar") he was good about it. Then one morning about 6 weeks later, he came flying out of the bedroom with his shirt up pointing to his belly, which was significantly reduced. He is quite pleased with himself now.

Thanks for taking the time to write this blog. We had diner last evening with a good friend who is a head of cardiology at a large suburban hospital. In short, he hasn't a clue when it comes to nutrition. Do you see any progress with cardiologists in this area? Or are they all just Statinators?

Okay, okay, I give. I don't want any man boobs! I'll try going wheat free for two weeks and see if I notice a difference in all this stuff that I read about on this blog.

So no wheat products and watch my carbs, right? Fruits/veggie carbs good, wheat/sugar carbs bad.

I'm also going to start cooking with coconut oil. George Dejohn in Dallas has talked it up on his radio program, so I'm going to finally give that a try as well.

Wish me luck. I think I'll be going through withdrawal cravings, big time.

Dr Davis

with regard to the comment on Budhas moobs it is very funny. My take is him being located in a wheat eating country - India could have contributed to his moobs (nice catch puddle) and perhaps the neurotoxins in the wheat gave him the nirvana experience *snicker snicker*

to add to the above

its the Laughing buddha with moobs and wheat belly not the Nirvana Buddha!

Hi,

I tried to help out many people but it seems hopeless at this point. Most don't believe me. I even tried to provide studies, etc but they refuse to do so. I hope that we eventually break through but as long as drug companies, etc continue to control things, it's going to be tough no matter what. It appears to be all about profits and federal gov't is for that. What a shame...

stopsmoking: You are not serious, are you? You intend to eat no wheat for two weeks and I suppose you expect results at the end of two weeks? That means you are looking for a QuickFix - but your body is not a machine with a reset button. You will have to invest a little more time and patience.

I wonder what makes sense for poor countries.  I see that Sonia Ghandi wants to wipe out malnutrition by giving every poor family a 77 pund bag of grain, sugar, and kerosene each month.

Anonymous - Fortunately, I'm pretty healthy and don't have anything to get a quick fix for, except a little belly fat. I just want to see if I can stop eating this for two weeks, then I'll see how I feel. When I stopped drinking sodas, I did feel better after two weeks. Nothing I could put into words, just better. That's what I meant by see how I feel.

What will probably happen is I will have proved to myself that I can go at least 2 weeks without, so I'll start another 2 week goal. That's what I did with sodas and it worked out pretty well - 4 years without a coke!

Hi Anon,

260 lbs and 5' 7" sounds typical.  Don't be so hard on your self.  The version of a low carb program you describe sounds lacking.  I have lost 55 pounds over about 18 months and holding.  I get it that you are frustrated.  You do not lose weight on a straight line on a low carb program.  You are not taking homeostasis in to account.  That is the body fighting you to keep your system in balance, therefor, you will hit plateaus, and because we are all different,  the duration between a weight drop could take weeks or even months.  But, rest assured the weight loss will start again.  It didn't take a few weeks to put on most of your weight and your body will fight to keep it on, because, it thinks famine is upon you.  If you think that just giving up wheat is going to solve all of your health problems, get over it.  Our idea of a health supporting evolutionary lifestyle that works is high saturated fat and unlimited flesh with a few very low starch veggies and a few not very sweet berries (1 cup daily mostly blue berries).  Don't worry about quantity, let your hunger drive limit you.  Eating as an evolutionary lifestyle dictates will automatically stop hunger and give you satiety.  After 18 months on our program my diabetes type 2is cured along with obesity.  I can't tell you every thing in this short comment, but, talk it over with your doctor and see what he thinks before you proceed.

Billy E
Editor, evmedforum.com

I am so the poster child of this syndrome.  Therefore, I've started my own blog on how to combat it.  I stubbled on you while trying to research other blogs that are somewhat like mine.  I love this.  You are brilliant.  Please visit mine, while rudimentary, I do believe we share the same concepts of health.  www.appleandpears.com

Hi, Anonymous--

Sadly, my colleagues are still trapped somewhere in "low-fat, take your Lipitor" land.

Anyone who has tested small LDL as many times as I have eventually comes to realize that the carbohydrates are the culprit, not the fat.

Although not directly related to this post, have you ever read this published study?

http://jn.nutrition.org/cgi/content/full/134/10/2517

The reason why I ask, is because I have never heard you mention the relevant association between genotype and LDL size.

Hello Doctor Davis

It seems to me you are describing a "hypos", just like those my newly diagnosed T1 step-son suffered from, until he learned to over-eat for his insulin dose. This in otherwise normal people would seem to be a failure of the glucagon response, whose function is to release glucose to the blood via glycogenolysis.

Recent food tests seem to show that many proteins induce as much insulin to the bloodstream as some carbohydrates do, which naturally enough reduces BG - as well as storing protein - and the glucagon response then steps in if BG goes too low.

You know this middle aged visceral fat used also to be called "beer belly", and according to some might even be re-labeled "fructose belly".
My point is, wheat may be cause in some, but there are other foods which manage to produce the same effects.

your article is very nice, i have found good information from this. Even i have found good information about Chet Holmes

Umm ... Playtex still makes bras!
http://www.google.com/search?aq=f&sourceid=chrome&ie=UTF-8&q=playtex+bras

Also, the "bloop" over the belt is not visceral fat, it is subcutaneous fat.  It's the hard bellies that look like a pregnant woman that are mostly visceral fat under the abs around the organs that is pushing outward.  Two good tests to distinguish the two are whether you can squeeze a roll (sub-Q) or how much disappears when you try to hold in your tummy really hard (sub-Q fat cannot be held in).  

I'm curious about the estrogen link.  In women, menopausal reductions in estrogen production are associated with increased VAT -- not weight gain per se but a shift of SCAT to VAT.  If VAT produces estrogen, is this nature's version of HRT? -- stimulating our secondary estrogen producing "organ" when the first one shuts down?  That seems odd given the negative metabolic consequences of VAT accumulation.

So Dr. Davis do you mean wheat or all grains?  I eat very little wheat (no breads or cereals here as we have kids that are gluten/casein free) but I do enjoy the rye bread that is popular here in Europe with my lunches.

LOL The USDA Playtex line was hilarious. But who knows anymore? Ours is a crazy world where the elites are completely wrong and unwilling to acknowledge it, while attacking others as idiots.

William Davis has written a very information to and knowledge about heart disease in men